With five more cases reported, situation now considered an outbreak by county officials

Yamhill County Public Health officials have confirmed five new cases of pertussis, also known as whooping cough, at Newberg High School, bringing the total to seven since mid-January.

According to Yamhill County Health and Human Services (HHS) Deputy Director Lindsey Manfrin, the situation is considered an outbreak per Oregon Health Authority investigative disease guidelines.

The Public Health arm of HHS shared the information with parents in a letter dated Feb. 26, encouraging families to continue adhering to the precautions it has been recommending since notifying the community of the first confirmed case in early January.

The three primary recommendations are to consult a health care provider if they or their children have symptoms of pertussis, to ensure families are up to date on their vaccinations and that pregnant women should receive the Tdap booster with every pregnancy to prevent infecting newborns after they are born.

Symptoms first present as a runny nose, sneezing, low-grade fever and a mild cough, usually beginning seven to 10 days after exposure, but onset can take as long as six weeks.

Coughing gradually becomes more severe and, after a week or two, the second stage of the illness begins, characterized by coughing spasms that end with long gasps or "whoops," sometimes resulting in vomiting, as the patient attempts to breathe. This stage can last for up to 10 weeks, but after undergoing a five-day course of antibiotics, patients are generally considered to be non-communicable.

The notification letter stated that people exposed to the infection could currently be symptomatic or become so between four to 21 days after close contact exposure. It also stated that close contact exposures did occur with members of the boys basketball and wrestling teams.

"Our investigations always include messaging to potentially exposed individuals and recommending prophylaxis in certain circumstances such as infants and pregnant women in their third trimester," Manfrin explained in an email. "We also balance that work with protecting individuals for confidentiality reasons."

Manfrin explained that people are generally contagious for about 21 days after the onset of a severe cough, but also during the week prior, although the risk is lower when symptoms are typically limited to a runny nose. People are also no longer considered contagious after completing a five-day course of antibiotics.

She added that people who were potentially exposed but did not get sick are not considered contagious, but with so many colds and flus around and variation from person to person, it can be harder to distinguish the symptoms of pertussis. Health care providers can test for it, though, which is why it is important to consult them.

"There are specific signs related to pertussis that are generally not seen in other illnesses such as the flu, including a specific sounding cough as well as coughs that are so hard an individual vomits afterward or even breaks ribs," Manfrin wrote.

Manfrin indicated it was not surprising to see new cases after the second case was confirmed in late January. In that instance, the county's notification letter sent out Jan. 29 noted people could have been exposed during a three-and-a-half week period spanning most of that month.

County officials also reiterated their basic advice to frequently wash hands with soap and water, to stay home when ill and to cover one's coughs and sneezes.

"The recommendation on frequent handwashing provides protection for two reasons," Manfrin added. "One, if an individual is sick they are not contaminating objects such as door knobs. Second, if an individual frequently washes their hands even when they are not sick they remove any potential contamination they may have received by touching something. This is particularly important before doing things like eating."

For more information, call the Public Health office at 503-434-7525.

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