Resurgence of whooping cough underlines need for vaccination
The recent resurgence of whooping cough cases in Australia highlights the importance of vaccination and also of isolating people who are infected, say Dr Philip Britton and Professor Cheryl Jones of the Children’s Hospital at Westmead and the Sydney Emerging Infectious Diseases and Biosecurity Institute.
Writing in the June edition of Australian Prescriber, the authors say older children and adults don’t always show the classical symptoms of the disease, such as the ‘whoop’ – but they’re often the person who infects a young infant. Whooping cough can be extremely dangerous for babies – it was once a major cause of infant mortality and there have been recent infant deaths in Australia from the disease.
‘Death from pertussis (whooping cough) is rare overall – but is close to 1% in infants under 6 months,’ the authors write.
‘Complications can include hospitalisation, bacterial infection, failure to thrive, cerebral hypoxia and encephalopathy in infants. Sleep disturbance, rib fracture and prolonged cough can also occur in adults.’
Vaccination, isolation and antibiotic treatment are important strategies in preventing the transmission of whooping cough, the authors write.
While the current national immunisation schedule recommends vaccinating infants at 2, 4 and 6 months of age with booster doses at 4 years and 15-17 years, waning immunity has been seen in older children and adults with this schedule.
‘For this reason, booster vaccination is now recommended for groups who have a high risk of being in contact with people in at-risk groups, including adults planning a pregnancy, adult family members of newborns, and child and healthcare workers.’
While there is limited evidence regarding the effectiveness of antibiotics as a precautionary measure to prevent the spread of whooping cough, it is still recommended for people who have been exposed to whooping cough and who have a high risk of passing it on to someone most at risk.
‘These include people in households where there are newborns or other children less than 2 years who have received less than 3 doses of vaccine, healthcare workers in maternity and neonatal units and infants in these units where a healthcare worker was the infected case.’
NPS clinical adviser Dr Philippa Binns says given that antibiotics are so important in treating and preventing the spread of whooping cough, it’s important that all Australians take action to prevent the development and spread of antibiotic resistance.
‘Antibiotics are important weapons in the fight against bacterial infections like whooping cough, so we need to make sure we keep them for when people really need them,’ she says.
‘This means not taking them for viral infections such as a cold or flu, because these cannot be treated with antibiotics.’