Whooping cough (whooping cough) – symptoms, treatment, complications. Home remedies for whooping cough

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Whooping cough is an acute infectious disease caused by the whooping cough Bordatella pertussis. The risk of getting whooping cough depends on the proximity and frequency of contact with the patient. Infection with whooping cough is spread by droplets when talking or coughing in the company of healthy people. Whooping cough can occur as early as a few days after birth when the infant is not receiving passive immunity from the mother.

What is whooping cough (whooping cough)?

Whooping cough is an infectious disease that causes an infection with bacteria Bordatella pertussis. It is dangerous because it secretes a pertussis toxin that causes leukocytosis with lymphocytosis and inhibits macrophages and lymphocytes traveling to the foci of inflammation. As a result, bacteria easily adhere to the epithelium located in the respiratory tract.

The source of whooping cough infection is a sick person, and the disease is transmitted by droplets through the upper respiratory tract. The disease most often occurs in the age range from 0 to 4 years, so the disease may appear in the first weeks after birth, as the infant does not receive passive immunity against pertussis from the mother.

The hatching period for whooping cough is 5-7 days to three weeks. Man is the only host for whooping cough sticks.

Whooping cough is contagious for about six weeks, It is greatest in the catarrhal period and at the beginning of the episodic cough, then it gradually decreases. After the implementation of antibiotic therapy, the infectivity period is reduced to approx. 5-7 days from the start of treatment.

The causes of whooping cough (whooping cough)

As mentioned above, whooping cough infection is caused by Bordatella pertussis. The infection spreads through droplets when coughing, sneezing, talking or through direct contact with the patient. The pathogenic effect of pertussis bacilli is based on the formation of lesions, including necrotic lesions, which are most often located in the area of ​​the bronchial mucosa, trachea and larynx.

In turn, the toxins secreted by bacteria cause changes not only in the respiratory tract, but also in the brain tissue. Toxins also increase the sensitivity of the cough center and irritate the cough receptors of the respiratory tract, as a result of which a characteristic cough appears, and the cough reflex persists long after the infection has resolved.

Symptoms of whooping cough (whooping cough)

The presence of several phases of the disease is characteristic.

1. Catarrhal phase of whooping cough

Disease symptoms are poorly marked and uncharacteristic. Appears:

1. conjunctivitis,
2. runny nose,
3. slight fever
4. dry cough (especially at night).

2. The paroxysmal phase of whooping cough

It takes 2–6 weeks. The symptoms of this phase vary depending on the age of the child.

In infancy, cough does not have to be the predominant symptom as sometimes it does not appear at all. Babies have bouts of breathlessness, with watery eyes, flushing, sometimes cyanosis and apnea. Apnea can also be the only symptom of whooping cough in newborns. In elderly patients, the characteristic coughing attacks gradually increase in frequency and intensity. Several to several dozen seizures may occur during the day. They can be triggered by physical or emotional stimuli such as eating, sneezing, yawning, nervousness, but they can also occur during sleep.

A whooping cough starts with 5-10 coughs in one exhalation, followed by a deep wheezing breath. This is similar to a rooster crowing and is often referred to as mowing. Often, vomiting occurs when coughing up sticky sputum.

Moreover, when coughing, the patient’s face turns red, turns blue, exophthalmos, tearing and salivation occur. In addition, in patients with whooping cough, veins swell, and coughing attacks can cause rupture of blood vessels, lead to haemorrhages and ecchymosis, skin and nosebleeds. Infants may experience apnea at the end of a coughing attack, followed by seizures. In the interictal period, the child is usually tired and sleepy, with no high fever, but a swollen face with petechiae.

3. Whooping cough – recovery phase

During this phase of whooping cough, the frequency and intensity of coughing attacks decreases, although it may be very long-lasting.

See also: “Is wheezing a symptom of a disease?”

Whooping cough (whooping cough) – complications

Whooping cough is the most difficult for children under 6 months of age. They are also at risk of the most severe complications. When it comes to whooping cough, complications in adults are rather rare, and when they do occur, they’re not as severe as in infants.

The most common complications of whooping cough are:

1. apnea and hypoxia (can lead to brain damage),
2. fainting
3. bleeding from the nose and ears
4. vomiting,
5. rectal prolapse
6. swelling and ecchymosis on the face,
7. pneumonia,
8. aneurysm rupture,
9. hernias,
10. urinary incontinence
11. breakage of ribs with acute, persistent cough,
12. malnutrition and weight loss resulting from vomiting,
13. no idea
14. pneumothorax,
15. otitis media
16. pertussis brain injury – with convulsions, disturbed consciousness, paresis and damage to the cranial nerves, which may leave permanent defect symptoms (this complication is most dangerous in infants and young children).

