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Covering the Cough: Pertussis Awareness

MAY 6, 2025 – The list is long of various – yet similar – respiratory illnesses which have historically plagued operational readiness.

Naval Hospital Bremerton population health and preventive medicine experts continually strive to limit the highly infectious ailments which impact active duty, retirees and dependents on an annual and seasonal basis.

Whether it’s the more common acute respiratory illnesses such as influenza, RSV [respiratory syncytial virus] and COVID, NHB and civilian colleagues with Kitsap Public Health District keep close track of such trends.

Added into that mix is awareness for another highly contagious bacterial infection.

Pertussis – more commonly known as whooping cough –is experiencing an increase in cases across the Puget Sound region.

According to Dr. Dan Frederick, NHB Population Health Officer, Kitsap Public Health District issued a health advisory last week regarding a significant increase in pertussis cases in the county since the start of the year highlighted by a real surge just two weeks ago with 10 [confirmed cases] in one week.

“The increases in the county are mirroring that of Washington state and the country. Due to this increase, providers should place pertussis higher on their list of possible diagnoses for patients with upper respiratory infection-type symptoms consistent with this condition, especially with persistent cough and people with smaller airways like children having that classic whooping sound with their cough, which tends to come in spasms. Obviously, pertussis vaccination status is a critical component in medical history,” explained Frederick.

Cmdr. Carolyn Ellison, Naval Hospital Bremerton Director for Public Health, notes there are two types of combination vaccines which include protection against pertussis, including DTaP, which in Washington State is a school-required vaccine for students in grades 7-12.

“Parents should ensure their young children and preteens adhere to [all] pediatric immunization guidelines,” advocated Ellison.

DTaP is specifically recommended for infants and young children up to age and designed to protect against diphtheria, tetanus and pertussis.

Although it is not a contagious disease, tetanus is a serious illness which may occur after an open skin wound is contaminated with a certain bacterium [clostridium tetani] that can be found in soil. Diphtheria is an acute upper respiratory illness and pertussis – a bacterial infection – affects the lungs.

Tdap – recommended for preteens, teens and adults – is a combination booster vaccine of tetanus toxoid, diphtheria toxoid and acellular pertussis is tailored for older, more mature immune systems.

For anyone unsure, please consult your provider or our Immunization Clinic for help in determining which vaccine is needed,” Frederick said.

Those who are at most risk for pertussis are infants younger than one-year, expectant mothers, even healthcare workers with direct contact to infected patients.

Pertussis symptoms differ by age, but the incubation period is usually five days to several weeks after being exposed.

It initially may be considered a common cold. A significant indicator is the duration of the cough. Those infected will continually suffer from an [intense] paroxysmal cough fit, which could include long inspiratory vomiting and a high-pitched whoop sound at the end of exhaustive coughing fits.

Kitsap Public Health District affirms that since 2024, there have been approximately 3,000 laboratory confirmed and epidemiologically linked pertussis cases reported in Washington [state], with the majority chronicled in the past six months. The highest case rates are in children under 12 months, children aged one to four years and teens aged 14 to 18 years.

Specially in Kitsap County, there have been 53 laboratory confirmed and epidemiologically linked pertussis cases reported with approximately 75 percent occurring in school age children and adolescents since October 1, 2024. Compiled statistical evidence also indicates nearly one in 10 Kitsap children entering kindergarten in 2023 were not up to date with their pertussis vaccines.

A school setting can provide a fertile ground for an affliction like pertussis which is spread by droplets after someone infected coughs, sneezes, or talks. Those droplets spray out and land on someone else and get inhaled into their lungs. Another person can also get infected by shaking hands, touching a handrail or doorknob that has the disease on it and then touching their own nose, eyes or mouth.

Frederick emphasizes that besides vaccination, there are also multiple protective measures which everyone can daily apply to mitigate the potential spread of pertussis or any other respiratory illness, such as hand washing; avoid touching your eyes, nose and mouth with unwashed hands; avoid close contact with sick people and maintain social distancing of at least six feet; cover cough/sneezes and discard used tissues and wash hands immediately afterwards; clean/disinfect frequently touched surfaces at least daily and cover your nose and mouth with a face mask when around others.

“We closely monitor all acute respiratory illnesses such as pertussis on a nationwide, state and local basis, and from our own lab,” added Frederick, strongly recommending vaccinations as the best way to help prevent serious illness from many respiratory illnesses.

“When someone gets vaccinated, they not only protect themselves but also help protect entire communities by preventing and reducing the spread of these infectious diseases,” stressed Frederick.

NHB’s Immunization Clinic provides vaccinations on a walk-in basis, Monday, Wednesday, Thursday, and Friday, from 8 a.m. to 3:30 p.m., and Tuesday from 10 a.m. to 3:30 p.m.

Story by Douglas Stutz
Naval Hospital Bremerton/Navy Medicine Readiness and Training Command Bremerton

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