Oregon public health officials are asking Oregonians to take steps to protect themselves and others from the slew of respiratory illnesses likely to emerge again this winter.

COVID-19 is not the only culprit – other respiratory illnesses include influenza and respiratory syncytial virus, or RSV, along with measles and whooping cough. Public health officials on Thursday encouraged people to get vaccinated and use other strategies to avoid getting sick, like hand-washing, avoiding indoor crowded gatherings and testing when symptoms appear. Face masks, while not mandatory, also help ward off illnesses, officials said.

“Fortunately, we have some very effective tools to help people risk less and do more this respiratory season,” Dr. Melissa Sutton, the health authority’s medical director for respiratory viral pathogens, said Thursday in a call with reporters.

Dr. Richard Bruno, health officer for Multnomah County, said the state has outbreaks currently of measles and pertussis, or whooping cough. So far, Oregon has had 31 cases of measles reported, the highest since 1991. None of those who contracted the highly contagious disease were vaccinated and two needed to be hospitalized, Bruno said. 

The last confirmed measles case was in mid-August, so Oregon may be near the end of the current outbreak, he said. However, now that children are back in school, more measles cases may emerge, Bruno said. Oregon schoolchildren are below the 95% vaccination rate that’s needed for “herd immunity” or when enough people are immune to the disease so that it cannot easily spread. 

Measles infects the respiratory tract and spreads throughout the body, often causing a high fever, cough, runny nose and rash. The measles vaccine is highly effective and required for school attendance though parents can opt out.

Oregon’s 550,000 schoolchildren are also required to be vaccinated against whooping cough, which has surged in Lane, Multnomah, Clackamas and several other counties.  So far, 560 people have been infected with whooping cough this year compared with 26 cases in 2023, state data shows.  

Whooping cough usually starts with cold-like symptoms that progress to an uncontrollable cough. Pertussis is caused by a bacteria, not a virus, which means it’s susceptible to antibiotics. If someone has a cough that’s not getting better, they should see their health care provider, officials said.

Both measles and whooping cough are among the most  contagious diseases in the world, Bruno said, and both have effective vaccines. 

If someone has had measles in the past, received two vaccine doses or was born before 1957, they are immune, he said. With whooping cough, most people usually get vaccinated by age 12 and updated every 10 years as part of a tetanus booster shot, he said. 

“Fortunately, we have vaccines for all of these illnesses to help protect us, so please consider making sure you are up to date,” Bruno said.

Groups of people who are particularly vulnerable to respiratory illnesses in general include young people, pregnant people, those with compromised immune systems and the elderly. Infants under 6 months old face the highest risk for RSV while adults older than 65 and people with compromised immune systems are more vulnerable to COVID-19.

Public health officials said people in rural areas, which have fewer providers, should get vaccinated. 

“In Harney County, which is where I live, it can be three hours in a single direction to get to medical care,” said Dr. Sarah Laiosa, public health officer for Malhuer and Harney counties. “And I think it’s really important to do the things that we could do to prevent the severe disease so that they don’t need to access that medical care that can be so hard to get to.”

Laiosa said people should talk to their health care providers about vaccinations rather than rely upon untrustworthy sources. 

“Unfortunately, there is an incredible amount of disinformation on vaccines in the world today, and it’s important that people seek information from a health care provider they trust before deciding what is best for them,” she said. “I want to encourage everyone out there to ask your health provider questions you might have. They want to hear from you, and they want to inform you and empower you.”

Outlook is unclear 

At this point, officials don’t know how severe COVID will be this winter. 

Unlike other respiratory diseases, cases surged this summer in Oregon. Health authority data, based on wastewater surveillance, indicates that COVID cases are still on the rise in Canby, Florence and Medford, while cases are leveling out at many other sites. The prevalence of COVID in Hood River, Siletz, Lincoln City, Klamath Falls and Grants Pass has decreased.

Officials at the federal Centers for Disease Control and Prevention have formulated short-term forecasts for COVID but those were placed on hold during the summer.

CDC officials recommend that everyone stay up to date on their COVID shots because their effectiveness wanes over time. The latest booster shots, which were recently approved, are now available and are recommended especially for those who are at least 65 years old or at high risk of infection.

With influenza, officials look to countries in the southern hemisphere, which go through winter before the north, to figure out what strains are circulating and how severe the flu season might be. But this year they’ve offered a mixed outlook. 

“We have a handful of countries who had quite severe influenza seasons, and then we have some countries that had really mild seasons, so we really don’t have a clear picture of what we’re facing this year,” Sutton said, adding that’s why it’s important to stay updated on vaccinations.