Challenging Response to Whooping Cough: Insights from Low Childhood Vaccine Coverage Areas in Narathiwat Province, Thailand 2024

Abstract

Pertussis, caused by the Bordetella pertussis bacteria, remains a global health concern, particularly affecting incompletely or unimmunized infants. This study, conducted in Narathiwat Province, Southern Thailand, has three aims: to describe the epidemiological characteristics of the pertussis outbreak, to assess the vaccine coverage status across all districts, and to describe the response of the Narathiwat Provincial Public Health Office’s Emergency Operations Center (Narathiwat EOC) to the outbreak. Between September 2023 and May 2024, Narathiwat EOC recorded 714 pertussis cases, with a male-to-female ratio of 1:0.9 and a median (interquartile) age of 2 (1–6) years. Over half (53.2%) of the cases had not been vaccinated with the diphtheria-tetanus-pertussis (DTP) vaccine. The lowest DTP coverage was observed in the districts of Si Sakhon, Rueso, Bacho, Chanae, and Cho-airong, which also reported the highest number of cases. Major challenges for the Narathiwat EOC included managing dynamic data, creating targeted strategies, effectively vaccinating children and mothers, identifying active cases, and administering chemoprophylaxis. The Narathiwat EOC addressed these challenges by implementing real-time data collection, risk-based control measures, innovative vaccination campaigns, targeted case-finding programs, and streamlined distribution of chemoprophylaxis. Effective strategies included addressing vaccine refusal by providing information on managing post-vaccination fever and engaging local advocates, and considering routine maternal immunization to protect infants in areas with low vaccine coverage, which could have significant policy implications at both the local and national levels.