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Parents of new babies should have whooping cough booster

Experts say vaccination could prevent fatal form of whooping cough in babies

OnMedica staff

Friday, 28 November 2008

Experts have called for all parents of new babies and other household members to be considered for a booster vaccination, according to an article published today on the BMJ’s website.

Paediatric intensive care doctors at the Royal Hospital for Sick Children in Edinburgh said this could be the most effective way of preventing the fatal form of whooping cough in young infants.

The infectious disease of whooping cough (pertussis) affects infants and young children and vaccination is usually given to infants at two to four months of age, with a further booster after three years.

Evidence, however, is growing that the incidence of pertussis is rising in adolescents and adults and infectious adults within a family are the main source of infection for unimmunised infants.

In an article in the BMJ, doctors form the Royal Hospital for Sick Children reported two fatal cases of invasive pertussis in unvaccinated young infants.

In the first case, a one-month old boy came to hospital with a five-day history of cough, runny nose and difficulty feeding. Both parents, and an elder sibling, reported coughing spells with vomiting in the previous two weeks.

The sibling was fully vaccinated. There was no record of the parents’ childhood vaccination status but the mother received a pertussis booster in 1986.

The child was transferred to intensive care, but despite maximum therapy, died within 24 hours.

In the second case, a six-week old girl came to hospital with a five-day history of cough and breathlessness. Her mother had a persistent cough for more than two weeks. The mother had received all her childhood immunisations including pertussis, there was no record of the father’s pertussis immunisation status.

The child died within 30 hours despite maximum therapy. The patient’s mother subsequently tested positive for pertussis infection.

The authors said these cases demonstrated the devastating course of invasive pertussis in young infants.

Pre-vaccination infants now accounted for the majority of pertussis-related complications, hospitalisations and deaths and most infants caught the disease from affected household members, with parents accounting for more than half of the cases.

Several countries, including the USA and Australia, have introduced booster doses for adolescents and adults, while France and Germany also recommend a targeted booster for parents and healthcare workers in contact with young children.

The doctors concluded the best solution was to prevent infection so the introduction of an adult booster or more targeted vaccination of household contacts of young infants should be considered.

A Department of Health spokesperson said the Joint Committee for Vaccination and Immunisation (JCVI) looked last year at the possibility of introducing a booster vaccination against whooping cough for adolescents and parents of young babies.

“The Committee decided not to recommend any changes to our current whooping cough immunisation schedule but to continue monitoring the situation carefully,” he said.

DOI:10.1136/bmj.39575.715787.80

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