The 100-day cough and those most at risk

According to a report from the UK Health Security Agency (UKHSA), 8 infants have died from whooping cough since the beginning of 2024. This highlights the seriousness of the disease in children under 6 months. Almost 5000 cases of whooping cough (pertussis) have been confirmed during this period.

These deaths are largely preventable by vaccinating pregnant mothers in the third trimester. Booster doses should also be given to those most likely to be in close contact with the child (father, grandparents, other relatives and friends). This practice has been called “cocooning”. A dose of the pertussis vaccine results in a surge of antibodies in the mother. These antibodies cross the placenta to provide protection for the baby for a few months (the most vulnerable period).

Vaccinating close contacts reduces the risk of transmission.

What is the whooping cough vaccine in Australia?

The whooping cough vaccine is a combination vaccine which includes tetanus and diphtheria. There isn’t a vaccine which has pertussis only. In Australia it is called the triple antigen or dTpa. The 2 commonly used vaccines are Adacel and Boostrix. The pertussis component might also be provided in a combination vaccine which includes polio (Adacel polio or Boostrix IPV). Travellers are often recommended to update their tetanus prior to travel, and this would update their whooping cough as well.

It is important to check with travellers whether they might have received a whooping cough vaccine in the recent past as this would mean their tetanus is also current. An expatriate worker might be recommended to have a one-time adult polio booster if working in a risk area for polio (wild polio or vaccine associated polio) and this might be given as a combination vaccine (tetanus-diphtheria-pertussis-polio) or as a single polio vaccine (IPOL).

Travellers from the UK might have had a DTP (Revaxis) before traveling or as a teenage booster. This does not include pertussis. The “P” is for polio.

Does whooping cough vaccination of pregnant women make a difference?

A consensus statement for vaccination in pregnancy was published on behalf of the Global Pertussis Initiative (GPI) in 2022. It highlighted several studies which demonstrated a vaccine effectiveness between 69 and 93% for laboratory confirmed pertussis infection, 91-94% for hospitalisation and 95% for mortality in infants under 2 months in high income countries. It also showed the benefits in a few middle-income countries including Brazil and Argentina.

The GPI was initiated in 2001 to raise global awareness on pertussis. Its main focus is on evidence-based interventions to reduce morbidity and mortality related to the disease.

Is whooping cough a notifiable disease in Australia.

Yes. It has been notifiable since 1991.

How many cases of whooping cough have been reported in Australia in 2024?

Over 9,000 cases of whooping cough have been reported in the past 12 months (to 26 May 2024). It is almost double the 5-year average which includes the pandemic years.

Of major concern is the large increase in the last quarter as compared to the 5-year average for the quarter. This is up almost 5 times. A rise in whooping cough cases was flagged in April.

Should travellers be vaccinated for whooping cough?

It would be sensible to be current for both whooping cough and tetanus when travelling. This can be covered with one vaccine (Australia has Adacel, Boostrix).

It is estimated that more than 24 million people are diagnosed annually worldwide with more than 160,000 deaths, mostly in children under 5 years.

How effective is the whooping cough vaccine?

The vaccine provides good protection in the first 12 months (> 90%) - great for travellers and pregnant women – but this protection lessens over 5-10 years.

How else can I reduce my risk of whooping cough?

Whooping cough (Pertussis) is transmitted by droplets. It passes from one person to another by coughing and sneezing (airborne via close contact) and via hands from objects. It is very infectious, but much can be done to reduce spread.

Where can I get a whooping cough vaccine?

The vaccine is widely available through pharmacies and general practice.

It is available free to eligible pregnant women (those with a valid medicare card) under the national immunization program (NIP). In Australia, it is generally given between 20 and 32 weeks of pregnancy.