2023-06-06 16:06:00
The bacterium Bordetella pertussis (Bordetella pertussis) is responsible for the pertussis disease, which manifests itself in prolonged paroxysmal coughing. Whooping cough has earned the dubious nickname “the century disease” due to its long duration. In the past – the disease was the number 1 cause of infant mortality. Since the vaccine was introduced into the routine, there has been a dramatic decrease in morbidity and mortality from this bacterium.
Tragedy in Jerusalem: an unvaccinated ten-week-old baby dies of whooping cough
Whooping cough is an infectious disease that affects the respiratory tract, mainly the trachea and bronchi. The disease is characterized by coughing attacks that end with a sharp inhalation of air that has a unique whistling sound. Whooping cough is a highly contagious disease, the bacterium is passed from person to person through fragments of secretions splashed from the mouth of a patient when he sneezes or coughs.
At what age do you get whooping cough?
Pertussis can be contracted at any age, among the young children the complications of pertussis are more common and therefore they are in an increased risk group, toddlers may develop a serious disease. But it must be emphasized that whooping cough can be fatal only in rare cases.
What are the symptoms?
The infection process lasts about 6-20 days, during which the bacterium incubates and multiplies inside the infected person’s body. After that, the symptoms begin to appear, and they last for a long time, sometimes even two or three months. Whooping cough usually develops in stages, at first the symptoms are mild, which worsen over time and only then does recovery begin.
Similar to many viral diseases, the first stage of the symptoms is the “catarrhal stage”, at this stage runny nose, phlegm, cough, discharge from the eyes appear, sometimes accompanied by fever.
The next stage is the “paroxysmal” stage, which is characterized by a paroxysmal cough. Small babies may turn red and turn blue while coughing. At the end of the coughing attack, there is an attempt to quickly introduce air into the lungs and this rapid entry of air through edematous airways produces the characteristic whistling sound. Often the cough is accompanied by vomiting at the end (in children, a cough accompanied by vomiting should always raise the suspicion of whooping cough).
The third stage is the recovery stage which includes a chronic cough, less attacks, and lasts on average about 6 weeks.
How are you treated?
Whooping cough can be successfully treated with antibiotics, most patients recover completely. If the disease is diagnosed in the first weeks of the infection, the doctor will prescribe antibiotic treatment to prevent its spread.
Five days from the start of taking the antibiotics, the patient is no longer contagious. Without the antibiotic treatment, the patient may infect others for 3 weeks from the onset of the coughing fits.
If pertussis is diagnosed at a late stage, antibiotic treatment will not be given because the bacteria that caused the disease is no longer in the patient’s body, and it is no longer contagious. Taking an antibiotic medicine will not affect the symptoms at this stage.
Among older children and adults, the symptoms of the disease will be milder, and in most cases rest, high fluid intake, removal of phlegm from the respiratory tract and isolation will be recommended to avoid infecting others. After three weeks from the start of the coughing attacks, there is a minimal risk of infecting others.
What are the possible complications?
Possible complications of whooping cough are pneumonia, convulsions as a result of high fever, low blood sugar and various types of damage to the nervous system and brain: lack of oxygen in the brain, small intracerebral hemorrhages and inflammation of the brain tissue. Whooping cough can cause death, especially in children who are in risk groups: small babies, premature babies and children with additional morbidity. There is also an increased risk of mortality in the elderly and adults with additional morbidity such as asthma, chronic lung disease, diabetes or obesity.
Can the disease be prevented?
In Israel, the disease is rare thanks to the vaccine against the bacteria. The vaccine against whooping cough is given to babies as part of the pentavalent vaccine against whooping cough, diphtheria, tetanus, polio and meningitis. The vaccine is given to babies in four doses, between the ages of two months and 12 months, and at school age two booster doses will be given to strengthen protection.
The vaccine against whooping cough does not contain the bacteria that causes the disease but only certain components of it, these cause the immune system to produce antibodies to the bacteria without causing the symptoms of whooping cough.
It is very important to emphasize that pertussis can be prevented by vaccinating the mother even before birth in the 27-36 weeks of pregnancy. The mother’s vaccination during this period before the birth gives her immune system a boost to produce antibodies at a high level and protects her from the infection. And even more important: antibodies that the mother’s system produces, also pass to the fetus and protect it in the first period of life until it begins to receive routine vaccines as part of the drops of milk.
It should be emphasized that the fact that the mother was vaccinated during pregnancy does not prevent the child from receiving his vaccinations as part of the routine vaccinations and the antibodies he receives from the mother protect him for a short and critical period and disappear. The vaccines he will receive in the milk treatment will be left in his body and will protect him for a long time.
Remember – vaccines are the most effective and safe way to protect our children and prevent illness with a host of consequences and complications. Be sure to vaccinate and vaccinate your children with all the routine vaccinations and in this way we will all protect our health, the health of our family and the health of the entire public.
The author is a nurse and director of the public health department at Maccabi Health Services
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