Whooping Cough: Prevalence, Factors and Control Measures in New Zealand

This report focuses on whooping cough as one of the most contagious and highly prevalent disease in New Zealand. The main symptoms include a prolonged cough with a whooping sound or gasping for breath. The disease is mainly controlled through vaccination but it can still be treated. The investigation identifies high population density as the main factor that contributes to the increased cases of whooping cough in New Zealand. The report recommends that government, policy enforcers and parents collaborate to immunize their children in order to strengthen herd immunity especially in the crowded and densely populated areas so as to minimize the risk of infection and spread of the disease in these areas.

Running head: whooping cough 1
Whooping cough
Student’s name
Institutional affiliation

Whooping cough 2
Abstract
This report focuses on whooping cough as one of the most contagious and highly
prevalent disease in New Zealand. The main symptoms include a prolonged cough with a
whooping sound or gasping for breath. The disease is mainly controlled through vaccination but
it can still be treated. Some of the factors that have led to the high prevalence rates of the disease
in New Zealand is high population which leads to overcrowding and large families, presence of
other airborne diseases in the family, social economic factors, the age of the child and low birth
weight. However high population has been considered as the main factor.
The methods used in the investigation include use of secondary sources, direct
observation, interviews and questionnaires and focus group discussions. From the results, it is
clear that population indeed plays a very major part in the spread of the disease and it is therefore
recommendable to researchers and policy makers to include control the population density as one
of the key strategies towards regulating the disease.
Background research
Whooping cough is an airborne disease that is both endemic in New Zealand and at the
same time a serious epidemic disease meaning that prevalence rates are very high. The initial
symptoms of the disease include Wiley, Cooper, Wood, & Leask, (2015) coughs with a slight
fever and a running nose. The disease takes about one week to ten days before the first signs of
the disease can manifest. The disease then develops into several coughing sprees that often end
in a whooping sound as the victim gasps for breath. In younger children, the child may not have
the long coughs but the child still gasps for breath and may even vomit in the process. Most
patients of whooping cough get tired from the cough and may often see their faces becoming red.

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Whooping cough, which is also commonly known as pertussis is a communicable disease
that mainly affects children below the age of five years. However, the disease may also affect
other age groups. In New Zealand, according to Khoury, (2017), the disease was initially
vaccinated using the whole cell vaccine, with time, this has come to be replaced by the accelurar
vaccines. However, a full immunization schedule of the disease includes both the whole cell and
the accellular vaccine. The world health organization recommends that children should receive at
least two doses of immunization. This is the main reason why in New Zealand, children are
given three doses of the vaccine which is administered at six weeks, three months and the last
dose at 5 months. Maternal pertussis immunization is also done to expectant mothers in order to
prevent mothers from the risk of infection and to also pass some antibodies to the young
offspring to help them reduce the risk of infection before the immunization period of six weeks.
Pertussis is a very endemic disease, its prevalence directly affects mortality rate whereby
it can be concluded that a reduction of the disease will also reduce the mortality. However, the
fact that prevalence rates are higher in children than in adults, pertussis accounts for most of the
hospitalizations and mortality in children. Immunization or treatment of whooping cough does
not guarantee lifelong immunity since the Bordetella pertussis is highly infectious causative
agent. Reports have also indicated that prevalence rates are slightly more in females than in
males (Radke, Petousis-Harris, Watson, Gentles, & Turner, 2017).
The risk factors associated with whooping cough includes contact with infected people.
This is proven by the fact that whooping cough is a highly communicable disease that can be
readily spread on from one person to another through air. Once inhaled, the bacteria inhibits the
epithelium and multiplies in the nasopharynx argues Hartzell, & Blaylock, (2014). In some
isolated cases, the bacteria may spread to the lungs. However, the bacteria is still very dangerous

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as it wears out the ciliated epithelium and inhibits it from secreting mucus and trapping foreign
substances. The bacteria also secretes certain toxic substances and it may lead to death by
multiplication of white blood cells which is known to cause pulmonary hypertension.
According to Moore, Ashdown, & Harnden, (2016) other factors that are also associated
with the high infection rates in New Zealand includes immunization record of children, social
and economic factors and the nature of families which also included the type of parents and
parenting styles. In younger children, the factors include the child’s birth weight, the age of the
child. With regard to the nature of families, some of the families in New Zealand are large and
larger families are at a higher risk since the disease can spread very first. At other times, all the
children in the family may not have full immunization which further increases the risk of the
disease. Finally, the presence of other related diseases such as coughs are at a higher risk since
the bacterium that causes whooping cough may be introduced into the air through a single cough.
Aim and hypothesis
The aim of the investigation is to identify the main factor that contributes to the increased
cases of whooping cough in New Zealand. As identified, there are so many factors that may be
used to explain the high cases of whooping cough in New Zealand. These factors include the
nature of homes, high population, lack of effective immunization, low birth weight and poor
parenting styles among other factors Cherry, Wendorf, Bregman, Lehman, Nieves, Bradley, &
Chen, (2018). However, this paper narrows down to high population density as one of the major
factors that causes the increased rate of whooping cough and as a co morbidity of other factors
causing the spread of the disease.

