Pennsylvania has seen more cases of whooping cough than any other state this year, with 2,165 cases of the serious bacterial infection reported as of late September.

At this time in 2023, the state had reported 205 cases to the Centers for Disease Control and Prevention. This year’s cases represent a 956% increase from the year before.

The continued outbreak prompted a statewide alert from health officials in early September, and the Children’s Hospital of Philadelphia re-instituted staff masking policies this summer to better protect employees and patients.

Whooping cough, or pertussis, is caused by a bacterial infection and can result in a severe cough that lasts for months. It’s particularly dangerous for infants, especially those too young to be vaccinated against the disease.

Preventative measures for whooping cough at CHOP

In August, seeing a rise in cases at its offices in Philadelphia’s collar counties, CHOP began requiring staff to mask in waiting rooms and while seeing patients in Montgomery, Chester, Bucks, and Delaware Counties in Pennsylvania and Burlington County in New Jersey.

At the end of September, with cases also rising in Philadelphia, CHOP staff began masking at their city facilities as well, said Erika Hayes, CHOP’s senior medical director of infection prevention.

“During the COVID-19 pandemic, we all got very, very good about not going out when we were sick and wearing our masks,” she said. “Mid-2020 to about late 2021, the number of pertussis cases were vanishingly rare, and it was because of these good practices.”

The health system is hoping that requiring staff to mask now can help slow the flow of cases.

In a statement, the state Department of Health said areas with high population density like Philadelphia and Pittsburgh are seeing the highest increases. Still, pertussis cases in Philadelphia have not been evenly spread among health providers: St. Christopher’s Hospital for Children in Kensington has seen only a handful this year. CHOP has seen 609 across its facilities in the region.

Hayes said she hoped cases might decrease soon. “But honestly, especially with the kids back in school, I am very worried that we may continue to rise,” she said.

Most of the pertussis outbreaks reported this year took place at middle schools, high schools, and colleges, state officials said. Montgomery County’s Plymouth Whitemarsh High School reported a pertussis outbreak among six students in April.

New Jersey also saw higher-than-usual whooping cough cases this summer, prompting an alert from the state health department, although the cases reported so far this year are now lower than year-to-date case counts from 2023. And the state is seeing far fewer cases than neighboring Pennsylvania, with just 128 cases reported this year.

What’s driving the rise in pertussis cases?

At Virtua Health in South Jersey, infection prevention officer Martin Topiel said the health system is seeing more whooping cough cases in its ERs and urgent care centers than usual.

But it’s unclear what exactly is behind the rise. Topiel said that better detection methods could contribute to an increase in reported cases.

Some patients also put off vaccinations during the COVID pandemic, Hayes noted, adding that the standard childhood Tdap vaccine, which protects against tetanus, diphtheria, and pertussis, wears off as you age. That might have put more patients at risk.

“People can become susceptible again to pertussis, and pertussis in adults and grown-ups looks like a little bit of a cold and then a cough that won’t go away for a long time,” she said. “A lot of people don’t get diagnosed. But it’s extremely contagious.”

Newborns are at the highest risk of infection and, in rare cases, death from pertussis. In very young babies, the symptoms of whooping cough might be more difficult to spot, since producing the distinctive “whoop” requires muscle tone not yet developed. Instead, they may struggle to breathe or stop breathing.

Preventing serious illness

That’s why it’s especially important for adults and older children to stay up-to-date on Tdap boosters—to protect babies under two months, who are too young to be vaccinated, Hayes said. It’s also important for pregnant people to receive a Tdap shot between 27 and 36 weeks gestation of each pregnancy, state officials said, in order to give newborns some added protection.

State officials said 94.6% of Pennsylvania’s kindergartners are vaccinated for pertussis. And 92.4% of 7th graders and 97.1% of 12th graders have gotten a Tdap vaccine.

Patients can still get ill from pertussis if they’re vaccinated, but the vaccine can prevent more serious outcomes, said Topiel.

“Pertussis can last a very long time and it can be quite disabling and uncomfortable once someone catches it,” he said. “I don’t want people to go through that.”

‘Vaccines are our best defense’

Earlier this summer, Emmani Osborne-Morrison came down with a cold. Emmani has a severe form of epilepsy, and her mother Juliette Osborne, a nurse practitioner from Lumberton, N.J., closely monitors her health.

“She was fatigued, not herself, not eating—I couldn’t make out what it was. I thought it might be chronic sinusitis. But then one night she started coughing,” Osborne said.

Emmani coughed for four hours straight, and Osborne got in touch with her primary care physician and was told to take her daughter immediately to the emergency room. There, she tested positive for whooping cough.

