Cases of Whooping Cough in Israel Have Risen 150% This Year

Increase in disease, which can be fatal and is passed on by coughing and sneezing, reflects global trend for the disease. Biggest rise is among infants and children from 5 to 14

File photo: Swine flu vaccinations in Tel Aviv, March 22, 2016.
Tomer Appelbaum

The number of cases of whooping cough diagnosed in Israel from the beginning of 2019 is two and a half times the number from the same period last year.

Between January and the beginning of November this year, 1,375 cases of the disease, also known as pertussis, were diagnosed, compared to only 555 cases for the same period in 2018 – a 148 percent increase, Health Ministry data show. Only 438 cases were reported for the same period in 2017.

Whooping cough is a highly contagious, airborne bacterial disease, and can be fatal. The infectious bacteria that cause the disease can be found in the respiratory tract and are spread through sneezing and coughing. The bacteria secrete a number of toxins in the respiratory tract and lead to attacks of a heavy cough that can last for weeks and cause vomiting. Infants infected during their first year of life are exposed to serious complications such as bacterial pneumonia, which can cause them to stop breathing and suffer seizures. Patients are treated with antibiotics and stop being contagious after about four full days of treatment.

The rising trend in cases of the disease in recent years is global and is striking at all ages – but especially among infants under a year old and in children ages 5 to 14. Experts say the reason for the increase in whooping cough is related to the drop in vaccination rates among the general population. But at the same time, the experts say it is also related to a natural drop in the effectiveness of the vaccine. Another possible explanation for the increase is a change in the bacterial strain behind the disease, known as Bordetella pertussis.

Dr. Joseph Danieli, medical director at Maccabi Health Services, said, “What we have seen in recent years in Israel is occurring in many countries around the world, including developed and developing nations. We see an increase in infection in unvaccinated groups, but also among those who have been vaccinated. It is possible that a reexamination is required concerning the vaccination program against whooping cough,” added Danieli. In recent years, awareness of the disease has grown, on the part of doctors too, which can explain some of the rise in diagnoses. But Danieli says the influence of families who do not vaccinate their children at all, or do not complete the entire course of vaccinations, is being felt – and this has increased the range of transmission of the disease.

Today, the vaccine against whooping cough is given to children in Israel in five doses as part of the regular vaccination program – from age two months through eighth grade (age 14).

In the early 20th century, whooping cough was a major cause of infant mortality, in this country and around the world, until vaccinations began. The vaccination was made part of the regular vaccination program in 1957 in Israel, and led to a 90 percent drop in the number of cases. But the protection provided by the vaccination is not 100 percent effective and does not provide lifelong immunity either, as its effectiveness wanes with a person’s aging.

As a result, the pertussis vaccination program has been expanded and changed: In 2002, the vaccination was changed with the goal of reducing the side effects it causes. From 2004 to 2006, the rate of infection from the disease jumped by 14 times compared to the mid 1990s. As a result, it was decided in 2008 to add another dose of the vaccine for children in second grade and then another in eighth grade. In 2015, a vaccine for pregnant women was added to protect babies in their first few weeks of life, until they receive their first dose of vaccine.