GPs and health practitioners have issued an urgent warning to parents to vaccinate their children, after a huge spike in the number of cases of whooping cough in the UK in recent months.
In the first quarter of the year, there were five cases of infant deaths from the illness with high rates of whooping cough among babies aged under 3 months. However, just over half of cases were in those aged 15 years or older (UKHSA, 2024a).
Figures for the last few weeks up to May outstripped the total for the whole of last year, with Nottingham and Bristol among the worst affected areas in the UK. In extreme cases whooping cough can lead to pneumonia or brain damage. A sick baby will need hospital treatment but even then, there is a danger whooping cough could prove fatal.
According to figures from the UK Health Security Agency (UKHSA), published in May, the number of cases is continuing to grow, with more than 1 300 confirmed in March alone. This came after 556 cases in January and 918 in February (UKHSA, 2024a).
Whooping cough, also known as pertussis or the 100-day cough, is transmitted through airborne droplets and cases have been rising in England as well as in other countries, since December 2023, due to a combination of factors. The illness is cyclical and known to peak every 3 to 5 years. The last big outbreak was in 2016, but like many other diseases, cases fell during the pandemic years due to restrictions and less socialising in public. This meant that a peak year was overdue.
However, the pandemic also brought into focus a big debate around vaccinations, and the public discourse around Covid seeped into attitudes relating to vaccines in other illnesses, according to GP, Dr Jacqui Bradley.
‘There was, and continues to be, some misinformation out there about the COVID vaccine on social media and this inevitably has a bearing on how people view vaccinations generally,’ she said. ‘On some levels, this has always been a challenge, due in part to the MMR scares of decades ago, and some parents remain reluctant to vaccinate their children over fears of side effects or other complications.
‘The end result is that we get a population that it under-vaccinated with little immunity, which leads to a spike in cases. The health authorities are now forced to remind people to ensure their children's inoculations are up to date.’
Whooping cough is a bacterial infection which affects the lungs. The initial signs and symptoms are similar to those of a cold and so might not be immediately obvious, and include a runny nose and sore throat. After a few days, this can develop into coughing bouts that can last for several minutes and tend to be worse at night.
Young babies may also make a distinctive ‘whoop’ sound or have difficulty breathing after a bout of coughing. However, not all babies make this noise which means whooping cough can be hard to recognise and diagnose.
‘GPs and health practitioners have issued an urgent warning to parents to vaccinate their children, after a huge spike in the number of cases of whooping cough in the UK in recent months.’
Patients who are diagnosed with whooping cough should stay at home and not attend nursery, school or work, until 48 hours after starting antibiotics. For those not taking antibiotics, they should isolate for 3 weeks after symptoms start (UKHSA, 2024a). This will help to prevent the spread of infection, especially to vulnerable groups, including infants. Healthcare professionals stress, however, that vaccination is the best protection for babies and children.
‘After a few years of limited circulation in the EU/EEA, particularly during the COVID-19 pandemic, more than 25 000 cases of pertussis were reported in 2023, and more than 32 000 between January and March 2024.’
Dr Gayatri Amirthalingam, Consultant Epidemiologist at UK Health Security Agency, said: ‘Vaccination remains the best defence against whooping cough and it is vital that pregnant women and young infants receive their vaccines at the right time.
‘Pregnant women are offered a whooping cough vaccine in every pregnancy, ideally between 20 and 32 weeks. This passes protection to their baby in the womb so that they are protected from birth in the first months of their life when they are most vulnerable and before they can receive their own vaccines.’
All babies receive three doses of the DTaP/IPV/Hib/HepB vaccine at 8, 12 and 16 weeks of age to protect against whooping cough and other serious diseases such as diphtheria and polio. A pre-school booster is later offered to children at the age of 3 years and 4 months.
Dr Amirthalingam added: ‘Whooping cough can affect people of all ages but for very young babies it can be extremely serious. Our thoughts and condolences are with those families who have so tragically lost their baby.’
NHS National Medical Director, Professor Sir Stephen Powis, said: ’With cases of whooping cough continuing to rise sharply across the country, and figures sadly showing five infant deaths, it is vital that families come forward to get the protection they need.
‘If you are pregnant and have not been vaccinated yet, or your child is not up to date with whooping cough or other routine vaccinations, please contact your GP as soon as possible, and if you or your child show symptoms ask for an urgent GP appointment or get help from NHS 111.’
The European Centre for Disease Prevention and Control (ECDC, 2024) recorded more cases in the European Union and other parts of Europe in the first 3 months of this year, than the whole of 2023. The organisation said: ‘After a few years of limited circulation in the EU/EEA, particularly during the COVID-19 pandemic, more than 25 000 cases of pertussis were reported in 2023, and more than 32 000 between January and March 2024.
‘The observed epidemiological picture can be ascribed to a number of factors, which include expected epidemic peaks, presence of unvaccinated or not up-to-date vaccinated individuals, waning immunity, decreased contribution of natural boosting in the overall population during the COVID-19 pandemic period.’
The latest UK government guidelines for healthcare professionals on diagnosis, management and care of patients with whooping cough (UKHSA, 2024b), can be found here: https://www.gov.uk/government/publications/pertussis-guidelines-for-public-health-management.