Five babies dead from whooping cough so far this year in biggest outbreak for 20 years
Waning immunity following vaccination' or natural infection may be to blameCases in babies under three months have gone up more than five times in two years

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UPDATED:

16:08 GMT, 5 July 2012

Five babies have died in the biggest whooping cough outbreak for two decades, the Health Protection Agency (HPA) said.

So far this year, five infants under three months have died as a result of the infectious disease.

There have been 1,781 confirmed cases in England and Wales in the first six months of this year compared with just 137 in 2010.

Protection: In the UK, children are vaccinated against whooping cough at two, three and four months of age, and again before starting school

Protection: In the UK, children are vaccinated against whooping cough at two, three and four months of age, and again before starting school

Increases in whooping cough are usually seen every three to four years.

The last rise in the number of confirmed cases was recorded in 2008.
However, in the first half of 2008, only 322 cases were confirmed.

An HPA spokeswoman confirmed that it is the biggest outbreak in two decades.

HOW TO SPOT IF A CHILD HAS WHOOPING COUGH

Whooping cough tends to develop in stages, with mild symptoms occurring first, followed by a period of more severe symptoms, before improvement begins.

The early symptoms of whooping cough are often similar to those of a common cold and may include:

runny or blocked nosesneezingwatering eyesdry, irritating coughsore throatslightly raised temperaturefeeling generally unwell

These early symptoms of whooping cough can last for one to two weeks, before becoming more severe.

The second stage of whooping cough is often called the paroxysmal stage and is characterised by intense bouts of coughing – referred to as 'paroxysms' of coughing.

The paroxysmal symptoms of whooping cough may include:

intense bouts of coughing, which bring up thick phlegm;a 'whoop' sound with each sharp intake of breath after coughing (although this may not occur in infants and young children);vomiting after coughing, especially in infants and young children;fatigue (tiredness) and redness in the face from the effort of coughing.

Each bout of coughing lasts between one and two minutes, but several bouts may occur in quick succession. The number of coughing bouts is usually between 12 and 15.

The paroxysmal symptoms of whooping cough usually last at least two weeks, but can last longer, even after treatment.

Source: www.nhs.co.uk

Increased disease activity has been linked to 'educational settings' and 'healthcare settings', the authority said.

The highest numbers of confirmed cases this year have been in the south west and south east of England.

Teenagers and adults over 15 were the worst affected but there has also been a sharp rise in whooping cough in babies aged under three months.

Between January and the end of May this year there were 138 cases confirmed in babies under three months, compared with just 22 cases in 2010.

The HPA said the increase may be due to better awareness among doctors and other healthcare professionals who are ordering more tests and so confirming more coughs as pertussis, or whooping cough.

It also suggested that 'waning immunity following vaccination' or natural infection would also contribute to the sharp increase.

While whooping cough can cause nasty symptoms in adults, it does not usually cause any long-lasting complications and can be treated with antibiotics.

However, there were a higher number of confirmed cases among adults than in children.

In the very young, whooping cough can be a serious illness and can lead to death in some cases.

Babies and children can often make a distressing 'whoop' sound while gasping for air after a coughing fit.

Older children and adults tend to suffer a prolonged cough.

Dr Gayatri Armithalingham, consultant epidemiologist in the immunisation department at the HPA said: 'Whooping cough, also known as pertussis, affects all ages. However, over the last few months the increase has extended to very young babies who have the highest risk of severe complications and death.

'Whooping cough can be a very unpleasant infection. Anyone showing signs and symptoms – which include severe coughing fits accompanied by the characteristic “whoop” sound in young children but as a prolonged cough in older children and adults – should visit their GP.

'Whooping cough can spread easily to close contacts such as household members.

'Vaccination is the most effective way to protect people from this infection and uptake of the vaccine is very good.

'Parents should ensure their children are up to date with their vaccinations so that they are protected at the earliest opportunity.

'The pre-school booster is also important, not only to boost protection in that child but also to reduce the risk of them passing the infection on to vulnerable babies, as those under four months cannot be fully protected by the vaccine.'