2023-06-26 11:52:54
Pertussis has made headlines in recent days following a tragic case of an unvaccinated baby. In order to put the information in order, Dr. Bat Sheva Gustman, a senior doctor in the Infectious Diseases Department at Meir Hospital from the General Group, explains the symptoms of whooping cough, how it is diagnosed, and the important vaccine that can prevent infection.
Whooping cough (in English: Whooping cough or Pertussis, pertussis) is an infectious bacterial disease caused by the bacterium Bordetella pertussis. The bacterium secretes toxins that damage different cells in the body and cause the symptoms of the disease.
The three stages of whooping cough symptoms:
The first stage, which is the most contagious, is characterized by symptoms of a runny nose and a mild cough. This stage is difficult to diagnose because there is usually no increase in body temperature, and it looks like a passing seasonal virus. However, already during this phase which lasts between one and two weeks: the cough is getting stronger – until the second phase appears.
In the second stage, the cough increases in intensity and frequency, becomes paroxysmal and appears in continuous series of coughs ending in a strong inhalation with a unique sound called “Whoop” in English. This unique sound is caused by the lack of air created during coughing. During the attack, the face turns red, and sometimes even turns blue, the veins in the neck and eyes stand out, and sometimes even vomiting is caused. Among babies, it is also possible to stop breathing (apnea) following the cough. This phase lasts several weeks.
The third stage is characterized by reducing the frequency of the coughing attacks and reducing their intensity – until the patient fully recovers.
Can whooping cough be dangerous?
About 50% of babies under one year old who get whooping cough need hospitalization. Complications from the disease can be pneumonia, dehydration, weight loss, sleep disorders, convulsions, encephalitis (inflammation of the brain tissue due to lack of oxygen to the brain during coughing), cerebral hemorrhages and sometimes even brain damage.
In any case where the cough does not go away and is characterized by severe attacks, or if you know of someone in the household or relatives who has recently contracted whooping cough, you should consult a doctor. Particularly severe coughing fits that cause pauses in breathing or convulsions will usually result in the patient being hospitalized.
Diagnosing asthma is done using a molecular test (PCR). The test is done on a sample from the nasopharynx (the uppermost part of the pharynx behind the nose) taken with a swab or on a sample of nasal secretions (nasal wash). In people one year old and older, the disease can also be diagnosed through a blood test, provided that at least one year has passed since the administration of the pertussis vaccine, and more than two weeks have already passed since the symptoms appeared.
Treatment methods
Giving antibiotic treatment already in the first stage, may shorten the duration of the disease. The treatment for the second cough stage of the disease has no effect on the course of the disease, but it reduces the contagion of the environment. Therefore, it is recommended to give it to the patient as long as he is at a stage where he may infect his environment.
In addition, it is recommended to give treatment to anyone who came into close contact with the patient (family members, friends, etc.), regardless of age or the number of vaccination doses they received in the past. The prophylactic treatment is mainly effective if given within 3 weeks of exposure to an infectious patient, but if it concerns people who belong to the risk group, the possibility of giving them the treatment up to 6 weeks after exposure should be considered. The risk group includes babies up to one year old, those suffering from suppression of the immune system and patients with chronic lung disease.
Pertussis vaccine
There is an effective vaccine against whooping cough that is included in the routine vaccinations of babies in Israel. Since pertussis was included in the vaccination routine, the incidence of the disease has decreased by 90%. In recent decades, a new vaccine has been used that significantly reduces the incidence of vaccine side effects.
It should be noted that immunity against the disease develops gradually, therefore babies in their first months of life are not fully protected against whooping cough. It is important to remember that even if the vaccine does not provide perfect protection, it provides good protection against the serious disease, and that almost all deaths from pertussis are of babies who were not vaccinated at all.
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