A huge outbreak of whooping cough is mainly affecting children aged 10 to 14 in Scotland.
Public health chiefs have urged pregnant women and parents with young children to ensure their vaccinations are up to date amid fears that the highly contagious bacterial infection will continue circulating at high levels until the autumn.
It comes as the UK Health Security Agency (UKHSA) confirmed that a further three babies in England have died as a result of whooping cough, taking the total so far this year to eight.
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There have been no recorded deaths from the disease in Scotland since 2015, but the current outbreak is the worst for more than a decade and some experts have warned that it is on track to be the most severe in 40 years.
Public Health Scotland (PHS) has now published its first quarterly report for 2024 on vaccine-preventable diseases.
This reveals that there were 1,084 laboratory-confirmed cases in Scotland between January and March, compared to just 73 in the whole of 2023.
Separate provisional data indicate that there have been 3,237 cases in total up to June 3.
The quarterly data shows that children aged 10 to 14 in Scotland had the highest incidence rate for the infection, with around 330 confirmed cases compared to around 30 in young infants.
In previous years, under ones made up the bulk of infections.
By area, incidence rates were highest in the Grampian, Lothian, and Greater Glasgow and Clyde health board regions.
The report also confirms that there were six confirmed cases of measles in Scotland between January and March.
Unimmunised infants are at highest risk of developing serious complications as a result of whooping cough.
Pregnant women are offered vaccination in pregnancy so that they can pass protective antibodies onto their newborn babies for the first weeks of life, until they are old enough to get the jag.
Babies can be vaccinated against pertussis from eight weeks old, with a booster aged three.
Although uptake remains higher in Scotland compared to other parts of the UK, it has been falling in recent years.
PHS said the scale of the current outbreak was also linked to the reduction in infections during the pandemic due to Covid social distancing measures.
Dr Sam Ghebrehewet, head of vaccination and immunisation at PHS, urged people to visit NHS Inform for details about vaccinations.
He added: “Being vaccinated is the best thing you can do to help protect against serious vaccine preventable diseases.
"Some of the diseases that these vaccines protect against have almost disappeared from the UK as a result of so many people being vaccinated against them over the years.
"We need to maintain high vaccination uptake rates to reduce the risk of infections occurring."
Meanwhile, the UKHSA confirmed that there have been 4,793 confirmed cases of whooping cough in England between January and April, including 181 cases in babies under three months old.
In England, around a quarter of cases are in children aged between 10 and 14 years.
Dr Gayatri Amirthalingam, a consultant epidemiologist at UKHSA said: "Our thoughts and condolences are with those families who have so tragically lost their baby.
"With whooping cough case numbers across the country continuing to rise and sadly the further infant deaths in April, we are again reminded how severe the illness can be for very young babies.
"Pregnant women should have a whooping cough vaccine in every pregnancy, normally around the time of their mid-pregnancy scan (usually 20 weeks).
"This passes protection to their baby in the womb so that they are protected from birth in the first months of their life when they are most vulnerable and before they can receive their own vaccines.
"The vaccine is crucial for pregnant women, to protect their babies from what can be a devastating illness."
Whooping cough is a "cyclical disease" which tends to peaks every three to five years.
However, Scotland's large major outbreak was between 2012 and 2013, when there were a total of 3,084 confirmed cases over a two year period.
Sometimes dubbed the '100-day cough' because it takes so long to shake off, the first signs of whooping cough are similar to a cold, such as a runny nose and sore throat.
After a week, the infection can develop into coughing bouts that last for a few minutes and are typically worse at night.
Some young babies may also make a distinctive "whoop" or have difficulty breathing after a bout of coughing.
Dr Andy Whittamore, clinical lead at the charity Asthma and Lung UK, said: "Whooping cough or pertussis is primarily spread by breathing in droplets from the nose or throat of infected people.
"Pertussis can even be spread by someone who has only a mild form of pertussis or does not have symptoms.
"Following basic rules of good hygiene, such as covering your nose and mouth when you cough or sneeze, washing your hands regularly, cleaning surfaces, and avoiding crowded, poorly ventilated spaces can protect you and others from whooping cough and other common infection such as colds, flu and Covid-19."
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