Experts warn against measles and whooping cough: Cases are increasing, precautions need to be taken.

In various cities of Turkey, especially in Istanbul, an unprecedented number of cases are being reported. Experts have issued urgent calls for action in response to the unusual increase in measles and whooping cough cases.

Experts state that they are encountering measles and whooping cough cases more frequently compared to the past, saying, "There has been an increase in the numbers of measles and whooping cough, with cases we have not seen in previous years. Both diseases can lead to very severe complications and can even be fatal if we are not vaccinated. No parent wants to see their child in such severe conditions; they regret it after witnessing it."

"SPREADING MUCH FASTER THAN COVID"

Cases are increasing, and precautions need to be taken; vaccination rates have been steadily declining in recent years. Measles is an infection that spreads much faster than COVID. Although no outbreak has been reported yet, there could be a possibility of an outbreak," they stated. Recently, it has been reported that many countries around the world are experiencing an increase in diseases such as measles and whooping cough. Experts indicate that situations like vaccine dose deficiencies and vaccine hesitancy could lead to serious problems by facilitating the spread of infectious diseases. Prof. Dr. Eda Kepenekli from Biruni University Hospital's Pediatric Infectious Diseases Department and Assoc. Prof. Dr. Deniz Aygün from Istanbul University-Cerrahpaşa, Faculty of Medicine, also pointed out the increase in whooping cough and measles cases compared to the past. Prof. Dr. Kepenekli and Assoc. Prof. Dr. Aygün provided information about the symptoms of whooping cough and measles while emphasizing the importance of vaccination.

"WE CAN LOSE BABIES; WE MUST NOT TAKE WHOOPING COUGH LIGHTLY"

Providing information about whooping cough, Pediatric Infectious Diseases Specialist Prof. Dr. Eda Kepenekli stated, "If we look at the reports from our colleagues working in both Istanbul and other provinces, there is an increase in whooping cough cases. One reason could be that we are now better able to diagnose whooping cough. Additionally, the whooping cough bacterium can sometimes show resistance to the classical antibiotics we use for whooping cough, which can lead to treatment failures. Despite providing treatment in the community, transmission can still occur. Another significant reason is unfortunately the vaccine hesitancy or indecision we have started to see more frequently in our country in recent years. Vaccination against whooping cough for both childhood vaccines and for all caregivers who will come into contact with the baby is our most important weapon. The group that suffers the most severely from whooping cough is individuals under the age of 2, but the most severely affected group is infants under 6 months old. While older children may experience whooping cough as paroxysms of cough without fever, which usually relieve with a deep breath, families may sometimes express, 'They are vomiting phlegm, and then they feel better.' In small infants, however, breathing can be interrupted after coughing fits, and sometimes we refer to this as apnea; they can be lost due to apnea attacks, and they may require intensive care. Sometimes, the coughing fits can cause such severe intracranial pressure increases that we can unfortunately lose infants due to intracranial bleeding. We must not take whooping cough lightly; its complications, especially in small infants, are very severe. Vaccination against whooping cough can be done during the last 3 months of pregnancy, which is actually the most effective method for a mother to protect her baby from whooping cough," she said.

"WE HAVE STARTED TO SEE DISEASES WE FORGOT ABOUT"

In statements regarding measles, Prof. Dr. Kepenekli said, "Two years ago, we experienced a significant increase in the number of cases, an outbreak, and we started to see measles cases on both the Anatolian and European sides. We had identified and reported that the cases started from vaccine hesitancy or from children who were inadequately vaccinated. Although this outbreak was brought under control within a few months, we had to monitor dozens of children in the hospital. There was a break in the vaccine, which is our most important shield against measles. I think this is perhaps a residual effect we are experiencing after the pandemic. The measles vaccine is one that we have been using for years both globally and in Turkey, and we know its effects and side effects very well; we have a lot of experience with it. Measles typically presents with a more severe clinical picture among rash diseases. The rash usually starts on the face and head and spreads to the body. The child can turn bright red, as if they have been exposed to heat or scalded. Accompanying symptoms include dry cough and redness in the eyes, and before that, symptoms like runny nose and sneezing, as if they have a cold, are also distinguishing features of measles, along with very high fever. For example, we generally expect the fever in rubella to be below 38-38.5, but in measles, it can reach as high as 39-40 degrees. There is a very successful immunization program being implemented in our country, and remaining compliant with the vaccination program is the greatest kindness children can do for themselves. We generally see whooping cough in school-aged children, who come with somewhat prolonged coughing fits. If someone in the household smokes, we know that respiratory infections occur more frequently and more severely. We are seeing measles and whooping cough cases more frequently compared to previous years. Measles is an infection that spreads much faster than COVID. No outbreak has been reported yet; only cases are being reported. Previously, the routine vaccination rate for childhood vaccines in our country was above 95%, and we were a very successful country, but in recent years, due to negative attitudes towards this vaccine, the rates have been steadily declining. For this reason alone, we have started to see diseases that we had forgotten about and had not seen for years again. Of course, there could be a possibility of an outbreak. Unfortunately, measles is not a viral infection with a standard antiviral treatment, so it is more important to protect against measles," she stated.

"NO PARENT WANTS TO SEE THEIR CHILD IN SUCH SEVERE CONDITIONS"

Speaking about the number of cases, Pediatric Infectious Diseases Specialist Assoc. Prof. Dr. Deniz Aygün said, "There has been an increase in the numbers of measles and whooping cough; these were not seen this frequently in previous years. The pandemic we have experienced recently and the global conditions have led to a decline in our vaccination rates. Vaccine hesitancy and indecision have unfortunately negatively affected this. The number of measles and whooping cough cases we are currently seeing, which I did not see during my residency, is unfortunately presenting to emergency services. Both of these infections are vaccine-preventable diseases; if we get vaccinated, we will either not catch these diseases or if we do, we will experience them very mildly. If we are not vaccinated, both diseases can lead to very severe complications and can even be fatal. Unfortunately, among the cases we observe, there are unvaccinated individuals. No parent wants to see their child in such severe conditions; they regret it after witnessing it, saying, 'I wish I had vaccinated them.' Families unfortunately realize the importance of vaccination only after experiencing the disease.

Both infections can be seen in all age groups, but the age group that is particularly affected and experiences severe cases is infants with whooping cough. Unfortunately, the whooping cough cases we are currently seeing are very young children, around 2-4 months old. There is no specific age group for measles; we have small patients, and we can also see it in adults and adolescents, whom we refer to as teenage children. Most of our cases are small children; the vaccine is available in our second month, but they can encounter the infection before they have the chance to be vaccinated. Therefore, there is an application called the cocoon vaccination strategy carried out by the Ministry of Health. By vaccinating the mother, father, grandparents, and other adults around, we protect our small baby who has not yet had the chance to be vaccinated, because whooping cough does not provide lifelong immunity. Cases are increasing, and precautions need to be taken. Unlike a pandemic like Covid-19, there is no intercontinental transmission, but we are seeing a number of cases that we have not encountered in previous years. Sick individuals should not be sent to school, general protective measures should be taken, and attention should be paid to distance, as these infections can spread not only through the air but also via droplets. I recommend adhering to our national vaccination schedule and, if possible, administering the seasonal flu vaccine to children," he said.