The statutory notifications of disease reports are a good-but-not-perfect indicator of certain infectious, or otherwise worrying outbreaks. They are a select list of diseases where healthcare workers have a statutory duty to report any cases diagnosed to a central authority. For speed of response, this diagnosis can can be done without laboratory confirmation, so - for example - with measles, these numbers include a significant proportion that turn out to be some other “ill child with measles-like-rash” case once the lab reports come back.
Still, the dynamics provide a clue as to the underlying trends, and with something like whooping cough, where the “whoop” is so distinctive that experienced GPs can diagnose it over the phone, it’s a particularly good guide to how many cases there may be around, even if a few may turn out to be false alarms.
These reports have been offline for a little while, as the UKHSA experiment with new ways of collating and publishing the results, so we haven’t actually seen anything since the summer.
But now, while the weekly tracking is still suspended, we do totals up to week 44 (i.e., up until last week, end of October).
For things like whooping cough. And … well … at first sight at least … wow:
Astonishingly, and despite what the chart looks like, this is fairly good news.
The reason this is good news is we already knew that this year had seen a quite absurd spike in whooping cough in May. Looked like this.1
And now we have updates for the totals of the 44 weeks to the end of October 2024, so we can take the difference, and estimate what the interim values would have had to be. The line won’t be quite right, but the average is.
Something like this:
So, this is only fairly good news. We are now ongoing with whooping cough cases at around 10x the rates they were in mid-2023, but at least we do not have them at 100x, which is where we spiked in mid 2024.
The trouble is this is an unstable situation. The achingly low rates of vaccination we are see (particularly in London and parts of the Midlands) implies that we should expect this new higher level of cases to continue, and new spikes to jab up every now and then, and harm young kids on a very regular basis.
Likewise, measles. We have come down from the spikes of late 2023-4, but we are still seeing higher levels ongoing, and will have new spikes with seasonal rhythms, as well as local outbreaks, each one of which has the potential to spread further.2
The worry is that it will take a truly huge outbreak of either measles of whooping cough - of the scale that we have not seen for decades - to do something astonishingly brutal. That is, for an outbreak of some vaccine-preventable disease to kill a sufficient number of children that people finally listen to public health messages and get themselves and their kids vaccinated at the 95%+ rates that you need for population-level suppression.
It would be really good indeed if we could come up with just about any way of getting to the needed vaccination rates that does not involve this “too many dead kids to ignore” step, but - so far - nothing seems to be working.
Excluding the last two weeks since these are always underreported.
Here showing lab confirmed results as so many of the NOIDS “cases” of measles turn out to be other things.