In winter 2023, an unexpected surge in whooping cough (pertussis) cases emerged across Europe. This concerning trend extended beyond Europe, affecting the US and reaching the UK’s highest levels in two decades. By March 2024, Europe reported over 32,000 cases, a dramatic increase from the yearly average of 38,000, according to the European Center for Disease Prevention and Control (ECDC).
Infants, the most vulnerable group, accounted for the majority of cases. Children aged 10-14 followed. Paul Hunter, a professor of medicine at the University of East Anglia, cautioned that actual numbers might be higher due to underreporting among older individuals and increased diagnostic awareness among doctors.
Early symptoms of whooping cough resemble a common cold, including runny nose, low-grade fever, sneezing, and mild cough. Severe coughing fits with a distinctive “whoop” can develop, particularly in children and infants. The disease can last up to 10 weeks, with serious implications for infants who lack early protection if their mothers were not vaccinated during pregnancy.
Several factors contribute to the rising cases. A decline in vaccine uptake among infants and pregnant women is notable. Pertussis vaccination rates during pregnancy vary significantly across Europe. For instance, in 2023, 88% of pregnant individuals in Spain were vaccinated, compared to only 1.6% in the Czech Republic. In the UK, rates dropped from 70% in 2016 to 60% in 2023.
The COVID-19 pandemic also played a role. Pandemic protocols like mask-wearing and reduced public mixing lowered flu and strep cases but may have contributed to decreased population immunity to pertussis. However, Hunter noted this alone doesn’t fully explain the tenfold increase in whooping cough cases, unlike the more modest rise in flu cases.
Another factor is the pertussis vaccine itself. The original mid-20th-century vaccine was highly effective but had significant side effects, leading to reduced uptake and subsequent outbreaks. The late 1990s saw the introduction of an acellular pertussis vaccine, which had fewer side effects but provided shorter immunity.
The rising whooping cough cases pose complex questions for public health officials. While protecting infants remains a priority, finding effective strategies to curb the spread among older populations is crucial for long-term disease control.
