Deadly whooping cough
BY Brian Johnston body+soul
Find out how to keep your family safe from the new whooping cough epidemic in Australia.
Whooping cough, properly known as pertussis, is a respiratory infection caused by bacteria and transmitted by an infected person who sneezes, coughs or even just talks. This is why it can spread so quickly among family members or schoolchildren.
Thanks to mass immunisation programs, pertussis cases in Australia fell to extremely low levels in the 1970s and 1980s, but have since been steadily rising and now average about 10,000 cases a year. The last five years have seen a significant increase in cases.
And while whooping cough epidemics aren't unusual, Australia is now experiencing a significant spike in numbers. Seven babies have died from the illness in the past two years. In Victoria alone, the 1300 infections since January are more than double the number for the same period last year. Sadly, one in 200 infected babies dies of pertussis.
"Although we have whooping cough epidemics every few years, this latest [has lasted] longer than usual," Dr Nicholas Wood, from the National Centre for Immunisation Research & Surveillance, says.
"It's probably a reflection of waning immunity in children. Also, a new test called PCR allows GPs to better diagnose pertussis, so we can now diagnose more cases."
One of the other reasons for the current epidemic may be that fewer parents are having their children immunised against whooping cough.
"There was a theory in the 1970s that the whooping cough vaccine caused encephalopathy, or brain damage," explains Dr Robert Menzies, from the Sydney Medical School at the University of Sydney. "Large studies found that, if there was a risk, it was very small. In any case, we now use a completely different vaccine, and it has been found to have no association with brain damage."
Not just kids affected
While many think of whooping cough as a childhood illness, Dr Menzies says only about five per cent of cases occur in children under the age of two. However, whooping cough is especially significant in babies and young children, as symptoms can be serious, with life-threatening complications.
"The youngest infants, who are either too young to be vaccinated or who haven't finished the vaccination course, are most likely to end up being hospitalised," Dr Wood says.
The concern is that many recent cases have been in adults aged between 35 and 55, which has formed a reservoir of infection in an age group which is currently raising children.
Whooping cough can be treated with antibiotics, but a debilitating cough can persist for weeks. Prevention is better than cure, and routine childhood vaccination is the best way to combat whooping cough, according to the Immunise Australia Program.
Babies should be vaccinated at two, four and six months, with a booster when they are four years old. Another vaccine is required for teenagers, which lasts into early adulthood.
Even though the vaccine prevents 85 per cent of cases – so there is a possibility you could contract the infection after being vaccinated – leaving a child unimmunised is playing with life and death, says Dr Ronald McCoy, spokesman for the Royal Australian College of General Practitioners.
He also suggests boosters for some adults because the vaccine doesn't give immunity for life and you can contract the disease more than once.
"Research shows most babies catch whooping cough from an adult who doesn't have an up-to-date booster," Dr McCoy says. "Prospective parents and parents of newborns, and all those coming into contact with newborn children, should be vaccinated."
How the vaccine works
The vaccine contains purified components of pertussis bacteria that stimulate the immune system to create antibodies against whooping cough.
"The vaccine can't infect you and cause disease," Dr Menzies explains. "But when the real bacterium arrive, your immune system 'remembers' the bugs, and attacks and kills them."
Minor side effects of the vaccine and boosters may include a temperature, nausea, pain, or redness and swelling at the injection site. Extremely infrequent side effects include significant pain in the arm or severe allergic reactions.
"An overwhelming amount of information highlights the safety of these vaccines," Dr McCoy says. "Reactions to vaccines are very rare, almost always minor and far less risky than leaving a person unimmunised to this deadly disease."
Learn how to protect your family from whooping cough.
Read our fact sheet on whooping cough.
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