Health Officials Report Significant Increase in Pertussis Cases
Health officials in Suffolk County, New York have reported a concerning rise in cases of whooping cough, also known as pertussis. As of December 31st, 2022, over 400 confirmed cases had been reported, more than double the number from the previous year.
The Suffolk County Department of Health has been closely tracking the outbreak over the past several weeks. Commissioner Gregson Pigott issued a health advisory on December 30th, urging medical providers to have a high index of suspicion for pertussis and to report all suspected cases.
Whooping cough is a very contagious respiratory disease caused by the bacteria Bordetella pertussis. It causes severe, uncontrollable coughing fits, which often end in a “whooping” sound as patients gasp for air. It can affect people of all ages but can be especially dangerous for infants.
Timeline of the Outbreak
The first inkling of a rise in pertussis cases came in early December 2022. Several pediatric clinics and hospitals reported seeing an uptick in prolonged cough illnesses among school-aged children. Many cases were initially thought to be viral infections or asthma exacerbations.
By mid-December, laboratory confirmations began coming back positive for pertussis. The Suffolk County Department of Health launched an investigation on December 19th after receiving over 20 reports in just one week. Contact tracing efforts ramped up to identify chains of transmission.
Table 1. Timeline of key events in the 2022-2023 Suffolk County pertussis outbreak
| Date | Event |
|---|---|
| Early December 2022 | Uptick in cough illness cases noticed by medical providers |
| December 19, 2022 | Over 20 pertussis cases confirmed, prompting health department investigation |
| December 30, 2022 | Commissioner Pigott issues health advisory on rising cases |
| December 31, 2022 | Over 400 cases confirmed to date |
The advisory from Commissioner Pigott on December 30th marked a turning point. He characterized the situation as an “outbreak which requires our attention and action.” Over 75 cases had been confirmed that week alone, suggesting accelerated spread throughout the county.
By year-end on December 31st, 2022, over 400 confirmed pertussis cases had been reported to the Suffolk County Department of Health. However, health officials believe the true number of infections may be significantly higher due to likely underreporting.
Possible Factors Contributing to the Outbreak
Health officials have not yet determined the exact reasons behind the dramatic rise in whooping cough cases in Suffolk County. However, several factors may be contributing to accelerated spread:
Waning immunity – Immunity from both pertussis infections and vaccinations wears off over time. Many adults may have declining protection decades after their last pertussis vaccine, leaving them vulnerable. Boosters are recommended but uptake is generally low.
Low flu vaccine rates – Flu activity has also been unusually high this season in New York. Some experts believe lower flu vaccination rates may reflect overall lower rates of preventative medical care during the pandemic – allowing multiple respiratory viruses to spread faster.
Holiday gatherings – December is filled with indoor social gatherings and travel as friends and families come together to celebrate the holidays. More face-to-face interactions likely enabled pertussis to spread between infected individuals and vulnerable contacts.
Ongoing pandemic impacts – Disruptions to routine healthcare and public health programs during the pandemic may have created immunity gaps and surveillance blind spots. Delayed boosters or lack of disease monitoring programs may be contributing to the outbreak.
Further epidemiological investigations will shed more light on the most significant contributors to the rise of pertussis in Suffolk County this winter season.
Response from Health Officials
In addition to tracking cases and monitoring trends, Suffolk County health leaders have responded to the whooping cough outbreak on several key fronts:
Raising clinical awareness – Health advisories sent to hospitals, clinics, and physicians aim to raise suspicion for pertussis among providers evaluating cough illness patients. Early recognition and reporting are critical.
Lab testing & treatment – The health department has worked to expand lab testing capabilities and ensure adequate antibiotic supply for treating active infections. Macrolide antibiotics like Azithromycin are first-line medications.
Contact tracing – Significant effort has gone into contact tracing to identify exposed individuals and recommending appropriate post-exposure prophylaxis antibiotics. Preventing secondary spread is a top priority.
Vaccination promotion – Health leaders are using media channels and community health events to promote pertussis vaccination, especially maternal Tdap boosters and childhood series completion. Preventing future infections remains paramount.
Enhanced surveillance – The collection and analysis of epidemiologic pertussis data has become more frequent and granular to closely track trends across Suffolk County in near real-time. Monitoring the outbreak is key to response calibration.
By implementing measures to reduce ongoing transmission, evaluate policy gaps, and prevent future outbreaks, health officials aim to curb the impact of the ongoing whooping cough epidemic on Suffolk County communities.
Outlook and Next Steps
The near-term forecast for pertussis spread in Suffolk County remains concerning to public health leaders. Cold winter months tend to be more favorable to respiratory pathogen transmission. Additionally, pertussis has an incubation period up to two weeks – meaning current cases likely represent infections acquired in mid-December when holiday travel and gatherings were at their peak.
Health officials expect reported cases to continue increasing substantially throughout January despite current interventions. Peak infection activity may not occur until late February or March.
To mitigate the outbreak, health leaders urge individuals to check their vaccination status, not go to school/work if symptomatic, and seek healthcare early if experiencing prolonged cough illness.
They also advise doctors to implement more widespread use of pertussis testing among cough patients. Surveillance and contact tracing efforts will continue intensifying over the coming weeks.
Table 2. Anticipated pertussis trends and public health actions during early 2023
| Anticipated Trends | Public Health Actions |
|---|---|
| Continued case increase through January and February | Raising clinical suspicion and testing rates |
| Possible case plateau late February to March | Expanding vaccine promotion and access |
| Gradual decrease through spring 2023 | Sustaining contact tracing and surveillance |
| Continued sporadic activity year-round | Planning long-term outbreak prevention policy |
Only time will tell how severe the current whooping cough outbreak becomes and how enduring its impacts prove to be. For now, Suffolk County finds itself still solidly in the midst of an expanding pertussis epidemic – one whose finale remains uncertain.
With coordinated efforts between health agencies, doctors, and communities, public health leaders hope to curb transmission as swiftly as possible. But they continue urging diligence and preparedness as the outbreak response enters 2023 in full force.
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