Published Date: 2000-11-05 23:50:00
Subject: PRO/EDR> Pertussis - Australia (New South Wales)
Archive Number: 20001105.1930
PERTUSSIS - AUSTRALIA (NEW SOUTH WALES)
***************************************
A ProMED-mail post
ProMED-mail, a program of ISID
<http://www.promedmail.org>
See Also
1997----
Pertussis - Australia 19971208.2447
Pertussis - Australia (05) 19971213.2478
Pertussis outbreak - Netherlands (02), response 19971021.2160
Pertussis outbreak - Netherlands, Comment & RFI 19971012.2127
1994
----
Emerging diseases 1993-94 19941003.0038
Date: 2 Nov 2000 21:30:53 +1100
From: Lizz Kopecny <ekopecny@mail.usyd.edu.au>
Source: ABC News, 1 Nov 2000 [edited
<http://www.abc.net.au/science/news/stories/s206624.htm>
First death of baby in NSW whooping cough epidemic
--------------------------------------------------
The Hunter Public Health Unit, in New South Wales, has confirmed a fatal
case of whooping cough in a baby. It is the first confirmed death of a baby
in the epidemic that has ravaged the state since mid-2000. There have been
2 553 cases in New South Wales to the end of October compared to 1 414 in
all of 1999. The New South Wales Health Department is so concerned about
the epidemic that the Chief Health Officer has written to every doctor in
the state advising them to look out for cases that then can be diagnosed,
treated, and kept away from babies.
Whooping cough, or pertussis, is a bacterial infection. It causes
inflammation of the respiratory tract and pertussis toxins paralyze the
hairs or cilia that normally remove secretions from the lungs. Coughing can
be so severe that ribs can break and blood vessels can burst in the brain.
The chronic cough may cause months of sleepless nights. Although babies
under 6 months are the most likely to die from whooping cough, there are
more cases in teenagers and adults.
"About 30% of cases in the Hunter Valley have been among 10 to 19 year
olds," said Mr Malcolm Rea, infectious disease officer, at the Hunter
Public Health Unit. Even though the Hunter Valley has the highest rates of
immunization in the state, the vaccine wears off after 5 to 10 years
leaving adolescents and older adults susceptible to infection and able to
pass it on to babies. Children can only be vaccinated against whooping
cough up until the age of 8 years because of concerns about the possible
side effects of the vaccine beyond this age. Unfortunately, the vaccine
doesn't provide adequate protection against severe disease until after the
third shot at 6 months of age. Earlier fears about potential side effects
from whooping cough vaccine led to many children not receiving the vaccine.
These fears have largely been overcome with the new "purified" acellular
vaccine. "Parents should ensure their children are vaccinated and keep
their babies away from people with coughs. People with coughs should stay
away from babies and visit their doctors to get a diagnosis," warned Dr
Jeremy McAnulty, Communicable Disease Epidemiologist at NSW Health. The
resurgence in whooping cough has been seen in many other countries with
high immunization rates including Israel, Holland, and the United States.
There is evidence that the vaccine may not be as effective as it once was
because the newer circulating strains of whooping cough are changing. Some
countries, such as France, have introduced a booster shot in adolescence.
We do not know when a booster shot may be available for Australians due to
the policy of the Therapeutic Goods Administration in Canberra not to
disclose whether they are considering a particular vaccine for licensing.
--
Lizz Kopecny
<ekopecny@mail.usyd.edu.au>
[Although ProMED-mail does not routinely cover vaccine-preventable
illnesses, it is apparent that pertussis is a re-emerging disease in many
parts of the developed world, despite high vaccine coverage rates. Mooi et
al. (Eur. J. Clin Microbiol. Infect. Dis. 19:174-181, 2000) have recently
suggested that population-based studies of _Bordetella pertussis_ isolates
using more highly standardized typing procedures may be helpful in
understanding the reasons for apparent vaccine failures. It is known that
booster injections of the newer acellular pertussis vaccines administered
to adolescents will stimulate immune responses in those individuals (Minh
et al. Pediatrics 104(6):e70, 1999), but the safety of such practices and
their impact on overall disease control remains to be established. - Mod.ES
......................................es/ds
*##########################################################*
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Visit ProMED-mail's web site at <http://www.promedmail.org>.
Send all items for posting to: promed@promedmail.org
(NOT to an individual moderator). If you do not give your
full name and affiliation, it may not be posted. Send
commands to subscribe/unsubscribe, get archives, help,
etc. to: majordomo@promedmail.org. For assistance from a
human being send mail to: owner-promed@promedmail.org.
############################################################
############################################################