Doctors explained the increase in the incidence of whooping cough in Russia by migration and the activity of anti-vaxxers

In Russia, the incidence of whooping cough has seriously increased: if 3.1 thousand cases were identified in the entire 2022, then in ten months of 2023 – 27.8 thousand. The professional service “Doctor’s Directory” conducted a survey of representatives of the professional community on this topic. 24.5% of respondents rated the situation in their region regarding whooping cough as tense; only 40% of respondents answered that among their patients there were no cases of this infection. Doctors attribute the surge to uncontrolled migration flows and powerful anti-vaccination propaganda. “The increase in the incidence of whooping cough in Russia may be associated with the complete abolition in 2023 of preventive and anti-epidemic measures introduced earlier to limit the spread of COVID-19,” representatives of the Russian Ministry of Health are confident.

In early December, Rospotrebnadzor reported a surge in the incidence of pertussis infection: at the end of ten months of 2023, the incidence rate was 11.5 per 100 thousand population. According to Rosstat, published in the statistical collection “Socio-economic situation of Russia”, from January to October 2023, 27.8 thousand cases of whooping cough were recorded, which became an absolute record in recent years. For the entire 2022, 3.1 thousand cases of whooping cough were identified in the country, in 2021 – 1.1 thousand. For six years, the maximum figures were noted in 2019 – then 14.4 thousand cases of the disease were recorded.

Whooping cough is an infectious respiratory disease caused by the bacteria Bordetella pertussis. Characterized by attacks of spasmodic cough, intoxication and primary damage to the respiratory tract.

The professional service “Doctor’s Directory” conducted a survey in December 2023 about the situation with whooping cough among 1,316 respondents. 24.5% of doctors rated the whooping cough situation in their region as tense, 29.9% as moderate, 2.3% as critical, 24.5% as calm, 18.8% could not answer. Only 40% of respondents answered that among their patients there were no whooping cough cases. 25.8% said that mainly children in their environment get sick, 6% – mostly adults, 15.4% noted that both adults and children get sick, 12.7% did not have information. Doctors attribute the increase in the incidence of whooping cough in Russia to uncontrolled migration flows (especially from neighboring countries) and powerful propaganda among the population from anti-vaccine activists. These answer options were chosen by 30.2% and 34.5% of respondents, respectively. The third most popular answer is lack of public awareness of the importance of vaccination – 12.8%.

The vast majority of doctors believe that everyone who has no contraindications should be vaccinated—this was the answer of 92% of respondents. However, 28 (2.1%) of the surveyed doctors do not recommend vaccination to anyone. Therapist, founder of the medical decision support system “Doctor’s Handbook” Konstantin Khomanov in this regard points out that “negativity towards vaccination” has its reasons. First of all, Mr. Khomanov notes, future doctors in universities are often given lectures on vaccination based on outdated scientific data. In addition, he points to the “powerful” anti-vaccination propaganda: “Leaders of anti-vaccination movements are usually excellent manipulators, charismatic, and able to present scientific information from an advantageous position.” Mr. Khomanov clarifies that “many doctors, in principle, do not trust anything foreign, neither vaccines, nor science.” “It is imperative to fight the anti-vaccination movement. This is a large and complex work that should be controlled by the state,” he emphasized.

When asked what vaccines against whooping cough are available in the region, 16.5% of respondents answered that only domestic (DPT), 6.8% – only foreign (Pentaxim, Infanrix, Adasel), 44% indicated that Both domestic and foreign drugs are available. The rest were unable to answer.

83 surveyed specialists (6.3%) admitted that in their medical institution there is an unspoken rule not to diagnose whooping cough. However, 62.5% do not have such a rule.

19.1% of doctors encountered consequences or complications of whooping cough in the form of damage to the respiratory system (bronchitis, pneumonia, pleurisy, emphysema, pulmonary atelectasis, pneumothorax), another 2.5% – in the form of injury due to coughing (rib fracture, rupture of the frenulum of the tongue, eardrums, abdominal wall muscles, hernias, rectal prolapse, hemorrhoids), 3.7% – in the form of damage to the nervous system (delayed psychomotor, speech development, neurosis, convulsive syndrome), 1.7% – in the form of vascular damage (stroke , retinal hemorrhages, petechiae). Only about 11% of doctors encountered complications after vaccination, while 8.8% indicated that a cause-and-effect relationship could not be proven.

Infectious disease specialist at the Doctis telemedicine service, Tatyana Kogut, believes that the rise in the incidence of whooping cough was expected for a number of reasons. “Firstly, this is the return of airborne infections to the arena after the pandemic, and secondly, a certain cyclical nature of the epidemic rise of whooping cough, which is observed every five to six years,” comments Ms. Kogut. “There was a noticeable rise in the incidence of whooping cough in 2010–2011 , then in 2015–2016, and in 2020 the pandemic came and the timing shifted.” Another reason, according to the infectious disease specialist, is the relative instability of the vaccinated organism: “It is believed that vaccination provides protection for an average of five to six years. But the Russian calendar does not provide for the vaccination of children against whooping cough before school. There is a commercial vaccine that can be used to vaccinate children from the age of four and adults up to 65 years of age, but this is an unroutine vaccination and few people take this vaccine.” Mrs. Kogut also points out that it is not always possible to immediately identify whooping cough, and if doctors have not encountered it for a long time, they assume other diseases. “Adult patients may not see a doctor at all with this kind of cough,” says Ms. Kogut. “For the first time this year, complications from whooping cough in the form of rib fractures were noted in adults.”

The chief freelance specialist of the Russian Ministry of Health for infectious diseases, Professor Vladimir Chulanov, confirmed that in ten months of 2023 the number of registered cases of the disease “among the total population” increased compared to the same period of the previous year. Moreover, more than 90% of the sick are children under 17 years of age inclusive. “The increase in the incidence of whooping cough in Russia may be associated with the complete abolition in 2023 of preventive and anti-epidemic measures introduced earlier to limit the spread of COVID-19,” noted Mr. Chulanov. “In 2020–2021, there was a decrease in the rate of vaccination of the population due to the introduction of restrictive activities that could affect the spread of whooping cough. In this regard, it is important to take additional measures to increase awareness of the population and medical workers on vaccine prevention, in particular on the effectiveness and safety of whooping cough vaccines.” Vladimir Chulanov added that currently, according to the drug labeling system, the number of vaccines for the prevention of pertussis infection in the regions is more than 4 million doses and there is no shortage of them.

Rospotrebnadzor, when asked by Kommersant to comment on the situation with the incidence of whooping cough, reported that “during the pandemic of the new coronavirus infection, restrictive measures served as a deterrent to the activity of the epidemic process for a number of infections, including whooping cough,” therefore, “the detection of whooping cough was recorded within a few dozen cases ” The department emphasized that the immunization plan (vaccination and revaccination) against whooping cough in 2023, carried out as part of the National Preventive Vaccination Calendar, has been 100% completed. Vaccination preparations are available in all regions. Compliance with the vaccination calendar will significantly reduce the statistics of outbreaks of this infection, the supervisory service added.

Natalia Kostarnova