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Vaccinate your child, Western Cape health department urges as whooping cough cases rise

Cape Town – The Western Cape Department of Health said it had picked up an increase in pertussis cases, commonly known as whooping cough, in the province.

According to the department, since January 408 cases had been reported in the country and 230 of these were in the Western Cape, most of them since September.

It said these laboratory-confirmed cases were probably only a small representation of the true number of cases in the community.

Pertussis is a vaccine-preventable disease, but young babies are most at risk of becoming severely ill from pertussis as they are too young to be immunised – the first pertussis immunisation dose is given at six weeks of age.

The department confirmed that seven babies under the age of 2 months had died from pertussis in the Western Cape this year.

“Pertussis is a highly infectious disease that affects the respiratory tract. It is caused by the bacterium Bordetella pertussis. Persons who are not immune to the bacterium through vaccination or previous infection can get pertussis at any age.

“However, some individuals such as infants and young children who are not vaccinated or partially vaccinated are at higher risk for infection and those with severe disease are at an increased risk.

“Individuals with a weakened immune system and those with chronic lung disease are also at high risk for severe disease,” the department said.

How does it spread?

Pertussis spreads from person to person through respiratory excretions when an infected person coughs or sneezes and an individual inhales the bacteria.

During the early stages, pertussis is highly transmissible.

What signs and symptoms should you look out for?

There are a wide range of symptoms which may vary from person to person.

The department said the onset of the disease was gradual and it could be mild or severe.

Symptoms usually appear 7–10 days after exposure, however, onset can range from 5–21 days.

The first symptoms signs are similar to those of the common cold and may include: nasal congestion, runny nose, mild sore throat, mild dry cough and minimal or no fever.

Days later the cough may become more severe and is characterised by paroxysms – which usually increase in frequency and severity as the illness progresses – followed by a whooping sound and/or vomiting after coughing.

This paroxysmal cough may last a month or two.

The department said in babies the cough could be insignificant or not present at all.

Babies might stop breathing and develop a bluish discolouration of the skin.

Adults and adolescents who have previously been vaccinated may present with minimal symptoms such as a sore throat or a persistent cough.

How is this diagnosed?

A medical practitioner collects a specimen from the back of a patient’s throat (this will be done through the nose) or by collecting sputum from a cough and sends the specimen for laboratory testing.

Treatment

The health department said antibiotics have shown to be an effective form of treatment in reducing the infectious period.

How can whooping cough be prevented?

Pertussis can be prevented by immunisation.

In South Africa, the Expanded Programme on Immunisation (SA-EPI) schedule includes four doses of acellular pertussis vaccine.

The primary series is given in three doses at six, 10, and 14 weeks of age in combination with other immunisations.

The fourth dose (booster) is given at 18 months.

“To protect those that are too young to be vaccinated, it is important that particularly the family members and close contacts of pregnant women or small infants have these routine immunisations up to date.

“When a case of pertussis is diagnosed, close contacts (persons with face-to-face exposure, including health-care workers) of the patient should receive antibiotic prophylaxis regardless of age or vaccination status with erythromycin for seven days, or azithromycin for five days,” the health department said.

It said containment measures were in place at its health-care facilities as part of standard infection control to limit the risk of infection. This included isolating the infected, wearing masks and giving antibiotic prophylaxis to close contacts.

“While we have several prevention measures in place, we call on all caregivers to be vigilant of the signs and symptoms. Should they pick up any of the symptoms in their children, they should take them to their nearest health facility immediately.

“Over the next few weeks, we will be coming into contact with many more people than usual. During this time there is also the risk of many bugs circulating. It is crucial that we continue protecting our personal space through good hand hygiene practices,” the department said.

It advised people who were not feeling well to protect others by avoiding social gatherings or wearing a mask when in contact with other people.

robin.francke@inl.co.za

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