Whooping cough outbreak declared in west part of AHS South Zone, including Lethbridge

Suttorp said new cases of pertussis have been confirmed, bringing the total to 15 new cases in the last two weeks. Overall, there have been 42 confirmed cases so far this year in the region.

In 2018, there were 58 cases in total across the South Zone.

“The concern about the additional cases is that they are locally acquired. Whooping cough, as I’ve mentioned before, is under-reported so there’s a spectrum of illness,” Suttorp said Wednesday morning.

“Little kiddies and infants have the most severe disease. Adults may just have a milder cough or a chronic cough, but they are infectious to others. So, when we see locally acquired cases without any travel history, we know there’s more out there.”

Suttorp said it’s not a major surprise to see this many cases. The South Zone saw outbreaks in 2009, 2012, 2014, 2017 and now in 2019.

“In communities where there are pockets of low immunization rates, we see ongoing transmission frequently and the literature also indicates that internationally, there are typically outbreaks every three to five years – large outbreaks in communities where there is not a high uptake of immunization.”

Suttorp did note however that, “individuals have their choice in Alberta to immunize or not immunize their children and themselves.”

HOSPITAL RESTRICTIONS

In addition to ensuring that people check to see if their immunizations are up-to-date, AHS has also put in some visitor restrictions at Chinook Regional Hospital in Lethbridge.

Restrictions are in place for the neonatal intensive care unit (NICU), as well as the labour and delivery, pediatrics and maternity units. Guests under 16 years of age will be restricted in those areas and visitors will be limited to two at a time per patient.

“That’s a pretty drastic measure but is something that we have done in every year – in 2009 and all those outbreak years that I mentioned,” Suttorp stated.

People with symptoms, including a cough or runny nose, are also reminded to not visit the hospital when they are ill. All of this is to protect the most vulnerable patients at the facility.

She said in years past, they’ve heard concerns from loved ones of those in hospital.

“We completely understand within Alberta Health Services and the different departments that it impacts that this impacts families. This is a time of celebration, but it’s also a time where we need to ensure that those very vulnerable [people] are protected.”

FOLLOWING UP ON CASES

Suttorp said another step that AHS takes during an outbreak is to follow up with all confirmed cases.

They contact the person who is ill and encourage them to get antibiotics for treatment. She said that the individual is asked to stay home at isolation for five days after completion of the intake of antibiotics.

“We’re asking individuals to sort of have heightened surveillance, to be aware about whooping cough, same as all our physicians and emergency departments because it’s a little bit of an interested disease,” she added.

“As I said earlier, some have mild disease and sometimes you bring a child in, and the child seems okay and there’s a history of a child really coughing, turning blue and/or vomiting after coughing yet right at that moment, it may look okay. So really, [we want to] raise awareness and to make sure that people seek medical attention when there is an ongoing cough. There are a lot of respiratory viruses starting to circulate at this time of year, so we’re just at the start of influenza – there’s other respiratory viruses, we all know that when we have kids at school so not all runny nose and mild cough are whooping cough.”

Suttorp said the “hallmark feature” of whooping cough is an ongoing cough after other symptoms, such as a runny nose and low-grade fever have gone away.

She’s asking anyone that may have been infected to contact their physician’s office before going in so proper preventative measures can be prepared to avoid the affected individual from potentially exposing others in the waiting room.

She added that if symptoms are shown 10 days after exposure to whooping cough, it’s important to seek medical attention immediately and antibiotics within the first couple of days can made an impact.

Across Alberta, all adults aged 18 and over are eligible for one free dose of vaccine. Suttorp said that the high school program has grade nine students receive the vaccine, if they choose. Anyone who has not had the vaccine after grade nine is eligible to one free dose.

SCHOOL IMPACTS

Suttorp said that some area schools have been impacted but could not specify which ones.

She explained that once a case is confirmed at a school, a letter is sent home to parents of students to inform them that their child may have been in contact with pertussis and they should watch for symptoms. The cough is spread on droplets i.e. coughing, sneezing and saliva on water bottles.

“Often, we see in relatively immunized schools where there [are] good immunization rates, we see an odd case here or there, two or three cases. In schools where we have majority not immunized, we see ongoing transmission for months. So, it’s definitely the difference between that herd immunity at a school level [that] is very important.”

Some adults can suffer a very serious cough for several months in extreme cases and younger people can end up vomiting. According to Suttorp, the “really young” can end up with pneumonia, seizures, a lack of oxygen to the brain and even death.

In 2012, an infant in the South Zone died due to pertussis.

In order to protect infants, all pregnant mothers in their third trimester (27 weeks and up) are offered a vaccine, regardless of their immunization history.

“The mom then builds an immune response to that vaccine, but passes on those anti-bodies to the unborn, and then when the baby is born it has anti-bodies for a couple of months before it is immunized. So that really is an effective and safe strategy that we are utilizing and offering to pregnant moms,” Suttorp explained.

People who believe they or a family member may be sick with pertussis can also call Health Link 811 before seeking medical care. Additional information on whooping cough can be found at immunizealberta.ca.

by Justin Goulet

Whooping cough outbreak declared in west part of AHS South Zone, including Lethbridge

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