pertussis

Canterbury free whooping cough boosters

Thursday, 19 April 2012

Pregnant women, from 30 weeks of pregnancy, and those who are up to two weeks after delivering their baby are being encouraged to have a free whooping cough immunisation.

For best protection of their newborn the booster immunisation would be given by the end of the 36th week of pregnancy (ideally between 31-33 weeks). This allows time for the woman's immune system to produce protection against whooping cough, reducing the risk she will have the disease when the baby is actually delivered. Circulating protection against whooping cough can also pass through the placenta into the baby and provide the baby with some of their own protection against the disease for a short period of time (this varies between mothers and babies). The immunisation can be given and is free between 37-40+ weeks of pregnancy.

The booster immunisation can be given anytime from 30 weeks of pregnancy to two weeks after delivery.

For best protection of the newborn the booster immunisation would be given by the end of the 36th week of pregnancy (ideally between 31-33 weeks):

  • This allows time for the woman's immune system to produce protection against whooping cough, reducing the risk she will have the disease when the baby is actually delivered and for the subsequent year when the baby's risk of complications from whooping cough is highest.
  • Circulating protection against whooping cough can also pass through the placenta into the baby and provide the baby with some of their own protection against the disease for a short period of time (this varies between mothers and babies).

However, after 36 weeks of pregnancy administering the booster immunisation:

  • Will increase the woman's protection against whooping cough, reducing the risk that she will have the disease during the baby's first year of life when their risk of complications from whooping cough is highest.
  • But may not allow enough time before delivery for the woman to produce whooping cough protection and for this protection to pass through the placenta into the baby.

However, after delivery of the baby administering the booster immunisation:

  • Will increase the woman's protection against whooping cough, reducing the risk that she will have the disease during the baby's first year of life when their risk of complications from whooping cough is highest.

Babies less than one year of age, and particularly less than six months of age, have the highest risk of getting whooping cough (pertussis) and needing to be hospitalised. Reducing the risk that their mother and other household members will get whooping cough means they are less likely to get the disease too. Immunity against whooping cough decreases over time, 10-15 years after having the disease and 4-6 years after having the vaccine people can get whooping cough again. This means that it is always around and there are outbreaks every few years.

After the course of whooping cough immunisations or after a booster immunisation around 86 people out of every 100 people will be fully protected from the disease. The other 14 people may still get pertussis but it is usually more mild than if they hadn't had the immunisation.

The whooping cough vaccine is combined with tetanus and diphtheria vaccines (Tdap). It doesn't contact the actual diseases and cannot cause disease. After years of administering non-live vaccines to pregnant women they are considered safe for both the mother and the fetus, e.g. in some countries the only time health professionals see women regularly is during pregnancy and the ante-natal visits are used to ensure they have a course of tetanus vaccine.

It doesn't matter of the pregnant women has recently had a tetanus and diphtheria (Td) immunisation because of a wound that may have been contaminated with tetanus. As long as four weeks have passed she can have the tetanus, diphtheria, whooping cough vaccine.

All the young children in the household should be up to date with their childhood immunisations. Older children and adults in the household should have a tetanus, diphtheria, whooping cough vaccine too. However they have to buy their vaccine through their GP.

Practice staff are reminded that the Tdap (Boostrix®) vaccine routinely in the vaccine fridge for the 11 year old immunisation IS NOT to be used for non-funded patients. Either Adacel® or Boostrix® MUST be purchased from Healthcare Logistics for anyone not having their 11 year old schedule immunisation.

For more information visit the Canterbury HealthInfo website - click on 'Women's Health, then on 'Pertussis (Whooping Cough) Vaccine for Pregnant and Postpartum Women.

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Changing pertussis strains

Thursday, 22 March 2012

Researchers at the University of New South Wales have identified an increase in pertussis cases caused by strains that are different to those in the acellular pertussis vaccine.

Australia has been experiencing epidemic levels of pertussis (whooping cough) since 2008 despite high levels of immunisation. However, deaths from the disease are lower than before immunisation against the disease was introduced.

