13 January 2012

Pertussis in Australia – update

Since 2009, the number of cases of pertussis reported annually in Australia has been increasing. During 2011 a total of 37,880 cases of pertussis (whooping cough) were notified in Australia, an increase of more than 3,000 cases compared to 2010. In New South Wales, Victoria and Western Australia, infection rates have exceeded those for the same period in 2009 and 2010 [1].

The majority of cases in 2011 occurred in four states: New South Wales (12,930), Queensland (8,819), Victoria (8,568) and Western Australia (3,763 [2].

Australia has high uptake of pertussis-containing vaccine in its national programme of vaccination of children [3]. However, because of the increased number of pertussis notifications, several states (including New South Wales, Queensland,  Western Australia and Victoria) are offering a targeted vaccination programme for unvaccinated children and some adults . Adults who are recommended to receive vaccine include parents of newborn infants, grandparents and others who have household contact with babies. Criteria for free vaccination for adults differ from state to state and may only be available for a limited time.

Pertussis

Pertussis is a highly infectious disease caused by the bacterium Bordetella pertussis; it is transmitted through the respiratory route. In addition to Australia, other countries that routinely have high coverage for pertussis vaccine have seen an increase in cases in older children, adolescents and adults in recent years [4].

A map showing worldwide immunization coverage for diphtheria, tetanus and pertussis, 2010 is available on the World Health Organization website. At least 90% coverage of infants with three doses of a pertussis-containing vaccine is the global target [5].

Risk for travellers

Primary and reinforcing doses of pertussis vaccine are routinely recommended for all children under the age of 10 years in the UK. The pre-travel health consultation is an ideal opportunity to ensure that the British schedule of vaccinations is up to date.

In the UK, pertussis-containing vaccine is not generally recommended for children over the age of 10 years or for adults [6]. However, acellular pertussis (as a combination vaccine DTaP) is recommended as part of adult immunisation in some other countries, including Australia [7, 8].

Non-immune travellers visiting affected areas in Australia and who will have close contact with children less than 12 months of age should practise routine respiratory precautions such as good hand hygiene and avoiding persons known to be infected. Long-term travellers to risk areas can consider receiving a pertussis-containing vaccine formulated for adults and adolescents at their destination.

References

1. Australian Government. Department of Health and Ageing. National Notifiable Diseases Surveillance System. Notifications of a selected disease by month: Pertussis. [Accessed 13 January 2012].  Available at: http://www9.health.gov.au/cda/source/Rpt_3.cfm

2. Australian Government. Department of Health and Ageing. National Notifiable Diseases Surveillance System. Notifications of a selected disease by state, territory and year: Pertussis.  [Accessed 13 January 2012]. Available at: http://www9.health.gov.au/cda/source/Rpt_4.cfm

3. World Health Organization. Immunization profile – Australia. 1 June 2011. Available at:  http://apps.who.int/immunization_monitoring/en/global

summary/countryprofileresult.cfm?C=aus

4. World Health Organization. Pertussis position paper; 2010; 1 October; 40(85):385-400. Available at: http://www.who.int/wer/2010/wer8540.pdf

5. World Health Organization. Pertussis. 21 June 2011. [Accessed 13 January 2013]. Available at: http://www.who.int/immunization/topics/pertussis/en/index.html

6. Salisbury D, Ramsay M, Noakes K (Eds.). Pertussis Ch.24. Immunisation against infectious disease 2006. Updated chapter 8, April 2011. Available at:  http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalasse

ts/@dh/@en/documents/digitalasset/dh_125944.pdf

7. Centers for Disease Control and Prevention. Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2006; 55(RR03):1-34. [Accessed 13 January 2012]. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5517a1.htm

8. The Australian Immunisation Handbook. Pertussis 3.14. Australian Government: Department of Health and Ageing. 9th Edition. [Accessed 13 January 2011.] Available at: http://www.immunise.health.gov.au/internet/immunise/

publishing.nsf/Content/Handbook-pertussis

Links

Health Protection Agency - Whooping Cough (Pertussis)

World Health Organization. Pertussis vaccines: position paper 2010