Doctor worried about whooping cough cases, but no community outbreak declared

READ MORE: 11 cases of whooping cough confirmed in Lethbridge & Raymond in the last week

However, Suttorp said she has not declared an outbreak of the illness.

“This is a higher incidence rate than [what] we usually see. At this point, we don’t have a community outbreak yet, but whooping cough is a common disease that we see in outbreaks. The last outbreaks we had were in 2009, 2012, 2014, 2017 – we had almost 500 confirmed cases and then last year, we had about 58 cases or so,” she said on Wednesday morning.

Back in 2012, Suttorp noted that an infant died due to whooping cough in Lethbridge County.

“Typically, in communities where there are low immunization rates, which is what we have here, every three to five years there’s a big outbreak.”

Suttorp noted that although immunization is important, those that are vaccinated are still at risk to catch the illness. Adults can be infected, but younger individuals are most at risk, according to Suttorp.

“Whooping cough is an interesting disease. If you’ve either had disease in the past or if you’ve had vaccine and all your boosters are up to date, there is always an amount of waning immunity, so your antibodies decrease over time, whether you’ve had disease, or you’ve been immunized,” she said.

“With this disease we see some of the adults are vulnerable to whooping cough. Adults, however, usually have milder disease and they have similar symptoms as children, but the cough may be a bit frustrating for a couple of weeks and it goes away.”

WHEN DOES IT BECOME AN OUTBREAK?

Suttorp said it’s the decision of the lead Medical Officer of Health, in this case her and her team, to call a community outbreak. She said they’ll look at many different factors, including geography, the spread of the disease, whether or not it’s related to travel or acquired locally and how cases are similar.

“With whooping cough, because there’s a spectrum of illness, meaning some individuals, especially young ones can be very severely ill and have severe complications – all the way to adults with minor symptoms, we always know that the number of cases – if we have 11 locally acquired cases, we know there’s more out there,” she said.

Dr. Vivien Suttorp speaking with media on October 9, 2019 (Lethbridge News Now)

“So, it’s a little bit of looking at the data on a daily basis, making sure our physicians are aware so that they have whooping cough on their differential [so] that if a kid comes in coughing for three weeks, to think about whooping cough as well, and parents [too]…if people are aware, then we can pick up these cases earlier and then we have a better sense of the disease in the community.”

Suttorp noted the Southern Alberta region has a higher incidence rate of whooping cough than most other places in the province. During the 2017 outbreak, there were just under 500 cases confirmed.

“Most of the time those outbreaks they then hit schools and they travel around a school, especially in schools where immunization rates are low,” she said.

“We have differences between geographic communities in childhood immunization rates so some communities we have a high uptake of vaccines and in other communities we have a smaller uptake.”

Suttorp said that at a “zone level”, compared to a larger zone like Calgary, overall childhood immunization rates are not much higher than other zones.

“However, we have differences between communities and between schools, so that’s why we have these outbreaks,” she added.

“If you have a lot of people immunized and everybody’s randomly mixing with everybody else, you don’t see that same amount of spread. So, 11 new confirmed cases in the small local area and three communities in and around Lethbridge worries me as compared as let’s say, having 11 cases in a very large location where there’s higher immunization rates…because there’s much more ability to spread disease in communities with low immunization rates.”

She said that after about five to seven days, a cough will persist while other symptoms – such as a runny nose, sore throat and low-grade fever – will go away. In some cases, for young children, the cough can get some bad that the child will vomit or let out an involuntary “whoop” sound.

In severe situations, the cough can persist for many weeks and months.

A standard lab test can usually detect whooping cough within the first two to three weeks of initial symptoms, according to Suttorp.

If a test is done, physicians can prescribe antibiotics to help fight the illness.

“Antibiotics given may not necessarily change the course of the disease, but people would become not infectious,” she said.

PROTECTION

Like other infections, Suttorp said it’s important to regularly wash your hands, and avoid sharing things like lipstick and water bottles.

“If you know that you’ve been in contact with a confirmed case and within seven to 21 days, you or your child starts coughing, then seek medical attention early, because earlier antibiotic treatment is actually better – because it may change the course of the disease,” she said.

“We don’t want to over-prescribe antibiotics because there’s so much viral illness out there but if you know you’ve been in contact or your child [has] with a confirmed case, early medical attention is appropriate.”

AHS follow up with confirmed cases and notifies anyone that the infected person may have been in contact with, such as at a children’s daycare.

Suttorp said they will have a letter sent to parents notifying them that their child may have been in contact with whooping cough, without revealing the identity of the infected.

“The less spread we have, the less of the bacteria we have in our overall community and therefore, we all as citizens of Southern Alberta protect those very vulnerable young infants and newborns.”

AHS also conduct daily surveillance and tracks immunization access to make sure vaccines are readily available. For more details on whooping cough, visit the Alberta Health Services website.

by Justin Goulet

Doctor worried about whooping cough cases, but no community outbreak declared

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