Lexington-Fayette County Health Department in Kentucky Issues Warning

Close-up of women coughing.

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As of May 20, 2024, the Lexington-Fayette County Health Department has upgraded pertussis, commonly known as whooping cough, to outbreak status following the confirmation of nine cases since late April. This includes three new cases reported on Monday. Among the recent cases are one at Lafayette High School, another at St. Peter and Paul Catholic School, and a community case involving an individual in their 80s.

All caregivers in central Kentucky are advised to remain vigilant for any signs or symptoms of pertussis and ensure that their children are either up to date on their vaccinations or have received the booster dose.¹

Relevant to this demographic, teens and adults are not immune to the complications of whooping cough, such as pneumonia. However, compared to infants and young children, the risks are generally lower in this age group, particularly among those who have received the whooping cough vaccine.

Despite this, in severe cases, hospital care may be necessary if complications arise. Individuals of all ages need to remain vigilant and seek medical attention if symptoms become severe or concerning.

Sanofi Pasteur, the exclusive DT vaccine manufacturer in the United States until recently, ceased production of the vaccine in late 2022. As of now, there is no licensed DT vaccine available in the country. However, the current supply of the Td vaccine is deemed sufficient. It is expected that the rise in Td vaccine usage will be minimal, given the infrequency of developing a contraindication to pertussis-containing vaccines.²

Whooping cough, caused by bacteria, typically shows its first signs 5 to 10 days after exposure. However, symptoms might not manifest for up to 3 weeks. Initially, it resembles a common cold, making it hard for healthcare providers to diagnose early on. Early symptoms, lasting 1 to 2 weeks, include. ³

• Runny or congested nose
• Mild fever (below 100.4°F)
• Occasional mild cough
• Babies may struggle to breathe, sometimes without coughing, leading to potentially life-threatening breathing pauses.

Later Symptoms come to light around 1 to 2 weeks after onset, severe symptoms may emerge, characterized by violent and uncontrolled coughing fits, known as paroxysms. These fits can persist for 1 to 6 weeks, sometimes longer. During coughing fits, individuals may:

• Emit a high-pitched “whoop” upon inhaling.
• Experience vomiting.
• Feel extreme fatigue post-fit but seem fine between episodes.
• Have disrupted sleep.
• Struggle to breathe, potentially leading to rib fractures.
• Many describe these coughing fits as the most severe cough of their lives.

People should seek medical attention if experiencing violent coughing or breathing difficulties, and promptly consult a healthcare provider. Seek immediate care if breathing becomes a concern.

References

1. LFCHD Declares Pertussis Outbreak in Lexington. Updated May 20, 2024. Accessed May 23, 2024. https://www.lfchd.org/19595-ytllkk/

2. CDC. About Young Children with a Contraindication to Pertussis-Containing Vaccines. Published January 23, 2024. Accessed May 23, 2024. https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/hcp/td-offlabel.html

3. CDC. Symptoms of Whooping Cough. Published April 2, 2024. Accessed May 23, 2024. https://www.cdc.gov/pertussis/signs-symptoms/index.html