There is a cough circulating that pediatricians say makes babies very sick. What is very worrying is that very young babies have died from it. The cough is whooping cough – or whooping cough.
This is a disease that can be prevented or whose impact can be reduced by vaccination.
But there has been an increase in cases lately: You may have heard people complaining about the 100-day cough. I’ve had it (and ended up in A&E when I couldn’t breathe) and wrote about it for Mail Online.
Since January, there have been 8,015 doctor notifications (whooping cough is a notifiable disease) and 2,041 laboratory-confirmed cases, compared to only 207 (an increase of about 3,800 percent) and 30 respectively in the same period last year.
In January and February alone this year, there were 52 cases of babies under three months of age with whooping cough; In contrast, there were only 48 cases last year.
Riley Hughes (pictured with his mother Catherine) was otherwise healthy when he died of whooping cough in 2015 at the age of 32
And these numbers may be a significant underestimate, since people with mild illness may not visit a doctor.
“We are seeing huge numbers of cases of whooping cough at the moment,” says Dr Liz Whittaker, pediatric consultant and honorary clinical senior lecturer in the department of infectious diseases at Imperial College London.
Pediatric intensive care units have ‘strong capacity’ for whooping cough and measles, meaning there are many cases.
Dr. Ronny Cheung, a pediatrician from the Royal College of Paediatrics and Child Health, added: ‘There’s no doubt we’ve seen a lot more of it in wards and emergency departments recently. My suspicion is that we are probably still underestimating the true prevalence at this time.’
While adults describe it as the worst cough they’ve ever had – causing difficulty breathing, incontinence and even broken ribs – in babies it can be fatal. ‘The mortality rate is one in a hundred deaths in the under three months category,’ says Dr Whittaker. ‘We don’t see this in other age groups.
“Except for coughing, which is quite intense, they can stop breathing.”
Their white blood cells also increase, sometimes reaching very high levels, “closing blood vessels and causing heart failure,” Dr. Whittaker adds.
The rise 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 one baby in the last quarter of 2023. But colleagues have told me about more deaths that are not yet included in official figures.
Whooping cough is a highly contagious bacterial infection, but people under three months of age are most at risk because they are too young to be vaccinated.
The first dose of whooping cough vaccine is normally given after two months. That is why pregnant women are offered the shot between the 16th and 32nd week, while the antibodies cross the placenta and protect the baby in the first few months of life.
Before this vaccination program was introduced, dozens of babies died every year in Britain.
“Most of our admissions are still in the less than three months pre-immunization group,” says Dr Cheung. ‘I have seen these babies in my practice with coughing fits, apnea (breathing pauses) or looking very sad (blue) or desaturating (with low oxygen levels), and that is very concerning.’
The number of two-year-olds who have had the full round of vaccinations has fallen over the past decade and whooping cough cases are skyrocketing
Danielle Knox knows how terrifying this can be. Her then seven-week-old son Tom was hospitalized for a week in December with a severe cough and episodes of apnea. He was treated with antibiotics and had to be suctioned regularly.
As Danielle, 33, a health sciences teacher from Glasgow, told me last week: because Tom didn’t make a ‘whoop’ sound he wasn’t tested for whooping cough; but very young babies do not have the typical ‘whoop’.
Other children require several readmissions. ‘I had a patient who was admitted for the third time in six weeks; he still bruises at night,” Dr. Cheung explains.
Airfinity, a disease forecasting company, says “the risk of infections is expected to remain high in the coming weeks.”
One of the problems is the low vaccination rate. By September 2023, the number of two-year-olds who had completed the schedule of routine six-in-one vaccinations (given at eight weeks, three months and four months), including protection against whooping cough, was 92.9 percent; in 2014 this was 96.3 percent.
And lack of awareness means the disease continues to spread.
Bryony Thomson’s ten-year-old daughter had whooping cough, which left her unable to breathe. The family moved a mattress to the bathroom so she could sleep there at night with running hot water – the steam provided relief.
Bryony, 38, a vet in Whitburn, County Durham, asked the headteacher to warn other parents as so many other children were also coughing. But the UKHSA advised against it as only one case had been reported. It takes two unrelated cases to issue a formal warning.
In the first week of January, Bryony’s daughter was coughing four times a minute and was taken to the emergency room in the middle of the night. ‘She was gasping for air and starting to turn blue. I was really scared.’
One doctor told Bryony that her daughter would be fine and that “nobody dies from whooping cough these days.”
Adults, although not as vulnerable as babies to the disease, can eventually break a rib, so forceful is the coughing
Fortunately, Bryony’s daughter recovered.
But Riley Hughes was an otherwise healthy baby when he died of whooping cough in 2015 at age 32.
By three weeks old, he had developed a mild cold and occasional cough. A doctor reassured his parents, Catherine and Greg, that he was doing well. But Riley was sleepy and wouldn’t wake up to feed, so they took him to the hospital.
He was admitted and diagnosed with whooping cough. His condition rapidly deteriorated and he was placed on life support.
“I wish I could remember the last time I saw Riley conscious,” Catherine says. “I just don’t remember the last time I looked into his eyes.”
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 the time was so short. But Greg was there during their son’s last conscious hours.
“Riley screamed and screamed. He would have been in a lot of pain from the needles and cannulas they administered. This is how my baby will last remember the world,” she says.
At three in the morning she received an urgent call from Greg: “The doctors say you need to come quickly.”
“Riley was placed in my arms. I was shocked at how red hot and swollen his little body was,” says Catherine from Perth, Australia. ‘The fallopian tubes were removed and we hugged, cried, kissed him and sang him a lullaby as the life slowly drained from him.
‘At 2pm our beautiful baby left us, left this world leaving us devastated and heartbroken.
“If I had been given 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 whooping cough vaccine. Days after Riley’s death, the vaccination program began, resulting in a significant reduction in the number of babies admitted to hospital with whooping cough.
‘It’s bittersweet. I am absolutely delighted that we have these fantastic pregnancy vaccination programmes, but am deeply saddened that they were not implemented in time for Riley,” said Catherine, who is now campaigning to encourage women to get vaccinated.
Yet uptake among pregnant women in Britain has fallen dramatically, from 74.7 percent in 2017 to just 59.5 percent in 2023. Dr. Whittaker says this is as low as 36 percent in parts of London.
The decline in booster doses for preschoolers is also of great concern to experts. ‘In Harringay this is down to 56 per cent and in Hammersmith and Fulham in London it is 65 per cent,’ explains Dr Whittaker. ‘This means that we have children of primary school age who do not receive sufficient protection. They all hang out together and pass it on.”
‘Plus, their parents have waning immunity and they pick it up, then pass it on. There is a small, perfect storm of whooping cough infections going on.”
‘The risk is that it will be passed on to someone with a weakened immune system or to a baby.’
Professor Kamila Hawthorne, chair of the Royal College of GPs, said: ‘We would urge all parents to check that their children’s vaccinations – and their own – are up to date.’
This is what drives 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 moving. You never ‘get over’ losing your child this way and you never forget the terrifying sound of the cough that took your child’s life.”
The advice from the UKHSA is that if you are infected you should avoid close contact with people who are at higher risk of serious illness (babies, the elderly and anyone with a weakened immune system). If you have to go outside, wear a mask.