Growing number of whooping cough infections in the US and Europe raises concerns among medical professionals

Cases of whooping cough, also known as pertussis, are increasing in the US and Europe. Experts claim they don’t know why. Health professionals throughout the European continent began to notice something strange in the winter of 2023. Pertussis, another name for whooping cough, was becoming more common. Furthermore, it wasn’t limited to Europe. Additionally, US health officials started to record an increase in instances of whooping cough. Furthermore, the number of cases in the UK has reached its highest level in twenty years.

The number of cases in Europe had increased by March 2024 compared to the previous ten years (the European Centre for Disease Prevention and Control (ECDC) did not issue numbers before to 2011). In Europe, reports of 32,000 instances were received between January and March of 2024. The ECDC estimates that 38,000 cases of pertussis are reported annually on average throughout Europe. Whooping cough incidences could tenfold rise in 2024 compared to a normal year if the current trend persists.

The bulk of instances in Europe occurred among newborns, a population for which whooping cough can be fatal, according to data from the ECDC’s most recent study on the matter. Ten to fourteen-year-olds accounted for the second-highest reported case group.

Paul Hunter, an English professor of medicine at the University of East Anglia, said DW that these numbers should be regarded cautiously. He indicated there might be more cases than were recorded. Babies are significantly more likely than other demographic groups to be diagnosed with whooping cough because they are at such a high risk of contracting it. It’s possible that a large number of elderly people suffer undiagnosed whooping cough as well.

However, Hunter added that there’s a chance that a similar spread is occurring. According to him, doctors may be more inclined to diagnose cases now that they are aware of whooping cough than they were in the past, which could further skew the statistics.

Use of vaccines during pregnancy

The symptoms of whooping cough initially resemble a cold. A low-grade fever, runny nose, sneezing, and sporadic coughing are possible symptoms for patients. However, after a few weeks of having pertussis, coughing fits that sound like a high-pitched “whoop” may begin. While minor cases might not have the accompanying whoop, the sickness is most severe in youngsters and newborns. Up to ten weeks may pass during this phase.

Say experts, they have no idea why there is a spike in instances. Like most infectious illness outbreaks, this one might be caused by a number of unrelated events happening all at once. It might be the outcome of the consistent drop in pertussis vaccinations given to expectant mothers throughout Europe, in addition to a general reduction in infant vaccination rates. This would provide some insight into the newborns’ situation. If their mothers did not receive a vaccination throughout their pregnancies, the newborns have no defence against whooping cough.

“​​You only start vaccinating children against whooping cough at about eight weeks,” Hunter stated. “And the majority of the most serious illnesses typically occur earlier than that.” The May ECDC report states that rates of pertussis immunisation during pregnancy vary greatly around the European continent. In 2023, 88% of expectant Spanish citizens received a pertussis vaccination. Just 1.6% of people in the Czech Republic, where instances of pertussis have sharply increased, had received the vaccination in the same year. Pregnant women’s uptake in the UK has decreased over the last ten years, going from over 70% in 2016 to roughly 60% in 2023.

The role of COVID
Furthermore, the increase may have resulted from a decline in population-wide immunity following the COVID-19 pandemic, as reported by health experts. The pandemic’s stringent measures to prevent SARS-CoV-2, such as mask use, hand washing, and limiting social interaction in public areas, resulted in historically low levels of flu and strep infections.

Cases have resumed growing since the pandemic’s termination. However, according to Hunter, that is insufficient to account for the sharp rise in whooping cough cases. This is because, before to the pandemic, whooping cough was not a serious illness in the general population. It was uncommon, but it was there. Not the flu, though. In the years after the pandemic, the number of flu cases may have doubled.

vaccination against pertussis

According to specialists, the whooping cough vaccines themselves may be the third potential aggravating reason. Midway through the 20th century, developed nations including the US, Canada, and portions of Europe saw the introduction of the first pertussis vaccination. It has unfavourable side effects despite being incredibly powerful. The ensuing dramatic decline in uptake resulted in outbreaks during the 1970s and 1980s.

Countries started rolling out second-generation pertussis vaccines in the late 1990s and early 2000s. Instead of using a full cell, this new version used an acellular shot. It was somewhat less successful than the first vaccine, providing immunity for a shorter duration, even though it did not cause the side effects.

What should I do next?
According to Andrew Preston, a professor and whooping cough expert at the University of Bath in the UK, the increase in instances raises challenging questions for medical professionals treating whooping cough, as reported by DW. He stated that while using boosters to reduce spread would be a possibility, “it’s not entirely clear how often you can boost without losing effectiveness.”

Or are we content with the current state of affairs, where everyone else only has to occasionally deal with a persistent cough as long as we can prevent newborns from being seriously sick and dying? Preston mentioned that there are pertussis vaccinations available now, some of which have the potential to confer “far superior” immunity in comparison to the two now in use.

But he said that it would be difficult to include these doses into the present immunisation regimen. In the UK and much of Europe, the pertussis vaccination is given in combination with five other vaccines in a single shot; therefore, adding a new vaccine would need redesigning the existing combination vaccine. “You’d have to reformulate all those other vaccines, and that’s just a monstrous task,” Preston added.

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