Published Date: 2012-01-11 16:01:24
Subject: PRO/EDR> Pertussis - Australia: (WA)
Archive Number: 20120111.1007036
PERTUSSIS - AUSTRALIA: (WESTERN AUSTRALIA)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Tue 3 Jan 2012
Source: IEWY News [edited]
The Department of Health [of Western Australia] is encouraging parents of young children to be aware of the symptoms of whooping cough and to ensure their families' vaccinations are up-to-date.
A total of 3597 cases of whooping cough have been reported to the Department up to 23 Dec 2011, compared to 1458 cases for the whole of 2010. Director of Communicable Disease Control Dr Paul Armstrong said notifications in Western Australia peaked at 704 cases for the month of November 2011, and although there now appeared to be some decrease, whooping cough activity in the community remained high.
"WA's last whooping cough epidemic was in 2004, and we have been overdue for a big year, which typically occurs every 3-4 years," Dr Armstrong said. "The increase in WA is consistent with whooping cough activity in other states in recent years.
"Whooping cough affects people of all ages, but the rise in infections is particularly concerning for children under 6 months of age, in whom infection can be very severe and even life threatening." There have been 4 deaths associated with whooping cough in babies in the past 4 years in WA.
[Byline: Linda Campbell]
ProMED-mail from HealthMap Alerts
[It is not clear how many of the cases in 2011 have occurred in the high risk group, infants under 6 months of age. The commonest complications of pertussis infection, especially in young infants, include apnea, pneumonia, and weight loss secondary to feeding difficulties and post-coughing vomiting. Seizures and death also occur. Other complications include difficulty sleeping, pneumothorax, nose bleeds, subconjunctival hemorrhage, intracranial hematoma, rectal prolapse, urinary incontinence, and rib fracture. The overall complication rate of pertussis is 5-6 per cent, but among infants younger than 6 months, the complication rate can be 3-4 times that number.
Recommendations on the use of "cocooning" acellular pertussis vaccines in the USA have been developed in an attempt to expand protection in susceptibles to prevent the substantial morbidity and mortality in infants who have not been yet adequately immunized. The now recommended use of the vaccine in pregnant women further expands these recommendations.
The increasing susceptibility in older children and adults to pertussis, usually manifesting as chronic cough without the typical "whoop," after appropriate primary immunization continues to be increasingly reported. Waning immunity is generally thought to be the cause of the problem, but other issues may be at work. - Mod.LL
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