Australia is grappling with a surge in whooping cough cases, with 2,799 reported in the first three months of 2024. Queensland and New South Wales are particularly affected, each recording over 1,000 cases.
Why are cases rising now, and what can you do to protect yourself?
Why are cases rising now?
The recent increase in cases is not entirely unexpected. Whooping cough outbreaks typically occur every 3-4 years. During 2020–23, COVID-related measures such as border closures, social distancing, and mask-wearing led to a significant decline in cases. If the usual outbreak cycle had followed, this period would have marked the onset of another outbreak.
However, the decline in routine whooping cough vaccinations during the peak of the pandemic may have left Australians more vulnerable now. This reduced immunity in the population is one factor contributing to the current rise in cases, observed not only in Australia but also in other countries like the United Kingdom and the United States.
Notably, children aged 10 to 14 have been particularly affected by this outbreak.
A potential superbug
Whooping cough bacteria have been evolving over the past two decades, becoming increasingly adept at evading vaccines and antibiotics. While most vaccines used in developed countries target three to five components of the bacteria, mutations in these genes have enabled the bacteria to evade detection by the immune system.
In Australia, a new strain emerged in 2008 that no longer produced pertactin, a key target of the vaccine. This strain quickly became dominant, comprising 90% of strains by 2017. Its ability to survive better in vaccinated individuals may have contributed to the high number of cases during the 2008 outbreak.
Moreover, since 2013, antibiotic-resistant strains of whooping cough have become widespread in China. Although these strains have not reached Australia yet, their emergence poses a concerning threat, particularly considering that certain antibiotics are not recommended for infants under two months, the age group most vulnerable to serious illness from whooping cough.
In light of these developments, it’s crucial to remain vigilant and take appropriate measures to protect oneself and others from whooping cough.
Who is at risk?
Initially, symptoms of whooping cough resemble those of a common cold or flu, including a runny nose, sneezing, mild cough, and fever. However, as the illness progresses into the second week, the coughing fits become more severe and frequent. Patients may gasp for air and produce the distinctive “whoop” sound after or between coughing bouts.
Treatment typically involves antibiotics, which are most effective when administered during the early stages of the illness. However, vaccination offers the best protection against whooping cough, preventing most cases of severe illness and reducing its spread within communities.
Children are typically recommended to receive six doses of a whooping cough vaccine, often combined with vaccines for other diseases, between the ages of approximately two months and 13 years. As immunity from these vaccines diminishes over time, adults, especially those in frequent contact with infants, should receive booster shots to maintain protection.
While it is too early to determine the extent of the current outbreak or the specific strains responsible for a potential outbreak, improved tracking of whooping cough strains, similar to COVID surveillance, is necessary to inform future vaccine development and treatments. Despite bacterial evolution, current vaccines remain highly effective at preventing severe illness and reducing transmission, serving as our primary tool in limiting outbreaks.
Eligible individuals can conveniently schedule their vaccinations at Heathershaw’s vaccination clinic online.
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