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Whooping Cough – A Comprehensive Guide

Whooping cough, also known as whooping cough, is a highly contagious bacterial disease of the respiratory system that can affect people of all ages . Despite the availability of vaccinations, whooping cough continues to pose a threat to public health, especially to infants and young children . In recent years, there has been an increase in pertussis cases worldwide, even in countries with high vaccination rates . This phenomenon is associated with a decrease in vaccination coverage, a decrease in post-vaccination immunity (lack of booster doses) and the selection pressure of the vaccines used, m.in. the pertussis vaccine. tags. In 2018, there were more than 151,000 cases of whooping cough worldwide . In this article, we will discuss the causes, symptoms, diagnosis, treatment, and prevention of whooping cough to help you understand the disease and protect yourself and your loved ones.

1. What is whooping cough?

Whooping cough is an acute infectious disease of the respiratory system caused by the bacterium Bordetella pertussis. These bacteria attach to the cilia that line the upper respiratory tract and release toxins that damage the cilia and cause swelling of the airways. The source of infection is a sick person who spreads the bacteria through droplets when coughing, sneezing or talking. People who have had whooping cough or have been vaccinated may get sick again, but usually have a milder illness.

2. Causes of whooping cough

The main cause of whooping cough is a bacterium that causes an infectious disease of the respiratory tract. Bordetella pertussis . Infection occurs through droplets, by inhaling air containing bacteria that have been sprayed by the patient when coughing, sneezing or talking . Risk factors are: an increase in the number of pertussis cases and reduced immunity.

• Lack of vaccination: Unvaccinated people are most at risk of getting sick.
• Weakened immunity: Immunocompromised people, including adults, are more susceptible to infection and a more severe course of the disease, especially if the number of pertussis cases increases. .
• Contact with the patient: Close contact with a person with whooping cough increases the risk of infection.
• Age: Infants and young children are most at risk of severe pertussis and complications.

3. Symptoms of whooping cough

Once infected with pertussis bacteria, symptoms usually appear after 7 to 10 days, although it can sometimes take longer . The incubation period of whooping cough is from 5 to 21 days . The symptoms of whooping cough vary depending on the age and immunization status of the patient, especially in the third trimester of pregnancy. tags. The typical course of whooping cough can be divided into three stages :

Catarrhal phase:

• It lasts 1-2 weeks.
• The symptoms resemble a cold: runny nose, slight fever, dry cough, weakness, irritability.
• The cough intensifies at night.
• This is the most infectious phase.

Paroxysmal cough phase:

• It lasts 4-6 weeks.
• It is characterized by strong, paroxysmal coughing attacks that can last 1-2 months and lead to vomiting, facial redness and even temporary hypoxia .
• In children, coughing often ends with a characteristic inspiratory wheezing, called “rooster crowing”.
• Apneas and seizures may occur in infants.
• In adults, the cough is usually less characteristic and can persist for more than 3 weeks.
• Coughing fits intensify at night .

Recovery phase:

• It can last for several weeks or even months .
• The symptoms gradually subside.
• Cough may return due to physical exertion or respiratory infection .

4. Diagnosis of whooping cough

Diagnosing whooping cough can be difficult because symptoms often resemble other respiratory diseases. In adolescents, adults, or partially immunized children, symptoms may be milder or atypical, making diagnosis difficult. The doctor makes a diagnosis based on:

• Medical history: The doctor will ask about the symptoms of whooping cough in children, contact with whooping cough patients and vaccination history. .
• Physical examination: The doctor will auscultate the lungs and examine the throat.
• Laboratory tests: To confirm the diagnosis, your doctor may order:
  • Seeds: Nasopharyngeal swab to grow Bordetella pertussis bacteria.
  • PCR: Genetic testing of a throat or nasal swab to detect bacterial DNA, including bacteria that cause pertussis – diagnostics. Bordetella pertussis .

5. Treatment of whooping cough

Treatment of whooping cough consists of:

• Antibiotic therapy: The drugs of choice are macrolide antibiotics such as azithromycin, clarithromycin or erythromycin . Antibiotics shorten the period of infectivity and relieve symptoms if given early.
• Supportive treatment: It includes antipyretics, cough suppressants and air humidification.
• Isolation of the patient: The affected person should avoid contact with other people, especially babies and young children, to prevent the spread of the disease. Isolation may end no earlier than 5 days after the start of antibiotic therapy. If no treatment has been administered, isolation should be extended to 3 weeks after the appearance of coughing attacks.

