Teenagers may be vaccinated against pertussis after a rise of more than 1000 cases this summer in England and Wales.
The Joint Committee on Vaccination and Immunisation is considering the move after provisional figures from the Health Protection Agency showed that 1047 cases of the disease were reported in July, bringing the total number of cases so far this year to 3523. The July figure is nearly as high as the number of reported cases in the whole of last year, 1118.
The committee is considering introducing a booster dose of the vaccine for teenagers and protecting newborn babies either by vaccinating them and their families or by vaccinating women during pregnancy (or both). There have been six pertussis related deaths in infants up to the end of July, which compares with five in the whole of 2008, when the annual number of reported cases last peaked. The disease is cyclical and peaks every three to four years. There were 902 cases in 2008, 722 in 2009, and 421 in 2010.
The current outbreak is mainly among teenagers and young adults, though the agency has seen high numbers of reports of cases among very young babies, with more than 235 cases diagnosed so far this year in babies under 3 months old. Young infants are at the highest risk of severe complications and death from the disease, because babies do not get vaccinated until they are 4 months old.
There have been 2725 cases among young people aged 15 years or over so far this year, up from 278 over the same period in 2008. Gayatri Amirthalingam, consultant epidemiologist at the agency, told the BMJ in July that immunity conferred by vaccination wanes over time, hence the high number of cases among teenagers and young adults.1
The south east of England has had the highest number of cases so far this year, with 698, the agency reported, then the south west, with 668.
A spokesman for the Department of Health for England said that uptake of vaccination against pertussis was still high and that it was investigating the recent increase in cases. He added: “The Joint Committee on Vaccination and Immunisation is looking at whether more people need to be vaccinated. Careful consideration is always needed around expanding any programme.
“Parents should make sure their children are up to date with all vaccinations and should speak to their GP if they need advice.”
Amirthalingam said: “GPs have been reminded to report cases quickly and been made aware of the HPA’s guidance to help reduce the spread of infection. This improved awareness may be contributing to the increase in numbers of laboratory confirmed cases.”
Journal: BMJ. 2012 Sep 4