The United Kingdom Health Security Agency (UKHSA) is closely monitoring a recent increase in respiratory infections, particularly among children, with a focus on pertussis, commonly known as whooping cough. This highly contagious bacterial infection is characterized by prolonged, severe coughing fits and poses a significant health risk, especially for infants. As of 29 January, 2024, 636 pertussis cases have been documented in the UK. While initial symptoms resemble a common cold, the persistent cough lasting weeks or months earns it the nickname “100-day cough.” Infants under six months and new-borns face the highest risk of complications, including hospitalization and even death.

Despite ongoing vaccination efforts, data from England and Wales reveals a worrying rise in whooping cough cases. This highlights the crucial role of immunization in controlling the spread of this potentially life-threatening respiratory illness. In light of these developments, increased public awareness, adherence to preventative measures, and renewed commitment to vaccination programs are essential, particularly for safeguarding vulnerable populations.

Impact of Whooping Cough on the UK

• As of 29 January 2024, Wales emerged as the most affected area in the UK, recording 135 cases, followed by the North West (101 cases), London (86 cases), South East (85 cases), Yorkshire and the Humber (61 cases), and North East (49 cases). Other regions, including the East of England, East Midlands, South West, and West Midlands, also report disease activity.
• This surge represents a nearly ten-fold increase compared to the 28 cases reported by general practitioners during the same period in 2023. The escalating trend is underscored by the fact that the entire year of 2023 saw 1,728 suspected cases, tripling the figures from both 2022 (560) and 2021 (527).
• The top five council areas with the highest infection rates are all located in Wales, led by Swansea (18 cases), followed by Pembrokeshire (16), Cardiff (15), Flintshire (15), and Rhondda Cynon Taf (14). In England, Liverpool records the highest number of infections (12), followed by Leeds (11).

Facts on Whooping Cough:

Incubation Period:

• Whooping cough manifests an incubation period of 7 to 10 days, during which the bacterium Bordetella pertussis establishes itself in the respiratory system.

Symptoms:

• Initial symptoms mimic a common cold, progressing to severe coughing fits with a distinctive whooping sound during inhalation.
• Intense coughing episodes may lead to vomiting and exhaustion, posing risks of complications, especially in infants.

Transmission:

• Highly contagious, whooping cough spreads through respiratory droplets and can persist on surfaces, contributing to indirect transmission.
• Infants and young children, particularly in communities with low vaccination rates, face heightened susceptibility.

Security Arrangements

Severity:

• Severity varies, with infants and young children at a higher risk of complications, including hospitalization and life-threatening outcomes.
• Potential complications encompass pneumonia, dehydration, and breathing difficulties, necessitating prompt medical attention.

Treatment and Vaccination:

• Antibiotics, such as macrolides (e.g., azithromycin), are prescribed early in the infection to reduce symptom severity and duration.
• To prevent further spread, individuals receiving antibiotics should refrain from work and other outdoor obligations until 48 hours after starting treatment.
• Antibiotics are most effective within the first 3 weeks of illness, and beyond this period, their efficacy diminishes.
• Vaccination is a crucial preventive measure, along with routine schedules for infants and young children, booster shots for adolescents and adults, and special attention to pregnant individuals. Pregnant women are advised to get vaccinated during each pregnancy to pass protective antibodies to newborns.
• In households with pregnant women or young babies, antibiotics and vaccination may be offered to protect them if symptoms started within 21 days.
• It’s essential to ensure all babies and children under the age of 10 are up to date with vaccinations and, in specific settings like boarding or special needs schools, to contact the health protection team in case of a diagnosis.
• Falling vaccine uptake levels, particularly in pregnant women, babies, and young children, emphasize the importance of vaccination during pregnancy (between 20 and 32 weeks) to passively protect new-borns and catching up on missed vaccinations at the earliest opportunity.

Recommendations

For Organisations:

• Enforce health protocols in the workplace: sanitization, mask usage, and distancing if applicable.
• Adapt policies as per health authority and government guidance, whenever recommended.
• Assess remote work options to reduce in-office staff if case trajectory goes up.
• Conduct awareness sessions against the spread of influenza and mycoplasma pneumoniae for employees.
• Encourage all employees to get a seasonal flu vaccine.
• Approve work-from-home option for employees if symptomatic.

For Individuals:

• Maintain distance from infected people. Wear masks if needed.
• Ensure good ventilation.
• Practice proper hand hygiene. Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcoholbased hand rub.
• Exercise caution and consider avoiding non-essential travel, especially if experiencing symptoms of respiratory illness. Stay informed about travel advisories and follow health guidelines issued by UKHSA for safe travel practices.
• Clean and disinfect all surfaces that are regularly touched.
• Individuals with suspected or confirmed flu or other respiratory illness should return to the office only when considered medically fit.