Whooping cough resurgence ‘highly concerning’ say experts

The disease’s return coincides with a drop in vaccinations, as expert says “we can expect more deaths unless we improve vaccination rates in the mother and the infant”

The UK is experiencing one of the biggest outbreaks of whooping cough for many years, with five infant deaths reported in England during the first three months of the year.

According to data published by the UK Health Security Agency (UKHSA), cases continue to rise, with 1,319 confirmed in March. This brings the total number of confirmed cases during the first quarter of 2024 to 2,793.

Whooping cough is a cyclical disease that tends to peak every three to five years and cases have been rising since December 2023. The last cyclical increase occurred in 2016 and it is thought the pandemic delayed its resurgence.

The disease’s return has likely been exacerbated by a decline in the vaccinations that protect against whooping cough. Michael Head, Senior Research Fellow in Global Health, University of Southampton said: “Vaccine coverage has dropped in recent years. Maternal vaccine uptake was 70% in 2017, but only 58% in 2023.

“The percentage of children vaccinated by their first birthday dropped slightly from around 93% just prior to the pandemic to 92% in 2022-2023. A similar drop (from 85% to 83%) is seen with the booster dose children can have prior to their fifth birthday. This may be contributing to the current outbreak.”

Dr Gayatri Amirthalingam, Consultant Epidemiologist at UKHSA said: “Vaccination remains the best defence against whooping cough and it is vital that pregnant women and young infants receive their vaccines at the right time.” 

Women are offered the vaccine during pregnancy, which passes protection to the baby so that they are protected in the first months of their life when they are most vulnerable. Babies are then given further doses leading up to the pre-school booster.

Dr Amirthalingam said: “Whooping cough can affect people of all ages but for very young babies it can be extremely serious. Our thoughts and condolences are with those families who have so tragically lost their babies.”

“Whooping cough is preventable, so this outbreak shows once again the paramount importance of engaging with vaccination programmes.” 

Professor Kamila Hawthorne, Chair of the Royal College of GPs, described the situation as ‘highly concerning’. She said: “Patients who have a weakened immune system, are very young or elderly, can experience serious symptoms, including breathing difficulties, rib fractures, vomiting and gastric distress, due to heavy prolonged coughing. 

 “Whooping cough is preventable, so this outbreak shows once again the paramount importance of engaging with vaccination programmes.” 

Professor Sir Andrew Pollard, Director of the Oxford Vaccine Group at Oxford University said: “Whenever we see a rise in cases, I am very concerned about the risk to babies and we have already seen infants in intensive care across the country this year and several deaths.

“Vaccines are our only defence against this disease and I am afraid that we can expect more deaths unless we improve vaccination rates in the mother and the infant. The outbreaks of both whooping cough and measles this year are the inevitable consequence of under-vaccination and should be a loud warning that the health of our children is at risk."