Why Covid-19 isn’t the only deadly cough pregnant mums in Malaysia should be concerned about

·4-min read
In the midst of the Covid-19 pandemic, it’s easy to forget about other diseases that pose a risk to you and your child. — AFP pic
In the midst of the Covid-19 pandemic, it’s easy to forget about other diseases that pose a risk to you and your child. — AFP pic

PETALING JAYA, June 14 — Covid-19 isn’t the only deadly cough that pregnant mothers have to worry about during this pandemic.

Local cases of pertussis, commonly known as whooping cough, have risen sharply from just eight in 2005 to a whopping 915 in 2019, according to data from the Health Ministry and the World Health Organisation (WHO).

Babies are especially vulnerable to the disease with 86 per cent of lab-confirmed cases occurring in infants below one year of age and 74 per cent of cases found in infants below six months old, based on a study in Malaysia from 2013 to 2014.

While pertussis is a vaccine-preventable disease covered under the National Immunisation Programme, infants can only receive the diphtheria, tetanus, pertussis (DTaP) vaccine when they turn two months old.

This means it’s important for pregnant women to get vaccinated with the three-in-one tetanus-diphtheria-pertussis (Tdap) vaccine as it helps protect babies during the first two months of life before they start their official vaccination schedule.

Whooping cough is on the rise once again in Malaysia. — Picture courtesy of Protect Me, To Protect My Baby
Whooping cough is on the rise once again in Malaysia. — Picture courtesy of Protect Me, To Protect My Baby

The Tdap vaccine has been shown to reduce an infant’s risk of getting infected with pertussis by over 90 per cent and reducing pertussis-related deaths in babies aged three months and younger by 95 per cent.

Hence, the Malaysian Society of Infectious Diseases and Chemotherapy recommends that all pregnant women receive a dose of the Tdap vaccine, best given between the 27 to 36-week gestation of pregnancy.

The vaccine is safe with minimal side effects typically consisting of soreness at the injection site, though some may also experience fatigue, body aches and mild fever.

A pregnant woman who gets vaccinated produces antibodies that are passed on to the foetus through the placenta, which gives the baby protection against whooping cough from the moment of birth.

The antibodies will also be passed on to the baby through breast milk if the mother chooses to nurse the child.

In light of this, a public awareness campaign named Protect Me, To Protect My Baby has been introduced in Malaysia to educate the public on the threat of whooping cough to young infants and the importance of maternal immunisation in protecting them from such diseases.

What is whooping cough and how do you differentiate it from Covid-19?

Maternal immunisation means babies will receive protection against whooping cough during the first few months of life while they are at their most vulnerable. — Picture courtesy of Protect Me, To Protect My Baby
Maternal immunisation means babies will receive protection against whooping cough during the first few months of life while they are at their most vulnerable. — Picture courtesy of Protect Me, To Protect My Baby

A 2014 study by WHO estimates that 5.1 million cases of whooping cough occur globally in infants less than one-year-old, with 50 per cent requiring hospitalisation and 85,900 cases ending in pertussis-related deaths.

Dr Patricia Lim Su-Lyn, an obstetrician-gynaecologist in private practice, spoke to members of the media recently to shed some light on the disease and the danger it poses to newborn babies.

Whooping cough is an acute respiratory infection caused by the Bordetella pertussis bacteria and is characterised by difficulty in breathing and a severe cough that may be accompanied by fever and vomiting.

Dr Lim said the disease is also known colloquially as the “40-day cough” due to the prolonged bout of coughing and hacking.

In severe cases, whooping cough can lead to pneumonia, convulsions, and brain damage.

Dr Lim said it’s important to be vigilant against whooping cough to avoid death and added burdens to the national healthcare system. — Picture courtesy of Dr Patricia Lim Su-Lyn
Dr Lim said it’s important to be vigilant against whooping cough to avoid death and added burdens to the national healthcare system. — Picture courtesy of Dr Patricia Lim Su-Lyn

In terms of differentiating whooping cough from Covid-19, Dr Lim said there are no definitive ways to tell the two diseases apart from relying on laboratory testing and the mother and baby’s vaccination record.

This is because it’s impossible to tell if coughing infants are exhibiting other tell-tale signs of Covid-19, such as loss of smell or taste.

“It is very difficult in the age of Covid-19 to distinguish between whooping cough and Covid-19 so we would need to run laboratory tests to determine what kind of infection it is.

“There’s no specific tell-tale sign because you can’t tell if the baby is experiencing other symptoms, like a loss of smell.

“We also have to go by history, so we would ask the mother if she has been vaccinated with Tdap during her pregnancy, which would mean it’s unlikely that the baby has (whooping cough),” said Dr Lim.

She added that whooping cough is much more infectious than Covid-19 which has a reproductive number (R0) that typically hovers around one.

The R0 for whooping cough is 17, which means that one infected person can potentially spread the disease to 17 other people.

Dr Lim said that it’s more important than ever to protect mothers and babies from this disease to avoid death and added burdens to the healthcare system, especially during a pandemic.

“If the public is not aware of this disease, we will see pockets of resurgence of this disease amongst infants and the number of hospitalisations and ICU admissions will go up.

“These babies will require respiratory assistance which will indirectly increase the economic burden on our healthcare system and a rise in infant mortality, especially for those below the age of three months.”

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