Bulgaria’s health authorities introduce measures for pertussis prevention and control across the country

In response to the rising incidence rate of whooping cough, Bulgaria’s health authorities are introducing epidemic-control measures across the country. There are no restrictions on the movement of people and the work of schools, institutions, traders and restaurants. According to the latest data, there are 843 confirmed cases of pertussis in the country. The infection is circulating in 25 districts (out of 28 in the country). Over 80% of the infected are babies younger than 12 months of age.

About 65% of the cases are concentrated in the districts of Sofia, Sofia-city and Kyustendil. Over 90 people have been admitted to hospital with complications from pertussis, according to a report by the chief state health inspector.

The measures, which come into force from tomorrow, May 9, and will apply until the end of July, provide for the opening of vaccination offices for pregnant women in the Regional Health Inspectorates across the country and daily monitoring for children with symptoms of the contagious disease in schools and kindergartens.

Changes to the immunisation schedule are now in effect. They give GPs the right to administer the first vaccine against pertussis when a baby is six weeks old, rather than after the eighth, as was previously the practice.

843 cases of whooping cough registered in the country, health minister says

"The timing of first, second and third dose, which are given at one month, apart is being changed, with the first dose administered two weeks earlier, when the baby is a month a half old. At the same time, the pneumococcal vaccine dose is also shifted for earlier administeration. We are shifting the two vaccines so that parents do not have to go to their child's GP every two weeks for immunisation, but the doses of the two vaccines are given at the same time," explained Dr Kremena Parmakova, head of department at the Ministry of Health.

Irena from Burgas has a baby less than a month old. She is happy with the changes in the immunisation shedule.

"I am very worried about pertussis and I would certainly prefer the immunisation to start earlier. The baby is now at the first consultation and if the doctor suggests I vaccinate him, I would agree. They did well to move the start of the vaccination for half a month earlier," Irena Staykova said.

GPs in Plovdiv are now contacting parents to inform them the immunisation of newborns starts when the baby is at the age of 6 months.

"If a sufficient number of vaccines are provided, I think they will be much calmer, because mothers who have babies, not yet two months old, are very worried about how to protect them - they do not make any contact with other people, they stay generally as in a sterile environment, to prevent the child from getting ill before the vaccine," said Dr. Stefka Koteva - a general practitioner in Plovdiv.

87% of those infected with pertussis in the country are children. Lowering the age for the first dose of the vaccine is safe.

"It has been tested that in children this vaccine is safe, and effective," says Dr. Kremena Parmakova, head of department at the Ministry of Health.

The vaccine is also safe for pregnant women. And the number of women who want to be immunised to protect their newborns from the infection is increasing.

"There is such interest. Including there is demand from older patients who are of mature age and not pregnant," explained Dr. Plamen Panayotov, a general practitioner.

The Ministry of Health provides free vaccine for pregnant women, they can be vaccinated in specially opened offices in health inspectorates across the country.

"An immunisation campaign for this recommended vaccination has been launched in the country. The immunisation of pregnant women is a one-time vaccination and is optional," Dr Galya Kondeva, caretaker minister for health, said today.

The vaccine is administered between the 27th and 36th gestational weeks. And 8 women were vaccinated today in the office for immunization of pregnant women in the Sofia Health Inspectorate.

"The procedure takes about 20 minutes - no more. It is necessary to prepare the vaccine, to carry out a consultation of the pregnant woman as the vaccine is given only to absolutely healthy people," said Dr. Rositsa Valkova - Sofia Regional Health Inspectorate.

In order not to wait, pregnant women can make an appointment for immunization by phone at the Sofia Health Inspectorate. In Burgas the office for vaccination of pregnant women will start working tomorrow.

"Pregnant women are advised to provide a document for the period of pregnancy they are in and it is desirable to have the opinion of the gynecologist," said Dr. Miroslava Kiselkova, head of the department "Anti-epidemic control", RHI Burgas.

The health ministry assures that enough vaccines are provided for pregnant women.

"There will be vaccines, pregnant women should be reassured, the quantity depends on the interest. If there is an increased interest in the coming weeks, the Ministry of Health will take the necessary measures to provide vaccines," explained Dr. Kremena Parmakova - Head of Department at the Ministry of Health.

From tomorrow the vaccination clinics for pregnant women in Plovdiv and Varna will be open.

"Mothers started giving birth later and later. Immunity by the age of 40 is to some extent exhausted. They cannot pass on enough antibodies to their children to protect them in the first months of the disease," said Prof. Tsonko Paunov, director of the Regional Health Inspectorate in Varna.

RHI in Stara Zagora, Pleven, Varna and Plovdiv should also provide opportunities for free pertussis testing under certain conditions.

"In Plovdiv, samples from Pazardzhik, Smolyan and Kardzhali will be tested at St. George's University Hospital," said Milena Panayotova, RHI Plovdiv.

According to the Chief State Health Inspector, the measures taken by the health authorities are implementing the recommendations of the European Centre for Disease Control.

"We hope that from now on the large immunisation coverage in Bulgaria will ensure a less intense epidemic and as few cases with severe course and complications as possible," said the Chief State Health Inspector.

Complications after pertussis were registered in 21 of the infected people. 13 of them were infants younger than 12 months of age.