Whooping cough – diagnosis

People presenting with symptoms of whooping cough are usually interpreted as patients presenting with flu-like symptoms. Whooping cough may be suspected in people who have been in contact with someone with whooping cough that lasts more than three weeks. The correct diagnosis is based on microbiological and serological tests. In people with whooping cough, the morphological examination will show high leukocytosis in the patient’s blood (20000–30000 / µl) with a large predominance of lymphocytes. Of course, this symptom does not determine the diagnosis, but it is very helpful at the stage of finding the answer.

In turn, the culture of Bordatella pertussis bacteria is used in the microbiological test.The test material can be taken in the form of a throat or nose swab. The obtained material is also often subjected to molecular testing. It is the gold standard in the diagnosis of whooping cough, which, unlike, for example, serological tests, can be performed in infants.

Whooping cough – serological diagnosis

The diagnosis of whooping cough is also based on a serological test, i.e. one in which the presence of antibodies to various bacterial antigens is checked. Testing of antibodies to pertussis toxin (PT) is one of the most popular specific serological tests. The most commonly used test is ELISA, i.e. enzyme immunoassay (also used for screening for Lyme disease or HIV infection).

The serological test is performed in the laboratory on the basis of the blood serum of the patient’s sample. Traditionally, blood is drawn from a vein in the arm. You do not need to fasting for whooping cough serology. It is best to report in the morning, although it is not a requirement. Before we start blood collection, it is advisable to consult your doctor about the medications you are taking.

If you develop whooping cough, the serological test should be performed twice, 4 weeks apart. The first time is in the catarrhal phase, i.e. in the first stage of the disease, and the second time in the recovery stage, i.e. in the last stage. The task of the serological test is to track and assess the correct response of the immune system, not just to detect pertussis bacteria in the body.

Serological tests are not a reliable test for whooping cough in the case of:

1. infants, because due to the presence of IgG antibodies from the mother, the tests are not very sensitive,
2. recently vaccinated (up to 12 months after dosing) due to vaccine antibodies.

However, they are effective when dealing with whooping cough:

1. in people who have been ill for a long time (about 2-3 weeks),
2. when antibiotic therapy is introduced,
3. in an epidemiological control situation.

Whooping cough – serological test results

Interpretation of the serological test for whooping cough presents no problems in unvaccinated people who have had the disease for the first time. Then, automatically in response to bacterial infection, IgA antibodies appear, which would not exist without contact with the pathogen or vaccine.

In contrast, it is more difficult to get a clear result for whooping cough in people who have been vaccinated with a whole cell or acellular vaccine, or in those who have had an infection in the past. Their organisms produce antibodies of the IgA class (usually after the first, basic vaccinations) and IgG (mainly after booster vaccine doses) to a different degree of intensity.

Blood test for serology test for whooping cough is positive when seroconversion occurs (development of antibodies in contact with the pathogen) or a minimum 2-fold increase in the concentration of specific antibodies.

Assessment of the serological test result for whooping cough involves not only detecting antibodies, but also determining their cut-off pointthat is, the limit of the amount of antibodies to define infection. So how to interpret the results?

IgG antibodies to whooping cough will appear for the first time without vaccination in the 2nd – 4th week after infection. After re-infection or immunization with IgG vaccination, they will occur in 1 or 2 weeks. The standards for whooping cough are:

1. ≥ 100 EU / ml – indicates a past infection,
2. ≥ 40 EU/ml — < 100 EU/ml – konieczność powtórzenia badania na krztusiec albo wykonanie w kierunku innych patogenów,
3. < 40 EU/ml – brak przebytego zakażenia.

It is worth adding that around the threshold of 100 EU / ml, both the sensitivity (up to 78%) and specificity (up to 98%) of the method are high. On the other hand, a lower threshold (up to 50 EU / ml) will give greater sensitivity, but less specificity, which will prove useful in an epidemic situation. The test will give a reliable result if their concentration cut-off is in the range of 50 to 100 EU / ml.

IgA whooping cough antibodies are considered to be an indicator of recent, natural (non-vaccine) infection. However, this is not the norm, and therefore it is more reliable to test the concentration of IgG antibodies. IgA is the class of antibodies that appear before IgG antibodies. They are highly specific but not very sensitive. For IgA in whooping cough there is no established cut-off point. Most often, however, the value from 10 to 20 IU / ml is considered as such.

Whooping cough (whooping cough) – treatment

Whooping cough, due to its contagiousness, is treated with antibiotics for a long time, and at every stage of the disease (it is important to exclude its cause). Proper care of the sick person has a great influence on the course of the disease. It is very important that a child with whooping cough has constant access to fresh air where they are, even in winter. However, long walks and intense movement games are contraindicated. In addition, the movement of the sick child should be limited, as increased physical exertion causes coughing attacks.

