Portugal registered 200 cases of whooping cough in the first four months of 2024, when in the entire previous year it had registered 22, the Directorate-General for Health (DGS) revealed today.
The increase in whooping cough cases also occurred across Europe.
Between the beginning of 2023 and April this year, 10 times more cases of the disease were registered in the countries of the European Union (EU) and the European Economic Area (EEA – plus Norway, Iceland and Liechtenstein) than in 2022 and 2021, indicates a European health agency report released today.
The study by the European Center for Disease Prevention and Control (ECDC) reports nearly 60,000 cases in the EU/EEA in that period, 25,130 in 2023 and 32,037 between January and March this year.
In a written response to Lusa, the DGS states that “the majority of confirmed cases [de tosse convulsa] occurred in pediatric age (86%), mainly in children between 10 and 13 years old (21%) and under the age of 1 year (20%)”.
According to the ECDC, the patients most at risk are babies under six months of age, unimmunized or only partially immunized, and “the majority of hospitalizations and deaths related” to the disease occur “in this vulnerable age group”.
In addition to these, older people and those with health problems also have a higher risk of serious illness and hospitalization.
“During the 2023-24 period, babies (under one year old) were the group with the highest incidence in 17 EU/EEA countries, while in six others it was the group between 10 and 19 years old (…). Most deaths occurred in babies.”
In a statement, the European agency points out that whooping cough continues to be a public health problem, as the disease is “endemic in the EU/EEA and around the world and causes significant epidemics every three to five years, even in countries with high vaccination coverage”, as is the case in Portugal.
In 2023, said the DGS, “vaccination coverage of the 5th dose of combined vaccine against tetanus, diphtheria and whooping cough reached 95% and it is estimated that 85% of eligible pregnant women will have been vaccinated”.
“The increase in the number of whooping cough cases across Europe shows the need to be vigilant. It is a serious disease, especially in babies”, says the European Commissioner for Health, quoted in the ECDC statement.
Stella Kyriakides recalled that there are “safe and effective vaccines” to prevent the disease and that “vaccination is the main tool to help save lives and prevent the disease from spreading further”.
According to the report, the increase in whooping cough cases, which occurred after a few years of limited circulation of the disease in the EU/EEA, especially during the covid-19 pandemic, may be linked to a series of factors, such as epidemic peaks expected, unvaccinated individuals or those who do not have up-to-date vaccines and the decrease in immunity and natural reinforcement in the general population during the pandemic.
The European health agency recommends that countries reinforce vaccination programs and maintain high vaccination coverage.
Furthermore, he adds, immunization against whooping cough during the second and third trimesters of pregnancy is highly effective in preventing illness and death among newborns.
Most EU/EEA countries now recommend this maternal immunization in addition to the routine childhood vaccination program.
The ECDC also advocates increasing the “awareness of health professionals about the epidemiological situation of whooping cough in their geographical area” and knowledge about the disease, the continuation of “whooping cough surveillance”, as well as ensuring the capacity to the early detection, diagnosis, response and control of outbreaks.
“Information about whooping cough should highlight that this is a highly transmissible disease and that it is necessary to protect children”, says the study.
The Directorate-General for Health says it maintains “permanent monitoring of the national and international epidemiological situation, adapting its actions to the risk for the Portuguese population”, adding that “at the beginning of May it sent an alert to the ULS [Unidades Locais de Saúde]private and social sector hospitals and health authorities”.
Among the public health measures to be applied, the DGS called for “the testing of possible or probable cases of whooping cough, based on nasopharyngeal secretions”, warning of the “need to vaccinate all pregnant women who meet eligibility criteria”.
Whooping cough is transmitted through droplets of saliva expelled by sneezing or coughing and through contact with objects containing the patient’s secretions, with the period of contagion being most intense in the first week in which symptoms appear.
