Whooping cough is making a post-COVID-19 pandemic comeback in China, with cases surging more than 20-fold in the first two months of this year.
The world’s second-most populous country reported a combined 32,380 cases of pertussis — more commonly known as whooping cough — in January and February, compared with 1,421 cases during the same period last year, the Chinese National Disease Control and Prevention Administration said.
There were 13 deaths.
The number of infections detected in the first 60 days of the year is near the total for last year, underscoring the risk of the highly contagious respiratory disease in China.
The nation endured a major respiratory disease outbreak last year after pulling itself out of the COVID-19 mire in late 2022, well after other nations had thrown open their borders and allowed pathogens to resume their traditional circulation patterns.
China provides free vaccines for whooping cough, usually in a combined shot that also protects infants against diphtheria and tetanus.
Experts said that the vaccine-induced immunity tends to wane as children reach adolescence. Chinese health authorities do not mandate or provide booster shots to help shore up immunity.
Discussions are needed to determine if the country should update the vaccine it uses for the disease or adjust the immunization program, Chinese Center for Disease Control and Prevention (CDC) Director Shen Hongbing (沈洪兵) said at a conference last month.
“It requires close attention to prevent and control the spread of whooping cough in China,” local media reports quoted Shen as saying.
Whooping cough infections have been rising in China since 2014, with more than 30,000 in 2019, the Chinese CDC said.
After a respite during the COVID-19 isolation days, they bounced back to almost 40,000 a year in 2022 and last year, the center reported.
Nuances around vaccination are contributing to the increase. COVID-19 disruptions, waning protection and genetic changes might all be playing a role.
Older patients can experience atypical symptoms, leading to misdiagnosis and allowing them to covertly carry and spread the infection.
Meanwhile, genetic changes might help the bacteria elude an immune system primed to detect it, allowing the pathogen to continue sickening even the immunized, a Beijing Daily report said.
Vaccination rates worldwide suffered during the pandemic. The percentage of children getting all three doses of the diphtheria, tetanus and pertussis shot plunged to 81 percent in 2021, the lowest level since 2008, the WHO and the UN Children’s Fund said.
The disease caused by the bacterium Bordetella pertussis is transmitted through respiratory droplets. It’s a significant cause of infant death worldwide and continues to be a public health concern despite high vaccination rates, according to the WHO.
China is not alone in its comeback. Whooping cough is endemic and epidemic cycles are occurring every two-to-five years, despite vaccination programs, the WHO said.
Some European countries have posted rising cases since the middle of last year, according to the European Center for Disease Prevention and Control. The Czech Republic is suffering its biggest outbreak since 1963, and both it and the Netherlands have reported whooping cough-related deaths.
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