Hungary already has 2.5 times more whooping cough cases than in past 7 years combined

In week 26, 19 new suspected cases of whooping cough were diagnosed by GPs in Hungary. This number does not seem to be an outlier, but it brings the cumulative number of cases this year to 115. This is an outstanding figure, given that in recent years the annual number of cases has typically ranged between 0 and 15.

While 115 cases nationwide still do not seem high at first glance, although compared to the previous years it is extremely high, but there are two points to bear in mind.

Firstly, over the past decades, developed countries, including the EU, with Hungary at the forefront (previously 98% vaccination coverage against the disease), have suppressed the disease.

Secondly, doctors who see patients for the first time do not always ask for laboratory tests, so the actual number of patients in the country may be many times higher than this.

The current weekly figure is also the second-highest this year, and illustrates the severity of the whooping cough situation in 2024, as

IN PREVIOUS YEARS THERE HAVE NOT BEEN AS MANY SUSPECTED CASES REPORTED IN A WHOLE YEAR AS THERE ARE NOW IN A SINGLE WEEK.

The graph below looks eerily similar to an epidemic infection situation.

A year-on-year comparison shows that the situation this year is very different from previous years, with a communicable disease once relegated to the background - we thought permanently.

Hungary already had 2.5 times as many pertussis cases In the first 26 weeks of 2024 as in the seven years between 2017 and 2023.

The reports of pertussis came from the capital and seven counties (Baranya, Győr-Moson-Sopron, Hajdú-Bihar, Jász-Nagykun-Szolnok, Pest, Somogy, and Tolna), the NNGYK weekly report details.

The microbiological tests carried out confirmed the clinical diagnosis in one case, while diagnostic tests are still ongoing for the remaining 18 patients.

In the report for the 25th week, the NNGYK said that in one of the 20 cases the disease was imported (from Austria), which was an indirect recognition by the epidemiological authority that the infection is already spreading within the country.

Why is this disease dangerous?

Pertussis, also known as whooping cough, is a highly infectious bacterial disease that affects the respiratory tract. It is caused by a bacterium found in an infected person's mouth, nose and throat.

Symptoms usually appear 7 to 10 days after infection. Initially, the symptoms are similar to those of a common cold, and include

• sneezing
• runny nose
• low-grade fever
• mild cough

The disease is most dangerous for unvaccinated babies (under 2-3 months), so their parents need to be very careful. Without vaccines, coughing fits can develop during the course of the disease, which can end in respiratory failure or even respiratory arrest.

Although pertussis can occur at any age, and the most commonly diagnosed age groups are infants under one year of age and adolescents between 10 and 20 years of age, an increasing number of adults are being diagnosed with pertussis.

Infants under six months, unimmunised or partially immunised, face the highest risk of severe disease outcomes,

with the majority of pertussis-related hospitalisation and deaths occurring in this vulnerable age group," the European Centre for Disease Prevention and Control (ECDC) warned in early May.

We have updated our data collection based on age distribution figures from the weekly NNGYK reports, which confirms that the infection is most commonly identified in infants, with a quarter of all pertussis patients up to the 26th week belonging to this age group. The second most affected group is adolescents between 15 and 19 years of age, with over 19% of all cases in this group.

40% of the cases were detected in the 0-14 age group and 59.1% in the 0-19 age group in the first 26 weeks.

The main reason behind the high prevalence of pertussis among young people is that under Hungary's compulsory vaccination programme, children receive the vaccine against the infection in infancy, followed by booster vaccinations at 6 years and 11 years. However, the specificity of the vaccine is that after five to six years its efficacy wanes. This means that it is at 15-16 years that young people become susceptible to the infection again, as shown in the age distribution chart below.

According to expert opinion, the combination shot given at 2 months of age (diphtheria, pertussis, tetanus, poliomyelitis, and Haemophilus influenzae b), provides effective and safe protection for babies up to about 3 months of age.

In its an article last week, Hungarian daily Népszava pointed out that whooping cough is a highly contagious disease with a susceptibility index of 90%. This index indicates how many out of 100 people who are not protected, for example by vaccination or by previous infection, will become ill if they encounter the pathogen.

It is therefore important to pay attention to the youngest children. That is why a report by Népszava last week made such a splash. It said that an epidemiological inspection was carried out by a staff member of the capital's government office at the paediatric intensive care unit of the National Institute of Cardiology (GOKVI), who coughed but did not wear a mask. Two days later, the inspector reported that he/she was ill and being treated for pertussis.

On Monday, the Budapest Police Headquarters told Magyar Hang that no charges have been filed in connection with the incident, and that the Budapest Police Headquarters is investigating the circumstances of the case.

There is a vaccine against it

In our last article, we wrote that the pertussis vaccine for adults (Boostrix Polio) that has been used so far is still unavailable nationwide.

In the meantime, we have received information from market players that there is a substitute for the booster vaccine for adults (Adacel Polio), which is currently available in pharmacies.

It is important to note that the vaccines required by the mandatory vaccination programme are available (infants receive this vaccine first at 2 months of age, followed by booster vaccines at 6 years and 11 years).

The rise in the number of cases of whooping cough across Europe shows the need to be vigilant. It is a serious disease, particularly in infants. We have safe and effective vaccines that can prevent it. Vaccination is our key tool to help save lives and stopping the disease from spreading further,

said Stella Kyriakides, EU Commissioner for Health and Food Safety, in May.

How it spreads

Pertussis is mainly transmitted by the inhalation of infected droplets from the nose or throat of an infected person. It can also be transmitted even if the infected person is mild and even asymptomatic.

Vaccination and treatment

The most effective protection against pertussis is full vaccination. The vaccination schedule differs from country to country, with some countries recommending booster doses at certain times, such as adolescence or pregnancy in women. 

Antibiotic therapy is also available, but to be effective it must be started at an early stage of the disease, within two weeks or so of onset. In the case of a very young infant or critically ill child, it is important to provide supportive care while they are in hospital.

Protective measures

Protective measures include wearing a mask to cover the nose and mouth to avoid the risk of infection. It is also recommended that those infected avoid close contact with young children and infants. In addition, people in close contact with infected persons can receive preventive treatment.

Cover photo (illustration): Getty Images