The Italian Society of Pediatrics (Sip) launches an alert for whooping cough in Italy. After the alarm from the European Center for Disease Prevention and Control (ECDC), which highlighted a more than 10-fold increase in cases in Europe, the infection is also being felt in Italy. The ongoing whooping cough epidemic is mainly affecting unvaccinated newborns and infants and has resulted in three deaths since the beginning of 2024, with an 800% increase in hospitalizations compared to last year.
What children risk with whooping cough: “It is unacceptable not to be vaccinated”
“Whooping cough is a highly contagious and dangerous disease, especially in the first months of life and in newborns who have a greater risk of complications and death”, declares the president of Sip Annamaria Staiano. “We can protect this particularly vulnerable population – he continues – through the immunization of mothers during the second and third trimester of pregnancy, which is highly safe and effective in protecting children who are still too young to be vaccinated. We invite pregnant women to get vaccinated against whooping cough because the lives of our little ones are at stake. It is unacceptable that in 2024 we could die from infectious diseases for which effective and safe vaccines exist.”
In Italy, from January to May 2024, 110 cases of whooping cough were recorded, with over fifteen hospitalizations of small infants in intensive care and three deceased newborns. The data were disclosed by Alfredo Guarino, president of the Campania section of Sip and were obtained as part of a Pnrr, Inf-Act project, which aims to develop new strategies for the early identification, prevention and treatment of threats infectious.
How many cases of whooping cough are there in Italy and where are they most common?
Most cases of whooping cough were recorded in Campania, Sicily and Lazio. “We have witnessed an increase in hospitalizations for whooping cough of 800% compared to 2022 and 2023, which in most cases concerned unvaccinated newborns and infants under 4 months of age – says Guarino – 95% of mothers These children were not vaccinated and 80% had not received any information on the availability of antenatal vaccination.”
However, the data could be underestimated: “They refer to hospitalized children in serious clinical conditions and are therefore certainly to be considered serious cases, therefore, they are only the tip of the iceberg with respect to the circulation of whooping cough, as non-pertussis cases are not considered hospitalized”.
The situation is worrying in Campania, where “over 30 hospitalizations of infants suffering from whooping cough in pediatric infectious disease centers in Naples” have been recorded, according to Guarino.
Seventeen patients were instead hospitalized for whooping cough in the first 4 months of 2024 at Umberto I in Rome, of which three ended up in intensive care. “In the same period last year we had only recorded one case – says Fabio Midulla, head of emergency pediatrics at the hospital – this is the first epidemic peak of whooping cough after Covid-19”.
Even from Sicily the news is not good: “Forty newborns and infants with whooping cough have been intercepted in the last 5 months in the emergency room of the Cristina hospital in Palermo, which is the reference point for western Sicily – the data reported by Domenico Cipolla, head of the hospital's pediatric emergency room – of these 10 ended up in neonatal intensive care. In the previous season, there had not been a single case. Vaccination coverage in pregnant women in Sicily is extremely low”.
How the whooping cough vaccine works: efficacy and tolerance
As the website of the Higher Institute of Health dedicated to infectious diseases, Epicentro, explains, the whooping cough vaccine is based on whole bacteria inactivated by heat. Often, it is given together with the diphtheria and tetanus vaccines.
In Italy vaccination is mandatory. It is administered to children starting from the eighth week of life. Due to the loss of immunity over time, multiple boosters are necessary: the first dose, the second and the third are given 6-8 weeks apart, to which a final booster dose is added around 2 years of age.
This vaccine is very effective, but its tolerance is not always good. For this reason, acellular vaccines have been developed, in which the entire bacterium does not appear, but only some bacterial proteins, which are nevertheless capable of activating the immune system. Acellular vaccines, effective and better tolerated in newborns, are recommended for primary doses and reinforcement doses.