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PERTUSSIS WHOOPING COUGH SPREADING
Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it’s marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like “whoop.”
Before the vaccine was developed, whooping cough was considered a childhood disease. Now whooping cough primarily affects children too young to have completed the full course of vaccinations and teenagers and adults whose immunity has faded.
Deaths associated with whooping cough are rare but most commonly occur in infants. That’s why it’s so important for pregnant women — and other people who will have close contact with an infant — to be vaccinated against whooping cough.
- Like the rest of the country, New England and Mid-Atlantic states have reported a dramatic surge in pertussis cases in 2024, with 7,075 cases compared to 1,502 cases in 2023.
- New York (including NYC) has seen the sharpest increase with 2,512 cases, up from 775 cases in 2023. Pennsylvania has reported 2,757 cases, an eight-fold increase from 337 cases last year. Connecticut, Massachusetts, and Maine have also seen notable increases, with Connecticut reporting 281 cases compared to just 9 in 2023, Massachusetts recording 715 cases versus 14, and Maine documenting 162 cases up from 66.
Once you become infected with whooping cough, it takes about seven to 10 days for signs and symptoms to appear, though it can sometimes take longer. They’re usually mild at first and resemble those of a common cold:
- Runny nose
- Nasal congestion
- Red, watery eyes
- Fever
- Cough
After a week or two, signs and symptoms worsen. Thick mucus accumulates inside your airways, causing uncontrollable coughing. Severe and prolonged coughing attacks may:
- Provoke vomiting
- Result in a red or blue face
- Cause extreme fatigue
- End with a high-pitched “whoop” sound during the next breath of air
However, many people don’t develop the characteristic whoop. Sometimes, a persistent hacking cough is the only sign that an adolescent or adult has whooping cough.
Infants may not cough at all. Instead, they may struggle to breathe, or they may even temporarily stop breathing.
New Jersey leads northeastern states with 5.4% outpatient influenza-like illness (ILI), showing a substantial increase over recent weeks. The state also leads for emergency department visits, now nearly at 1% of visits.
New York is coming in at 2.7% outpatient ILI and hospitalizations at 1.2 per 100,000, indicating a steady rise in activity. New York City is substantially higher at 6% outpatient ILI; last week also saw a notable jump in emergency department visits for ILI.
New England is in better shape but with consistent increases, with Massachusetts reporting 2.4% ILI, Connecticut at 2.6% ILI with hospitalizations at 0.8 per 100,000, and Rhode Island at 1.6% ILI and moderate wastewater activity.
Northern New England maintains lower levels, with Maine at 1.6% ILI, New Hampshire at 1.5% ILI, and Vermont at 0.8% ILI, though all show slight upward trends.
Pennsylvania also has rising ED visits, with activity highest in the eastern part of the state, and increasing wastewater concentration.
Things are still really quiet across much of the Northeast, but spread is increasing in a few places.
Regionally, wastewater activity held steady at minimal levels this past week. However, at the state level, we are seeing some increases. Wastewater activity is very high and increasing in Massachusetts.
Concentration moved from moderate to high activity in Pennsylvania and Maine, and is also high and increasing in Rhode Island. In New Hampshire, activity declined slightly, but remains high.
It is moderate and increasing in Connecticut.
However, activity remains stable at minimal levels in New York and New Jersey and at low levels in Vermont.
Trips to the emergency room remain at minimal levels (<1.5% of all ED visits, see plot below) in all states in the region.
However, ED visits increased moderately or substantially this past week across most of the region, including in those states where wastewater activity remains low (i.e., New York and New Jersey).
Hospitalizations also ticked up slightly in New York – to 3.1 hospitalizations per 100,000 people. Hospitalizations held steady at 3.2 in Connecticut (which is fairly low for the state, but not minimal).
The Northeast is seeing an increase RSV transmission, with several states showing increases in both clinical and wastewater indicators.
Massachusetts leads northeastern states with 0.9% ED visits, showing high wastewater activity. New Jersey follows at 0.9% ED visits with minimal wastewater activity.
Rhode Island and New York report 0.6% and 0.6% ED visits respectively, with New York showing hospitalizations at 1.8 per 100,000 and minimal wastewater activity.
However, these levels are favorable compared to southern states, which are nearing 2% ED visits.
The northern states show lower activity, with Connecticut at 0.5% ED visits and hospitalizations at 1.6 per 100,000, though showing very high wastewater activity. Maine and Vermont maintain lower levels at 0.1% and 0.1% ED visits respectively.
Several viral causes of respiratory infections are circulating.
These all tend to cause mild to moderate upper-respiratory tract infections, with standard cold and flu-like symptoms: runny nose, headaches, cough, sore throat, and fever. However, infants, older adults, and people with weakened immune symptoms are at greater risk of developing more severe disease, including bronchitis and pneumonia.
- Human coronaviruses continue to be on the upswing.
- Rhinoviruses/enteroviruses are declining, but remain elevated (22.5% test positivity).
- Adenoviruses remain moderately elevated but appear to be declining. In addition to the standard symptoms listed above, adenoviruses can also cause a range of other symptoms, including pink eye, diarrhea, vomiting, nausea and stomach pain.
- Parainfluenza seems to have peaked and is declining. In addition to the standard symptoms listed above, parainfluenza viruses can also cause ear pain, and are a common cause of croup in small children. In more severe cases, people may develop a barking cough and wheezing.
As expected, norovirus has continued to climb.
It is now high in the Northeast with 11.7% test positivity.
This represents a nearly 5-fold increase in the past 3 weeks.
This is starting to approach its peak of the past year, which was 14.3% in April.
Nevertheless, the Northeast continues to have the lowest rates of norovirus in the country by far (currently, the West has nearly double the rate of the Northeast).
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New:
- Connie’s Thin Crust Cheese Frozen Pizzas (more info)
- Daily Veggies Enoki Mushrooms (more info)
- Sprouts Markers Market Gyro Family Kit (more info)
- MadeGood Granola Bars (various flavors and varieties) (more info)
Previously reported:
- Large-scale cucumber recall is affecting both whole cucumbers and prepared foods with cucumbers
- Blue Ridge Beef log Puppy Mix [for Dogs]. While not for human consumption, humans may be infected by Salmonella if they do not adequately wash their hands or contaminated surfaces after handling the product. (more info)
- Kirkland Signature Organic Eggs (more info)
- Ready-to-eat fruit and vegetable products sold by Gracie’s Kitchen (more info)
- If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.
- The United States has a target of 95% coverage for the measles-mumps-rubella (MMR) vaccine among children in kindergarten. New York and Connecticut exceed this protective threshold at 97.7% immunization coverage, as does Rhode Island at 97.1% and Maine at 97.5%.
- However, Massachusetts and New Jersey fall slightly below optimal measles protection at 96.3% and 93.2% respectively, while Vermont and New Hampshire at 92.9% and 89.2% are notably under the 95% target. Despite the variability, the region has the highest coverage in the country.
- The region has reported 15 locally-acquired (vs travel-associated) measles cases so far in 2024 compared to 0 in 2023.
