Whooping cough on the rise in Fargo

[MUSIC PLAYING] CATHY WURZER: Perhaps you've noticed more kids, maybe your own, with runny noses and phlegmy coughs. Respiratory illnesses are increasing, and so are the number of hospitalizations. Minnesota is seeing an increase in RSV cases among kids. We're going to talk about that in a few minutes.

Whooping cough is on the rise. So far, 41 cases of pertussis have been recorded in Minnesota this year. In Fargo, in just the past month, Cass County has reported 12 cases of the virus, more than they typically see in a whole year. Joining us right now are Dr. Tracie Newman and epidemiologist Brenton Nesemeier. They're both with the Fargo Cass Public Health Department. Thank you both for joining us.

TRACIE NEWMAN: Thank you for having us.

CATHY WURZER: Brenton, since you're an epidemiologist, what's a normal or an acceptable number of cases in a year?

BRENTON NESEMEIER: I can only speak for North Dakota, but in North Dakota, we probably typically see anywhere from 12 to 16 cases throughout the year statewide. So having 12 cases, like you mentioned, in a month in one county can be alarming. But an acceptable number would be zero because it is vaccine preventable.

CATHY WURZER: It is. OK, I was just going to ask, what do you think's going on here?

BRENTON NESEMEIER: So, with the COVID pandemic, we did see a decrease in vaccination rates. And with everyone having cough and flus in that respiratory season, pertussis isn't always on the panel for testing. So we think that there's a little bit of a lack of testing, but also a decrease in immunity due to lack of vaccination.

CATHY WURZER: So, doctor, what do symptoms look like? What should parents be looking for?

TRACIE NEWMAN: Well, sometimes pertussis can just cause mild cold symptoms for one to two weeks, right? So this might include things like a runny nose, congestion, low grade fever and cough. But the difference with whooping cough is that cough will go on to last for weeks to months, right?

And because whooping cough can appear to be nothing more than the common cold, like Brenton was just saying, often, our providers won't suspect it or diagnose it until things become more severe. So we encourage you to see your provider if your child is experiencing longer duration symptoms than you would expect, has prolonged fevers, or is having trouble breathing fast or hard, something of that nature.

CATHY WURZER: I don't think I've ever heard someone with whooping cough. Is there a specific something to listen for?

TRACIE NEWMAN: Yeah, so whooping cough is caused by a certain bacteria that really severely attacks the lining of our airways and lungs. And as such, one of the major symptoms is these violent bursts of coughing. We call them paroxysms of cough. And what happens is people will cough so harshly and so severely, their lungs kind of empty out of air. And in between those, they take a sharp inhalation in, and that is when you hear a really distinct whoop or whooping sound. That's where it gets its name.

CATHY WURZER: I know you both are busy here. So Brenton, I want to get to you in just a second here. When is it bad enough to see a doctor, though? A lot of parents might want to know. I'm hearing this, this sound. My child just really doesn't look good or is not feeling good. When should they run into, say, the doctor or an ER?

TRACIE NEWMAN: Yeah, it's a great question. So first, I would just say that infants under the age of one are really our population at greatest risk of developing severe problems or even life threatening illness from whooping cough. So our youngest, most vulnerable babies, we would err on the side of caution. Particularly if you are in a daycare setting or something of that nature where you think you've been exposed, or certainly, if you receive notification from the state that your child was exposed, I would really encourage them to be assessed.

But otherwise, like I said, if you're having a really long duration of cough, if you're ever worried about dehydration in a young child, a fast or hard breathing, where they feel like they can't control their symptoms.

CATHY WURZER: Say, Brenton, I thought whooping cough typically peaks in the summer. Am I right or wrong about that?

BRENTON NESEMEIER: So, there are peaks to whooping cough, but it doesn't follow a seasonality trend. Cases may peak in the summer or late summer, early fall, due to the fact that's when parents may go in and parents may check out their kids right before school starts. And as a result, you may see more cases, or as more kids are starting to come indoors, that's when cases may typically peak because there's more exposures happening.

But there is true to the case that whooping cough cases or pertussis do peak about every 5 to 10 years, which follows a waning of immunity. And that's why we do recommend a booster of TDAP or re-exposure to pertussis in a sense because you're being revaccinated about every 10 years for adults, or if you're pregnant, or if you're elderly or if you're immunocompromised.

CATHY WURZER: Hm, interesting that whooping cough was almost eradicated, I understand, in the 1940s after they invented the vaccine. And as you've just said, it's kind of cyclical in terms of waxing and waning. What's Cass County-- located, of course, that's the county seat, is Fargo. What's Cass County doing to educate folks about, you really should get a pertussis vaccination, not only for your kids, but for yourself?

BRENTON NESEMEIER: So, good question. So aside from the news release, we did put out a communication to our providers, which went out to all of our pediatric providers, all of our urgent care providers, letting them know about the increases in cases. And then we work with our school districts as well and letting them know their vaccination rates. And those school nurses have certain requirements that they look at and making sure that the parents know that their kids are out of date with the vaccine, so that they can get them in.

And I think that's the big thing, is, educating parents on the harmful effects of these vaccine preventable diseases. That's really what we can do and trying to get them to go in to a provider's office to get updated.

CATHY WURZER: Say, doctor, because there is so much going around, I mean, we're talking about pertussis, whooping cough, but there's also RSV, which I'm sure you're seeing cases of RSV. And COVID is still around. What do parents do? Should they just say, look, let's just get tested to see what we're dealing with here?

TRACIE NEWMAN: Well, that's a tough question. Yeah, I think it depends. Like Brenton said, we're trying to educate what we're seeing in the community and maybe having testing based on that. But I think if you're ever worried about an illness in your child, that's something for your provider to assess and decide what testing or treatment might be necessary.

CATHY WURZER: And what's the best way for people to protect themselves from this virus?

TRACIE NEWMAN: Yeah, so definitely vaccinations are our best available protection. The CDC and our groups recommend vaccinations really for all ages. We routinely vaccinate our infants for this. They actually receive five vaccines of this before the kindergarten age group. And then we give our adolescents a booster, as well as the other groups that Brenton previously mentioned.

And I would just encourage people that we know vaccinated individuals usually do not get as sick. So they experience a less severe illness. They're also less likely to transmit this bacteria to household contacts and others around them. Vaccinated people who get whooping cough, they don't cough as many days. They experience less coughing fits, less whooping, and less vomiting after coughing and things like that, so.

CATHY WURZER: Helpful to do the usual public health things like wash your hands. Maybe even wear a mask, perhaps. I mean, I know people don't want to hear that. But is that something to look at if you're worried and you're in a large area?

TRACIE NEWMAN: Yeah, hygiene is always a good one, as you said. Washing is good. Even just respiratory etiquette, right? Like trying to avoid coughing into your hands, try to cover your cough, cough into your elbow. Those types of things are very helpful. Pertussis is an entity we actually do preventative antibiotics for as well. I don't think we've mentioned that. So if you're diagnosed, you are treated with five days of antibiotics. And often, we will treat your contacts and people living in your household as well.

CATHY WURZER: Hm, interesting. All right, I appreciate your time. Thank you for the information. And best of luck in the weeks ahead.

TRACIE NEWMAN: Thank you so much.

BRENTON NESEMEIER: Thank you.

CATHY WURZER: We've been talking to Dr. Tracie Newman and epidemiologist Brenton Nesemeier. They're both with Fargo's Cass Public Health Department.