The WHO-supported Disease Early Warning System (DEWS) of the Ministry of Public Health has reported, investigated and coordinated the response to eight outbreaks of whooping cough in April and May. In the past week there were two outbreaks - from Chemtal District of Balkh Province and from Panjwai District of Kandahar Province.
When the DEWS surveillance officers confirm an outbreak of whooping cough, all the health partners have been assisting in the response. Provincial Health Directorate, WHO, UNICEF, and the NGO providing health services each is playing their role in providing antibiotics, vaccines, and health teams to go door-to-door to check for patients and provide antibiotics. The antibiotic erythromicin is effective for treating the cases and is also given to all the children and adults in the household to prevent further transmission. Very ill infants need to be hospitalized. The immunization outreach plans are also revised to be sure all children are covered with three doses of vaccine in all the surrounding areas.
The report is not back from Panjwai District yet, but in Chemtal District, Balkh, 13 cases of suspected pertussis were found from one village, no deaths.
In Shahwalikot, Kandahar, 5 May, there were 68 cases from 14 villages, no deaths; AHDS vaccinated 1583 children in follow-up campaign.
In Guzara District, Herat, 30 April, 21 suspected cases from one village, no deaths, while in Obeh District, Herat, 24 April, 135 suspected cases from 4 villages, no deaths: Central Lab in Kabul confirmed the causative organism Bordatella pertussis. Parenteral antibiotics and O2 cylinder provided for treating very ill children in the hospital.
In Babi Kas village of Khogiani District of Nangrahar, 17 April, there were 15 cases of suspected pertussis and one death.
In Naili District, Daikundi, on 9 April, 300 ARI cases were reported including 4 adult and 9 childhood deaths. MoPH helicopter took medical team, medicines, and vaccines on 15 April and treated the cases and conducted vaccination campaigns in the area for both measles and pertussis.
Whooping cough, also called pertussis, is prevented by having all of the infants in a community covered with three doses of DPT vaccine by their first birthday. Without full vaccination, the disease is easily spread from person-to-person through coughing and sneezing. Symptoms start similar to a common cold - runny nose, sneezing, low-grade fever and a mild, occasional cough. In a typical case, the cough continues to worsen until, after one to two weeks, the patient has spasmodic bursts of coughing with the characteristic highpitched "whoop" as the patient tries to breathe in. The coughing spells may continue for up to 10 weeks. The disease is especially severe in infants and may be fatal.
WHO and UNICEF are assisting the National EPI to provide training and vaccines, and micro-planning with all NGOs implementing the Basic Package of Health Services so that coverage of DPT3 can be improved to greater than 80% in each district.