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In Poland, the incidence of whooping cough remains at a stable but quite high level. The disease is spread by droplets and is very dangerous. Prof. Iwona Paradowska-Stankiewicz, national consultant in the field of epidemiology from the National Institute of Public Health – National Institute of Hygiene.
- The symptoms of whooping cough can be confused with the SARS-CoV-2 coronavirus infection as one of the common symptoms is coughing. However, there are a few differences that help with diagnosis
- Young children who have not yet been vaccinated are at risk of developing whooping cough, as well as adolescents, pregnant women and adults. Whooping cough “does not ask” for age
- «An exercised doctor’s ear can recognize whooping cough by the typical nature of a cough in young children. In adults, it may be more difficult and requires additional research, as there may be many causes of chronic cough, e.g. smoking cigarettes »
- You can find more up-to-date information on the TvoiLokony home page
WHO records 40 million cases of whooping cough worldwide each year, of which approximately 400 people die. So it is not a forgotten disease?
Prof. Iwona Paradowska-Stankiewicz: On the contrary, the incidence in Poland has also remained at a stable, relatively high level for several years: about 2 cases are registered annually, and some certainly remain unregistered. It is an acute infectious disease of the respiratory system, also known as whooping cough, and is characterized by severe coughing fits. It spreads by droplets. The pathogen that causes it (Bordetella pertussis) produces toxins, the most potent of which is the so-called whooping cough toxin. It causes necrosis of the respiratory tract epithelium, and consequently the secretion and accumulation of thick mucus, which causes coughing and the occurrence of breathing difficulties with the characteristic “foam”.
Recurrent, severe and severe cough is typical of children, and in adults it is chronic and tiring, so there is a greater risk of being overlooked or confused in differentiating its causes.
How is it diagnosed?
The basis is a medical history regarding the symptoms of the disease and vaccinations against whooping cough, and secondly, the knowledge that diseases often occur in the so-called outbreaks, e.g. in schools, i.e. asking about contact with a coughing person. A positive PCR test result, taken from the patient’s nostrils through the nostrils, helps in making the final diagnosis, as pertussis sticks exist between the nasal cavity and the pharynx. Other methods can also be used, e.g. growing pertussis bacilli on a specific medium, or testing the level of antibodies in the blood.
Can the symptoms of whooping cough be confused with SARS-CoV-2?
You can, although some symptoms are characteristic of both infections. The common element is the cough, and in whooping cough it can be very severe and troublesome and may persist for at least two weeks. As for the SARS-CoV-2 virus, coughing can also be a heraldic symptom, it can persist and worsen, but it can also cause shortness of breath. And this should be a warning signal that you should consult with your doctor. In addition, with coronavirus infection, most cases have a fever that is absent with whooping cough.
Who gets whooping cough?
The risk groups are the youngest children, before receiving the first doses of the pertussis vaccine, as well as teenagers, pregnant women, and adults and the elderly, that is, practically everyone, because this disease does not look at age. Surviving whooping cough leaves immunity for several years, but there are repeated cases of illness.
The situation is similar after vaccinations – administration of the full course, including booster doses, maintains immunity for 5-7 years, and according to some scientific reports – up to 10 years. For this reason, a booster vaccination is recommended for everyone after 10 years.
How is the vaccination course?
In Poland, according to the Protective Vaccination Program, it is obligatory to administer the whole cell DTPw vaccine against whooping cough at: 2, 3-4, 5-6 months of age and a supplementary dose at 2 years of age, usually at 16-18 months of age (basic cycle). Children from 5 years of age (6 years of age) will receive a booster dose with acellular vaccine (DTPa). The vaccine with a reduced content of diphtheria and pertussis antigens (dTap) is given to adolescents in the age of 14 as part of compulsory vaccinations. (next booster dose). Since 2017, a recommendation has been added to vaccinate against pertussis (dTap) in people aged 19, in place of the mandatory vaccination against diphtheria and tetanus.
Who else should get vaccinated?
Older people, to protect the youngest children with whom they come into contact and who have not yet been vaccinated. And also pregnant women, because the newborn child gains immunity thanks to the antibodies produced in the mother’s body. Please consult your doctor about the optimal timing of this vaccination. In the case of adults, these are recommended vaccinations, and therefore paid.
How is whooping cough treated?
Antibiotics (mainly macrolides) because it is a bacterial infection. Despite recovery, the disappearing cough may persist for several weeks, and in extreme cases even for several months. A person taking a macrolide antibiotic no longer infects others after five days.
Can whooping cough be detected and treated with telemedicine?
An exercised doctor’s ear can recognize whooping cough by the typical nature of a cough in young children. In adults, this may be more difficult and requires additional research, as there may be many causes of chronic cough, e.g. smoking.
What are the complications of whooping cough?
They can occur in 6 out of 100 patients and most often affect children under 6 months of age. The most common complications are: pneumonia (the most common cause of death in children), and pneumothorax, otitis media, deafness, rib fracture, congenital aneurysm rupture, hernia, urinary incontinence and neurological complications – convulsions, brain edema, intracranial bleeding, etc. Vaccination is the best method to avoid these severe complications, as it gives individual and population immunity.
What about SARS-CoV-2 prophylaxis?
It can be specific and non-specific. We have to wait for the first one, the most effective as vaccinations – the first ones may appear in the first quarter of next year. So we are left with non-specific prophylaxis, the basis of which is a healthy lifestyle, masks, disinfection and social distance. None of us had immunity to the coronavirus, but thanks to vaccinations that have been carried out for many years, we can and should get vaccinated against whooping cough.
The editorial board recommends:
- When not to vaccinate a child? Contraindications to vaccinations
- The biggest myths about immunization
- Splitting vaccinations: “one visit – one vaccine”
Authorized press interview prepared by the Journalists for Health Association in connection with the World Pneumonia Day and the XXIV edition of the Quo Vadis Medicina? Fri “Dangerous pneumonia in the time of the coronavirus pandemic”, 2020.
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