“The news about whooping cough is troubling, as this highly contagious bacterial disease is making a strong comeback,” emphasized Mr. Nikolaos Sypsas, President of the Hellenic Society for Infectious Diseases, Internist-Infectious Disease Specialist, Professor of Pathophysiology-Infectious Diseases at the Medical School of the National and Kapodistrian University of Athens (EKPA), and Scientific/Administrative Director of the Infection & COVID Unit at “Laiko” General Hospital. He made these remarks during a recent briefing on the opening of the 24th Panhellenic Infectious Diseases Congress, set to take place at the Megaron Athens International Conference Center from March 13 to 16.

The numbers are alarming. In 2023, Greece recorded nine cases of whooping cough, whereas in 2024, cases skyrocketed to 438. “This represents a 4,800% increase,” stated Mr. Aristotelis Tsiakalos, Board Member of EEL, MD, PhD, Internist-Infectious Disease Specialist, President of the Hellenic Society for Obstetric and Gynecological Infections, and President of the Infection Committee at “Leto” Hospital. He further noted that over a 16-year period, from 2000 to 2016, the total recorded cases were 509.

The situation remains concerning, as Mr. Tsiakalos reported that in 2024, two infants died from whooping cough, while two others required admission to neonatal intensive care units (NICUs).

Vaccination of pregnant women between the 27th and 36th weeks of gestation is the only way to protect newborns by providing them with the necessary antibodies to fight the infection if exposed, the expert stressed. This has been a strong vaccination recommendation for decades.

However, he explained that, according to a study conducted in two private hospitals in Athens—set to be presented at the congress—only 3.8 out of 10 pregnant women (38%) receive the vaccine.

“Vaccination is the ultimate tool to curb the devastating rise in whooping cough cases,” concluded Mr. Tsiakalos, clarifying that a past infection in early life does not change the strong recommendation for vaccination during pregnancy. The vaccine is the only way for the mother to transfer protective antibodies to the baby.

“Vaccines save lives. Everything has side effects, but vaccines are safe and effective,” added Ms. Maria Chini, Board Member of EEL, Internist-Infectious Disease Specialist, and Head of the 3rd Internal Medicine Department and Infection Unit at “Korgialenio-Benakeio” General Hospital of the Hellenic Red Cross.

Meningitis: Correct Response Strategy by EODY in Patras

Unfortunately, whooping cough is not the only disease making a comeback in the post-COVID era. “After the pandemic, we have entered a new era with new challenges, where both new and old diseases are re-emerging,” noted Mr. Sypsas. He cited recent outbreaks of meningitis, RSV virus, and even the resurgence of measles due to inadequate vaccination coverage, which led to the first measles-related deaths in the U.S. in a decade.

Vaccination gaps remain a serious issue, Mr. Sypsas stressed. However, regarding the recent meningitis cases in Patras that alarmed the public, he clarified that mass vaccination of students was not the correct approach. Over the past 20 years in Greece, there have been 1,100 cases of meningitis, with 20 being fatal, resulting in a mortality rate of 6 percent—a figure within expected limits, according to Mr. Sypsas.

Mass vaccination is recommended only when there is data suggesting a mini epidemic, defined as 10 cases per 100,000 people. “In Patras, the cases were sporadic, so the decision by the National Public Health Organization (EODY) to implement mass chemoprophylaxis rather than mass vaccination was the right one,” explained Mr. Sypsas.

He also reminded that the only time meningitis disappeared from Greece—with zero reported cases—was during the pandemic when lockdowns prevented transmission.

Multidrug-Resistant Bacteria: A Major Threat

Greece continues to hold a negative record in hospital-acquired infections in Europe, according to the Hellenic Society for Infectious Diseases. For this reason, new guidelines on the proper use of antibiotics by doctors will soon be issued, along with public awareness campaigns by EEL, Mr. Sypsas stated.

“Greece records over 20 deaths per 100,000 people due to hospital-acquired infections caused by multidrug-resistant bacteria, which translates to approximately 2,500 deaths annually,” warned Mr. Stelios Asimakopoulos, Treasurer of EEL, Associate Professor of Internal Medicine-Infectious Diseases at the University of Patras Medical School, and Head of the Special Infections Unit at the University Hospital of Patras.

Discussing the causes of this phenomenon, Mr. Asimakopoulos pointed to the overuse of antibiotics both in the community and in hospitals, as well as the excessive burden on hospitals with too many patients and insufficient staff. He noted that controlling the spread of infections in hospitals is challenging because isolating every patient with a multidrug-resistant infection is not feasible. Instead, hospitals rely on cohorting, where patients infected with the same pathogen are grouped together in designated areas.

A major dilemma for hospital doctors, according to Mr. Asimakopoulos, is deciding how and when to treat a hospital-acquired infection. Physicians must choose between the immediate administration of an advanced antibiotic—potentially increasing bacterial resistance—or waiting for lab culture results to guide treatment, thereby avoiding unnecessary antibiotic use.

Advances in rapid pathogen identification techniques in microbiology are expected to reduce waiting times and enable more precise antibiotic prescriptions. Mr. Asimakopoulos explained that new technologies could shave off three to five days from the current identification process of multidrug-resistant pathogens. These include Gram-negative bacteria, with the most significant threats being Acinetobacter, Klebsiella pneumoniae, and the fungus Candida auris, he noted.

Get Vaccinated

Vaccination is the primary means of prevention against both old and emerging infections. “Get vaccinated, get vaccinated, get vaccinated,” emphasizes Professor Sypsas. “Vaccination is the most effective public health policy for preventing infections. Recent data indicate very low acceptance of adult vaccination—not only for COVID-19 but also for many other diseases such as influenza, pneumococcus, and RSV virus. This is due to ‘vaccine fatigue’ and misinformation regarding vaccine safety, while the enormous health benefits for the population are overlooked. Tragically, after many years, Europe is once again experiencing outbreaks and deaths from measles, whooping cough, and diphtheria,” stresses Mr. Sypsas.

Finally, Ms. Aikaterini Argyraki, General Secretary of the Board of Directors of the Hellenic Society of Infectious Diseases, Internist-Infectious Disease Specialist, and Coordinating Director of the Pathology Clinic at GNNA “Sotiria,” highlighted the necessity of “convincing citizens of the importance of vaccination through their family doctor, as this is not the responsibility of hospital physicians.” She also acknowledged that for this to happen, there must be a functional and effective Primary Health Care system.