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Whooping cough wave is still accelerating nationwide. Here’s what to know about symptoms and treatment.
A wave of whooping cough infections is continuing to worsen nationwide, data from the Centers for Disease Control and Prevention suggests, with weekly reported cases now accelerating to the highest levels seen in the U.S. for years.
At least 259 pertussis cases were reported during the first week into August, the CDC now tallies, up from 215 weekly cases towards the end of June.
Pennsylvania has reported 1,489 cases so far this year, the most of any state. New York has reported the next largest total of cases, at 1,266 infections.
The increase comes as CDC officials have been warning for months of a return to the pre-pandemic trends of the illness. Whooping cough is caused by the bacteria Bordetella pertussis, which had plummeted to record lows during the COVID-19 pandemic, likely due to more people at the time wearing masks and staying home from schools and offices.
So far this year, a total of more than 10,000 pertussis cases have been reported by health departments. By mid-June, total cases this year reached more than triple what they were compared to the same time last year.
Reported cases this year are also now higher than they were right before the pandemic, which had reached around 8,000 cases by early August of 2019.
Why are whooping cough cases accelerating?
Many diseases that spread from person-to-person through the air like pertussis saw rates of infections drop during the COVID-19 pandemic.
“It’s likely mitigation measures used during the pandemic (e.g., masking, remote learning) lowered transmission of pertussis,” the CDC said in July.
That interrupted what had been signs that pertussis rates were starting to trend up again, after dropping from a previous peak in 2012.
“The increase in pertussis that we are observing continued right up through the start of the COVID-19 pandemic in 2020, after which we saw the dramatic decline in reported pertussis, which was similar to trends in other nationally notifiable diseases,” Tami Skoff, a CDC epidemiologist, said at an April event hosted by the National Foundation for Infectious Diseases.
A number of factors were behind the gradual increase in pertussis cases before the pandemic, Skoff said, like better rates of diagnosing and reporting infections.
Another reason may trace back to the switch in the 1990s to a safer type of vaccine, known as “acellular” shots, whose protection lessens over time.
“We believe one of the driving factors and one of the largest contributors is waning protection from acellular pertussis vaccines,” Skoff said.
Skoff said the CDC’s vaccine experts do not currently plan to revisit the topic of pertussis vaccines, after deciding against booster recommendations for the 2012 surges. But new vaccines could result in changes to the agency’s guidance, she said.
“There are vaccines moving forward in the pipeline. Hopefully in the next few years, we’ll have vaccines with longer duration of protection available,” she said.
What are the symptoms of whooping cough?
Doctors typically divide whooping cough into at least three stages, which start with an initial onset of symptoms similar to the common cold, like cough and runny nose. Symptoms typically set in around a week after the patient was first exposed to another person who was contagious.
The cough worsens for up to six more weeks, often into the characteristic “whooping” sound, which occurs as patients struggle to breathe after bursts of rapid coughs to try to expel mucus building up in the body’s airways.
That can result in the skin turning blue or purple, because of the lack of oxygen in their body, and vomiting afterwards.
The symptoms can look different depending on the age of the patient. Infants are at the greatest risk of severe pertussis, with the highest rates of hospitalizations.
While vaccines and better treatments have prevented the thousands of childhood deaths pertussis used to cause each year early during the 20th century, severe cases can result in complications like pneumonia and neurologic issues, especially in infants.
How is whooping cough treated?
Antibiotics can be effective at reducing whooping cough’s severity, especially if started early during an infection, the CDC says. They can also be given to at-risk close contacts of pertussis cases to prevent them from getting sick.
Doctors can test patients with symptoms using a swab pushed deep into the nose. Those tests are most accurate when done within the first three weeks of the cough, the CDC says.
“In the setting of waning immunity and we are seeing more and older individuals and oftentimes I’ll hear from clinicians, we don’t think about pertussis in older individuals or they come to healthcare much later when some of the diagnostic tests aren’t accurate,” Skoff said.
Testing is not always needed to start patients on antibiotics, especially if they are at risk of severe disease. People diagnosed with pertussis can be given antibiotics like azithromycin for up to five days to treat infections, though it does not guarantee that people will see faster relief from their symptoms.
