December 2017

Immunisation critical to prevent whooping cough

The early stages of a national whooping cough (pertussis) outbreak, means it’s critical pregnant mothers are immunised in the last three months of their pregnancy and that babies have their first immunisation at six weeks old and on time, says Lakes DHB Paediatrician Dr Johan Morreau. 

Johan Morreau says babies under one year are most at risk of serious complications from whooping cough including death, brain damage and severe pneumonia. Whooping cough results in a seriously debilitating cough which can last for three months and causes significant distress for babies and families.

“Those who get the sickest are our new born babies. That’s why it’s so critical pregnant mums are immunised. This produces antibodies which pass across the placenta and help protect the baby until they receive their first whooping cough immunisation at six weeks.”

Johan Morreau says epidemics occur around every three to five years. If not enough people are immunised there is no herd immunity to stop diseases going through the community and the disease resurges.

“The reality is if we don’t ensure herd immunity by ensuring everyone is fully immunised on time, babies will continue to die from diseases like whooping cough. All of this is preventable if people are immunised properly.”

As a young doctor working in the United Kingdom at a time when whooping cough immunisation rates were at a significant low (late 1970s), he saw two very young babies come to hospital having died during their coughing bouts.

“The babies coughed themselves to death and we couldn’t save them. Fortunately death is uncommon, but while more often just a mild illness in older children and adults it can be very serious, particularly for the very young. There can be significant complications as well as a distressing 100 day cough which is awful for babies and their families. It’s a horrible disease. If anyone is in any doubt they should look at the videos on the Ministry of Health site showing a baby that’s got whooping cough and the horrible coughing they experience.”

See http://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/whooping-cough/whooping-cough-stories

There has been an increase in the number of whooping cough cases in our area and across New Zealand this year. From 1 January 2017to 1 December 2017, there have been 122 cases of whooping cough (pertussis) notified locally to the Medical Officer of Health. Of these, 38 have been in the Lakes DHB area (Rotorua/Taupo and Turangi) and 84 cases have been in the Bay of Plenty. For Bay of Plenty and Lakes districts there have been 11 hospitalisations of individuals with pertussis since January (to the 30th of November). Ten of the 11 hospitalised cases were young children (under the age of 15 months). This highlights the importance of immunisation to prevent pertussis infection recommended for pregnant women (between 28-38 weeks), and the importance of immunisations for infants at six weeks, three months, and five months of age.

Nationally, from 1 January–10 November 2017, a total of 1315 cases of whooping cough were notified around the country. Of these cases, 82 were babies aged less than one year old. Half of these babies were hospitalised.

Whooping cough is a highly infectious and distressing illness caused by bacteria that are spread through the community by coughing and sneezing, in the same way as colds and influenza. Symptoms start with a runny nose, fever and dry cough. Coughing gets worse over the next few weeks developing into attacks of coughing and sometimes vomiting. The ‘whoop’ sound occurs as a baby draws a breath after a long coughing attack.

The most effective way to protect babies is for their mother to be immunised during pregnancy (between 28 and 38 weeks) so that antibodies are passed on to the baby. These antibodies will help reduce the likelihood of the baby becoming ill with whooping cough before their first immunisation at six weeks.

Johan Morreau says it is really important that babies get that first immunisation on time and further childhood immunisations are required at three months, five months, four years and 11 years to ensure ongoing protection.

If you are worried about your baby, for free advice phone Healthline on 0800 611 116, or see your GP.

If you’re not sure if you or your family members are up to date with immunisations, please contact your family doctor to check.

For more information visit http://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/whooping-cough