28 October 2011

Pertussis in Australia – update

Between 1 January and 27 October 2011, 29,586 cases of pertussis (whooping cough) have been notified in Australia, with a peak during August and September [1]. In New South Wales, Victoria and Western Australia, infection rates have exceeded those for the same period in 2010 [1].

The majority of cases have occurred in four states: New South Wales (10,336), Queensland (6,884), Victoria (7,137) and Western Australia (2,086) [2].

Australia has high uptake of pertussis-containing vaccine in their national programme of vaccination of children [3]. However, because of the increased number of pertussis notifications, several states (including Australian Capital Territory, New South Wales, Northern Territory, Queensland and Victoria) are offering a free 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 differ from state to state and may only be available for a limited time. South Australia and Tasmania are not currently running any such programs [4].

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 [5].

A map showing worldwide immunization coverage for diphtheria, tetanus and pertussis, 2010 is available on the WHO website. At least 90% coverage of infants with three doses of a pertussis-containing vaccine is the global target [6].

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 [7]. However, acellular pertussis (as a combination vaccine DTaP) is recommended as part of adult immunisation in some other countries, including Australia [8, 9].

Non-immune travellers visiting affected areas in Australia and who will have close contact with children under 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. Number of notifications of Pertussis, Australia, in the period of 1991 to 2010 and year-to-date notifications for 2011. [Accessed 28 October 2011].  Available at: http://www9.health.gov.au/cda/Source/Rpt_3_sel.cfm

2. Australian Government. Department of Health and Ageing. National Notifiable Diseases Surveillance System. Number of notifications of Pertussis, received from State and Territory health authorities in the period of 1991 to 2010 and year-to-date notifications for 2011.  [Accessed 28 October  2011]. Available at:

http://www9.health.gov.au/cda/Source/Rpt_4_sel.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. Australian Government. Department of Health and Ageing. Immunize Australia Program: Pertussis (whooping cough). 18 May 2011. [Accessed 28 October  2011]. Available at: http://immunise.health.gov.au/internet/immunise/publishing.nsf/

Content/immunise-pertussis

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

6. World Health Organization. Pertussis. 21 June 2011. [Accessed 28 October 2011]. Available at: http://www.who.int/immunization/topics/pertussis/en/index.html

7. 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

8. 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 28 October 2011]. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5517a1.htm

9. The Australian Immunisation Handbook. Pertussis 3.14. Australian Government: Department of Health and Ageing. 9th Edition. [Accessed 28 October  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