Since the start of the year, cases of whooping cough have reappeared in France and in Puy-de-Dôme. This respiratory illness can be very serious in infants.
In the first quarter of 2024, around fifteen clusters, mainly in communities, but also in families, or around 70 cases, were reported to Public Health France for France (34 cases in 2020, 4 cases in 2021). In Auvergne, as confirmed by Doctor Christine Jacomet, head of the infectious diseases department at Clermont-Ferrand University Hospital, this resurgence is also observed for the same period in the hospital center. Since March 2024, around twenty cases have been recorded: 5 newborns, 1 child under 2 years old, 8 school-aged children and 6 adults.
Very contagious disease
“Whooping cough is a highly contagious bacterial respiratory tract disease. Its attack rate is enormous: 75%! It is transmitted via droplets emitted when coughing. It is very problematic in newborns and still a Source of mortality in them today. Around ten children die from it in France every year. Likewise, it can be severe in fragile people, that is to say the elderly, those who are immunocompromised, those suffering from respiratory pathologies and in pregnant women,” recalls Christine Jacomet, doctor.
Signs, symptoms
Whooping cough is characterized by a cough that quickly progresses to fits accompanied by characteristic signs.
This is the disease of rooster crowing: when the patient takes a breath, he emits a high-pitched sound. With very short, difficult inspiration phases and very long expiration phases. Whooping cough does not cause fever
In adults, the disease is often atypical. “If you have been suffering from a persistent cough for more than a week, without fever, and all other pathologies have been ruled out, you should think about whooping cough if your vaccination record is not up to date,” emphasizes the doctor.
Severity and treatments
“The infection is a toxinfection: the toxin of the bacteria causes necrosis of the respiratory mucous membranes. Severe cases are treated in intensive care, as newborns can die from asphyxiating or syncopal apnea. » Antibiotic therapy helps reduce contagiousness. “There is also prophylactic treatment for those close to us and those in contact at risk. »
Why are cases resurfacing?
As with measles, “it is the lack of vaccination which is at the origin of cases of whooping cough. It is not normal to see sick children when vaccination is compulsory,” notes Christine Jacomet. It is often adults who infect newborns. “Because we lose the protection conferred by the vaccine after several years. »
Vaccination recommendations
Christine Jacomet, head of the infectious diseases department at Clermont-Ferrand University Hospital.
Very well tolerated, the whooping cough vaccine is compulsory for infants from two months of age, with two other boosters at 4 and 11 months. Other boosters are recommended during childhood (6, 11, 13 years old) then at 25 years old. “This vaccination is also strongly recommended for pregnant women in the second trimester of pregnancy so that they transmit strong immunity to their newborn until he can be vaccinated himself and benefit from the vaccine protection that will occur around 6 months,” specifies the doctor.
“You must be up to date with your vaccinations and interpret the vaccination recommendation as a necessity for yourself and others. For vulnerable people and pregnant women, you should consider updating your vaccination with your doctor, pharmacist or infectious disease services. »
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Evolution of the number of whooping cough cases 2017-2022 until 2024
According to surveillance data from the Renacoq network (hospital pertussis surveillance network), since the last pertussis peak in 2017-2018 (162 cases reported), the number of cases has continued to decrease to reach 34 cases. in 2020 and 4 cases in 2021 in infants under 12 months.
Same observation regarding the data from the Sentinelles network (research and monitoring network in primary care, general medicine and pediatrics in mainland France) reporting one case per year in the general population over the same period. This low rate was maintained during the Covid period due to health measures.
Evolution 2023-2024
In 2023, only 2 cluster cases were reported to Public Health France between October and December, with 18 cases of whooping cough in Ile-de-France.
At 1?? quarter of 2024, around fifteen clusters (grouped cases) mainly in communities (nursery schools, primary schools, daycare centers and nursery homes) but also in families and totaling 70 cases have been reported to Public Health France.
Michele Gardette
[email protected]
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