School has not even started, but whooping cough cases are on the rise again in Hungary

During the last week of August, the weekly number of suspected pertussis patients reached 86, just below this year's peak (89) after a sharp drop to 64 on the 34th week. The National Centre for Public Health and Pharmacy (NNGYK).confirmed the clinical diagnoses with microbiological tests in 20 cases and diagnostic tests still ongoing in the remaining patients.

The outlook is not rosy, with the start of the new school year on 2 September, which will see a multiplication of contacts in communities.

We would therefore not be surprised to see a further increase in the number of new suspected cases of whooping cough each week from September, and on top of that, the spread of upper respiratory illnesses from physical encounters in various communities. We've been reporting in recent weeks that the spread of Covid is also building up.

The number of suspected pertussis cases reported for the 35th week brings the cumulative number to 613 this year, an outstanding figure compared to previous years when only a few cases were found in Hungary. This is strange, because the high rate of vaccination has meant that GPs have generally encountered these diseases mostly in textbooks, and very seldom in practice.

We have repeatedly discussed in our previous articles why pertussis is spreading this fast now:

It is no coincidence, in light of the above figures and trends, that a few weeks ago the NNGYK finally acknowledged that the disease is epidemic. The term has not been used in official communications and announcements, but Ágnes Galgóczi, the head of epidemiology at the NNGYK, has already put it that way.

She told InfoRadio about a fortnight ago that the current rate of spread is also due to the fact that more and more samples from patients with acute cough symptoms are sent to laboratories and suspected cases get registered.

By age group, the most affected are under one year olds, who are unvaccinated or partially vaccinated due to their age, she added.

Of course, there are epidemiological measures for whooping cough.

"They check that the notification is made and if the diagnosis is confirmed, a contact search will be carried out. In some cases, the vaccination status of contacts needs to be assessed and epidemiological surveillance is necessary, the expert explained.

She added, however, that these are individual epidemiological measures, which are carried out by local public health authorities for each reported case. National action is not necessary, she said.

We have previously e-mailed questions to the authority asking whether they plan to recommend vaccination not only to specific groups of the population, but also to make it compulsory or recommend it to certain groups, especially those who work with infants in paediatrics. We have not received any response from the NNGYK so far.

In its statement three weeks ago (in response to our articles on the vaccine shortage), the authority said that due to the high interest in Europe, the vaccine is temporarily less available, but a new large shipment of Adacel polio vaccine arrived in Hungary at the end of the previous week and would be available in pharmacies nationwide after 14 August.

The NNGYK said on 13 August that Hungary received 10,000 Adacel Polio vaccines, but there have been several reports in the press that the pharmacies are out of both Adacel and Boostrix, and when they are available - possibly in state-run vaccination centres - a shot could cost as much as HUF 22,000. Some places even charge for administering the jab and/or for the physician's assistance.

The latest database of National Institute of Pharmacy and Nutrition (OGYÉI) on medicine shortages shows that Adacel has been in short supply since the end of February, without any indication on when the shortage would end. The list only names 'manufacturing problem' as the cause. The causes behind the shortage of Boostrix Polio are 'manufacturing problem' and 'market considerations'. Repevax is not even on the list.

"The pertussis vaccine is prescribed by a GP, after which the product can be dispensed in pharmacies with a prescription. To protect unvaccinated and partially vaccinated babies, it is important that they receive their vaccinations on time and that they are not unduly delayed.

"For their vaccination, the supply of vaccines is ensured - for the compulsory vaccination programme, the NNGYK purchases vaccines centrally," reads the statement, in which the authority also reiterates its previous epidemiological recommendations.

"To protect infants, the NNGYK continues to recommend vaccination for expectant mothers in the 3rd trimester, as well as revaccination for close family members. The newborn's immune system is still partially unprotected against environmental influences and infections. For this reason, the NNGYK stresses that during the first two months after birth, visits with the newborn should be avoided, and you should also avoid crowded places and limit the number of visitors to your newborn."

Portfolio has previously reported in several articles that the most vulnerable group is infants. They were also the group with the highest incidence at week 35. And in the first 35 weeks of this year, 134 of all suspected cases, practically one in five, were infants. If we look at a wider age group of children between 0 and 14 years of age, they make up almost 44% of all cases this year (269 in total), while up to 19 years the share is 55.5% (340 cases).

Cover photo (for illustration purposes only): Getty Images