Flathead City-County Health Department officials have reported three more pertussis (whooping cough) cases, raising the county total to 56 and adding Somers Middle School to the list of affected school districts.

The three new cases included two children who were not given the recommended antibiotic treatment after the health department informed their families of their exposure.

Referred to as prophylactic treatment, the antibiotic regimen usually takes five days and kills the bacteria that spread the highly communicable disease to others.

“Most disturbing is that one of the cases was not started on prophylaxis due to the health-care provider not feeling it was necessary,” County Health Officer Joe Russell said.

“We follow the nationally recognized guidelines for identifying close contacts of known pertussis cases. Information regarding close contacts generally comes from the schools and the cases. When recommended intervention strategies are not followed, we can expect additional cases.”

Community Health Director Jody White said earlier that the next few weeks would reveal if exposed people were taking the antibiotics since the incubation period of the disease averages six to 12 days. She said the department considers stopping transmission of pertussis of utmost importance.

“We are concerned with our infant population as they are too young to be immunized and don’t have the naturally acquired abilities to fight the infection,” White said. “Protecting infants is essential, as hospitalization rates can run higher than 50 percent and there is a one percent chance that a hospitalized infant will die.”

Health officials say that people diagnosed with pertussis should not go to daycare, school, work or any public gathering until they have taken at least five days of antibiotic treatments. When a person is diagnosed, everyone in their household and all other close contacts needs to take antibiotics as a precaution.

Symptoms of pertussis mirror those of a cold or the flu but with a cough that lasts longer than a week and grows into a violent cough that may cause a whooping sound as the patient tries to breathe. People may vomit or break ribs from the violence of the cough.