A Preventable Disease Returns: Whooping Cough in Ecuador

Whooping cough, or pertussis, a respiratory illness known for its intense coughing fits, is making an unwelcome comeback in Ecuador. Despite being preventable through vaccination, the nation is witnessing a concerning rise in cases, prompting questions about public health strategies and vaccination coverage.

Is Ecuador Facing an Epidemic?

While the Ministry of Public Health (MSP) has yet to make an official declaration,leading epidemiologists suggest that Ecuador is already experiencing a whooping cough epidemic. Dr.Marcelo Aguilar, a tropicalist and epidemiologist, notes that the number of cases in the first four months of 2025 has already surpassed the total number recorded in 2024.Specifically, over 220 cases have been reported in early 2025, compared to 141 cases throughout the entirety of 2024.

This surge in cases raises concerns about the effectiveness of current preventative measures and the potential strain on the healthcare system. An epidemic, in epidemiological terms, is defined as a situation where the number of current cases exceeds that of the preceding period, a threshold that has evidently been crossed.

Understanding Whooping Cough: Transmission and Prevention

Whooping cough is caused by the bacterium Bordetella pertussis. It spreads easily through respiratory droplets produced by coughing or sneezing. While it can affect individuals of all ages, infants are particularly vulnerable to severe complications. Vaccination remains the moast effective way to prevent the disease.

The resurgence of whooping cough can be attributed to several factors, including:

• Reduced Vaccination Coverage: Disruptions during the COVID-19 pandemic led to decreased vaccination rates.
• Vaccine Hesitancy: Some parents are hesitant to vaccinate their children due to misinformation or concerns about side effects.
• Health System Challenges: Delays in timely responses from the health system have further exacerbated the situation.

Globally, the World Health Association (WHO) estimates that pertussis affects millions each year, highlighting the importance of maintaining high vaccination rates to protect vulnerable populations.

Vaccination Guidelines: Who Should Be Vaccinated?

Ecuador’s vaccination schedule includes three doses of the DTP vaccine (diphtheria, tetanus, and pertussis) during the first year of life, followed by two booster shots during school age and adolescence using the DT vaccine (diphtheria and tetanus).This regimen is designed to provide long-term protection against these diseases.

During outbreaks, vaccination may also be recommended for individuals who have been in close contact with confirmed cases, regardless of their prior vaccination status.

Vaccination Exceptions: When to Avoid Vaccination

While vaccination is generally safe and effective, there are certain contraindications. Vaccination is typically not recommended for older adults or individuals with specific immune conditions, unless they have been directly exposed to a confirmed case. The primary focus of vaccination efforts remains on children and adolescents.

Adult Risk and Vaccination

Adults who did not receive booster shots may contract whooping cough, but the risk of severe complications is generally low. Most adults retain some immunity from childhood vaccinations. However, it’s vital to note that immunity wanes over time, making booster shots crucial for maintaining protection.

If an adult did not receive reinforcements, he could get sick, but the vital risk is very low. The majority of adults already have some immunity for having received the first doses in childhood.

Marcelo Aguilar,epidemiologist

vaccination During Pregnancy

Routine vaccination during pregnancy is not typically recommended. However, in high-risk situations or areas with high virus circulation, vaccination may be considered.The primary goal is to protect newborns, which is best achieved by strengthening vaccination efforts in childhood.

Vaccination Schedule Stability

Ecuador’s vaccination schedule has not been modified recently. Changes to vaccination guidelines require thorough, evidence-based technical evaluations and are not implemented hastily.

The Debate Over Mandatory Vaccination

Currently, vaccination is not mandatory in Ecuador. This has led to challenges in achieving optimal vaccination coverage, as healthcare providers require written authorization from parents to vaccinate children in schools. The lack of mandatory vaccination has been identified as a contributing factor to the current low coverage rates.

The Role of Public Health infrastructure

A weakened public health system has further compounded the problem. In recent years, healthcare has not been prioritized politically, and climatic events such as El Niño and severe winter conditions have exacerbated the situation.Addressing the whooping cough resurgence requires strong technical leadership and adequate resources to support public health initiatives.

The Municipality of Quito’s Health Ministry has confirmed a case of whooping cough in a student at a municipal school, with close contacts being monitored. this highlights the ongoing efforts to contain the spread of the disease.