Whooping Cough Cases Should We Be Worried

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Under the National Immunisation Programme, children ought to receive four vaccine shots by the time they are 18 months old. (Freepik pic)PETALING JAYA: A recent emergence in cases of pertussis, more commonly known as the whooping cough, has raised public concern about a potential outbreak of the disease in the country.
Last week, the Pahang health department confirmed three new cases in Rompin, Pahang, involving a mother and her two children.
Just three months earlier, 76 cases were detected in Sabah, with one fatality, compared to just seven and no fatalities in the same period last year.
Ads by KioskedHealth director-general Dr Radzi Abu Hassan dismissed talk of an outbreak and reassured Malaysians that the ministry is on top of things. Still, concerns persist over the disease.
FMT takes a closer look.
What is pertussis? 
Whooping cough is a disease caused by Bordetella pertussis, a bacterium which can be spread through the air when an infected person sneezes or coughs.
Its early symptoms usually include a runny nose, mild fever and a mild cough, which may last between one and two weeks, according to Dr Eg Kah Peng, a consultant paediatric respiratory physician at the Universiti Malaya Specialist Centre.
Eg said patients may at a later stage develop violent coughing fits that may last for up to 10 weeks. In some cases, they may also experience respiratory distress and other complications, including pneumonia, seizures, inflammation of the brain (encephalopathy) and even death.
Ads by KioskedYoung infants are particularly at risk of experiencing apnoea, which is when they suddenly stop breathing for 20 seconds or longer, Eg said.
Former deputy health minister Dr Lee Boon Chye said while whooping cough can affect people of all ages, unvaccinated infants and children are susceptible to a higher risk of infection.
Although uncommon, it can also be fatal, he said.
The present situation in Malaysia 
According to Radzi, as of Aug 19, a total of 329 whooping cough cases and 23 deaths have been reported this year. In the same period last year, a total of 697 cases were reported.
Out of the 329 cases, Sabah recorded the highest number of cases at 181, followed by Selangor (51), Kuala Lumpur and Putrajaya (15), Pahang (13), Perak (13), Melaka (12), Negeri Sembilan (12), Johor (9), Sarawak (8), Kelantan (7), Kedah (3), Terengganu (3), Penang (1) and Labuan (1).
Ads by KioskedInfants under 12 months formed the age group with the highest number of cases (189, or 57.4%), while 94 cases (28.6%) involved those aged one to 10.
In April health experts quoted in a report by The Star suggested that the high number of cases in Sabah may be due to the large number of unvaccinated migrants in the state.
Prevention is better than cure 
Whooping cough is usually treated with antibiotics.
The Centers for Disease Control and Prevention (CDC) says that although whooping cough is treatable, it is vital that patients receive treatment early. According to the US public health agency, prolonged illness of three weeks is likely to damage the body.
“When you get treated early, it also reduces the disease transmission rate and the chance of developing serious complications,” Eg told FMT.
Ads by KioskedNonetheless, she said the most effective measure against whooping cough is vaccination. Under Malaysia’s National Immunisation Programme (NIP), children routinely get four doses of the vaccine – administered when they are aged two, three, five and 18 months.
Under the NIP, these children receive a combination vaccine, known as Hexaxim (DTaP-IPV-HepB-Hib), which also provides immunisation for five other infectious diseases, namely diphtheria, tetanus, polio, Hepatitis B, and Haemophilus influenza type B.
However, Eg said the efficacy of the vaccine fades with time, usually lasting up to 10 years.
“It’s not a lifelong vaccine. Some studies show that it wanes after five years, so the protection rate is not the same as when it was given,” she said.
Eg recommends that adults get a booster vaccination (Tdap) every 10 years. Pregnant women are also advised to receive a Tdap shot during the third trimester so immunity can be passed on to their newborns for the first months of their lives.
Meanwhile, Lee said the health ministry should look into the possibility that some adults may not have been vaccinated. He said the NIP should be reviewed, if necessary, to provide for it.
Ads by Kiosked“Is there a problem with the implementation (of the programme)? It should not have been a big public health issue,” he said.
Last week, Radzi said the health ministry’s immediate priority is to ensure the whooping cough immunisation coverage among children in the country exceeds 95%.
‘No reason to panic’ 
Despite the recent cases, Lee said there is no reason to push the panic button.
“It’s not a big problem because first of all, it is treatable. Number two, we should have a very high population immunity for whooping cough because most of us have gone through the vaccination programme.
“The risk of widespread infection of whooping cough is extremely unlikely.”
Ads by KioskedEg urged members of the public to practice good respiratory hygiene etiquette, by covering their nose and mouth when sneezing and coughing. They should also seek medical help immediately should they experience any symptoms, she added. - FMT

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