Infectious diseases expert Professor Robert Booy says it’s been eight years since an outbreak and urges GPs to talk vaccination with patients.
Latest national notifiable diseases data has confirmed what experts feared was coming this year – a pertussis outbreak.
Case numbers are pushing 2000 (1998 laboratory confirmed cases as of 14 December), more than four times higher than this time last year (481), with the numbers spiking during the past three months.
The National Notifiable Disease Surveillance System dashboard showed 2021 was also a year with comparatively low case numbers across the country (550).
Infectious diseases paediatrician and Immunisation Coalition member Professor Robert Booy urged GPs to discuss vaccination with their patients, especially the vulnerable, the elderly and those who have close contact with infants, the population most at risk of serious illness and death.
“It’s eight years since we last had an outbreak in Australia and normally, they come every four years,” said Professor Booy.
“So this is likely to be a big outbreak, if only because there are so many more susceptible children and adults out there to catch it.”
He said children born during covid were particularly susceptible to pertussis because lockdowns and social distancing during the pandemic meant they were not exposed in any way to the disease.
Professor Booy also said this applied to other diseases like RSV, which has also seen a spike in cases this year (125,211 cases this year as of 14 December, compared to 95,971 in 2022).
“You will have noticed that many people at school and work and in shopping centres are symptomatic [with respiratory symptoms] and it’s not just because they’ve got mild covid,” he said.
“They could have a half dozen infections including pertussis but also RSV and adenovirus and paraflu [parainfluenza] – this is what we call an immunity debt.
“Through limited exposure to infection for two to three years [during the covid pandemic], many people lost or diminished their antibody levels, so many more people are so susceptible not only to pertussis, which has been eight years and coming, but loads of other things.”
NSW is leading the country in terms of reported pertussis case numbers (as of 14 December) with 766 cases, followed by Queensland (732 cases), Victoria (284), South Australia (121), Western Australia (57), the ACT (24), Tasmania (11) and the Northern Territory (3).
Professor Booy said there were several “signpost” periods in people’s lives when they should be getting a pertussis booster.
“One of them would around 15 when you get a booster in high school anyway, and then 10 years later at 25, before people have children, and then at 50 they get a booster before the grandchildren arrive, and at 65 on retirement to protect themselves as well as their grandchildren,” he said.
“I use those signposts 25, 50 and 65 as reminders to people.”
In addition to this, all pregnant women should receive a booster, as well as close family members such as other parents and grandparents.
Professor Booy said he was working with Vaxxas, a Queensland-based biotechnology company developing needle-free vaccine delivery platforms with its Nanopatch.
The company’s technology features thousands of micron-sized pointed tips, or projections, which help to deliver vaccines directly to the abundant immune cells found just below the surface of the skin.
The patch-delivered vaccination process is patient-friendly, requires less vaccine than traditional injections into the muscle, and no refrigeration is required.
Professor Booy said clinical trials were underway to use the technology for a needle-free pertussis vaccine which could be delivered alone, without the addition of diphtheria or tetanus, which it is combined with in the current vaccine.
“The DTP [diphtheria, tetanus, pertussis vaccine] that people are getting, mostly they don’t need the diphtheria and the tetanus,” said Professor Booy.
“So we’re asking pregnant women to be vaccinated every pregnancy. Not many people are having three babies anymore, but those who are having a second and a third, and a fourth baby may get more symptoms than they otherwise need to [from the vaccination] because they’ve got antibodies to D and T.
“I do think it’s [the Nanopatch] is going to be an important advance.”