6. Whooping cough prevention

The most effective way to prevent pertussis is preventive vaccination . The pertussis vaccine is given in combination with diphtheria and tetanus (DTP) vaccines. Although the pertussis vaccine does not provide lasting immunity, it significantly reduces the risk of contracting the disease and, if infected, alleviates the course of the disease and shortens its duration . There are two types of pertussis vaccines:

• Whole cell vaccines: They contain whole, killed cells of pertussis bacilli. They are used to carry out vaccinations against pertussis as part of the Preventive Vaccination Program (PSO) in children up to the age of 3. They are highly effective, but they are burdened with a higher risk of developing adverse post-vaccination reactions.
• Acellular vaccines: They contain only a few fragments of pertussis bacillus, which stimulate a protective response of the immune system. They can occur in a highly combined form (the so-called 5-in-1, 6-in-1), which additionally protects against other diseases. Acellular vaccines are effective and well tolerated.

Vaccinations in children:

• Basic vaccination: 4 doses of DTP vaccine at 2, 3-4, 5 and 16-18 months of age.
• Booster doses: at 6 and 14 years of age.

Vaccinations in adults:

• Booster: every 10 years to prevent an increase in whooping cough cases. .
• Vaccination of pregnant women: between 27 and 36 weeks of gestation.

Post-exposure prophylaxis:

• People who have been in contact with a whooping cough patient may be given antibiotics prophylactically to prevent the disease from developing.

Cough hygiene:

• Covering the mouth and nose when coughing and sneezing.
• Washing your hands frequently.
• Avoiding close contact with the sick.

7. Whooping cough in infants and young children

Whooping cough is especially dangerous for babies and young children because their immune system is not fully developed . In infants, the symptoms of whooping cough can be atypical and include:

• Difficulty breathing.
• Apnea.
• Cyanosis.
• No characteristic “rooster crowing”.

Complications of whooping cough in infants are more common and more serious than in older children and adults . They may include:

• Pneumonia.
• Brain damage.
• Convulsions.
• Death.

Preventive vaccinations are crucial for protecting infants against whooping cough . It is important to note that breastfeeding does not protect babies from whooping cough and vaccination is still necessary . Because infants are not fully immunized after vaccination, it is important that those around them are also vaccinated to reduce the risk of infection.

8. Whooping cough in adults

In adults, whooping cough is often milder than in children. Symptoms may resemble a cold or bronchitis and include:

• Chronic cough.
• Qatar.
• Sore throat.
• Low-grade fever.

Despite its milder course, whooping cough in adults can lead to complications such as:

• Pneumonia.
• Rib fractures.
• Urinary incontinence.
• Sleep problems .

Studies indicate that young adults and the elderly are the main source of infection for newborns and infants up to 6 months of age who have not yet developed immunity after vaccination . Therefore, it is important for adults, especially those who come into contact with young children, to take vaccine boosters regularly.

9. Whooping cough in pregnancy

Whooping cough in pregnancy can be dangerous for both the mother and the baby . Vaccination against pertussis in pregnancy protects the mother from getting sick and also transmits antibodies to the baby, which reduces the risk of contracting the disease in the first months of life .

Vaccination against pertussis in pregnancy is recommended between the 27th and 36th week of pregnancy, and in the case of a risk of premature birth – after the 20th week of pregnancy . From October 15, 2024, pertussis vaccination for pregnant women is free of charge in Poland .

10. Complications of whooping cough

Pertussis complications are more common and serious in infants and young children . Pneumonia is a common complication of whooping cough . Complications of whooping cough include:

Complications of tetanus and pertussis can occur in the absence of vaccination.	Description	The Risk Group includes adults and children who have not received the pertussis vaccine.
Pneumonia	Inflammation of the lungs, which can lead to difficulty breathing and respiratory failure.	Infants, elderly
Otitis media	An infection of the middle ear that can cause ear pain, fever, and hearing loss.	Children
Atelectasis	Collapse of part or all of the lung, making it difficult to breathe.
Pneumothorax	Accumulation of air in the pleural cavity, which compresses the lungs and makes breathing difficult.
Convulsions	Involuntary muscle spasms, which can be caused by fever or hypoxia of the brain.	Babies, toddlers
Cerebral edema	Fluid buildup in the brain, which can lead to brain damage.	Infants
Intracranial bleeding	Bleeding into the brain, which can lead to stroke or death.
Encephalopathy	Brain damage that can cause permanent neurological problems such as epilepsy, mental retardation, or deafness.	Infants
Rib fractures	Rib fractures, which can occur as a result of a strong cough.	Adults
Urinary incontinence	Involuntary urination.	Adults
Hernia	A protrusion of an internal organ through an opening in the abdominal muscles.
Brain damage		Babies, toddlers
Aneurysm rupture
Bleeding from the ears and nose

In the elderly, young children and patients with chronic diseases, whooping cough can lead to death .

11. Summary

Whooping cough is a serious infectious disease that can be prevented with preventive vaccinations. Vaccinations, including pertussis vaccination in pregnancy, are important for all ages, and especially for infants, young children, pregnant women and immunocompromised people. tags. If pertussis is suspected, a doctor should be consulted for diagnosis and treatment . To find out more about whooping cough, visit the website of the Ministry of Health or the World Health Organization (WHO).