“Antibiotics are intended to prevent transmission of pertussis to others and do not shorten the disease course or improve symptoms,” doctors said in an article published by the American Academy of Family Physicians, citing a review of 13 trials.
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After Tyre Nichols’ fatal beating, Memphis officer texted photo of bloodied man to ex-girlfriend, she testifies
A former Memphis police officer charged in the fatal beating of Tyre Nichols sent his ex-girlfriend a photo of the badly injured man on the night he was punched, kicked and hit with a police baton following a traffic stop, according to trial testimony Wednesday.
Brittany Leake, a Memphis officer and Demetrius Haley’s former girlfriend, testified during the criminal trial that she was on the phone with Haley when officers pulled Nichols over for a traffic stop. She said she heard a “commotion,” including verbal orders for someone to give officers his hands.
The call ended, but Haley later texted the photo in a group chat comprising Haley, Leake and her godsister, she testified. Prosecutors displayed the photo for the jury. It showed Nichols with his eyes closed, on the ground with what appeared to be blood near his mouth and his hands behind his back.
Leake said that when she saw the photo, her reaction was: “Oh my God, he definitely needs to go to the Med.”
The Med is shorthand for Memphis’ trauma hospital.
The fatal beating, caught on police bodycams and street surveillance cameras, has sparked protests and calls for police reform. Officers said they pulled over Nichols for reckless driving, but Memphis’ police chief said there was no evidence to substantiate that claim.
Haley, Tadarrius Bean and Justin Smith are on trial after pleading not guilty to charges that they deprived Nichols of his civil rights through excessive force and failure to intervene, and obstructed justice through witness tampering. Their trial began Sept. 9 and is expected to run three to four weeks.
George Walker IV / AP
The Memphis Police Department fired the three men, along with Emmitt Martin III and Desmond Mills Jr., after Nichols’ death. The beating was caught on police video, which was released publicly. The officers were later indicted on the federal charges. Martin and Mills have taken plea deals.
During her testimony Wednesday, Leake said she deleted the photo after she saw it and that sending such a photo is against police policy.
“I wasn’t offended, but it was difficult to look at,” she said.
Leake said Haley had sent her photos before of drugs, and of a person who had been injured in a car accident.
Earlier Wednesday, Martin was on the witness stand for a third day. Defense attorneys tried to show inconsistencies between Martin’s statements to investigators and his court testimony. Martin acknowledged lying about what happened to Memphis Police Department internal investigators, to try to cover up and “justify what I did.”
But Martin said he told the truth to FBI investigators after he pleaded guilty in August, including statements about feeling pressure on his duty belt where his gun was located during the traffic stop, but not being able to see if Nichols was trying to get his gun. Martin has testified that he said “let go of my gun” during the traffic stop.
Martin Zummach, the attorney for Justin Smith, asked Martin if he knew of any reasons why Nichols did not simply say, “I give up.”
“He’s out of it,” Martin said. “Disoriented.”
Martin testified that the situation escalated quickly when Haley pulled his gun and violently yanked Nichols from his car, using expletives and failing to tell Nichols why he had been pulled over and removed from the vehicle.
“He never got a chance to comply,” Martin said.
Nichols, who was Black, was pepper sprayed and hit with a stun gun during the traffic stop, but ran away, police video shows. The five officers, who also are Black, then beat him about a block from his home, as he called out for his mother.
Video shows the officers milling about and talking as Nichols struggled with his injuries. Nichols died Jan. 10, 2023, three days after the beating.
An autopsy report shows Nichols – the father of a boy who is now 7 – died from blows to the head. The report describes brain injuries, and cuts and bruises on his head and elsewhere on his body.
Jesse Guy testified that he was working as a paramedic for the Memphis Fire Department the night of the beating. He arrived at the location after two emergency medical technicians, Robert Long and JaMichael Sandridge.
Guy said he was not told about the medical problems Nichols had experienced before he arrived, and that Nichols was injured, seated on the ground and unresponsive.
