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An increase in cases of whooping cough in Spain has triggered the Andalusian Health Service (SAS) to ramp up its vaccination process. The Carlos III Health Institute announced this week that in the second quarter of 2023 a young baby died from the disease.
Paediatrician Marta Garín (@dragarinpediatra) pointed out whooping cough is vaccinated in Andalucía at two, four, 11 months and six years of age. "The usual practice is to vaccinate as these ages, but it is envisaged that in situations of outbreaks we can bring the vaccination forward or carry out a more extensive vaccination," she said. There are also plans to give extra doses of vaccine to children under seven years of age who have had their last dose more than four years ago. "These are special measures that are taken in cases of outbreaks," she added.
Currently, what is known is that children who turn six years old in 2024 can already be vaccinated. To reinforce this, health centres are calling for parents of children of this age (born in 2018) to go through the inoculation process now.
Pertussis (whooping cough) is an endemic respiratory infection with epidemic outbreaks occurring on a cyclical basis. The disease is highly contagious and is transmitted by close contact with an infected person through coughing or skin contact.
This Monday it was made public that a baby died last year from whooping cough in Spain - his mother had not been vaccinated. The death was revealed in an epidemiological report on the situation of whooping cough in Spain in 2023. The study, prepared by the National Epidemiology Centre (CNE), part of the Carlos III health institute, details that 2,560 cases of whooping cough were reported in 2023, with an incidence of 5.6 cases per 100,000 inhabitants. Most cases occurred in the paediatric age group (71.5% in children under 15 years of age), with the 10 to 14 age group accounting for 36.3% of total cases.
The Andalusian association of family and community nursing, Asanec, said whooping cough has been in a sustained epidemic since 2010 in Spain. According to data from the Carlos III institute, since 2011 an average of 4,000 cases per year have been declared, with a maximum peak between 2014 and 2019. The report published by the National Epidemiology Centre, which analyses the period between 2005 and 2020, reports a total of 43,534 cases of whooping cough, recording 10,281 hospitalisations (82.7% in children under three months of age). As for the data for Andalucía, SUR can confirm from sources in the ministry of health that in 2023 there were 175 cases, compared to just four in 2022.
These sources said Covid-19 made whooping cough, which has now returned, almost disappear. By way of comparison, in 2019 (before the pandemic), Andalucía recorded 286 positive cases of whooping cough.
Dr Garín pointed out that the immunity of the whooping cough vaccine is not eternal, and this is something that the population is sometimes "unaware of". "It is estimated that immunity drops from three to four years post-vaccination and disappears between four and seven years of age. That is why it seems interesting to recall the vaccine six years after the last dose (around 12-14 years of age), as the peaks of incidence of this disease are grouped into two age groups: infants and adolescents. This would prevent greater disease and transmission in this group of adolescents," she added.
Vaccination
The paediatrician described whooping coughs a "particularly serious" disease in infants under four months of age, and concerning in infants under 12 months of age and which, in general, does not usually cause major problems in infants older than this age. "With infants under four months we are lucky that they benefit from the vaccination of pregnant women in the last trimester of gestation... that will last for about six weeks, so we protect them until the baby receives its first dose of vaccine," she said.
However, she considers it "vital" to limit the contact of children under three to four months, to take special care in gatherings where there are children with symptoms or sick adults, and to limit kissing. "As terrible as it sounds, we should not kiss them," Dr Garín said. "Let's remember that 80% of whooping cough cases in this age group are spread through contact in the home," she added.
In these cases, the situation can be worrying, as practically all children under three to four months of age with whooping cough will require hospitalisation, as will most children under seven months of age. "The cases we are seeing are 80% under 15 years of age, correctly vaccinated and with a mild case," the doctor said. "Andalucía has very high vaccination rates, 95% in children and 90% in pregnant women. So, yes, a call for calm and also for common sense: let's continue to vaccinate and avoid kissing infants," she said.
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