Pertussis (Whooping Cough) Epidemic in Iceland and Europe

These cases are not confined to any specific group but are predominantly clustered in the capital area, where most of the population resides. However, cases have also been identified in other regions. The age range of those diagnosed spans from 2 to 60 years old.

While the Chief Epidemiologist does not receive reports of hospitalizations, communications with doctors have revealed that two individuals—one teenager and one adult—required hospitalization due to pertussis. Fortunately, neither case was severe.

If you suspect pertussis has entered your home, especially if vulnerable individuals are present, please contact your primary care center, Heilsuvera's online chat, or the Primary Care Information Center at 1700 for guidance. Testing or treatment may be necessary. Remember, sick children should stay home from school or daycare, and sick adults should refrain from going to work. Pertusis can remain contagious for 4 to 5 weeks. Further information about pertussis can be found on the Directorate of Health's website.

Vaccination against pertussis

Pertussis is circulating in society now, and it is crucial to protect vulnerable groups, particularly children under 6 months of age. Vaccination not only prevents illness in young children but also helps protect others from severe illness if they are infected. It's also essential for pregnant individuals to receive vaccination to safeguard newborns.

Population groups at risk due to pertussis

During a pertussis outbreak, extra precautions should be taken in households with vulnerable individuals. Limiting visitors and ensuring those who enter are healthy can help reduce the risk of transmission. Vulnerable groups include:

• premature infants,

• infants under 6 months old,

• unvaccinated or partially vaccinated infants in their first year,

• pregnant individuals (especially those nearing delivery), and

• people of all ages with lung disease or compromised immune systems.

Pertussis in Europe

A recent risk assessment from the European Centre for Disease Control and Prevention (ECDC) highlights that pertussis remains an ongoing concern in Europe and globally. While the disease is considered endemic worldwide, outbreaks tend to occur every 3 to 5 years. In 2023, EU/EEA countries reported over 25 thousand cases, but this year, from January to March alone, 32 thousand cases have been documented. By comparison, in 2019, just over 34 thousand cases were reported throughout the entire year.

The highest incidence of pertussis in the 2023–2024 period has been among infants in their first year of life, with a significant frequency also seen among young people aged 10 to 19 years. Moreover, there have been reports of increased cases in the UK and Northern Ireland, which lie outside the EU/EEA.

This significant increase in cases can likely be attributed to the reduced spread of pertussis during the COVID-19 pandemic, coupled with somewhat lower vaccination participation rates during the same period. This has resulted in more individuals being susceptible to infection and illness.

It's important to note that pertussis vaccines used in vaccination programs are highly effective and safe. Their widespread use significantly reduces both morbidity and mortality associated with the disease. If vaccination participation were lower, the situation now could be even more severe.

Participation in children's vaccinations in Iceland 2017–2022 according to the Chief Epidemiologist's vaccination plan against pertussis. Numbers in parentheses indicate the recommended dose. DTP vaccine: diphtheria, tetanus, pertussis.

The Chief Epidemiologist

Reference:

ECDC, 8 May 2024: Increase of pertussis cases in the EU/EEA