Health Protection Scotland (HPS) has noted an increase in reports of pertussis (or whooping cough) in 2012. So far in 2012, HPS has received 150 reports of laboratory confirmed cases, compared to 22 in the same period in 2011. HPS is working with boards across NHSScotland and our counterparts across the UK to manage this increase in cases.
This is consistent with a rise in whooping cough across England and Wales, and also with the generally cyclical nature of whooping cough in the community. Cases of whooping cough tend to increase every three or four years, although the number of cases in Scotland this year exceeds the number reported in the last peak year in 2008.
Young infants are most severely affected by this highly contagious infection and are more likely to develop complications, which can require hospital treatment. Adults and older children may have milder symptoms and are less likely to make the characteristic 'whoop' sound. Very young infants also may not make the 'whoop' sound after coughing, but bouts of coughing can be followed by difficulty breathing.
Early symptoms of whooping cough are much like an ordinary cold and may include a blocked or runny nose; sneezing; watering eyes; a dry, irritating cough; sore throat; slightly raised temperature and feeling generally unwell. These early symptoms can last for one to two weeks and then progress to bouts of coughing which may be followed by vomiting. A 'whoop' sound may be heard at the end of the bout of coughing, though this is not always present.
Dr Martin Donaghy, HPS Medical Director, said: “Whooping cough spreads easily and can be very unpleasant for those affected. Anyone showing symptoms such as severe coughing fits in younger children, which may be accompanied by the “whoop” sound, or a prolonged cough in older children and adults, should consult their GP for advice. Individuals should ensure they practice good “cough etiquette”, such as covering the mouth and nose with a disposable tissue when coughing or sneezing, disposing of this tissue immediately and ensuring good hand hygiene.”
While whooping cough can be treated with antibiotics, vaccination is the most effective way to prevent spread of the disease. Children are offered pertussis vaccine as part of the “5 in 1” vaccine at two, three and four months of age as part of the routine childhood vaccination programme, which also protects against diphtheria, polio, Haemophilus influenzae type b and tetanus. A booster dose of vaccine is given when children are around three years and four months old.
Parents are encouraged to ensure their children are up to date with their routine vaccination schedule to protect themselves and others who they come into contact with, especially younger children. Uptake of this schedule remains high in Scotland, at over 95%.
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Notes to the Editor
Age Breakdown for Laboratory Confirmed Cases of Pertussis in Scotland in 2012 (to 19 April)
- 0 – 4 years: 27
- 5 – 14 years: 28
- 15 – 19 years: 14
- 20 – 59 years: 62
- 60 – 64 years: 5
- 65+ years: 14
- Total: 150
Laboratory Reports and Clinical Notification Data for Scotland
- 2000. Laboratory reports: 86. Clinical notifications: 93
- 2001. Laboratory reports: 79. Clinical notifications: 106
- 2002. Laboratory reports: 109. Clinical notifications: 99
- 2003. Laboratory reports: 50. Clinical notifications: 60
- 2004. Laboratory reports: 48. Clinical notifications: 87
- 2005. Laboratory reports: 59. Clinical notifications: 51
- 2006. Laboratory reports: 54. Clinical notifications: 67
- 2007. Laboratory reports: 62. Clinical notifications: 98
- 2008. Laboratory reports: 117. Clinical notifications: 134
- 2009. Laboratory reports: 118. Clinical notifications: 104
- 2010. Laboratory reports: 82. Clinical notifications: 47
- 2011*. Laboratory reports: 119. Clinical notifications: 88
*NB data for 2011 is provisional at this point
What is the difference between laboratory confirmed cases and clinical notifications?
In Scotland there are two means by which the number of cases of pertussis are counted; notifications and laboratory reports. Clinical notifications are based on the clinical diagnosis of pertussis by a GP or other doctor and do not require the infection to be laboratory confirmed. These are published each week in the HPS Weekly Report. Laboratory reports are based on the laboratory isolation of the bacteria, its detection by molecular methods or the detection of an immune response in a blood sample from the patient.
If there is 95% vaccine uptake, why aren’t more people immune?
Unlike some infections, immunity to pertussis is not lifelong. This is the case with both natural immunity gained after having been infected with pertussis, and immunity gained from vaccination. This is known as waning immunity and does not represent a failure of the vaccine.
More information on pertussis is available on the HPS website
http://www.hps.scot.nhs.uk/immvax/pertussis-whoopingcough.aspx or NHS Inform at http://www.nhsinform.co.uk
Vaccine uptake statistics are available at:
Health Protection Scotland (HPS) is a division of NHS National Services Scotland (NSS), a special health board providing services critical to frontline patient care and supportive of the efficient and effective operation of NHS Scotland.