Austin Whooping Cough Surge: RSV & Flu Impact

Pertussis, also known as whooping cough, is having more than a moment right now. And that is not good. Cases of the bacterial respiratory disease have increased by 58% already this year from all of last year, Austin Public Health announced Friday.

The more than 154 cases have mostly been in school-age children: 90 in people ages 7-19 and 34 in kids ages 1-6. The rest fall outside those age ranges. The majority of cases are in unvaccinated or not fully vaccinated people.

Pertussis’ most common symptom is a barking cough that sounds like a “whoop” at the end, though younger kids might not have the “whoop” sounds, but might cough so hard they vomit or gag. It is especially dangerous for infants who are too young to be vaccinated, for older people and for people who have conditions that compromise the immune system’s ability to fight the infection.

“I am concerned that we need to come back to a place where we understand that we live in one of the countries with so much scientific advancements and prior eradication of things like measles because we had such good vaccine coverage,” said Dr. Desmar Walkes, the public health authority for Austin and Travis County. “Vaccines do help people from getting sick. It’s good for us to remember the science supports that fact.”

These schools have received notices of at least one case:

• Austin Achieve Middle School
• Bridge Point Elementary School
• Austin Achieve Elementary School Northeast
• Linder Elementary School
• Akins Early College High School
• Barton Creek Elementary School
• Marshall Middle School
• Lamar Middle School
• Langford Elementary School
• McCallum High School
• Reilly Elementary School
• Blazier Elementary School

It’s not just happening in Austin. Around the state, this is the second year Texas has experienced a rise in cases from the year before. The 3,500 reported cases in Texas this year is four times the amount reported through the same period last year, the Department of State Health Services said at the beginning of November when it issued a health alert. In 2023, there were 340 cases, but 1,907 cases last year, most of them occurring in November and December. The state has said more than 85% of cases have been in children, according to its preliminary data.

Vaccination rates have dropped among school-age children. Last school year, only 74.31% of kindergartners and 85.26% of seventh graders in the Austin school district were up to date on their TDAP vaccine, according to the Texas Education Agency. To achieve herd immunity, a community needs to hit 95% vaccination rates.

Austin Public Health is working with schools and the community to increase vaccination rates by offering more mobile vaccine clinics as well as getting the word out about its Shots for Tots program, which offers low-cost vaccines for people who don’t have insurance. This increase in pertussis cases is happening at a time when Austin Public Health has lost federal funding for programs, including in disease prevention and surveillance.

“We are committed to providing what we can to our community,” Walkes said. “As we go forward, if people start prioritizing getting their shots, we will keep pace and stop the spread of this disease.”

The vaccine for diphtheria, tetanus and pertussis, known as the TDAP vaccine, is given in five doses early on: 2 months, 4 months, 6 months and then 15-18 months and 4-6 years. At age 11-12, a sixth dose should be given.

Adults should get the vaccine every 10 years, and it usually comes with the tetanus vaccine, but you should check to make sure you got the combined vaccine. Any adult who has not been vaccinated just needs one shot to be considered fully vaccinated.

Pregnant women should be given a TDAP vaccine in their third trimester to protect their baby as a newborn.

If you are not sure if you are up to date, check with your primary care physician.

Early symptoms of the disease look like a common cold: low-grade fever, mild cough and runny or stuffy nose.

Later symptoms include coughing fits with or without a “whoop” noise when someone gasps for air after coughing, as well as vomiting after coughing, feeling tired, difficulty sleeping and broken ribs from coughing. The cough can be soothed with honey, but many of the cough medicines should be avoided and nebulizers don’t work for this illness.

Babies and young children can have difficulty breathing even if they don’t have a cough.

The early symptoms last one to two weeks. Then, usually by the second week, people develop the cough with the “whoop” sound. That stage can last an additional one to 10 weeks.

In the final stage, people might feel better, but their lungs are susceptible to infections for many months.

Seek care if your child has been exposed to someone with pertussis. Your doctor might prescribe antibiotics to help fight the infection before symptoms emerge. If child has a persistent cough longer than 10 days, which is often worse at night, they should see a doctor even if you are not sure if they have been exposed to the disease.

Pertussis is treated with a five-day course of antibiotics. Once that is done, you can come out of quarantine. If you don’t take the antibiotics, you would have to quarantine for 21 days.

If you have been exposed to pertussis, consult with your doctor. Based on your risk factors, you might start antibiotics to prevent the infection and be asked to quarantine for those five days you are on antibiotics.

Currently Central Texas has low levels of flu, but those cases are increasing.  The positivity rate for tests rose to around 20% at the beginning of the month, according to Austin Public Health.

Dr. Jazmin Gonzalez, a pediatrician at Austin Regional Clinic’s Good Night Ranch location, has seen mostly flu B, with all the flu symptoms including body aches, high fever, diarrhea, nausea and vomiting.

Antiviral flu medicines can be used in the first 48 hours to lessen the symptoms, but also might be given to people at risk for severe symptoms even after that.

Flu cases are expected to increase as people gather for the holidays. Getting a flu shot now is the best protection for serious illness, Gonzalez said.

Cases of RSV, respiratory syncytial virus, are increasing. This respiratory virus is dangerous in babies and older people. There is now a vaccine for this virus that can be given to older adults, infants younger than 8 months and to pregnant women to offer their newborns protection. With RSV, it’s important to keep kids hydrated and to try to relieve kids of the mucus by suctioning the nose and putting them in a steamy room.

Hand, foot and mouth disease also is circulating. This virus, which typically affects children younger than 5, comes with a fever, rash and mouth sores. The rash is typically gray blisters. Gonzalez, though, is seeing hand, foot and mouth in older kids this year. As well, the rash is spreading to arms and legs, not just the feet and hands.

Kids with hand, foot and mouth disease need to be kept hydrated, and they need to stay out of school and daycare until no new blisters have appeared and the ones they have are started to scab over.

Mpox cases are once again increase, Walkes said. Austin Public Health is trying to spread the message to the community most at risk for this disease to get vaccinated. Mpox is spread by skin-to-skin contact and sex.

• Stay home if you are sick.
• Wash your hands frequently.
• Avoid touching your mouth and nose.
• Get vaccinated for the disease that have a vaccine.