BACTERIOLOGY
cases of whooping cough with 89,000 deaths each year.13
A more recent study
cited by Centers for Disease Control and Prevention (CDC) estimates the prevalence to be around 24 million cases in children under five with just under 161,000 deaths.3,17
The majority of cases
are seen in infants under six months, possibly due to differences in the timing of vaccination programmes and also the immature immune systems seen in this population.4
Within European primary
care it is estimated that in 2016 around 3% of adults presenting with an acute cough have pertussis.24
WHO data suggest that in 2022 there Fig 3. WHO Pertussis- number of cases per WHO region 2023.13 vaccine hesitancy22 may be the cause of the global increase in pertussis disease.
UK epidemiology In England and Wales we are experiencing an increase in pertussis infections. Between January and April 2024 there were 4,793 confirmed cases reported, with eight infant deaths during this period. This compares with a total of 858 cases in 2023. Disease is cyclical peaking every 3-5 years with the last peak occurring in 2016 with almost 6,000 cases. Current figures suggest cases may be higher than this in 2024. The UKHSA whooping cough daily incidence per 100,000 population for GP in-hours consultations depicted in
Figure 2 from the latest UKHSA confirmed cases,23
to the current rise in cases seen in 2024. The maternal vaccination programme commenced in the UK in 2013, and since this time there have been 29 pertussis disease deaths in neonates. Sadly of these 29 deaths, 23 were from mothers who did not have or declined the vaccination during their pregnancy.23
Global picture There is currently confusing evidence on the global prevalence of pertussis infection, largely due to timelines of data collection. The WHO estimates via its website – from data collected in 2018 – that there are more than 151,000
clearly shows a significant rise due
was around 14.3 million zero-dosed children globally. Encouragingly of those children that were vaccinated, 84% had received all three DTP3 doses. However, a worrying statistic shows that the global vaccine uptake for pertussis in pregnant women is around 46%.13
This picture is
also seen in the UK with vaccination rate of pregnant women in 2023 as low as 58% and more locally in greater London the rate was down at 36%.23
The WHO
does go on to state that most of the 5.2 million deaths in children under five are from preventable causes. A significant proportion of these can be attributed to vaccine preventable diseases.13
Summary To summarise, pertussis is a vaccine preventable disease and we have the tools to potentially irradicate it globally. While the efficacy of the vaccine does reduce over time, its effectiveness in preventing a poor prognosis in neonates cannot be understated. It is concerning
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