Parents urged to immunise children
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June 7 marks the start of the WDHB’s three-week Boostrix vaccination programme against tetanus, diphtheria and pertussis (whooping cough) for Year 7 school students.
 
For children who received the vaccination at six weeks, three months, five months and four years it will be their fifth vaccination for these three diseases.
 
For those children who have never been vaccinated against tetanus, diphtheria and whooping cough, parents are urged to book them into a catch-up programme with their GP or practice nurse.
 
“Some may argue that we no linger see tetanus, diphtheria and whooping cough in our community. Others may think that their unimmunised children will be protected because most children in our community are immunised,” says WDHB immunisation coordinator and communicable disease nurse Karen Howard.
 
“It’s true that due to high immunisation rates diphtheria isn’t often seen in New Zealand these days. But tetanus is a toxoid that lives in the ground and it can easily be transmitted to people and animals. Children and adults are particularly at risk if they have a ‘dirty’ wound which occurs when you step on an old nail in the garden, or have an open wound from an accident. Herd immunity (when those who are immunised protect those who are not) doesn’t apply for tetanus.
 
“Whooping cough is spread in the air by infectious droplets and we currently have a whooping cough epidemic in New Zealand. Its disease that is alive and kicking in Whanganui where we have one confirmed case and six ‘probable’ cases. At least one local school has had many children off sick with coughing. Local GPs have been informed that whooping cough is in our community now, and they have been advised to keep a look out for it.”
 
Karen says whooping cough is a very infectious disease that can seriously affect babies and infants. The characteristic ‘whoop’ sound (made by effort of inhaling) is usually only present in babies. Older infants, children and adults tend to have a persistent cough similar to that found in the other upper respiratory infections. Coughing can last several months and can be associated with vomiting. Other symptoms include a runny nose, sneezing and a low-grade fever. For one to three children per thousand, whooping cough leads to permanent brain damage, paralysis, deafness, blindness or in rare cases, death.
 
Karen says the disease is usually milder in adolescents and adults, but they can transmit it to others. In the US, two thirds of cases reported are in adolescents and adults. In fact, 90 percent of non-immune household contacts will catch whooping cough. Furthermore, 50 to 70 percent of susceptible school contacts may also catch it. Most infants hospitalised with whooping cough (when a source can be identified) have caught the disease from an older household member – usually the mother. It has been estimated that up to 20 percent of severe adult coughs that last one to three months are caused by whooping cough.
 
“Some people talk about the ‘100-day cough’ thinking it’s different from whooping cough when in fact it’s the same disease,” Karen says. “Others believe maternal antibodies will protect their babies but almost no maternal protection passes to the newborn against whooping cough either in utero or via breast milk.
 
“Antibiotics can’t treat whooping cough but they are given to reduce the transmission of the organism and they may be given to all household and other close contacts of the infected person. Cases must be excluded from school or day care for 21 days if the child is not on antibiotics – or for five days if they are taking antibiotics. Every contagious person will infect another 12-17 people.”
 
Several years ago whooping cough was added to the Year 7/11-year-old immunisation schedule. Extending whooping cough vaccination coverage in New Zealand is currently being debated. The strategies under discussion include universal adult immunisation and selective immunisation of new mothers and their families, and selective immunisation of health and child care workers. These strategies aim to cocoon newborn babies who are most at risk of serious disease and death. Around 75 percent of babies under six months old, require hospitalisation.
 
Covering coughs and good hand washing (and hand drying) practices will minimise the spread of many infections, including whooping cough. Immunisation is the best protection.
 
“Be Wise. Immunise. For parents of Year 7s, if you have a Boostrix consent form still sitting at home, please return to the school asap,” Karen says.
 
For further information, please contract Karen Howard, Immunisation Co-ordinator at Public Health, or your Practice Nurse or GP. You could also check out the following website: www.immune.org.nz.