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Last Updated: Sunday, 24 August, 2003, 23:02 GMT 00:02 UK
Doctors miss whooping cough cases
Infants are vaccinated against whooping cough from two months
Doctors are failing to diagnose potentially deadly whooping cough in some children, a study suggests.

Researchers have found that one in four infants who were admitted to hospital with whooping cough like illness were not given the drugs they needed.

They have also confirmed that some children catch the disease from adults and older brothers and sisters.

This is despite the fact that the vast majority of people have been vaccinated against the disease.

Whooping cough or pertussis is most dangerous in children less than one year old. It can lead to pneumonia, convulsions and, in rare cases, brain damage or death. Serious complications are less likely in older children and adults.

Admitted to hospital

Dr Natasha Crowcroft and colleagues at the Health Protection Agency looked at 126 infants under five months and 16 children under the age of 15 who had been admitted to hospitals in London with a whooping cough like illness between 1998 and 2000.

They identified 25 infants and eight children with the disease. Two infants subsequently died.

In the UK, adults may be transmitting whooping cough to infants
Dr Natasha Crowcroft ,
Health Protection Agency
They found that seven of the 25 infants did not receive a macrolide antibiotic, the drug of choice for treating whooping cough.

This not only reduced their chances of fighting off the disease but also left other patients and medical staff at risk of infection. Many were in paediatric intensive care units (PICU) with other vulnerable children.

Writing in the journal Archives of Disease in Childhood, the researchers said: "Twenty eight per cent of infants with proven pertussis did not receive a macrolide antibiotic and risked transmitting the infection to staff and other patients.

"Pertussis is extremely infectious and a missed diagnoses in PICU may lead to outbreaks among extremely vulnerable infants."

The researchers said many of these children may not have been diagnosed with whooping cough because they did not have typical symptoms.

They said the findings highlighted the need to test all children who show even possible signs of infection.

The researchers found that many of the hospitalised infants had not been fully vaccinated against whooping cough because they were too young.

The vaccine is usually given to infants after two months. They receive three doses at monthly intervals.

Infected by adults

The study also found that two out of three children had probably contracted the disease from a parent or older siblings.

This was despite the fact that the vast majority of adults and all of the siblings had been vaccinated against the disease.

Previous studies have suggested that many children catch whooping cough from other members of their household.

In 2001, the government introduced a new vaccine booster programme for children before they go to school to try to reduce the risks of them catching the disease.

Figures from the Health Protection Agency show that the number of reported cases of whooping cough have fallen since the booster programme was introduced.

In 2001, 800 children under the age of 15 were diagnosed with the disease. Last year, that figure was down to 384.

However, some scientists believe parents and adults working with children should also be given a booster to stop them passing it on to children.

The authors of this latest study appear to back that proposal.

"Any future changes to the immunisation programme may need to take into account the fact that in the UK, adults may be transmitting whooping cough to infants," they said.




SEE ALSO:
New jab against whooping cough
15 Oct 01  |  Health
Gene map of cough killer
11 Aug 03  |  Health


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