As many as one in five children who are taken to the GP with a persistent cough could actually have whooping cough, researchers claim today.
This is despite most of the children being fully vaccinated, say Dr Kay Wang of Oxford University, UK, and her team in the British Medical Journal. They explain that whooping cough, or pertussis, is one of the most common vaccine-preventable diseases. It is responsible for almost 300,000 deaths a year in children worldwide.
In the UK, babies are vaccinated against the disease at two, three and four months of age, with a further preschool booster three years afterwards. Uptake has been over 90% since 1992, but immunity from the vaccine may only last for four to 12 years.
The latest study raises questions about additional booster doses of vaccine should be administered as children grow up.
The team set out to estimate the rate of whooping cough in 279 children aged five to 15 years, presenting between November 2010 and December 2012 at 22 general practices in Thames Valley, UK, with persistent cough lasting from two to eight weeks. Those with serious underlying medical conditions were not included.
Of the children, 20%, “had evidence of laboratory-confirmed pertussis infection”, including 18% of those who were fully vaccinated. If the preschool booster vaccine had been given seven or more years previously, the risk of pertussis was over three times higher than for those who had it more recently.
Pertussis can cause “clinically significant cough in fully vaccinated children”, report the authors. They add: “These findings will help to inform consideration of the need for an adolescent pertussis booster vaccination in the UK.”
Wang, K. et al. Whooping cough in school age children presenting with persistent cough in UK primary care after introduction of the preschool pertussis booster vaccination: prospective cohort study. BMJ 25 June 2014; doi: 10.1136/bmj.g3668 [abstract]
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