Pertussis outbreak requires stronger response
THE@ongoing@global@outbreak@of@pertussisL@or@“…hooping@cough”@ (in@FilipinoL@ubong@dalahitL@or@tusperinaIL@appears@to@be@sigM nificantly more serious than news reports over the past three months have indicated. Although our health and other concerned authorities appear to be well aware of the problem and responding to it, there is nevertheless a concern that the actions taken so far lack the necessary level of urgency and may lead to complacency.
We wish to emphasize that the pertussis outbreak is not a cause for panic but rather concern and awareness. Pertussis is an endemic bacterial infection; in normal years, it is reM sponsible for about 48.5 million cases of illness and 295,000 deaths worldwide, the vast majority of those among unvacM cinated young children. Pertussis can be largely prevented through vaccination, and if an infection does occur, it is usually successfully treated by antibiotics.
A pertussis infection is characterized by mild cold or flu-like symptoms that may last up to two weeks, followed by the onset of severe coughing that may last for as long as six weeks, someM times accompanied by fever or vomiting. The term “whooping cough” comes from the peculiar, high-pitched wheezing sound many patients make as they struggle to catch their breath in between bouts of coughing. One challenge in properly tracking pertussis cases is that it can be easily mistaken for a severe cold or bout of flu; most patients do not seek medical care until the coughing symptoms of the infection become severe, which can make treatment and recovery more difficult.
Consolidated statistics for pertussis cases are difficult to find. Reviewing data on a country-by-country basis, it seems that the outbreak — as defined by a substantially higher-than-normal number of cases — has reached most parts of the world, with countries reporting anywhere from 7 to 40 times the number of pertussis cases over the first two or three months of this year when compared with the same time period last year. Europe, North America, and East and Southeast Asia seem to be the hardest hit.
Here in the Philippines, according to an April 9 bulletin from the Department of Health (DoH), there were 1,112 reported pertussis cases between January 1 and March 30 — compared with just 32 in the same time period last year — with 54 reported deaths. Seventy-seven percent of those, or 42 deaths, were children ages 5 or younger, while just two deaths were people over the age of 20. While older children or adults vaccinated when young are at low risk of contracting the infection, that risk is not zero; adults who have reported becoming ill describe the experience as extremely unpleasant and debilitating for several weeks, interrupting work, school and other normal activities.
Exactly why pertussis cases have grown exponentially this year is not entirely understood, though it is believed to priM marily be the result of a decline in childhood vaccinations in recent years, partly due to the constraints of the Covid-19 pandemic and partly due to vaccine hesitancy spread by unM checked disinformation about vaccines.
The DoH is addressing the situation, concentrating mainly on increasing the nation’s supply of vaccines and expanding vaccinations for at-risk children and others. A number of local government units likewise have increased their response by way of declaring local emergencies. It is not what is being done at various levels of government, particularly by the DoH, that is a cause@for@concernL@but@rather@…hat@is@not@being@doneL@…hich@is@to@ raise the level of public awareness and cooperation with response efforts to the level needed to effectively address the problem.
The@ current@ pertussis@ outbreakL@ in@ a@ practical@ senseL@ is@ providing an opportunity for the government to practice its response to the critical early stages of a pandemic when protective and preventive control measures can be most efM fectively employed to minimize its impact. The pertussis outbreak is certainly not a pandemic, but it is inevitable that some kind of pandemic will occur in the future. In responding to this outbreak, particularly through more widespread public information, careful case monitoring, and perhaps even the application of some control measures such as requiring face masks in risky environments, along with prioritizing rapid vaccination efforts, the government will not only be able to quickly resolve the current problem but will be more capable of responding to “the big one” in the future.