How dangerous is whooping cough? How do you recognize measles? These and six other questions about two ‘forgotten’ diseases

The measles outbreak in Eindhoven, the growing number of reports of whooping cough and four deceased babies, bring two ‘forgotten’ diseases back into focus. What kind of diseases are they, and how dangerous are they? Eight questions about measles and whooping cough.

1. How contagious are measles and whooping cough?

Measles is extremely contagious, much more contagious than flu, for example. The virus can survive for hours in droplets in the air. Someone with measles infects twelve to eighteen others, it is already contagious before the characteristic red spots appear.

Whooping cough, an infection caused by bacteria, is also highly contagious. Surprisingly enough, especially in the beginning, before the typical coughing fits start. Whooping cough is also transmitted by cough droplets. If one family member has whooping cough, on average 90 percent of the family members will become infected if they are not protected. You are if you have been vaccinated or have had whooping cough in recent years.

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2. How do you recognize these diseases?

Measles has been in the national vaccination program since 1976, so long that many general practitioners have little experience with it, one of them wrote on X. So how can this disease be recognized? The condition begins with fever, cold, general malaise. The red spots only appear after three to seven days. White spots in the mouth and hypersensitivity to light can put GPs on the track of measles earlier.

Whooping cough is also often not noticeable at first because it starts with a normal nose cold. The barking cough and wheezing only occur after one or two weeks. Babies can become exhausted from coughing and therefore have difficulty drinking. Both diseases have a fairly long incubation period: after infection it takes more than a week before you become ill. Whooping cough patients also remain contagious for a long time, up to five weeks without antibiotics.

3. How dangerous are these diseases?

More than half of babies who get whooping cough end up in hospital, according to the RIVM. This year, four children died from whooping cough. Frequent coughing and lack of oxygen can lead to brain damage. For adults, the disease is less dangerous, but not without risks. Pneumonia and collapsed lung are a few possible complications. You can even break your ribs from coughing.

The risk of dying from measles in a developed country like the Netherlands is small: one in ten thousand, but measles is not harmless. In severe cases it causes pneumonia or brain inflammation. The latter only manifests itself after a few years and is then fatal. Anyone who has had measles remains more susceptible to other infectious diseases for a long time.

4. What is the treatment?

There are no medicines for measles. Most patients recover after a week to ten days. However, it is advisable to call your GP so that source and contact research can be carried out. And patients must stay home to prevent the spread.

Whooping cough can be treated with antibiotics, although the bacteria are often gone by the time the diagnosis is made. If there is an unprotected baby in a family with whooping cough, the whole family can be given antibiotics to get rid of the bacteria.

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5. How well do vaccines protect?

A vaccine never completely protects everyone. But vaccinating pregnant women against whooping cough (since 2019) has ensured that nine out of ten young babies exposed to the disease do not get whooping cough. And if vaccinated children do become infected, they become less ill. Spread over the first year, children receive four whooping cough injections in a cocktail that also protects against diphtheria, tetanus and polio. When children are four and their resistance to those diseases has decreased, they receive one more injection.

Children do not receive the measles vaccine until they are fourteen months old and then when they are nine years old, in the combination shot against mumps, measles and rubella (abbreviated to MMR). Because the measles vaccine does not protect children up to one year of age as well as it does when they are fourteen months old, this shot comes relatively late.

Children with an increased risk of getting measles – for example because it appears in the environment or because they go to a country with a lot of measles – can be vaccinated earlier. This is possible from six months, when they no longer have antibodies from their mother. Pregnant women should not receive the measles vaccine because it may affect the baby. The measles shot works very well: after one shot, 95 percent of those vaccinated are protected, after two shots that is 99 percent.

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6. Should unvaccinated adults still get a shot?

People born before 1976 have usually not been vaccinated, because measles was not yet included in the national vaccination program at that time. Before 1965, there was no vaccine at all and almost everyone got measles, which meant that people built up resistance themselves. Adults who have not had measles and have not been vaccinated can still be vaccinated. Healthcare personnel can receive an occupational vaccination from the GGD to protect themselves and others.

Whooping cough has been in the national vaccination program since 1957. Adults can also still be vaccinated against whooping cough. Although they themselves are unlikely to become ill from whooping cough, they can prevent babies and other vulnerable people from becoming infected. The Health Council advises employers to offer staff who work with young children a whooping cough vaccination every five years.

7. Do the vaccines have unpleasant side effects?

The whooping cough vaccine contains small, harmless pieces of whooping cough bacteria: these put the body to work to produce antibodies. In measles, it is weakened viruses in the vaccine that provide immunity. They are still alive, but no longer cause serious illness. The vaccination may cause some pain or redness at the injection site, headache and drowsiness also occur. Children sometimes become a bit hangry. The MMR vaccine also sometimes causes these types of mild side effects. In rare cases, children will have a febrile convulsion about a week after the MMR injection (one in five to ten thousand). It is said that you can get autism from the measles vaccine. This is based on a fraudulent study by a doctor who was subsequently dismissed from the profession.

8. Are the current outbreaks unusual?

The RIVM sees a measles outbreak every ten to fifteen years, the last major outbreak was ten years ago. This year the reports come from people from Eastern Europe who work here as well as from schoolchildren. Traditionally, large outbreaks mainly occur in areas with a low vaccination rate, but these are no longer just Christian communities.

The RIVM is particularly concerned about the large number of whooping cough reports: now almost three hundred per week. Whooping cough peaks every two to four years, with a peak in 2012. Here too, outbreaks are no longer limited to the Bible Belt. The municipality of Ede has the most reports, but it occurs everywhere in the Netherlands.

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