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Video: Whooping Cough Enters A New Round
Whooping cough enters a new round
Scientists are sounding the alarm because of the decrease in population immunity from "childhood" diseases. Following measles, whooping cough infection "raised" its head, the pathogens of which are actively circulating among children and adolescents, and the incidence is growing every year. According to experts, the inclusion of a repeated revaccination against whooping cough in the National Calendar could stop the spread of infection.
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Scientists are sounding the alarm because of the decrease in population immunity from "childhood" diseases. Following measles, whooping cough infection "raised" its head, the causative agents of which are actively circulating among children and adolescents, and the incidence is growing every year. According to experts, the inclusion of a repeated revaccination against whooping cough in the National Calendar could stop the spread of the infection.
What is whooping cough?
Pertussis is an acute infectious disease caused by the bacterium Bordetella pertussis. Once in the human body, it multiplies rapidly and releases a toxin that affects the respiratory tract. The disease is accompanied by bouts of spasmodic cough, which is extremely dangerous for young children. Pertussis is especially dangerous for children in the first months of life, among whom there is the highest mortality rate from this infection. Infants often have attacks of holding and stopping breathing, pneumonia, atelectasis, convulsions, and acute encephalopathy develop. However, in older children, whooping cough can be difficult, complicated by pneumonia, heart failure (in severe pneumonia), otitis media, collapse, hernias, rib fractures.
The probability of contracting whooping cough through contact with a patient is 90%. The main measure for the prevention of pertussis infection is specific preventive vaccination.
The problem of an increase in the incidence rate was discussed at the All-Russian meeting "Unresolved Issues of Pertussis Epidemiology in the Russian Federation and New Opportunities for Its Vaccine Prevention". According to the epidemiological data announced at the meeting, in 2015 the incidence of whooping cough in Russia increased by 36.8%. At the same time, a significant number of cases of the disease - 37.9% fell on children aged 7-14 years. In 2016, the upward trend in morbidity continued - the number of registered cases increased by 27.4% compared to 2015.
In the first half of 2018, the incidence rate has more than doubled compared to the same period last year. Such indicators indicate another cyclical rise in this infection (and not only in Russia), experts say. And also about the active circulation of the causative agent of pertussis infection and maintaining the level of bacterial carriers among adolescents.
Moreover, official epidemiological data may not reflect the real picture of the incidence. So, according to the chief epidemiologist of the Ministry of Health of the Russian Federation, head. Department of Epidemiology and Evidence-Based Medicine of the Sechenov University of Nikolai Briko, the traditional cultural method for diagnosing whooping cough is not sensitive enough, and serological and PCR methods are still very limited. In addition, the true incidence of whooping cough in children of preschool and primary school children is underestimated due to the prevalence of mild and erased forms of the disease.
Meanwhile, as noted by Briko, for specialists, the increase in the incidence of whooping cough in recent years has not come as a surprise. The reason for this was also a decrease in population immunity predicted by experts and a decrease in the immune layer 5-7 years after the initial routine DPT vaccination. Similar conclusions were reached at the St. Petersburg Federal Budgetary Scientific Institution of Epidemiology and Microbiology. Pasteur, where the state of post-vaccination immunity to whooping cough was studied in children aged 3-15 years. Specialists drew attention to the fact that the proportion of children with signs of a previous infection increased on average 6-7 years after the last vaccination.
The infectious disease doctors see a way out of this situation in the subsequent revaccination against whooping cough, which is currently not provided for in the Russian National Vaccination Calendar. Routine DPT vaccination (diphtheria, whooping cough, tetanus) is given to children three times, starting at three months of age, with revaccination one year after the last dose. However, revaccination at an older age concerns only diphtheria and tetanus. And this is despite the fact that, as explained by the head of the Department of Prevention of Infectious Diseases of the Federal State Budgetary Institution Children's Research and Clinical Center for Infectious Diseases of the FMBA of Russia, Professor Susanna Kharit, post-vaccination immunity to the infectious agent begins to decline within 1-3 years after vaccination.
And how abroad?
According to a review of international experience presented at the meeting, routine revaccination against whooping cough in children aged 4-6 years is included in the national calendar of preventive vaccinations in 51 countries (including the USA, Canada, most of the EU and a number of CIS countries). The third revaccination at the age of 9-17 is carried out in 39 countries. And monitoring for pertussis infection obtained from these countries shows that after the first revaccination, the incidence among children 4-10 years old significantly decreases, and due to the epidemiological effect - in infants.
And this is one of the strongest arguments of infectious disease specialists for revaccination. The fact is that infants receive the first dose of the vaccine at the age of three months at best. Immunity to the disease develops gradually after receiving the next dose of the vaccine, so in the first months of life, children are not protected from the disease. In this regard, in a number of countries (in particular, in England, in Israel), vaccination of expectant mothers in late pregnancy has already been introduced.
What to do?
Experts insist on the need for compulsory revaccination of Russians at six and 14 years old, and from 18 years and older - every 10 years (as they are now vaccinating against diphtheria). Adequate immunization of the population can help save thousands of children and adults, experts say. But the expansion of the National Calendar will require additional funding, especially since the DPT vaccine cannot be used for children over six years old, a less reactogenic (and more expensive) acellular vaccine is needed.
Russian epidemiologists have more than once applied to the Ministry of Health with a request to include revaccination against whooping cough in the National Calendar, but so far there is no information about the department's response.
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