Whooping cough outbreak in Manitoba blamed on parents not immunizing

Southern Manitoba is experiencing an outbreak of the highly-contagious and possibly-fatal whooping cough.

About three patients have already been hospitalized, according to the province's medical officer of health for vaccines, Dr. Tim Hilderman.

He said the southern regional health authority has recorded 40 cases compared to the usual five or six at this time of year. Normally, there are just 10 in the entire year, he said.

Twenty of the current cases are children under the age of five. Ten more are people between the ages of five and 14, while the rest around closer to, or older than, 18.

"In the southern RHA we started to see an uptick in pertussis cases, whooping cough, back in August … [but] we aren't seeing it anywhere else in the province," Hilderman said, adding the last outbreak was in 2012.

Many people not immunized

Hilderman attributes the spike in the cough to parents who don't immunize their children and said he wouldn't be surprised if more cases are diagnosed.

Over time, children require six shots to be fully vaccinated. Those less than six months of age, who might have only one or two doses of vaccine are not adequately protected and that's the age range where the outbreaks are typically seen, Hilderman said.

As a physician and a parent, to be honest, I have a difficult time understanding it.- Dr. Tim Hilderman on people not immunizing children

But in this outbreak, the majority of people are those old enough to have received some doses of the vaccine, but have not, he said.

"The majority of cases that comprise this increase in southern RHA are un-immunized. These are not vaccine failures or even incompletely-immunized individuals — they are un-immunized."

Of the 40 diagnosed cases, only four people were immunized.

"The remaining 36 were un-immunized. Their families chose to not immunize them," Hilderman said, underscoring the importance of getting the vaccines as an infant can die from the cough.

"As a physician and a parent, to be honest, I have a difficult time understanding it. We know the pertussis vaccine is a safe and effective vaccine," he said. "Estimates of effectiveness sit in that 80-85 per cent range following the first three doses.

"Every year in Canada we have several deaths due to pertussis. We haven't had to this point in this cluster that level of severity, but make no mistake, pertussis can be a fatal disease of infants."

One of complications is pneumonia, which can be significant enough to prevent an infant from getting adequate oxygen, he said. They could end up needing antibiotics or even ventilation. 

What is whooping cough?

Whooping cough (pertussis) is a highly-contagious bacterial infection that spreads through coughs and sneezes or by sharing food and drink. Symptoms initially resemble a mild cold, progressing to severe bouts of coughing that can last for weeks. Pertussis most commonly affects infants and young children and can be fatal, especially in children less than one year of age. 

Anyone who has experienced mild cold symptoms that have progressed to a severe cough after seven to 14 days, along with persistent bouts of coughing that have a 'whoop' sound, is encouraged to see their primary health-care provider. Symptoms are often more severe in children than adults.

Can it be treated?

Pertussis is usually treated with antibiotics prescribed by your family physician.

In terms of caring for someone with pertussis, warm apple juice or tea may help break the coughing spasms and is soothing. A cool mist from a humidifier may also help. (The humidifier must be cleaned every two to three days.) For children, gentle suction with a bulb syringe and saline water may be used to get rid of thick secretions in the nose and throat.

Also, it is important for those with pertussis to drink lots of fluids to prevent the mucus in the lungs from becoming sticky and to loosen the mucous in the nose and throat. Fluids also clear secretions and make breathing easier.

All people in close contact with someone diagnosed with pertussis may need to take an antibiotic to prevent them from getting sick or passing it to other people. This includes people in your immediate household and any daycare contacts you may have. 

How can whooping cough be prevented?

Keep away from things that trigger coughing, such as tobacco smoke, perfumes, or pollutants. Proper cough and hand-washing etiquette is also an important way to prevent the spread of infection. This includes covering your mouth and nose with a tissue, or your upper sleeve, when you cough or sneeze; putting the used tissue in a wastebasket; and washing your hands with soap and water, or cleaning them with an alcohol-based hand rub.

What should I do if I suspect my child has pertussis?

Call 911 if you or your child:

• Is struggling to breathe.
• Passes out from coughing.
• Face, hands or feet turn blue during coughing and colour does not go away after coughing (For children under the age of one).
• Stops breathing for more than 15 seconds.

Go to the emergency department if you or your child:

• Experiences fast or difficult breathing.
• Becomes dehydrated.
• Has a fever higher than 40.5 C (104 F) after treatment with ibuprophen or acetaminophen.

Call or see your primary health-care provider immediately if you or your child:

• Experiences coughing spasms that cause the face, hands, or feet to turn blue (symptoms disappear when coughing stops).
• Becomes very sick.
• Has been exposed to pertussis and cough occurs 21 days or more later.
• Has a cough that lasts more than six weeks

SOURCE: Winnipeg Health Region