Whooping cough is a highly contagious bacterial infection whose transmission occurs mainly within the family or in communities through contact with a sick person with a cough. Even though the number of cases of whooping cough has decreased significantly since the introduction of the vaccine, the bacteria continues to circulate. Infants too young to be vaccinated and adolescents and adults who have lost vaccine protection are the most affected populations. Outside our borders, Europe is currently experiencing an upsurge in cases of whooping cough with significant epidemics in Croatia, Denmark and the United Kingdom and significant increases in Belgium, Spain and Germany. In France, since the start of 2024, around twenty grouped cases (or clusters) have been reported to Public Health France in 8 French regions versus 2 grouped cases in a single region (Ile-de-France) for throughout 2023. Given this clear increase in the number of cluster cases reported, Public Health France remains vigilant and recalls the importance of vaccination to protect people at risk of serious forms.
A resumption of the circulation of whooping cough begins in France
Whooping cough progresses in cycles of recrudescence every 3 to 5 years. In France, surveillance data from the RENACOQ network (the hospital pertussis surveillance network) have shown six epidemic peaks in recent years: 1997, 2000, 2005, 2009, 2012-2013 and 2017-2018. Since the last peak of whooping cough (162 cases reported), the number of cases has continued to decrease to reach 34 cases in 2020 and 4 cases in 2021 in infants under 12 months. Same observation regarding the data from the Sentinelles network (the research and monitoring network in primary care general medicine and pediatrics in mainland France) reporting 1 case per year in the general population over the same period. Even if a rebound in the disease could be expected in France in 2021-2022, the exceptional context and the health measures implemented as part of the COVID-19 epidemic have probably reduced the transmission of whooping cough.
The data published today, from the latest surveillance report, indicate a greater resumption of the circulation of whooping cough in recent months in mainland France. Thus, the RENACOQ network (monitoring hospitalized infants under 12 months since 2016) reported in 2022, 45 cases and in 2023, 39 cases (unconsolidated data). Regarding grouped cases in 2023, only 2 grouped cases were reported to Public Health France between October and December with 18 cases of whooping cough in Ile-de-France: they concerned intrafamilial grouped cases (13 cases), clusters in the community (4 cases) and a final isolated case with no link in the surroundings of the reported clusters. In the first quarter of 2024, around fifteen clusters, mainly in communities (nursery schools, primary schools, daycare centers and nursery homes) but also in families and totaling 70 cases were reported to Public Health France (data not consolidated for the current year 2024 ).
The multiplication in the number of cases compared to 2023 and the sharp increase in grouped cases indicate a resumption of community circulation of the bacteria which could intensify in the coming months. Vigilance remains essential, with the need to increase public awareness of this disease and its prevention methods. To date, the French situation is not comparable with that of our European neighbors and across the Atlantic who have reported several hundred cases per week since the last quarter of 2023.
Number of hospitalized cases of whooping cough in children under 17 years of age (1996-2015) and in infants under 12 months of age (2016-2023), RENACOQ data. (*2023 data, not consolidated)
The importance of reporting and the measures to be taken with regard to the patient and those around them
Whooping cough is not a notifiable disease but cases must be reported to the Regional Health Agency in two specific situations:
- as part of the reporting of nosocomial infections or
- during the occurrence of grouped cases (from 2 cases) whether intrafamilial or in communities.
Furthermore, measures must be taken with regard to the patient and those around them, in particular for people at risk and in communities at risk (maternity wards, nurseries, health establishments, etc.) such as eviction of the patient and the implementation of antibiotic treatment for sick people, antibiotic prophylaxis for contact subjects not protected by vaccination as well as an update of the vaccination of the exposed population. It is also recommended to have at least the first case confirmed biologically and to send a sample, bacterial isolate or DNA extracted from the sample to the pertussis CNR to confirm in particular the species.
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Vaccination, the only means of protection against whooping cough
The vaccination policy against whooping cough in France aims to reduce severe forms, hospitalizations and deaths linked to whooping cough which mainly occur in infants under 6 months of age. It is based on three complementary strategies:
- early primary vaccination of infants as soon as they are old enough to be vaccinated, i.e. from the age of 2 months, and the administration of iterative boosters at 6 years, 11-13 years and up to as an adult (25 years old with the possibility of catching up until 39 years old);
- vaccination of pregnant women, recommended from the second trimester of pregnancy, favoring the period between 20 and 36 weeks of amenorrhea;
- in the absence of vaccination of the mother during pregnancy, vaccination of the mother postpartum and of people likely to be in close contact with the infant during its first 6 months of life (so-called cocooning strategy) .
People at risk of severe forms of whooping cough are, beyond infants not protected by vaccination, people suffering from a chronic respiratory disease (asthma, chronic obstructive pulmonary disease, etc.), immunocompromised people, women speakers. It is therefore recalled that vaccination is recommended for immunocompromised people, health professionals (including in accommodation establishments for dependent elderly people (EHPAD), people working in close and repeated contact with infants under the age of 6 months, medical and paramedical students, early childhood professionals including childminders, people who regularly babysit.
As European Vaccination Week approaches, Public Health France provides numerous tools and resources to better understand the challenges of vaccination and raise public awareness of vaccination recommendations.
Documents to download
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Whooping cough. Pregnant women. The 5 good reasons to get vaccinated
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Whooping cough – Adults: 5 good reasons to get vaccinated
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