Whooping cough

The whooping cough is an infection of the respiratory system that affects mostly infants babies under six months old . One of the main symptoms of this disease is coughing spells, which are very intense.

It is not currently a public health problem, despite being a serious disorder. Although the majority of who suffer from whooping cough are mostly children, adults can also suffer from this disease.

What is it?

It is known as whooping cough to an infection of the respiratory system; It is produced by the bacteria known as Bordetella pertussis . Its main characteristic is that it is a highly contagious infection .

Pertussis outbreaks often occur cyclically over time. It especially affects children and adolescents under the age of fifteen, as well as babies under six months. It is precisely among this second population group that more deaths occur due to this disease.

Whooping cough can also occur in the elderly. It is one of the population groups most vulnerable to infection and, in addition, in which more complications can occur, such as brain hemorrhages.

Different stages

This disease is divided into three stages, each with its own characteristics and signs.

• Catarrhal: it is the first phase that occurs, which begins approximately one week after incubation. During the catarrhal stage, the bacteria gradually cover different areas of the respiratory system, such as the throat. The symptoms in the vast majority of cases are mild, such as sneezing or night coughing; Others can also occur, such as watery eyes or lack of appetite.
• Paroxysmal: begins seven days after the start of the catarrhal stage. The cough becomes much more frequent, and it also occurs during the day; the coughing attacks are of great intensity and in the vast majority of cases there is great respiratory distress. Also, as bacteria plug the airway, the inhaled air whistles past, resulting in a high-pitched sound.
• Convalescence: little by little the patients recover from the symptoms; begins four weeks after incubation. The cough can happen for several months.

Symptoms of whooping cough

The symptoms of whooping cough get progressively worse. This disease begins with mild signs such as a stuffy nose and a mild cough. Between one and two weeks after incubation, symptoms begin to worsen: very strong cough, shortness of breath, vomiting after coughing spells …

How is it spread?

It is a very contagious infection whose transmission is through small droplets that are expelled when coughing, sneezing, or talking . Therefore, transmission occurs between people. Unlike other infectious diseases, transmission through direct contact with contaminated objects is very rare.

Of course, contact with a whooping cough patient does not necessarily imply that the person in question will suffer from this disease. It is estimated that in 10% of cases the infection does not occur despite close contact with a sick person.

Whooping cough: diagnosis

The diagnosis of pertussis in its initial phase can be complex since in many cases the symptoms are very similar to those of a common cold or flu . In case of suspected pertussis, the doctor takes a sample of the excretion from the patient’s nose and throat for later analysis in the laboratory.

The truth is that direct cultivation of the bacteria is complex. Also, if done in the final stage of whooping cough, it can result in a false negative.

Generally, the doctor suspects this disease when the following symptoms occur: catarrhal process that lasts more than two weeks, very violent coughing episodes and sometimes accompanied by vomiting and hoarse noise from the larynx when taking air after coughing episodes .

Whooping cough treatment

Once the diagnosis of pertussis is confirmed, it is essential to determine the appropriate treatment. The most common is the administration of antibiotics from the group of macrolides, such as azithromycin or erythromycin.

In addition, depending on the degree of infection and the symptoms described, patients require other supportive measures, especially oxygen treatment to improve their breathing. To control coughing attacks and minimize their intensity, the administration of cough suppressants such as codeine is frequent.

Prognosis of pertussis

Although pertussis is a serious infection, the vast majority of patients recover without complications. However, it is important to note that the recovery process is slow , although progressive; antibiotic administration and support measures are key.

The prognosis is somewhat more complex in children under one year of age; It is estimated that around 2% of pertussis patients die from complications arising from the infection.

From one year of age, whooping cough is not a serious disease, much less fatal.

Complications

As we have pointed out, complications arising from pertussis infection are not very frequent, although they can occur. The most common are those that we explain below.

• Bronchopneumonia: it is a respiratory disease that arises as a result of an infection. It is a kind of pneumonia that attacks the bronchi; sometimes it invades the lung tissue, thus giving rise to a series of complications.
• Otitis: one of the most common diseases among the smallest. It consists of an inflammation of the ear due to an infection, the most common symptoms of which are pain, fever and hearing loss.
• Inguinal hernia – a bulge in the groin that occurs most often in men. It occurs when the anterior abdominal wall breaks at a certain point and an organ in this area protrudes through the hole. This is a complication that occurs due to the effort produced during coughing spells.
• Apnea: Apnea is a problem that occurs when breathing stops. In relation to whooping cough, it generally occurs when the coughing episodes are very intense and prolonged over time.

Pertussis vaccine

Today, the best way to prevent this disease is the vaccine; in Spain it is included in the official vaccination schedule . It is known as a triple bacterial vaccine; diphtheria , tetanus and pertussis.

It is administered in a total of five doses ; at two, four, six, and eighteen months of age. The last dose is given at age five. In the case of pregnant women, it is recommended that pregnant women be vaccinated between 27 and 36 weeks of gestation for pertussis. It is worth noting that this vaccine immunizes the fetus against infection and, in addition, considerably reduces the risk of the baby becoming infected during the first months of life.

Of course, the immunity offered by the pertussis vaccine is not 100% effective. And it is that the protection against this infection is progressively diminishing from two years after the last administration. Therefore, if the last dose is administered at the age of five, from the age of seven, the protection against whooping cough is decreasing.