Research into the strains of pertussis bacteria causing the disease in Australia between 2008-2010 has been published online in the Journal of Infectious Diseases. The study found an increase in the number of non-vaccine pertussis bacteria isolated in samples from people with the disease between between 2008-2010 compared with the number isolated between 2000-2007.

The next step is to identify if the non-vaccine strains are more likely or less likely to be causing more serious pertussis disease than the vaccine strains. A project between the National Centre for Immunisation Research and Surveillance (NCIRS) in Australia and the university researchers is underway.

Continued immunisation with the current whooping cough vaccines, following the National Immunisation Schedule, is recommended until the implications of the non-vaccine pertussis strain can be identified.

Professor McIntyre, Director of NCIRS commented that The vaccine may not be as good as we'd like but it does seem to be preventing the most extreme cases." Australia is reviewing whether a a booster pertussis immunisation should be added to the Australian schedule at 18 months of age.

The citation for the recently published journal article is Octavia, S., Sintchenko, V., Gilbert, G. L., Lawrence, A., Keil, A. D., Hogg, G., & Lan, R. (2012). Newly Emerging Clones of Bordetella pertussis Carrying prn2 and ptxP3 Alleles Implicated in Australian Pertussis Epidemic in 2008–2010. Journal of Infectious Diseases, 205(8), 1220-1224.

 

 

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Whooping cough risk at Middlemore Hospital

Thursday, 10 May 2012

A midwife working at Middlemore Hospital exposed mothers and new babies to whooping cough before being diagnosed with the disease.

Whooping cough (also known as pertussis) is a highly infectious disease caused by bacteria which is easily spread through coughing and sneezing, much like the common cold. However, when contracted by vulnerable groups, such as babies and infants (those under 12 months of age) and women in the last three months of their pregnancy, whooping cough can lead to severe illness and rarely, death.

Middlemore Hospital acted promptly when the midwife was diagnosed with whooping cough. Auckland Regional Public Health Service (ARPHS) has been working closely with Middlemore Hospital and mothers who may have been exposed to whooping cough while at hospital.

Mothers at risk were contacted directly by ARPHS, by phone and letter, and advice provided regarding symptoms and antibiotic prophylaxis. General Practitioners (GPs) of those who may have been exposed to whooping cough in hospital, have also been informed in writing and appropriate management advice provided.

All Lead Maternity Caregivers (LMC), including GP’s and postnatal Midwives of the indentified contacts, were provided with information and guidance on treatment of mothers and babies should they visit for advice and on what they can do as the LMC to protect those in their care from pertussis.

In addition, ARPHS has provided advice to Lead Maternity Carers throughout the region (Auckland, Counties Manukau and Waitakere District Health Boards).

Clinical Director, Dr Julia Peters says “we fully understand that these mothers may be concerned about the health of their newborn babies. We encourage them to be vigilant for symptoms and to contact their GP immediately if they have any concerns. Auckland Regional Public Health Service is also available on: 09 623 4600 or www.arphs.govt.nz.

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Immunisation against whooping cough

Friday, 3 August 2012

Researchers at the Queensland Children's Medical Research Institute recently published data comparing the rate of pertussis in children who received the whole-cell pertussis vaccine with children who received the acellular vaccine.

Not surprisingly they identified that children who received the whole-cell vaccine were less likely to get whooping cough.

A number of factors could contribute to the results of this study:

  • Technology that tests for pertussis infection has improved significantly since the whole-cell vaccine was used in Australia, and New Zealand, and an increase in the number of laboratory diagnosed cases may reflect better identification of the disease now than back then.
  • The whole-cell vaccine, used overseas as part of the World Health Organization Expanded Programme on Immunization, generates a very robust immune response that can be associated with noticeable injection site reactions, high fevers and hours of persistent screaming. New Zealand, Australia, the UK and US moved to using the acellular pertussis vaccine to reduce the risk of these unpleasant and, for parents, often frightening and unacceptable vaccine responses. However, a less reactive vaccine also means a reduction in the immune response when compared with the whole-cell vaccine.
  • It is possible that over time there have been small changes in characteristics of the pertussis bacteria and the current acellular pertussis vaccine is still effective against much of the bacteria's characteristics but is less effective against the changed ones.
  • Pertussis remains highly infectious and no matter how immunity is acquired i.e. through whole-cell immunisation, acellular pertussis immunisation or actually having the wild type disease, immunity wanes over time and controlling the disease remains a significant challenge.

