Cagayan de Oro’s pertussis scare: When an ‘outbreak’ isn’t really an outbreak

CAGAYAN DE ORO, Philippines – The head of the Cagayan de Oro City Health Office has drawn criticism for announcing on Tuesday, April 2, that the city was seeing a pertussis outbreak, despite city hall documenting only one case and two suspected infections.

City Health Officer Rachel Dilla’s announcement quickly became the subject of viral posts, spreading rapidly on social media and causing alarm in the city.

Later, Dr. Dilla retracted her statement, explaining that her use of the word “outbreak” during an interview with local broadcaster Magnum Radio was not intended to convey a large-scale epidemic.

She earlier told the radio station, “Outbreak siya kay tungod na-control naman unta ni sya nga sakit through vaccination. So, whenever naay maski usa ka kaso o duha, amo nanang gitawag nga murag outbreak, kanang wala naman unta na siya.”

(We call it an outbreak because this disease was supposed to be under control through vaccination. So, whenever there is even one or two cases, we refer to it as an outbreak, since it should no longer be occurring.)

Dr. Ellenietta Herundina Maria Victoria Gamolo, assistant director of the Department of Health (DOH) in Northern Mindanao, said the situation in Cagayan de Oro cannot be considered an outbreak.

“Pertussis was never declared as eradicated or eliminated. It is under control since we have the vaccines for it. The ones who got sick in Region 10 were all unvaccinated,” Gamolo said.

The health department recorded six cases of pertussis, also known as whooping cough, throughout the region as of March 23, and only two are laboratory-confirmed. 

Of the six cases, three are from Cagayan de Oro and one each from the provinces of Bukidnon, Misamis Oriental, and Misamis Occidental. 

There was no pertussis case documented in the city or Northern Mindanao from January to March of 2023. The DOH, however, documented 63 cases in the succeeding months in the region last year.

Gamolo noted that Dilla used the word “maybe” in her controversial radio interview, implying that she was unsure about her outbreak declaration. 

She said health officials can only declare an outbreak “if cases are higher than the expected number of cases, and deaths are observed.”

Dilla acknowledged her miscommunication, clarifying that the local health office had observed an “increase” in both confirmed and suspected cases of pertussis in Cagayan de Oro compared to the same period in 2023. This year’s cases involve infants from barangays Carmen, Gusa, and Macasandig.

“We, in the City Health Office, consider this not lightly. We really have to do more of what we are doing,” Dilla told Rappler on Tuesday.

However, her retraction came after her initial interview had already been widely disseminated on social media. The Facebook post by Magnum Radio alone garnered over 11,000 views and more than 500 shares as of posting time.

Ailyn Estillore, a mother from Barangay Carmen, expressed her disappointment over Dilla’s initial announcement, admitting to panic after encountering the social media posts, fearing for the safety of her two young children.

“Naka sink in sa ako huna-huna nga basin mas grabe pa ni sa COVID-19. Murag ana akong nabati nga kahadlok,” Estillore told Rappler.

(The thought that this could be worse than COVID-19 began to sink in. That’s how scared I was.)

A store manager in Barangay Kauswagan, Jennifer Generalao, said she became anxious as the radio interview with Dilla and the subsequent social media posts rekindled her traumatic memories of the worst period of the COVID-19 pandemic’s peak, which had severely impacted her career.

Dilla, meanwhile, said the uptick in confirmed and suspected pertussis cases in Cagayan de Oro could be linked to the city’s suboptimal routine immunization rates, which saw only 77% of children fully immunized in 2020. The figure slightly improved to 78% in 2021, reached 80% in 2022, and then 86% in 2023, with the COVID-19 pandemic impacting vaccination efforts.

In response, some 2,000 doses of the 5-in-1 pentavalent vaccine, which includes protection against pertussis, were distributed across all health centers in the city. 

Local health officials said priority was being given to people in villages reporting instances of whooping cough to mitigate further spread of the disease.

The DOH said pertussis is a highly contagious bacterial respiratory infection that can be transmitted from person to person through coughing and sneezing. Health officials said this can be prevented by good hygiene, such as covering the mouth while coughing and sneezing using disposable tissues and wipes, or the elbow and upper arm, and frequent hand washing. – Rappler.com