There is a cough that pediatricians tell me makes babies feel very sick. What is deeply worrying is that some very young babies have died as a result. The cough is whooping cough or whooping cough.
It is a disease that can be prevented or its effects reduced through vaccination.
But recently there has been an increase in cases: you may have heard people complaining about the 100-day cough. I had it (and ended up in A&E when I couldn’t breathe) and wrote about it for Mail Online.
Since January, there have already been 8,015 medical notifications (whooping cough is a notifiable disease) and 2,041 laboratory-confirmed cases, compared to just 207 (i.e. an increase of around 3,800 percent) and 30 respectively on the year passed during the same period.
In January and February of this year alone there were 52 cases of babies under three months old with whooping cough; On the contrary, during all of last year there were only 48 cases.
Riley Hughes (pictured with his mother Catherine) was healthy when he died of whooping cough at just 32 days old in 2015.
And these figures may be a significant underestimate, since people with mild illness may not see a doctor.
“We’re seeing a huge number of whooping cough cases at the moment,” Dr Liz Whittaker, a pediatric consultant and honorary clinical professor in the department of infectious diseases at Imperial College London, tells me.
Pediatric intensive care units have “response capacity” for whooping cough and measles, which means there are many cases.
Dr Ronny Cheung, consultant pediatrician at the Royal College of Paediatrics and Child Health, adds: “There’s no doubt we’ve seen a lot more of this on wards and in A&E in recent times.” “My suspicion is that we are probably still underestimating the true prevalence at this point.”
While adults describe it as the worst cough they’ve ever had (it causes difficulty breathing, incontinence, and even rib fractures), it can be fatal in babies. “Mortality is one death in every 100 in the under-three-month category,” says Dr. Whittaker. ‘We don’t see this in other age groups.
“In addition to coughing, which is quite intense, they can stop breathing.”
Their white blood cells also increase, sometimes reaching very high levels, “causing blockage of blood vessels and leading to heart failure,” adds Dr. Whittaker.
The surge in cases has already claimed the lives of babies too young to receive the vaccine.
The UK Health Security Agency (UKHSA) reported the death of a baby in the last quarter of 2023. But my colleagues have informed me of other deaths that do not yet appear in the official figures.
Whooping cough is a highly infectious bacterial infection, but children under three months old are most at risk because they are too young to be vaccinated.
The first dose of pertussis vaccine is usually given at two months, so pregnant women are offered the vaccine between 16 and 32 weeks, as antibodies cross the placenta and protect the baby in the first months of life.
Before this vaccination program was introduced, dozens of babies in the UK died each year.
“The majority of our admissions are still in the less than three-month pre-immunization group,” says Dr. Cheung. “I’ve seen these babies in my office and they come in with coughing spells, apnea (pauses in breathing), or looking very dark (i.e. blue) or desaturated (with low oxygen levels), and that’s very concerning.” “.
The number of two-year-olds who have received the full round of vaccines has declined over the past decade, and cases of whooping cough are skyrocketing.
Danielle Knox knows how scary this can be. Her son Tom, then seven weeks old, was admitted to hospital for a week in December with a severe cough and episodes of apnea. He was treated with antibiotics and needed regular suctioning.
As Danielle, 33, a health sciences teacher from Glasgow, told me last week, because Tom wasn’t making a “scream” sound, he wasn’t tested for whooping cough; but very young babies do not make the typical “cry.”
Other children need multiple readmissions because of this. “I had a patient who was admitted for the third time in six weeks; he was still having blue attacks at night,” explains Dr. Cheung.
Airfinity, a disease prediction company, says “the risk of infections is expected to remain elevated in the coming weeks.”
One of the problems is low vaccination rates. In September 2023, the number of two-year-old children who had completed the routine six-in-one vaccination schedule (given at eight weeks, three months and four months), which includes protection against whooping cough, was 92.9 percent; in 2014 it was 96.3 percent.
And lack of awareness means the disease continues to spread.
Bryony Thomson’s ten-year-old daughter had whooping cough and couldn’t breathe. The family moved a mattress into the bathroom so she could sleep there with hot water running at night; the steam relieved him.
Bryony, 38, a vet in Whitburn, County Durham, asked the headteacher to alert other parents because many other children were also coughing. But the UKHSA advised against it because only one case was reported. Two unrelated cases are needed to send a formal alert.
In the first week of January, Bryony’s daughter was coughing four times a minute and was taken to the ER in the middle of the night. ‘She was gasping for air and started turning blue. She was really scared.’
A doctor told Bryony that her daughter would be fine and that “no one dies from whooping cough these days.”
Adults, although not as vulnerable as babies with the disease, can end up breaking a rib from the force of coughing.
Fortunately, Bryony’s daughter recovered.
But Riley Hughes was a healthy baby when he died of whooping cough at just 32 days old in 2015.
At three weeks old, he developed a mild cold and occasional cough. A doctor assured her parents, Catherine and Greg, that she was fine. But Riley was sleepy and wouldn’t wake up to feed him, so they took him to the hospital.
He was admitted and diagnosed with whooping cough. His condition deteriorated rapidly and he was placed on life support.
“I wish I could remember the last time I saw Riley conscious,” Catherine tells me. “I just don’t remember looking into his eyes for the last time.”
She had gone home to rest (she had been in the hospital for four days with virtually no sleep and was exhausted), not realizing that time was so short. But Greg was there for the last few hours aware of his son.
‘Riley was screaming and screaming. He would have been in a lot of pain from the needles and cannulas that were being administered. “This is how my baby will remember the last time in the world,” she says.
At 3 a.m. he received an urgent call from Greg telling him: “The doctors say you have to come quickly.”
“They placed Riley in my arms. I was shocked at how hot and swollen her little body was,” says Catherine, from Perth, Australia. “They removed the tubes and we hugged, cried, kissed him and sang him a lullaby as her life slowly passed away.
‘At 2pm, our beautiful baby left us, left this world and left us devastated and heartbroken.
“If I had been offered a whooping cough booster during pregnancy, there’s a good chance Riley would still be with us today.”
But when Catherine was pregnant, it was before Australia offered the maternal pertussis vaccine. Days after Riley’s death the vaccination program began, resulting in a significant reduction in babies hospitalized with whooping cough.
“It’s bittersweet. I’m so glad we have these fantastic pregnancy vaccination programs but I’m really sad that they weren’t rolled out in time for Riley,” says Catherine, who is now campaigning to encourage women to get vaccinated.
However, uptake among pregnant women in the UK has fallen dramatically, from 74.7 per cent in 2017 to just 59.5 per cent in 2023. Dr Whittaker says in some parts of London it is as low as like 36 percent.
The decrease in the booster dose in preschool also deeply worries experts. “In Harringay it has reduced to 56 per cent and 65 per cent in Hammersmith and Fulham in London,” explains Dr Whittaker. ‘This means we have children of primary school age who do not have adequate protection. They all hang out together and pass it on.’
“Also, their parents have waning immunity, they get it and then pass it on. There’s this little perfect storm of whooping cough transmission going on.
“The risk is that it will be transmitted to someone who is immunocompromised or to a baby.”
Professor Kamila Hawthorne, president of the Royal College of GPs, said: “We urge all parents to check that their children’s (and their own) vaccinations are up to date.”
This is what motivates Catherine. ‘In all the cases I have heard of, where parents lost their babies to this insidious disease, they did not have, or were not offered, a vaccine during pregnancy.
‘Their stories are heartbreaking. You never “get over” the loss of your child this way and you never forget the terrifying coughing sound that ended your child’s life.’
UKHSA advice is that if you are infected, avoid close contact with people at higher risk of becoming seriously ill (babies, older people and anyone who is immunocompromised). If you have to go out, wear a mask.
