By the end of the week it will be clear if a pertussis epidemic needs to be declared

Bulgaria’s Chief State Health Inspector, Assoc. Prof. Angel Kunchev, on April 23 said that by the end of the week he would propose to the health minister to declare an epidemic. Because of the high incidence in children less than 1 year old, the health ministry will allow the first vaccine to be given a month and a half after birth, rather than after the second month as the practice has been so far.

School pupils will switch to online learning if necessary. The confirmed cases of pertussis to date are 314, of which 214 were in Sofia. There are enough vaccines for the children in the stores of the Health Ministry.

Whooping cough cases in Sofia on the rise

Early this morning, the caretaker Prime Minister summoned Health and Education Ministry officials to the Council of Ministers over pertussis.

"We should react and we should react quickly. This is the idea now, to tell what is happening, what measures we will take together and with what," said Dimitar Glavchev - caretaker Prime Minister.

"General practitioners are the ones who should very carefully check the implementation of the immunisation schedule, because a large part of the problems are related to the non-implementation of the immunisation schedule," said Galya Kondeva - caretaker Minister of Health.

"Babies should start getting vaccines against whooping cough at an earlier age, when they are at the age1,5 months, in order to protect them against whooping cough, because you see these two children who died - they were both in this age group (less than 2 months old)," added the Chief State Health Inspector.

The government's press office explained that the health ministry will allow doctors to immunise babies half a month earlier - at one and a half months, rather than after the second month. Angel Kunchev told journalists in Sapareva Banya that this is the practice in many European countries.

"The brevity of the product prevents a lower age. The way to do it is by first officially declaring an epidemic, which allows the minister by his order to temporarily change the routine immunisation schedule, lowering the age for the first dose of pertussis immunisation," Angel Kunchev said.

"This will be separate for each region. 60-70% of the cases currently confirmed are in Sofia," explained Galya Kondeva – caretaker Minister of Health.

- Is Sofia actually facing an epidemic?

Galya Kondeva: I would not say so.

Caretaker Minister did not specify the pertussis incidence rate in Sofia, at which an epidemic will be declared.

"At the moment I think we have at least 2,000 to 3,000 cases for sure. Actually 314 were registered until yesterday, today there are probably 400-500. So yes, it is a budding epidemic. It is undeniable. It's scary for children up to 1 year old. especially for children up to 2 months old because they haven't reached immunisation age," said Assoc. Prof. Angel Kunchev.

The caretaker Health Minister said enough pertussis vaccines have been made available for children and stressed that immunisation coverage in the country is more than 90%.

Health Minister: We have enough pertussis vaccines for babies and young children

"Whether immunised or non-immunised, people can get sick. Pertussis persists with cyclical epidemics every 3–4 years," Galya Kondeva said.

Doctors can send samples for a free pertussis test for children up to 5 years to the capital's health inspectorate and the Centre for Infectious and Parasitic Diseases, but under conditions set by the health ministry.

"If the doctor decides that the child should be tested, he will make the arrangements and send the samples through the RHI," the caretaker Health Minister further explained.

If a parent asks for a test, they will have to pay for it at a private laboratory because there is currently no discussion about pertussis tests being paid for by the Health Insurance Fund. An expert council under the Minister of Health is to issue an opinion on immunisation of adults and pregnant women.

"You know there was a time with a tradition of not letting people see the new baby for the first 40 days. Neither relatives nor family members were allowed. Only the mother looked after the baby and that was it. So a measure like this and quarantine, would do the same job, as a prevention," said Assoc.Prof. Angel Kunchev.

About 600 doses of vaccines for adults are available in pharmacies. By the end of the week, another 2,000 doses are expected to be delivered, the caretaker Health Minister said.