- Pertussis is considered endemic in the U.S. and cases are cyclical.
- Rockland’s health commissioner said the county and state were monitoring cases.
POMONA – Rockland County’s health commissioner announced in a recent Board of Health meeting that the county has 12 cases of pertussis, a highly contagious respiratory tract infection that is especially serious in babies.
Also known as whooping cough, pertussis is considered endemic in the U.S. Cases are cyclical, so there may be a rise in a region at various times. Rockland, in previous years, has had as few as five pertussis cases in 2017 and as many as 57 in 2019. Health officials say cases of most viruses dropped during the pandemic; so far this year, the Rockland health department has recorded 25 cases.
The virus can be prevented with vaccination. However, the pandemic has led to a vaccination delay for many babies, which Dr. Patricia Schnabel-Ruppert pointed to as a concern.
Recent data from the state Department of Health documented low polio vaccination rates for babies age 2 and under. The Monsey ZIP code of 10952, for example, showed a 37.3% polio vaccination rate for babies. The state’s vaccination rate for that group is about 79% and Rockland’s is 60.3%. Vaccination data for pertussis was unavailable but the shots are on similar timetables.
“Some people do catch up,” she said, adding that school-age children show a higher vaccination rate for childhood diseases, especially after New York state changed vaccination regulations for schools that no longer allow vaccine exemptions for religious reasons.
Rockland’s 2018-2019 measles outbreak pushed for the change in law, Schnabel-Ruppert said. “That’s how serious it was,” she said of the outbreak that sickened 312.
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Referencing the new cases of pertussis and the county’s experience with measles, Schnabel-Ruppert told the Board of Health that the county is keeping watch. “So, here we go again,” she added.
The pertussis cases are not classified as an outbreak, according to the New York State Department of Health, because there does not appear to be a common setting among the cases. The state health department is monitoring Rockland’s cases with the local health department.
Westchester County has no cases of pertussis, while Orange County has reported six since July 1, five of which are in babies under the age of 2.
The Orange County health department reported the five babies sickened had not been vaccinated, and the older child had the full primary vaccination series against pertussis.
Protection against whooping cough
Pertussis starts out with similar symptoms to the common cold − runny nose, mild fever. After two weeks, the tell-tale high-pitched “whoop”-sounding cough may develop. The coughing fits can be violent and cause vomiting. The disease can lead to complications and hospitalizations, especially for babies. About 1% of babies under age 1 who contract whooping cough die, according to the CDC.
Two kinds of vaccines used in the United States help protect against whooping cough:
- Diphtheria, tetanus, and pertussis (DTaP) vaccines for babies and children under age 7.
- Tetanus, diphtheria, and pertussis (Tdap) vaccines for older kids and adults
Babies should get three DTaP shots: at 2 months, 4 months and 6 months. Then two boosters are given: at around 18 months and age 4 to 6.
Preteens should get one shot of Tdap as a booster around age 12.
A whooping cough booster is also recommended at the beginning of the third trimester of pregnancy, for every pregnancy, to protect newborns before they are old enough to get their own vaccines.
Grandparents and caregivers of babies should check their vaccination status and consider a booster, said Westchester County Health Commissioner Dr. Sherlita Amler.
“While we do not have any cases of pertussis that we are aware of right now, pertussis, or whooping cough, is a contagious bacterial infection that often circulates and we take it seriously,” Amler said. “Any schools that learn of a suspected case should reach out to the health department for assistance in following up. Any grandparents or other adults who care for infants or young children who are not fully vaccinated should make sure they are up to date on their TDaP vaccine, because they can be a source of infection for little ones. And of course, be sure that your children keep current with their vaccines too.”
Focus on polio
Meanwhile, Schnabel-Ruppert said the department’s focus on polio continues.
In July, a Rockland County resident was reported to have the first case of paralytic polio in the U.S. in decades. The commissioner confirmed during the Board of Health meeting that his paralysis is considered permanent. “Which is so, so unfortunate for this young adult,” she said.
Subsequently, the U.S. Centers for Disease Control and Prevention and the state health department tested Rockland’s wastewater, using samples leftover from COVID tracking, and found polio was being shed in the county. The samples were linked to a strain of virus found in wastewater in London and near Jerusalem. Since then, wastewater in Orange, Sullivan, Nassau counties and New York City have tested positive for polio. Gov. Kathy Hochul has declared a state disaster emergency.
There have been no more cases of polio reported in Rockland or the U.S., Schnabel-Ruppert said, “thank goodness.”
Schnabel-Ruppert said the health department is working with pediatricians who serve those areas with low vaccination rates to ensure their patients are given the opportunity to get or catch up on vaccinations. “I’m talking about contacting every family of the little ones,” she said.
The polio strain that sickened the Rockland young adult was derived from exposure to someone who had an old-fashioned oral polio vaccine and then shed the virus, a rare occurrence for the live vaccine. Oral polio vaccine hasn’t been used in the U.S. for more than two decades but is still employed in parts of the world where polio is considered endemic.
The Rockland resident had never been vaccinated against polio.
State health officials have recommended polio vaccination boosters for people in areas where polio is circulating who are considered at high risk, including medical workers and sewer workers. Schnabel-Ruppert said Wednesday anyone who may have contact with potential polio cases or with wastewater should be boosted. “Rockland is a small county.”
Nancy Cutler writes about People & Policy. Follow her on Twitter at @nancyrockland.
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