According to public health reports, whooping cough, also known as pertussis is on the rise in the UK and lasts for 100 days. Highly contagious infections in children, especially newborns, have more than doubled since 2022.
As per the recent notifications of infectious diseases weekly report issued by the UK Health Security Agency (UKHSA), there have been 1141 cases of whooping cough in England and Wales from Week 1 to 47 of 2023. The data is alarming compared to the corresponding figures from 2021 – 454 cases and 2022 – 450 cases reported in the same period.
Besides, the UKHSA report also highlights that the cases of whooping cough have increased between the 27th to the 47th week of 2023 (July to November) when 716 cases, or nearly 63% were reported.
What is a 100-day cough and its symptoms?
Whooping cough is also known as the 100-day cough, as it lasts for three months and is spread by droplets produced when the infected person coughs and sneezes. The bacterial infection is caused by Bordetella pertussis which affects the lungs and airways.
According to the World Health Organization, the first symptom like a mild fever, runny nose or cough usually appears 7 to 10 days after contracting the infection. Which in typical cases, gradually develops into a hacking cough followed by whooping cough (hence the common name).
Whooping cough is generally seen in babies less than two years and it’s not very common in older children or adults, says Dr Sarat Kumar Naidu, specialty doctor, emergency medicine, East Lancashire Hospitals NHS Trust, UK. He said that whooping cough can affect adults but it’s not as severe as it can be in children.
Dr. Naidu says to see a doctor if the symptoms persist for more than a week.
Why is there an increase?
Since the COVID pandemic in 2020, the number of pertussis cases has increased, said Dr Naidu. “The reason could be the lockdown measures that reduced the chances of people getting infected from any disease and building natural immunity. The reduced number of infections has caused reduced immunity in people. This is not a good sign as an outbreak of any disease can lead to mass spread,” he told Happiest Health.
Role of vaccination
As per the stringent public health policy in the UK, every child is inoculated against vaccine-preventable diseases. To protect newborn babies, pregnant women in the UK are also vaccinated between 16 and 32 weeks of pregnancy.
According to Dr Naidu, a few years ago, the UK switched from the painful vaccine (whole-cell pertussis), which is associated with side effects such as fever, pain and swelling at the injection site, to the painless vaccine (acellular pertussis), which confers immunity for a shorter period, perhaps up to 1 – 1.5 years, which may have also been a reason for the rise in cases.
Dr Naidu says that according to the UK immunization schedule, the vaccination is given to children at 8,12 and 16 weeks. “There is no single vaccination against whooping cough, but a combination of a 6-in-1 vaccine is administered: diphtheria, hepatitis B, Hib (Haemophilus influenzae type b), polio, tetanus, whooping cough,” he said.
“Whooping cough is not like chickenpox where if you are infected once, you will not get infected again due to its lifelong and permanent immunity,” said Dr Naidu. He said that a person may get exposed to the pertussis infection multiple times but it is not as severe in adults as it is in children. “The pertussis vaccine too will not give a lifetime immunity and it protects children from the infection for one or two years post which they need to take a booster,” he said.
Whooping cough booster is a must
The vaccination has been very effective due to which we have not seen any cases in the last few years in India, says Dr Upendra S Kinjawadekar, president of the Indian Association Of Pediatricians (IAP). “Booster is a must to ensure the antibodies are maintained. The immunity of the vaccine wanes over a period of time and they must take boosters up to adolescence,” said Dr Kinjawadekar.
According to the Indian immunization schedule, children are given DTwP at 6, 10 and 14 weeks. “The boosters are given at 1.5 years, 4.5 years and 10 years which many fail to take and that could be a reason why their immunity towards the infection becomes low,” Dr Kinjawadekar said.
Dr Naidu said that according to the UK vaccination schedule, children must take a booster dose after 3.5 years.
Though the studies have shown that both whole-cell and acellular vaccines are equally effective, Dr Kinjawadekar opines that if the early primary immunization series (first three doses of DwPT) is given with whole-cell vaccine, it is more effective. “I believe that India is performing well in preventing whooping cough due to usage of whole-cell vaccines,” he said.
Complications and treatments
The complications include pneumonia, subconjunctival hemorrhage (where the blood vessels in the white of the eye, break), aseptic meningitis (inflammation of the meninges, a membrane covering the brain), seizures, and apnea (life-threatening pauses in breathing) said Dr Kinjawadekar.
Dr Naidu says that the treatment protocol for whooping cough is to start antibiotics after a week as it is a bacterial infection. “They are kept under observation at the hospital or home if they are stable, for one to three weeks as that’s the period when the disease is most contagious and can spread fast,” he said.
Takeaways
- Whooping cough also known as pertussis, a highly contagious infection that lasts for 100 days is rising in the UK.
- The number of pertussis cases has tripled over the last year with a 250% increase in England and Wales.
- Bacterial infection affects the lungs and the airways and is severe in children, especially newborns.
