Contents
It was completely silent about whooping cough for several decades. We forgot about its existence, it seemed like a disease from old books and movies. Now, however, it is attacking children and adults again. According to WHO, it is already one of the 10 most common infectious diseases that kill children. And it turns out that even vaccination or disease does not protect us forever.
Even 20 years ago, there were one hundred cases of whooping cough in Poland, often also called whooping cough, per year. At the moment, it is about 3000 cases. Epidemiologists suspect, however, that this is only the tip of the iceberg. Many patients are still not properly diagnosed. Doctors who have heard in studies that it is a childhood disease, absent for several decades in Europe, seeing an adult patient with typical symptoms still often diagnose influenza, asthma, or bronchitis instead of whooping cough.
Immunity after vaccination against whooping cough, diphtheria and tetanus (DTP)
10 years ago, doctors and patients were convinced that an integrated vaccine against whooping cough, diphtheria and tetanus (called DTP), when given to infants, would protect against this disease for life. Meanwhile, it is not so! In 2002, doctors from the Medical University of Warsaw examined the level of antibodies in children. While in six-year-olds the resistance to whooping cough reached 80%, two years later, in children from the first and second grade, it dropped to 50%. Thanks to these studies, the vaccination schedule was changed and for several years preschool children have been receiving an additional dose of the vaccine. But it also doesn’t work for life! Therefore, doctors recommend another vaccination in high school.
– We also encourage young mothers to vaccinate immediately after childbirth, together with their husband, in-laws, nanny and all those who will come into contact with the baby, an integrated vaccine for tetanus, whooping cough and diphtheria – says Edyta Rudnicka, gynecologist.
And rightly so! A study by epidemiologists from the School of Public Health at the University of North Carolina at Chapel Hill in the US shows that as many as 55% of babies under 6 months of age who get whooping cough come from their parents.
– Whooping cough can be tiring for strong adults, but for small children, before the first vaccination, it is a lethal threat – warns Rudnicka. – So let’s do these vaccinations, not only so that we do not get sick ourselves, but above all for the safety of babies. It is worth knowing that even those who once suffered from whooping cough should be vaccinated; their immunity may last even several years, but is not at all lifetime.
People who give up vaccination, fearing post-vaccination reactions, can opt for a cellulose, i.e. cell-free (DTPa) vaccine. It contains only some components of the bacteria, not the whole pertussis, so the risk of complications is much lower.
And the probability of getting infected is really huge: as many as 95% of non-immune people who come into contact with bacteria, mainly transmitted by airborne droplets, become infected!
Whooping cough – symptoms and diagnosis
Whooping cough is difficult to recognize, even if you are an experienced doctor. Sneezing, runny nose, low-grade fever and dry cough resemble the common cold. So most people try to recover from their disease – and even if they see an internist or ENT specialist, chances are that they will be sent home advised to rest, drink a lot, and take medication to alleviate the sore throat.
Characteristic for whooping cough is the intensification of coughing attacks at night, usually around 2.00:3.00 AM to XNUMX:XNUMX AM. But again: not every person who coughs primarily at night has whooping cough. A flat pillow is often to blame (when we lie down, it is more difficult for us to breathe and cough up, so we start to cough incidentally), very dry air, or dust and mites in the bedroom (e.g. a mattress is their habitat).
However, while with a cold, a dry cough usually gradually turns into a wet cough after a few days, and then begins to disappear, with whooping cough it intensifies, prevents sleep, causes gagging (and even vomiting), rupturing blood vessels in the eyes, nose bleeds, conjunctivitis. Infants may experience paroxysmal sneezing instead of coughing. Characteristic for whooping cough is the wheezing breath that the sick person takes after an exhausting cough attack. This condition usually lasts 6-8 weeks, but can last up to 15 weeks! Many people, however, do not go to the doctor because they have ‘only a cough’ – and apart from seizures, they feel normal, can work, etc.
Complications and treatment of whooping cough
Meanwhile, whooping cough can cause many serious complications. In young children, if left untreated, the disease can lead to cerebral hypoxia, which results in permanent damage! There is also a risk of apnea, cyanosis, convulsions – and eventually death. Complications that can arise at any age include pneumonia, bronchitis and otitis, emphysema, pneumothorax, and empyema.
The smaller the child, the greater the risk of severe complications. The same is true for the elderly or those with chronic diseases, in whom coughing attacks quickly lead to weakness. With such people, as with babies, you have to go to the hospital without waiting for the persistent cough to pass by itself. It may be necessary to suck up their secretions!
In all patients, regardless of age, blood tests or a throat swab are required to clearly confirm the disease; finding antibodies against Bordetella pertussis bacteria is the best evidence that we have whooping cough. Normal morphological examination of patients with whooping cough shows an increased number of leukocytes (20-100 / mm3) and lymphocytosis (up to 90%).
Whooping cough is treated with antibiotics given for at least two weeks. Additionally, medications are also given to relieve cough attacks; often they are not typical antitussives, but sedatives. However, cough suppressants or thinning mucus should not be given – it may cause suffocation! It is also very important to ventilate the apartment and humidify the air, and avoid spicy, hot, cold dishes, etc. during illness. not only with whooping cough, but also with the common cold.
Text: Liliana Fabisińska
Read more in The Coughing Universe