Pertussis outbreak: High Health Authority recommends vaccination to protect toddlers

Based on data from Public Health FranceHowever, the number of reported cases of pertussis has increased in recent years. Circulation of the bacterium, which was very high in the first half of 2024, has been increasing in recent weeks. The High Authority for Health (HAS), seized by the Ministry of Health, published on July 22, 2024 a press release warning about the situation and calling for strengthened vaccination recommendations.

What is pertussis?

Pertussis is a contagious respiratory disease caused by the bacterium ‘Bordella pertussis’. It manifests as frequent, prolonged coughing fits. It is estimated that an average of 15 to 17 people in the family or community may be infected by a person who is ill.

This contamination is carried out by the air in contact with the patient by droplets coming from the nose or from the mouth during coughing or by postillons during speech.

Contagiousness begins as soon as rhinitis appears and is maximal during the first week of cough. It lasts 3 weeks without treatment but only 5 days after effective antibiotic therapy is started.

The disease can sometimes become severe in certain frail people:

• pregnant women;
• persons suffering from immunosuppression;
• older people;
• infants under 6 months of age. In infants not yet protected by vaccination, whooping cough can be particularly severe, leading to complications such as pneumonia, seizures and hospitalizations, as babies under 3 months of age are routinely hospitalized.

If you or someone close to you has respiratory symptoms, wear a maskespecially if you are around infants or vulnerable people. In addition to vaccination, it is recommended to adopt protective measures to prevent the spread of contagious diseases, especially during the summer.

What are the emergency situations to consult?

Seek medical attention as soon as possible and contact the emergency department if needed for the following:

• your infant under 3 months of age coughs;
• during coughing spells, the ends of your child’s fingers and around his or her mouth become bluish;
• your child stops breathing even for a short time, or the fits make breathing difficult or fast;
• your child appears lethargic (sleepy);
• has seizures (body movements that cannot be stopped) or malaise;
• refuses to drink, vomits, and shows signs of dehydration;
• has a high fever;
• he seems weak to you.

What are the vaccination recommendations?

The HAS recalls that the vaccination recommendations aim primarily to reduce the risk of severe illness in newborns and infants too young to be protected by their own vaccination. HAS considers that, in the current epidemic context, linked to the major Olympic and Paralympic Games, the most effective strategy remains pertussis vaccination, as planned in the vaccination schedule:

• pregnant women from the second trimester of pregnancy, with a focus on the period between 20 and 36 weeks of amenorrhea, to protect the newborn and infant up to 6 months of age through active transplacental transfer of maternal antibodies;
• infants with the first dose as early as 8 weeks, regardless of whether the mother was vaccinated during pregnancy, and the second dose at 4 months, with a booster at 11 months. Minor infections (e.g. nasopharyngitis, otitis, bronchitis or mild diarrhea) and/or low grade fever should not result in the postponement of vaccination.

If pregnant women are not vaccinated during pregnancy, a cocooning strategy with vaccination should be implemented:

• for the mother immediately postpartum, before discharge from the maternity ward, even if she is breastfeeding;
• for those around the newborn (parents, siblings, grandparents, and others who may have close and long-term contact with the infant during the first 6 months of life). A booster dose for close contacts of the newborn/infant may be given if the last injection was given more than 5 years ago.

Recall in adolescents and adults

A booster vaccination is recommended between the ages of 11 and 13 years for adolescents.

A booster vaccination at 25, 45 and 65 years of age is recommended for professionals in close contact with newborns and infants under 6 months of age (health care professionals, including in institutions for dependent elderly people - EHPAD); or if the last booster vaccination was given more than 5 years ago.

A booster vaccination at 25, 45 and 65 years for other health care professionals is recommended, especially for:

· health care professionals in maternity, neonatal and pediatric services;

· community health professionals (liberal physicians, physiotherapists, IMPs, etc.);

· medical and paramedical students;

· early childhood professionals including maternal assistants;

· regular babysitting.