2024-02-16 08:54:43
Frequent, serious and contagious. This is the cover letter of the whooping cough. This infection attacks the respiratory system and, sometimes, due to its symptoms, it goes unnoticed without complications. But in the babies under six monthsparticularly in those of three who have not yet been vaccinated, the whooping cough poses a risk for its complications.
What is whooping cough?
The whooping cough or pertussis is a respiratory infection caused by bacteria Bordetella pertussis (B. pertussis). It is an endemic infectious pathology worldwide, with a cyclical epidemic pattern and highly contagious.
The contagion capacity is high (attack rate of 80-100%), and can occur in sick or asymptomatic people. Its only known reservoir is human and transmitted by air.
It affects all age groups, with significant morbidity and mortality in children under three and four months. Is a notifiable disease.
The whooping cough It is an endemic infection with a cyclical epidemic pattern, with peaks every two and five years. Until the 90% of cohabitants and 50-80% of school contacts can be infected after the exhibition.
76% of whooping cough cases occur in children under 14 years of age and 15% are diagnosed in adults between 25 and 54 years old, as stated in the 2055-2020 report of the National Epidemiological Surveillance Network (Renave) of the National Epidemiology Center (CNE) of the Carlos III Health Institute (ISCIII).
How many cases and outbreaks of whooping cough are there per year?
From 2010, the incidence of whooping cough has increased worldwide, both in countries with low and high human development index, including those with high vaccine coverage. The cases occurred mainly in adolescents, adults and infants who had not started or completed the primary vaccination.
Since 2005, fewer than 60 deaths have been recorded. Between 2005 and 2020, 43,534 cases of whooping cough were reported. For all age groups except those under one year of age, more cases of whooping cough are reported in women than in men.
Between 2005-2019, The maximum incidence was recorded in the last epidemic wave (2014-2019) with a peak in 2015.. The drastic reduction in the incidence of whooping cough in 2020 in all age groups is an unexpected epidemiological phenomenon, a consequence of the Covid-19 pandemic.
In between In 2021 and 2022, almost 400 infections were added. And in 2023, a total of 1,597 cases have been reported to Renave. An increase in cases has been registered compared to those declared annually in the 2020-2022 pandemic period, with 761, 147 and 250 cases respectively. The number of cases reported last year is even lower than in pre-pandemic years.
What are the incubation and contagion periods like and how long do they last?
The period of incubation It is 9-10 days (with a maximum interval between 6-20 days).
The period of transmissibility or contagion is broad. It is very contagious, especially in the early catarrhal phase. A person with whooping cough is contagious from the beginning of this stage until the first two weeks after the onset of paroxysmal cough (approximately 21 days) or up to five days after starting treatment effective antibiotic.
How do you prevent infection with the bacteria responsible for whooping cough?
The Vaccination in pregnant women has been shown to be the most cost-effective measure to prevent serious cases in infants, which has radically reduced the number of cases in Spain. Neither natural infection with B. pertussis nor vaccination confers prolonged immunity.
In Spain, as stated by the ISCIII, vaccination against whooping cough It began in the 1960s with the DTP (diphtheria, tetanus, and pertussis) vaccine. Adverse reactions associated with the DTP (whole-cell pertussis) vaccine prompted the development of acellular vaccines that, in principle, maintained effectiveness and improved safety.
Since 2005, only the acellular pertussis vaccine (DTPa) has been administered.. The vaccination schedule against whooping cough included in the vaccination schedule has been modified over the years.
Currently administering a schedule with four doses: 2 months, 4 months, 11 months and 6 years. Additionally, to reduce severe illness in infants, the administration of a dose of dTpa vaccine to pregnant women from the 27th week of gestation.
Primary vaccination coverage has remained very high over the last few decades, exceeding 95% since 2000. Vaccination coverage with dTpa in pregnant women exceeds 85%, as stated in the latest ISCIII report.
What are the symptoms of whooping cough?
The whooping cough course with whooping cough attacks (paroxysmal cough) that usually ends in a long inhalation accompanied by a high-pitched whistle (respiratory stridor, that is, gasping for air).
The clinical presentation varies with age, and in adolescents and adults, the disease is usually mild. In infants under six months, the disease presents a higher risk of complications (pneumonia and encephalopathy) and mortality.
It should be suspected in patients with cough in fits of more than 14 days, which can end in a stridor or inspiratory “rooster”.
How is the infection detected?
He diagnosis is often delayedbecause its clinical symptoms are generally nonspecific: it begins like a cold.
For babies, symptoms may include apnea pauses with and without cyanosis and/or posttussive vomiting (caused by the continuous act of coughing).
The diagnostic technique of choice is PCR in aspirate-wash or nasopharyngeal exudate, as in Covid. Admission should be considered in infants younger than four and six months or if complications are suspected.
How is whooping cough treated?
The treatment with macrolides (antibiotic) eliminates B. pertussis from the nasopharynx and reduces the risk of transmission, as long as it is started within the first 21 days after the onset of symptoms.
The cough can persist for up to three monthsbecause there is no effective symptomatic treatment.
It has to be done contact studystarting prophylaxis in the straits and reviewing the vaccination schedule, to assess completing the vaccination schedule and/or booster dose.
Los suspected, probable or confirmed cases should be isolatedavoiding contact with young children (especially those who have not yet received the primary vaccination series) until five days after the start of antibiotic treatment.
People who do not receive antibiotic treatment should be in respiratory isolation, for 21 days from the onset of cough paroxysmal or until it disappears.
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