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Complacency Putting Kiwi Infants at Risk - Experts

Complacency Putting Kiwi Infants at Risk - Experts

Health experts are warning thousands of Kiwi infants could be exposed to whooping cough this summer; with new research showing many adults are complacent or fail to understand how to prevent the spread of the disease.1

The warning comes as health officials declare a nationwide outbreak of whooping cough with over 1300 New Zealanders contracting the disease since the beginning of 2017.2

Whooping cough (pertussis) is a potentially deadly illness for babies especially caused by the bacterium Bordetella pertussis, one of the most contagious diseases affecting the human population.3,4

Dr Helen Petousis-Harris, Senior Lecturer, Dept General Practice and Primary Health Care of the University of Auckland, says worryingly Kiwis are failing to understand how easily the disease can be transmitted, as evident in the latest study.1

The research found that almost all (96%) respondents had heard of whooping cough however less than two-thirds (61%) were aware that it is possible for adults to pass on whooping cough to infants.1

Only a quarter of respondents said they were vaccinated for whooping cough and had received a booster shot. A further 29% said they had been vaccinated but had not had a booster and almost half (46%) of NZ adults were unaware whether they were vaccinated or had received a booster against whooping cough.1

Dr Petousis-Harris says the lack of awareness about the vulnerability of young infants among Kiwi adults is putting the health of our most vulnerable at risk.

“Whooping cough is one of the most contagious diseases. It's a tricky disease and one that puts a lot of stress on the public health system. It is critical that babies and pregnant mothers are immunised to provide a viable defence to the disease” she says.4

Dr Petousis-Harris says adults are also at risk of complications including rib fractures, weight loss, urinary incontinence and fainting from severe coughing.7

In addition to high numbers of children catching whooping cough, the disease can be devastating for the elderly with those aged over 70 having the second highest percentage of hospitalisations next to children aged under one.8

“Whooping cough is a highly contagious disease, which can have devastating consequences for infants including; pneumonia, seizures, brain damage and death,” she says.3,4,7

Research estimates over seventy percent of infant cases are passed on by parents and close contacts.5,6 The NZ Ministry of Health Immunisation Handbook notes that immunisation is recommended (but not funded) for these groups to help protect babies who can’t be fully vaccinated until they are six months old.4 Mums-to-be can get immunised free during pregnancy, so that they can pass their protection on to their babies for their first weeks of life.4

Paediatric Intensivist at Starship children's hospital Dr Anusha Ganeshalingham, says there is nothing more distressing as a physician than to treat a child with a disease which can easily be vaccinated against.

Dr Ganeshalingham says during the last outbreak in 2011-2013, 38 children were admitted to Starship PICU with whooping cough – and two children died.9

“It is really distressing for our team when we are unable to save these babies and to see the absolute terror and then grief that the parents have to endure and also the guilt they can feel when their baby dies from what is essentially a preventable illness” she says.

She says in addition to the impact on families, it costs over $42,000 to treat each child in paediatric intensive care who contracts a severe form of the preventable disease.9

“The children may need to be transported from around the country on specially equipped helicopters and aircraft flights before being treated by a team of specialists” she says.

During the 2011–2013 epidemic there were 572 hospital admissions at an estimated cost of $4.2 million.9

Both experts warn parents of the importance of being up-to-date with their immunisations before travelling this holiday season and also asking other family members and friends to check they have been vaccinated before coming into contact with newborn babies.

“We advise parents to also watch out for the symptoms of whooping cough among infants which may include a high temperature, runny nose, sneezing, and coughing that progresses to coughing fits followed by a characteristic whoop. Eating or drinking may trigger a coughing fit and cause vomiting, or the infant can stop breathing”.3,10

“Adults may present with just a persistent cough lasting months - which can make it harder to diagnose - if in doubt see your healthcare provider as soon as possible” says Dr Ganeshalingham.4


Footnotes:

1. GSK Research. Report on the Public understanding of whooping cough survey. October 2017. WISE Boostr002068.

2. Ministry of Health. National outbreak of whooping cough declared. Dec 2017. Available at: https://www.health.govt.nz/news-media/media-releases/national-outbreak-whooping-cough-declared. Accessed 08/01/2018.

3. Immunisation Advisory Centre. Pertussis (Whooping cough)- fact sheet for parents and caregivers. Available at: https://www.immune.org.nz/sites/default/files/DiseasePertussisImac20130226V04Final_0.pdf Accessed 08/01/2018

4. Ministry of Health. Immunisation Handbook 2017. Wellington: Ministry of Health; 2017.

5. Wendelboe AM et al. Pediatr Infect Dis J. 2007;26:293–99.

6. Zepp F et al. Lancet Infect Dis. 2011;11:557–570.

7. CDC Pertussis – Clinical complications 2017. Available at: http://www.cdc.gov/pertussis/clinical/complications.html Accessed 08/01/2018.

8. Institute of Environmental Science and Research Limited. Monthly Notifiable Disease Surveillance Report – Nov Dec 2017. Available at: https://surv.esr.cri.nz/PDF_surveillance/PertussisRpt/2017/PertussisReport8December2017.pdf Accessed 8/01/2018

9. Ganeshalingham A et al. NZMJ. 2016.129;1445:76-82.

10. Immunisation Advisory Centre – Pertussis. Available at; https://www.immune.org.nz/diseases/pertussis Accessed 8/1/2018.

ends

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