The family quarantined and took preventative antibiotics to prevent the infection from spreading through the household. Emmani was over the worst of it in about two weeks, her mother said, likely because she had been vaccinated.

Osborne advised parents to make sure their kids are vaccinated, too—and to watch out for unusual cold symptoms they might otherwise miss.

“It was very crazy hearing that she had whooping cough when she had already been vaccinated,” Osborne said. But, she said, “vaccinations are our best defense. I believe Emmani’s vaccine helped reduce or shorten her symptoms.”

2024 The Philadelphia Inquirer, LLC. Distributed by Tribune Content Agency, LLC.

Former President Donald Trump was in Pennsylvania on Saturday and isn’t done with the battleground state just yet. Trump will hold a rally in Reading, Pennsylvania, Wednesday evening, his campaign announced Saturday.

The former president will likely criticize the Biden-Harris administration’s handling of the southern border and inflation.

“With prices up over 20 percent and real wages down since Kamala Harris took office, Pennsylvanians are struggling to make ends meet,” a news release from the Trump-Vance campaign read in part. “Meanwhile, tens of millions of illegal immigrants have flooded our country on Kamala’s watch, worsening already sky-high rent and real estate costs.”

The rally will be held at the Santander Arena on Penn Street in Reading; doors open to the event at 3 p.m. According to the Trump-Vance campaign, the former president is scheduled to deliver his remarks at 7 p.m.

If re-elected president, Trump said he would secure the country’s borders and protect American workers from unfair competition to make America “safe, wealthy and great again,” according to a news release from the Trump-Vance campaign.

The Harris-Walz Pennsylvania campaign team released a statement regarding the former president’s upcoming visit to Berks County. 

“As president, Trump killed over 275,000 jobs in the commonwealth, gave handouts to his ultra-wealthy friends at our expense and tried to rip away our health care,” a statement by Onotse Omoyeni, Pennsylvania Rapid Response director for Harris for President, read in part. “A second term would be even worse: he’ll raise costs by nearly $4,000 and give more handouts to the super-rich and big corporations while trying to cut our Social Security and Medicare.”

On Saturday, Trump returned to Butler, Pennsylvania, for the first time since he was nearly assassinated almost three months ago. During the rally, Trump paid tribute to firefighter Corey Comperatore, who was killed in the July 13 assassination attempt while trying to shield his family from the bullets. 

The former president also praised the Secret Service for their protection during the assassination attempt. Billionaire Elon Musk also joined the former president on stage and called the 2024 election, “the most important of our lifetime.”

Justice P. Kevin Brobson, however, said in a concurring opinion that the groups waited more than a year after an earlier high court ruling to bring their challenge, and it was “an all-too-common practice of litigants who postpone seeking judicial relief on election-related matters until the election is underway that creates uncertainty.”

Many voters have not understood the legal requirement to sign and date their mail-in ballots, leaving tens of thousands of ballots without accurate dates since Pennsylvania dramatically expanded mail-in voting in a 2019 law.

The lawsuit’s plaintiffs contend that multiple courts have found that a voter-written date is meaningless in determining whether the ballot arrived on time or whether the voter is eligible, so rejecting a ballot on that basis should be considered a violation of the state constitution. The parties won their case on the same claim in a statewide court earlier this year but it was thrown out by the state Supreme Court on a technicality before justices considered the merits.

Democrats, including Gov. Josh Shapiro, have sided with the plaintiffs, who include the Black Political Empowerment Project, POWER Interfaith, Make the Road Pennsylvania, OnePA Activists United, New PA Project Education Fund Pittsburgh United, League of Women Voters of Pennsylvania and Common Cause Pennsylvania.

Republicans say requiring the date is an election safeguard and accuse Democrats of trying to change election rules at the 11th hour.

The high court also rejected a challenge by Republican political organizations to county election officials letting voters remedy disqualifying mail-in ballot mistakes, which the GOP says state law doesn’t allow. The ruling noted that the petitioners came to the high court without first litigating the matter in the lower courts.

The court did agree on Saturday, however, to hear another GOP challenge to a lower court ruling requiring officials in one county to notify voters when their mail-in ballots are rejected, and allow them to vote provisionally on Election Day.

The Pennsylvania court, with five justices elected as Democrats and two as Republicans, is playing an increasingly important role in settling disputes in this election, much as it did in 2020’s presidential election.

Issues involving mail-in voting are hyper-partisan: Roughly three-fourths of mail-in ballots in Pennsylvania tend to be cast by Democrats. Republicans and Democrats alike attribute the partisan gap to former President Donald Trump, who has baselessly claimed mail-in voting is rife with fraud.