Babies and Whooping Cough

 

 

Whooping cough is a terrible disease in babies

and it is the under-1 year-olds that are the most severely affected with nearly 1% of the infected dying from it.

The incubation period is between 4 – 21 days and during this time it is highly contagious with up to 80% of the unvaccinated catching it.

The main reservoir of infection is in adolescents and young adults (whose personal immunity has worn off). But for all of us (even if we get the native infection) the antibody level (hence our immunity to the disease) wanes over a couple of years.

The horrible disease is that of a lung infection with thick sticky mucus. After a few days of a ‘cold-like’ illness, the bouts of coughing start. Such is the irritation of the mucus and the difficulty in coughing it up, the patient can cough hard and repeatedly, emptying their lungs of air, before a violent inhalation causes the characteristic ‘whooping’ sound (pronounced ‘hoop’, by the way).

Adults have been known to break a rib or rupture a disc in the neck with the violence of the coughing fit.

Babies however most often just present with stopping breathing (‘apnoea’), and when they contract the infection, they can get many complications including pneumonia, seizures, brain swelling and even death.

How can we protect our vulnerable babies?

Since the late 1990’s we’ve had the acellular vaccine which is remarkably safe and effective. Unfortunately it doesn’t generate enough antibodies in babies under 6 weeks of age. To protect them after

Meningococcal type B: An effective vaccine at last!

A new meningococcal vaccine was approved by the TGA last year.  This month the Australian Technical Advisory Group on Immunisation has put out a recommendation about it. The present meningococcal vaccine already on the immunisation schedule is effective against serotype C, but this one is effective against the much more common serotype B.

The Disease:

Invasive meningococcal disease (IMD) is a really nasty disease and is the leading cause of meningitis and septicaemia globally. It tends to affect the under 5 year age group (with another peak in adolescence) and particularly attacks infants. The incidence in the under 1 year olds is 14 cases per 100,000 population and 5.8% of these babies die. Not only that, in the survivors over a third of them have long term effects, either brain damage or even amputation of limbs. Though often occurring in epidemics, there is always an incidence of the disease lurking in the background.

The vaccines

The present vaccine available on the schedule is very effective against the serotype C and the incidence of disease from that has fallen to very low levels since its introduction in 2003 (45 disease notifications in NSW in 2003, down to 2 in 2012). Serotype B (MenB) however remains at about 45 notifications a year.

Bexsero® is a recombinant (i.e. manufactured, no live components) vaccine that contains a number of components that induce antibodies in the recipient that can attack parts of the germ. It appears to be effective against about three quarters of the MenB strains around. It has been tested

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