The remorseless return of whooping cough

A generation ago officials in the UK were close to eradicating the disease but last week health authorities revealed that it is now more common than at any time in the past 20 years.

The potentially fatal disease is caused by highly contagious bacteria (Bordetella pertussis) spread by coughing. Whooping cough, also known as pertussis, is particularly dangerous for infants who are too young to be fully immunised.

There were almost 1,800 new cases confirmed in England and Wales in the first five months of 2012 (with 700 of these occurring in May alone). This compares with 221 cases in the first five months of 2011 and 136 cases over the same period in 2010.

In 2011, the rise in new cases was primarily seen among adolescents and adults, prompting experts to contemplate a booster campaign for teenagers amid concerns over waning immunity. There has also been some debate about whether pertussis vaccination should be promoted for pregnant women and older people.

This year’s increase has been largely attributed to new cases in infants under three months who are at the highest risk of severe complications and too young to be fully immunised. The UK recorded five pertussis-related deaths in infants between January and May of 2012.

Illness in young infants often follows contact with infected adults, including close family and maternity ward personnel.

Sharp rises in whooping cough cases have also been seen in the Netherlands, New Zealand, Australia and the US. Last month a hospital in Lyon, France, reported an antibiotic-resistant case of pertussis in an 18-day-old infant. The baby survived but had to be hospitalised for one month.