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Infectious Pertussis, commonly known as whooping cough, reached its highest incidence in over two decades following a frightening epidemic in the prior year, according to official data. Health authorities attribute the unprecedented surge in England to COVID-19 lockdowns, which sparked a sharp rise in pertussis infections, nicknamed the ‘100-day cough’ due to its persistent nature.
Pertussis Cases Surge Post-Lockdown
Nearly 15,000 instances were documented in 2024—17 times higher than the total number recorded throughout 2023. Tragically, eleven infants perished, marking the deadliest outbreak in a decade. All affected babies were under three months old.
Monitoring and Vaccination Efforts
While cases began to decline after May, infection levels remained elevated for the rest of the year, necessitating vigilant oversight, as per UK Health Security Agency (UKHSA) officials.
Health experts also appealed to expecting mothers to receive the pertussis vaccine amid declining jab rates post-pandemic—a trend attributed to growing vaccine hesitancy.
Early Symptoms and Diagnosis
Initially, whooping cough presents symptoms similar to a common cold, typically characterized by a runny nose and sore throat. However, within about a week, patients may develop protracted coughing episodes lasting several minutes, difficulty breathing after coughing, and a distinctive ‘whooping’ sound between coughs.
Additional signs of pertussis include expelling thick mucus, which can induce vomiting, and facial redness.
2024 Pertussis Statistics
According to UKHSA surveillance reports, there were 14,894 laboratory-confirmed cases in 2024, compared to 856 in 2023. Pertussis cases peaked in May and June, with 3,034 and 2,419 reported, respectively—constituting more than a third of the annual total.
Age GroupDistribution
Over half (58.8%) of the cases were among individuals aged 15 and above, with nearly one-fifth (18.2%) in children aged 10 to 14.
However, infection rates remained high among infants under three months, who are most vulnerable as they are too young for full vaccination.
Infectious whooping cough spreads at a rate comparable to measles.
Public Health Recommendations
UKHSA officials are urgently working to boost vaccination rates and encourage expectant mothers to get inoculated.
The vaccine protects newborns in their initial months of life when they are most susceptible and before they can receive their own vaccinations.
Current Vaccination Rates
However, only a quarter of pregnant women in some London regions have received the pertussis jab, offered between 16 and 32 weeks, with rates below 50% in other parts of the capital and Birmingham.
Vaccination during pregnancy is essential for passively protecting infants until they can benefit from the infant vaccine program.
The UKHSA advises pertussis vaccination in every pregnancy, ideally around 20 weeks but no earlier than 16 weeks. Before the pregnancy jab roll-out in 2012, dozens of infants died annually from pertussis. Since then, only 32 fatalities have been recorded as of 2024, with all but six of the mothers being unvaccinated.
Antibiotic Treatments: What GPs Should Know
If a whooping cough case is suspected, general practitioners (GPs) can prescribe one of four antibiotics: clarithromycin, erythromycin, azithromycin, or co-trimoxale. Children typically need liquid formulations of the medication, dosed based on their weight rather than standard tablets.
While antibiotics may not alleviate symptoms, they are crucial as they render patients non-infectious within 48 hours, aiding in curbing the bacterial infection’s spread.
However, if infection has persisted for an extended period, antibiotics will not accelerate recovery.
Whooping cough is a cyclical disease that typically reaches its peak every five years. The last peak occurred in 2016, with nearly 6,000 confirmed cases.
Prior to the pandemic, between 2,500 and 4,500 suspected cases were reported annually, dropping to around 500 during the COVID-19 crisis.
Lockdowns curtailed pathogen transmission as social interactions decreased. According to UKHSA officials, the COVID-19 pandemic’s impact has led to diminished population immunity, echoing resurgence patterns seen with flu and respiratory syncytial virus (RSV).
However, current infection rates are far below the annual peak of 170,000 recorded in the 1940s. Pertussis is caused by Bordetella pertussis bacteria spread through coughing and sneezing.
Individuals become contagious around six days post cold-like symptom onset, remaining infectious up to three weeks after coughing begins.
While less severe in older children and adults, whooping cough can still cause rib pain, hernias, ear infections, and urinary incontinence in these age groups.