Why are measles and whooping cough making a resurgence in Europe?

According to the Spanish Association of Vaccinology (AEV), the recent outbreak of whooping cough in Guadalajara and the resurgence of measles in several European countries highlight the importance of timely vaccination in childhood. Although the situation in Spain is far from alarming, throughout 2023 There are 1942 cases of whooping cough in our country.. Meanwhile, measles in Spain remains under control with just a dozen confirmed cases, all imported from the country or having had close contact with it. But in countries such as Britain and Romania, the trend has reversed in unvaccinated regions.

According to the British Health Agency, in 2023 there will be 1603 suspected cases measlesLast December, an outbreak in Birmingham left fifty children hospitalized. In general, the whole of Europe is experiencing this renaissance. The number of cases has risen from 900 in 2022 to more than 42,000 in 2023, according to WHO.

For its part, infections choking cough They are also growing across the continent, including Spain, although it is a pathogen “in a completely different epidemiological situation,” notes Josefa Masa Calles of the National Center of Epidemiology (ISCIII).

“Whooping cough was already increasing before the pandemic,” he recalls, “and now, without restrictions on human contact and after a period of very low circulation (which weakens the population’s immunity), outbreaks may occur.” His transfer was quick. Our country has registered 737% more cases than in 2022. The EU’s epicenter was Denmark, which reported more than 1,200 cases and one death, the first infant to fall ill in that country in 13 years. What’s happening?

What is whooping cough, what is measles and how to distinguish its symptoms

From the University Hospital of Guadalajara, pulmonologist Olga Mediano explains to Newtral.es that, in fact, “we have an increase in whooping cough cases in Henares corridor and they have already encountered this situation in pediatrics in other cases, and since in the vast majority of cases children are vaccinated, these are mild cases.”

Both whooping cough and measles are diseases mandatory declaration in Spain. The Carlos III Institute of Health (ISCIII) reminds us that whooping cough is a respiratory tract infection caused by bacterium Bordetella whooping cough. Like measles, whooping cough very contagious and is transmitted through direct contact with respiratory secretions or droplets of saliva sick person.

Although initially confused with a cold, symptoms such as Whooping cough which ends with a long breath accompanied by a high-pitched whistle. Children under six months of age and immunocompromised adults are at greater risk complications, especially from the second week of infection. In general, in vaccinated people it occurs in a mild form.

He measlesfor its part, is virus families paramyxovirus. It is usually benign; This can cause complications such as pneumonia, otitis media, laryngotracheitis and diarrhea. In rare cases, it can cause encephalitis or death. In this case, vaccination is very effective against infection.

Measles and whooping cough return, especially when vaccinations fail.

For both measles and whooping cough it is vaccination is required, especially against the former, which could be an elimination disease (in Spain it was considered eliminated in 2016–2017). As immunologist Margarita del Val (CBMSO-CSIC) explained in the Newtral podcast It’s not the end of the world eitherVaccination in childhood is key, even if it does not prevent infection, although it does prevent the severity of the disease or becomes less effective over time – as is the case with the whooping cough vaccine.

In the case of measles, it is a very effective barrier against transmission. “Vaccines give us protect others from infecting others“This is an investment for all our fellow human beings,” Del Val said. Similarly, epidemiologist and pediatrician Kike Bassat (ISGloblal) notes that measles “serves to some extent as an indicator that tells us how the coating works vaccine.” He explains that he is “very, very sensitive to a percentage drop of just one or two vaccination points.”

“Measles is very, very sensitive to minimal reductions in vaccination rates. “It’s very contagious.”

The expert recalls that this is one of the most contagious viruses known, and herd immunity is achieved in approximately 95% of the vaccinated population. “Each person could theoretically infect (R0) 14 to 18 people, unless there are other containment measures, there will always be a surge when vaccinations fall.”

Whooping cough vaccine tooworks great, but not for life, protection weakens over time. This is why we see cases in teenagers, the elderly or children under six months of age who have not completed the vaccination schedule (the first dose is prenatal),” Bassat told Newtral.es. This explains why, when examining historical data, we see times with larger and smaller outbreaks, even with proper vaccination coverage.

Dr. Mediano emphasizes, “Families are not getting messages from non-believers that vaccines don’t work because outbreaks are happening. It is the vaccine that makes the symptoms spontaneous and less severe.”

The pandemic leads to whooping cough and measles.

Data published by UNICEF and WHO in 2022 concluded that the pandemic was largely due to a drop in systematic vaccination rates. “The data is terrible,” Angel Hernandez Merino (Vaccine Advisory Committee of the Spanish Pediatric Association) explained at the time. “25 million children did not receive a single dose of diphtheria, tetanus and whooping cough vaccine in the first year of life in the world. . Childhood vaccinations are given shocked by the pandemic earthquake.”

Bassat believes that “after three strange years of children being infected, we are seeing a kind of effect recover from many diseases“, including whooping cough. “This is another sign that we are returning to infectious disease transmission.” And it is enough that vaccination has fallen, even if only slightly, for this to be reflected in the statistics, although the data, he clarifies, is not alarming.

Whooping cough vaccination – revaccination after birth – fell by an average of 2.42 points percentages between 2019 and 2021, with a slight recovery in 2022. Vaccination against measles fell by 1.96 points during the pandemic, although coverage nearly recovered to previous levels in 2022, reaching 97.2% for the first dose. First, it can prevent many serious cases in infants. Second, it effectively slows down transmission. Both save lives.

Measles reappears when at least 95% of the population is not vaccinated.

herd immunity designed for measles vaccine 95%. Pediatrician Fernando Moraga-Llop of AEV explains that the average coverage in Spain for the triple virus (measles, rubella and mumps) in 2022 (latest data) was 97.2% for the first dose and 93.9% for the second dose. On average this is because there are some autonomy that does not reach this threshold immunity: Castilla-La Mancha did not reach 91% with the first dose. La Rioja (91%), Catalonia (94.4%) and Castilla-León and the Canary Islands (both 94.7%) also fell below herd immunity levels, according to the Vaccination Information System (Civamim).

In the case of the second dose, which is administered to children aged 3–4 years, the following communities did not comply with the recommendations: Basque Country and La Rioja with a percentage of 88%, followed by Castilla-La Mancha (88 0.8%), Extremadura ( 90.2%), Canary Islands (90.3%), Catalonia (93.1%), Castile and Leon (93.6%), and Galicia and the Community of Madrid (94.5%).

Margherita del Val, speaking to Newtral.es, insisted: “We must understand why people doubt that vaccines will help them and give them all the information they need. Because vaccines work, and the clearest proof is how they stopped the (Covid) pandemic.”

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