Nichols had no pulse and was not breathing, and it “felt like he was lifeless,” Guy said.
In the ambulance, Guy performed CPR and provided mechanical ventilation, and Nichols had a pulse by the time he arrived at the hospital, the paramedic said.
Guy said Long and Sandridge did not say if they had checked Nichols’ pulse and heart rate, and they did not report if they had given him oxygen. When asked by one of Bean’s lawyers whether that information would have been helpful in treating Nichols, Guy said yes.
Long and Sandridge were fired for violating fire department policies after Nichols died. They have not been criminally charged.
The five officers also have been charged with second-degree murder in state court, where they pleaded not guilty. Mills and Martin are expected to change their pleas.
Federal prosecutors have previously recommended a 40-year sentence for Martin. A date has not been set in state court yet.
Nichols worked for FedEx, and he enjoyed skateboarding and photography. The city of Sacramento, where Nichols grew up, named a skatepark in his honor. “Tyre fell in love with skateboarding at a young age and it wasn’t long before it became a part of his lifestyle,” states the resolution approved by the city council. He had a tattoo of his mother’s name.
“Tyre Nichols’ family have been praying for justice and accountability from the very beginning of this tragedy,” Ben Crump and Antonio Romanucci, the civil rights attorneys representing Nichols’ family, said in a statement when the trial began.
Boeing’s CEO said Wednesday that the company will begin furloughing “a large number” of employees to conserve cash during the strike by union machinists that began last week.
Chief Executive Kelly Ortberg said the people who would be required to take time off without pay starting in coming days include executives, managers and other employees based in the U.S.
“While this is a tough decision that impacts everybody, it is in an effort to preserve our long-term future and help us navigate through this very difficult time,” Ortberg said in a company-wide message to staff.
Boeing didn’t say how many people will face rolling furloughs, but the number is expected to run into the tens of thousands. The aerospace giant had 171,000 employees at the start of the year.
About 33,000 Boeing factory workers in the Pacific Northwest began a strike Friday after rejecting a proposal to raise pay by 25% over four years. They want raises of at least 40%, the return of a traditional pension plan and other improvements in the contract offer they voted down.
Scott Brauer / Bloomberg via Getty Images
The strike is halting production of several airplane models including Boeing’s best-selling plane, the 737 Max. The company gets more than half of the purchase price when new planes are delivered to buyers, so the strike will quickly hurt Boeing’s cash flow.
Ortberg said selected employees will be furloughed for one week every four weeks while retaining their benefits. The CEO and other senior executives will take pay cuts during the duration of the strike, he said, without stating how deep the cuts will be.
All work related to safety, quality, customer support and certification of new planes will continue during the furloughs, he said, including production of 787 Dreamliner jets, which are built by nonunion workers in South Carolina.
Ortberg said in a memo to employees that the company is talking to the International Association of Machinists and Aerospace Workers about a new contract agreement that could be ratified.
“However, with production paused across many key programs in the Pacific Northwest, our business faces substantial challenges and it is important that we take difficult steps to preserve cash and ensure that Boeing is able to successfully recover,” he said.
Boeing’s chief financial officer warned employees earlier this week that temporary layoffs were possible.
The company, which is based in Arlington, Virginia, but has most of its commercial-airplanes business located in the Pacific Northwest, is also cutting spending on suppliers, freezing hiring and eliminating most travel.
Despite two full days of talks assisted by the Federal Mediation and Conciliation Service, the union said Wednesday that no resolution had been reached and no additional negotiations were scheduled, according to CBS Seattle affiliate KIRO-TV.
Striking workers are picketing at several locations in the Seattle area, Oregon and California. The union, which recommended the offer that members later rejected by a 96% vote, is surveying the workers to learn what they want in a new contract. The union’s last strike at Boeing, in 2008, lasted about two months.
If the walkout doesn’t end soon, Boeing’s credit rating could be downgraded to non-investment or junk status, which would make borrowing more expensive. Shortly after the walkout began Friday, Moody’s put Boeing on review for a possible downgrade, and Fitch said a strike longer than two weeks would make a downgrade more likely.
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