Infant whooping cough concern

By Caroline Price

The ongoing increase in whooping cough cases has extended to very young babies, reports the Health Protection Agency (HPA), prompting further efforts to step up the immunisation programme.

The overall number of cases has continued to rise, with a further 675 cases reported in June, bringing the total for the year so far to 2,466 - more than double the total for the whole of 2011. In addition, there have now been 186 cases in infants under 3 months this year, which compares with 72 during the same period last year and 84 when the last peak occurred, in 2008.

The HPA said it is considering recommendations from the Joint Committee on Vaccination and Immunisation (JCVI), which has put forward a number of proposals to tackle the outbreak.

These include the option of giving babies their first DTaP/IPV/Hib jab earlier than usual, at 6 weeks of age, rather than delaying the start of immunisation if parents are unable to bring them to an appointment at 8 weeks. Data suggest that a significant proportion of infants receive their primary immunisation late, with approximately 20% not having their first dose by 10 weeks of age.

The JCVI is also calling on the Department of Health to hold discussions with the BMA and RCGP on ways to encourage GPs to clear waiting lists and actively advocate timely immunisation of infants. One barrier to timely immunisation may be the capping of clinic appointments by practice IT systems, according to the JCVI's June meeting minutes.

Other proposals for increasing immunisation include the vaccination of healthcare staff working with neonates, introduction of a booster dose of pertussis vaccine in teenagers and offering the vaccine to pregnant women.

Dr Mary Ramsay, head of immunisation at the HPA, said the Agency is working closely with the JCVI to "consider the most effective ways to tackle the ongoing outbreak".

"In the meantime we are actively reviewing our cases to see what interventions could have the quickest impact on the spread," she added.

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