Weakened children should move little and rest a lot with the window open, because the attacks of coughing themselves are a lot of physical exertion. Children should take care of something interesting – busy coughing less. For older children, calmness is also important, because the anxiety of the environment affects the child and increases the frequency of attacks. Parents should not show their terror when a child coughs, as this may aggravate the attack. The diet for whooping cough does not need to be modified.

The pharmacological agents of choice are usually macrolides (clarithromycin, azithromycin), and co-trimoxazole is administered to people who cannot take such preparations.

A side effect of antibiotic therapy is the depletion of the bacterial flora that is crucial for the patient’s immunity. The prescribing physician usually recommends probiotics – medications or dietary supplements with protective effects. Below you will find our suggestions for supplements to help rebuild a healthy microbiome, along with links to the cheapest deals:

1. Probiotic for infants and young children in drops – check the offer
2. Probiotic for babies in sachets – check the offer
3. Probiotic for children over 3 years of age – check the offer

What are the methods of preventing whooping cough (whooping cough)?

Prophylaxis is mainly based on vaccination against whooping cough. Ideally, it is given to children in the first months of life. In addition, every sane person should avoid contact with people who have whooping cough. It is worth isolating patients in isolation – about 5-7 days after starting an antibiotic, and up to about 3 weeks after the appearance of a paroxysmal cough, if the antibiotic was not used. It is very important that all people who come into contact with pertussis patients use post-exposure chemoprophylaxis (especially pregnant women, infants).

Whooping cough and pregnancy

Getting whooping cough during pregnancy has no significant influence on its course. Pertussis bacilli are not able to penetrate the fetus, much less cause its defects. Women who were vaccinated against whooping cough as a child develop mild disease. The doctor introduces antibiotic therapy, which should be carefully followed according to the guidelines.

When treated, whooping cough is contagious for 5 days, and its hatching length is on average one and a half months. Moreover, in adults it is possible to get whooping cough without severe symptoms. Therefore, if the child is to appear soon, it is worth vaccinating relatives who will have contact with the newborn. Newborns are especially vulnerable to whooping cough due to the lack of proper antibodies. Vaccination is not possible until the age of 6 weeks. Then the first dose is given and the second one 4 to 6 weeks later.

A booster immunization for whooping cough is recommended for pregnant women. Vaccination for pregnant women is usually performed between the 27th and 36th week. Thanks to this, the antibodies reach the fetus, giving it natural protection against pertussis bacilli for the first weeks after birth. In addition, the bacteria is transmitted by droplets, therefore the vaccine is also a protection for the mother, who may become ill and infect the newborn.

Also read: “Infectious diseases of the mother during pregnancy, which disrupt the development of the fetus.”

Whooping cough vaccine

One of the best ways to prevent pertussis is to get vaccinated. For this purpose, a combined DTP vaccine is used, which simultaneously immunizes against three diseases: whooping cough, tetanus and mud. There are currently two forms of vaccine – acellular (DTaP) and whole-cell (DTP). In Poland, vaccination is included in the mandatory vaccination list.

So when it comes to whooping cough, the vaccine for children is mandatory in 6 doses:

1. the first in the 6th week of life (DTP or DtaP),
2. the second in the 10th – 12th week of life (DTP or DtaP),
3. the third in the 5th – 6th month of life (DTP or DtaP),
4. the fourth in the 16th – 18th month of life (DTP or DtaP),
5. first booster dose at 6 years of age (DtaP)
6. second booster dose at 14 years of age (DtaP).

The adult whooping cough vaccine is not compulsory, but it is worth giving it, especially if you are exposed to people who are sick. It is about, for example, parents of children in preschool and school age, or employees of educational institutions or care and education institutions. In principle, it is not known until when to repeat the whooping cough vaccine.

Until recently, the whooping cough immunization program only included the first two doses. The extension of the program was due to the continued increase in whooping cough incidence among adolescents and adults. The first symptoms were noticed already in the 90’s. The situation mainly affects people between 10 and 20 years of age. This means that people aged 14 and over who have not been included in the new program may develop whooping cough despite being immunized as a child.

The reasons for this situation are believed to be the gradually weakening immunity after vaccination in the human body with the high contagiousness of whooping cough bacteria, which causes the disease. It is assumed that immunity is expected to last for an average of 10 years for the DTP whole cell vaccine for whooping cough. In contrast, the DTaP acellular pertussis vaccine provides protection for up to 5 years.

Importantly, having whooping cough does not give full immunity to the disease. It is therefore not a contraindication to vaccination.

Whooping cough – home treatments

Despite the fact that home medicine is making a comeback, whooping cough is impossible to cure without antibiotics. It is even difficult to fight its symptoms individually. The disease-causing bacteria can only be neutralized by the vaccine antibodies or the antibiotic in the body. So when you get whooping cough, home treatments won’t work. However, additional activities, such as humidifying the air in the rooms or resting, will certainly be a good idea.

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