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A hypothesis can be drawn from the population as the main factor causing the high rates
because the whooping cough is a highly communicable disease. It is evident that for all airborne
diseases, large population is one of the factor that contributes to the spread (Teepe, Broekhuizen,
Ieven, Loens, Huygen, Kretzschmar, & Coenen, 2015). This case notwithstanding, whooping
cough can also be associated with large populations in New Zealand. High population density in
some areas due to social and economic factors makes families to be so close whereby a single
case of the disease easily ends up being an epidemic. High population density is also observable
at the family level, where families may have many children. This lowers the efficiency of
immunization which in turn weakens the herd immunity therefore predisposing children to the
risk of infection. Finally, large populations leads to overcrowding whereby a single case spreads
easily due to increased contact.
Investigation methods
Some of the investigative methods employed in the investigation include the collection of
secondary data. Secondary data was collected from EpiSurv which is the national database that
contains information on notifiable diseases (Kiedrzynski, Bissielo, Suryaprakash, &
Bandaranayake, 2015). Some of the other materials that were consulted include the
communicable disease control manual of 2012 from the government ministry, information from
the national immunization register, the district of health board databases and also collection of
information from various hospital records. Most of the information collected from these
secondary sources contained detailed information on immunizations, hospitalizations and
treatment of whooping cough among the people of New Zealand (Deane, 2015). The distribution
of infection among the various ages was also collected and also the periods when people were

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infected the most. From the health records collected in hospitals, it was also possible to identify
chief factors that lead to high disease prevalence rates in New Zealand.
Direct observation was also one of the methods that was greatly employed whereby the
nature of many homes was observed and analyzed. It was discovered that many people live in
populated homes and houses are clustered in the most populous areas. High population therefore
increases the risk of infection. The observation also included interviews and questionnaires
which were distributed across many parents randomly. The parents were expected to give details
of when and if at any one time their children had been infected with the disease. The parents
were to answer a few questions about the disease to ascertain that it is whooping cough. They
were also told to give the number of children in the homestead and in the neighborhood and the
infection rates of the disease. Finally, they were also asked to highlight the main factor they
could attribute their child’s illness to.
Finally, focused group discussions were conducted among health workers, parents and
students. The focus group discussions mainly analyzed the cases of illness and attributed the
cases to the factors that caused the illness (Hayles, Cooper, Sinn, Wood, Leask, & Skinner,
2016). The focus group discussions also focused on isolated cases in situations where the disease
did not occur in highly populated areas.
Results of investigation
According to the secondary sources that were analyzed, the overall rates of whooping
cough prevalence rates in New Zealand in the recent years have been ranging at 201 infections
per every 10,000 people. The prevalence of infants below one year was higher than that of
children between 1 to 5 years. While focusing at the immunization rates, the investigation

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showed that the percentage of efficiency increased with age whereby at the age of six months,
only less that 90% of children were immunized while by the end of one year, the percentage of
immunized children was above 95% (Raoof, Pereira, Dai, Neutze, Grant, & Kelly, (2017).
According to the observation, it was clear that in children that lived in large families, six
out of every ten children were ,likely to be infected with the disease at one time in their life
before they attained school going age. Another observation was that the size of families was
largely influenced by the socioeconomic conditions of the families. The same results were also
evident from the questionnaires and interviews. This is so because, many of the respondents
believed that their children got infected because the disease was passed on to their children by
other children because they played or were brought up together. These responses triggered the
hypothesis that population was considered a key factor for the spread of the disease. Lastly, from
the focus group discussions, it was also evident that many people also suggested that
overcrowding is a main factor for the spread of the disease since in overcrowded places, the
bacterium easily spreads from one person to another through the air.
Discussion
The results obtained are helpful to the government, health institution, students and
members of the public in various ways. To begin with, they help to explain the disease patterns,
spread and prevalence rates. This knowledge is important to researchers, government and other
policy makers who are determined to control the disease pandemic. It may also help to advise
and minimize threats in children.
In conclusion, it is clear that population plays a major role in the spread of whooping
cough. It is therefore recommendable that government, policy enforcers and parents collaborate

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to immunize their children in order to strengthen herd immunity especially in the crowded and
densely populated areas so as to minimize the risk of infection and spread of the disease in these
areas.

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