The key messages are:

  • The acellular pertussis vaccine still has a protective effect and it is important for infants to receive their National Immunisation Schedule vaccines on time at 6 weeks, 3 months and 5 months of age.
  • Parents and people in close contact with infants less than one year of age should have their immunity against pertussis boosted by immunisation to reduce the risk they will infect a vulnerable infant.
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Waikato free whooping cough boosters

Friday, 14 September 2012

The special whooping cough vaccine programme for pregnant women from 20 weeks gestation and new mothers up to two weeks after delivery ended on 30 September 2013.

From 1 October 2013 pregnant women in the Waikato District Health Board area can only receive a free Boostrix® between 28-38 weeks of pregnancy through their local doctor.

Women who did not receive a whooping cough booster immunisation (Boostrix®) before 38 weeks of pregnancy can purchase the vaccine through their local doctor.

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Baby Sativah's struggle with whooping cough

Monday, 27 August 2012

Three week old Sativah's video highlights effects of whooping cough on babies.

Waikato mum Stacey Illingworth is sharing video footage of her baby’s struggle with whooping cough to help prevent other parents going through the same trauma. Stacey and her daughter Sativah returned home to Te Aroha recently after spending five weeks in Waikato Hospital.

“I would hate for any family to have gone through what we have. It is the worst possible feeling waking up at 5am to find your little baby lying there not breathing, and nearly losing her. I urge everyone to vaccinate their babies as soon as they can and for mums and dads to get immunised too,” Ms Illingworth said.

View the full Ministry of Health media release here.

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Pertussis

Saturday, 1 September 2012

Pertussis, commonly known as whooping cough, is a highly infectious bacterial infection spread by coughing and sneezing.

It causes severe bouts of coughing, which may be accompanied by vomiting and a whooping sound. Pertussis can last up to 3 months and is sometimes referred to as the ‘100 day cough.’ The symptoms are more obvious in children, because infants and adults are less likely to ‘whoop.’

Visit our pertussis disease page for more information.

 Pertussis fact sheet for parents and caregivers

 

 

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Capital and Coast free whooping cough boosters

Thursday, 15 November 2012

The whooping cough vaccine is available for family/whānau of infants less than one year of age who are already accessing specified immunisation services.

The vaccine, Boostrix®, is available through general practice (GPs).

The District Health Board (DHB) will pay for the vaccine. However, providers may charge the patient a small vaccine administration fee. Please ask your GP about any vaccine administration cost.

Who is eligible?

  • Only family/whānau of infants less than one year of age already receiving immunisations through the following services:
    • An outreach immunisation service
    • An open immunisation clinic
    • One of the following Very Low Cost Access primary health services:
Compass Primary Health Care Network Ora Toa PHO Well Health Trust
Waitangirua Health Centre Ora Toa - Cannons Creek Newton Union Health Service
Massey Student Services Trust Ora Toa - Takapuwahia Te Aro Health Centre
Victoria Student Health Centre Ora Toa - Mungavin Porirua Union and Community Health Service
Pacific Health Service Porirua Ora Toa - Poneke Evolve Wellington Youth Service
Hora Te Pai Health Services    

 

 

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Funded Boostrix® in pregnancy

Wednesday, 12 December 2012

PHARMAC have extended the availability of funded Boostrix® for pregnant women between 28-38 weeks gestation from 1 January 2013.

New Zealand is in the midst of a pertussis epidemic. PHARMAC recently sought feedback on a proposal to extend funded Boostrix® for pregnant women in addition to those aged 11 years as per the National Immunisation Schedule.

Considerations and commentary around this decision are available in the  PHARMAC media release.

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Infanrix®-IPV

DTaP-IPV

Infanrix®-IPV is used for primary and booster vaccination of infants and children to protect against diphtheria, tetanus, pertussis and poliomyelitis. Infanrix®-IPV can also be used for catch-up immunisation for children up to their 10th birthday.

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