Credit CDC
# 5798
Updating a story from late in November (see UK: Three Whooping Cough Deaths In October), while the number of new UK Pertussis cases reported in November dropped over the previous month, they still remain well above average.
The HPA released the following update this morning.
Whooping cough cases remain high
21 December 2012
Figures published by the Health Protection Agency (HPA) today show that cases of whooping cough have continued at high levels during November with 1,080 confirmed cases reported for England and Wales, bringing the total number of cases so far this year to 8,819*. No deaths were reported in November.
The total of 1,080 cases reported during November represents a decrease from October when 1,631 cases were reported for England and Wales, which is the first time we’ve seen a decrease in monthly numbers since the current outbreak began in the middle of 2011. However, a decrease in cases is usually seen at this time of year so this does not necessarily represent the end of this severe outbreak.
At the end of September, the Department of Health announced that pregnant women would be offered whooping cough vaccination to protect their newborn babies, who do not usually start their vaccinations against whooping cough until they are two months of age. The aim of the vaccination programme is to help to boost the short term immunity passed on by women to their babies while they are still in the womb.
It is too soon for this vaccination campaign to have had an impact on the case numbers we are seeing, however, the Department of Health recently reported an uptake of around 40 per cent in pregnant women.
Dr Gayatri Amirthalingam, consultant epidemiologist for immunisation at the HPA, said: “The November figures show a welcome decrease of whooping cough cases since October. However, it is very important to note that we usually see a reduction in cases of whooping cough at this time of year so this decrease is in line with normal seasonal patterns.
“The recent announcement that at least 40 per cent of pregnant women received the whooping cough vaccine in the first month of the programme is very encouraging. We would like to remind pregnant women how serious this infection can be in young babies and how it can in some cases cause death. Vaccination between 28 and 38 weeks of pregnancy should offer babies the best protection against whooping cough before they receive their own vaccines.
“As well as this, parents should ensure their children are vaccinated against whooping cough on time, even babies of women who’ve had the vaccine in pregnancy – this is to continue their baby’s protection through childhood."
Whooping cough, also known as pertussis, affects all ages. Young infants are at highest risk of severe complications and death from whooping cough as babies do not complete vaccination until they are around four months old. In older children and adults whooping cough can be an unpleasant illness but it does not usually lead to serious complications. Whooping cough is a highly infectious bacterial disease which spreads when a person with the infection coughs and sheds the bacteria which is then inhaled by another person.
Dr Amirthalingam continues, “Parents should also be alert to the signs and symptoms of whooping cough – which include severe coughing fits accompanied by the characteristic “whoop” sound in young children but as a prolonged cough in older children or adults.”
(Continue . . . )
The reasons behind the spike in Pertussis cases (not only in the UK, but in the U.S., Australia, and elsewhere) are complex, and not completely understood, but some factors may include:
- lower vaccination uptakes
- the move away from whole cell pertussis vaccines to safer – but less broadly protective - acellular vaccines in the 1990s
- evolutionary changes in the Bordetella pertussis bacteria.
Recent evidence published in the NEJM suggests that protection from the newer acellular pertussis vaccine – introduced in the early 1990s – may wane sooner than previously suspected.
Waning Protection after Fifth Dose of Acellular Pertussis Vaccine in Children
Nicola P. Klein, M.D., Ph.D., Joan Bartlett, M.P.H., M.P.P., Ali Rowhani-Rahbar, M.D., M.P.H., Ph.D., Bruce Fireman, M.A., and Roger Baxter, M.D.
N Engl J Med 2012; 367:1012-1019 September 13, 2012DOI: 10.1056/NEJMoa1200850
While not 100% perfect, the Pertussis vaccine remains the best way to prevent Whooping Cough.
As noted above, the rise in whooping cough isn’t just a problem in the UK. The graphic below shows that – except for California – every state in the union has reported an increase in Pertussis cases this year over 2011 (through week 46).
For more on the prevention of Whooping Cough, and the role of the Tdap vaccine, visit:
