Since the beginning of 2024, the High Authority for Health (HAS) has been warning about the marked increase in cases of whooping cough. Contacted by the Ministry of Health, the HAS published a press release on Monday, July 22, warning about the situation and calling for the strengthening of vaccination recommendations to protect newborns and infants. What’s new? How do you know if you are affected by vaccination? Franceinfo takes stock.
1 What is the situation in France?
In its new recommendations, the HAS mentions a “worrying epidemic context”. Since the beginning of 2024, France has been experiencing “a sharp increase in the number of infections” And “at least 17 deaths, including 12 in infants aged 2 months and under”recalls the HAS.
In its bulletin of June 28, Santé publique France (SPF) counted 14,866 positive PCR tests out of 67,161 tests carried out over the year, representing a positivity rate of 22.1%, compared to 3.7% in 2023. Between January and May 2024, the percentage of positive tests increased by 20.2 points. In addition, the Sentinelles health research and monitoring network recorded 78 cases, reported by general practitioners and pediatricians, between January 1 and June 2, 2024, compared to zero over the same period in 2023. For its part, the Renacoq network, the hospital network that monitors cases, indicates that 80 infants under 12 months have been hospitalized since the beginning of the year, including 59 under 6 months, compared to 41 in 2023.
A judged situation “unpublished” by Stéphane Paul, head of the clinical immunology department at the Saint-Etienne University Hospital. “In France, the various whooping cough surveillance indicators confirm an epidemic situation established on the territory”notes SPF in its bulletin. It is nevertheless complicated to have a more precise vision of the situation.“As whooping cough is not a notifiable disease, these figures could even be higher.”the agency explains to franceinfo.
2 Why is the number of cases exploding?
Whooping cough evolves in cycles of recrudescence every three to five years. The last epidemic peak dates back to 2017-2018, according to the hospital network for whooping cough surveillance. Another peak was therefore expected in 2021-2022, but according to Public Health France, the exceptional context and the health measures due to Covid-19 have “probably reduced transmission” of the disease.
According to immunologist Stéphane Paul, the current resurgence may be linked to the barrier gestures applied during the pandemic. “At that time, there were very few cases of whooping cough, which had an impact on protection.”he assures franceinfo. “The immune system needs to be stimulated regularly to be immune”Vaccination coverage of pregnant women also plays a role, he said. “They are getting vaccinated less, which contributes to the transmission and resurgence of the disease”says Stéphane Paul.
3 How do I know if I have whooping cough?
This highly contagious bacterial infection is characterized mainly by coughing fits, more frequent at night, especially in adolescents and adults. Respiratory infection due to the bacteria Bordetella pertussis is also accompanied by a whistling sound “evocative”according to the immunologist. The infected patient does not show any signs of fever.
While these symptoms disappear after a week or even ten days in patients without health problems, they can persist longer in others. “Individuals with more sensitive immune systems may have symptoms for several months.”explains Stéphane Paul. People with asthma, the elderly, those susceptible to lung infections and very young children are therefore particularly affected. “Lung function can be reduced because the lungs are damaged by the infection.”he reports. “The ultimate risk is therefore respiratory distress and then death.”.
To date, there is no curative treatment, but it is possible to improve breathing with certain medications. In addition, in the event of a long-term infection, antibiotics are prescribed. To identify cases of whooping cough, saliva and nasopharyngeal tests are carried out in a laboratory under prescription. If in doubt and if you have been coughing for more than fifteen days, consult your doctor.
4 What is the vaccination plan?
In France, vaccination against this disease has been mandatory for infants from 2 months of age since 2018. Contamination occurs from adults, who transmit the disease to babies too young to be vaccinated. This is why the general population must have a booster vaccine at 11 months, 6 years, between 11 and 13 years, and then at 25 years. Health professionals must, for their part, give other boosters at 25, 45 and 65 years.
In order to better contain the whooping cough epidemic, the HAS has recommended, since 2022, that pregnant women get vaccinated from the second trimester of pregnancy, and preferably between 20 and 36 weeks of amenorrhea. This method is considered the most effective by the HAS, thanks to transfer via the placenta “maternal antibodies” towards the infant. More broadly, Health Insurance also encourages adults with parental plans to get vaccinated against the disease.
In addition to these guidelines, the HAS added new recommendations on July 22, 2024. The High Authority recommends the method of “cocooning”an anglicism meaning to rest in cozy comfort. If a mother did not have the vaccine during pregnancy, she should do so before leaving the maternity ward, the body advises. In this scenario, the rest of the newborn’s close entourage also receives a booster dose if their last injection was more than five years ago.
Finally, professionals in close contact with newborns and infants under 6 months of age must also receive a booster vaccination if their last injection was more than five years ago. This booster is also possible for other health professionals if they wish.
5 And how are things going with our neighbors?
“Outside our borders, Europe is currently experiencing a resurgence of cases of whooping cough”warns immunologist Stéphane Paul. This is indeed what is noted in a report from the European Centre for Disease Prevention and Control (ECDC), published at the beginning of May. This European Union agency counted 25,130 cases in 2023 and more than 32,037 between January and March 2024. “Similar figures were observed in 2016 (41,026) and 2019 (34,468)”the report says. The current situation therefore appears to be approaching previous cycles of resurgence of the disease. In Europe, between January 2023 and April 2024, 19 deaths were reported to the ECDC.
Major whooping cough outbreaks have been recorded in Croatia, with more than 1,000 cases recorded since the beginning of the year, compared to a few dozen usually, according to figures from the Croatian National Institute for Public Health. Significant increases have also been reported in Denmark, the United Kingdom, Belgium, Spain and Germany, specifies Santé publique France.
Although the epidemic had previously seemed limited to Europe, it has now crossed the Atlantic. “Data from the United States shows that cases are starting to increase as well”underlines Stéphane Paul. In a report published at the end of July, the Pan American Health Organization counted 7,251 cases of whooping cough between January and June 2024, which corresponds to an increase of 300% compared to the same period in 2023.