Painful Whooping Cough

whooping cough host and care

Whooping cough is a bacterial disease that can be fatal, especially for babies. What are the symptoms of whooping cough? How is whooping cough diagnosed? And yes, it can be prevented – through vaccination!

What are the symptoms of whooping cough?

For cough 3 stages:

The first stage (Catarrhal 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 usually there is no increase in body temperature, and in most cases, the doctor says that “there is nothing to do, it is a virus, and it will pass.” However, there is a symptom that can be noticed already during this phase that lasts between one and two weeks: the cough is getting stronger – until the second phase appears.

In the second stage (paroxysmal 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 a lack of air created during coughing (hence the name of the disease in English: Whooping Cough).

During the attack, the face turns red, and sometimes even turns blue, the veins in the neck and eyes stand out, and sometimes you also vomit after such a coughing attack. Babies may also stop breathing (apnea) following the cough. This phase lasts for several weeks.

The third stage (Convalescent 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?

The answer to this question depends on the severity of the disease and the condition of the patient. Soft babies and the elderly are at risk of having a serious illness that requires hospitalization. About 50% of babies under one-year-old who get whooping cough need hospitalization. 

Complications from the disease can be pneumonia  (about a quarter of babies under one-year-old who get whooping cough suffer from this complication), dehydration, weight loss, sleep disorders, convulsions, encephalitis (inflammation of the brain tissue due to a lack of oxygen supply to the brain during coughing), cerebral hemorrhages and sometimes even brain damage and death.

As mentioned, the death rate from the disease among babies up to one-year-old is 1%. In adults, rib fractures and loss of control over urinating while coughing may occur.

When should you see a doctor?

In any case where the cough does not go away and is characterized by severe attacks of the type described above, or if someone in the household or relatives is known to have recently contracted whooping cough.

A decision on hospitalization – as with any disease – depends on the severity of the disease. For example, particularly severe coughing fits that cause pauses in breathing or convulsions will usually result in the patient being hospitalized.

How do you differentiate between a whooping cough and a common cold?

A common cold is usually characterized by a runny nose, sore throat, and mild fever. It is common for a cold to be accompanied by a cough, but this is usually a mild cough that goes away after a few days or at most after a week or two. 

Whooping cough, on the other hand, is characterized by weeks of paroxysmal coughing as described above. One should especially suspect if the patient has not been vaccinated or has come into contact with a pertussis patient. In any case of suspicion of whooping cough, you should contact a doctor for diagnosis and treatment.

How do you get whooping cough? 

The bacterium that causes pertussis is easily carried in the air in tiny droplets (spray), therefore sneezing, coughing, and touching hands (that have previously touched a sick person) can transfer the bacterium from person to person.

The bacterium adheres to the respiratory tract, and usually after an incubation period of 7 to 10 days, the signs of the disease appear. Rarely there may be an incubation period of 5 to 21 days.

A patient is considered contagious from the catarrhal stage of the disease until approximately 3 weeks after the onset of the cough. If he has been treated with appropriate antibiotics, he is considered infection-free after 5 days of treatment.

Whooping cough in adults:

Whooping cough in adults

Whooping cough, also known as pertussis, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. While it is commonly associated with children, whooping cough can affect adults as well. Diagnosing whooping cough in adults can be challenging due to its resemblance to other respiratory illnesses. Treating whooping cough in adults often involves a combination of antibiotics and supportive care.

If you suspect that it is whooping cough – how do you make sure that this is indeed the correct diagnosis? 

Diagnosis of whooping cough is done using a molecular test (PCR). This 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.

Is there a treatment for whooping cough? 

Yes, there is treatment. Administering antibiotic treatment in the first stage of whooping cough – the catarrhal stage (before the paroxysmal cough stage) – may shorten the duration of the disease.

The treatment during the offensive cough stage no longer affects the course of the disease, but it has value because 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 surroundings. 

In addition to this, it is recommended to give treatment to everyone who came in close contact with the patient (household members, friends at daycare and kindergarten, etc.) regardless of age or the number of vaccination doses they received in the past.

The preventive treatment is mainly effective if it is given within 3 weeks of exposure to an infectious patient, but if it is someone who belongs 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.

The decision to which of those who come in contact with a patient with whooping cough should be given preventive treatment is made by the doctor according to his medical judgment and by the guidelines of the Ministry of Health.

Can the disease be prevented?

Yes! There is an effective vaccine against whooping cough that since 1957 has been 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 2002, the cellular vaccine (the “cellular” also called DTP), which was prepared from a whole-killed pertussis bacterium, was replaced by a new, non-cellular vaccine (“acellular” also called DTaP). The new vaccine is also prepared from a killed bacterium, but it is more purified. This change was made in all developed countries. With the beginning of the use of the new vaccine, the incidence of the side effects of the vaccine decreased a lot.

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 should be remembered that even if the vaccine does not provide perfect protection, it provides good protection against severe disease and almost all deaths from pertussis are of babies who were not vaccinated at all.

Why, despite the vaccine, has there been an increase in the incidence of pertussis worldwide in recent years?

There are several hypotheses for this, including:

  • The vaccine does not provide lifelong protection, and there is a decline in its effectiveness over the years. That is why teenagers and young adults contract the disease and are the source of environmental contamination – especially unvaccinated babies or those who have not yet had time to complete the initial series of vaccinations.
  • It is possible that the effectiveness of the current vaccine is less than the effectiveness of the previous vaccine. As mentioned, the replacement of the vaccines was done to reduce the side effects observed in the old vaccine.

And what about pregnant women? 

Vaccination of the pregnant woman at the end of pregnancy (preferably between the 27th and 36th week, by the guidelines of the Ministry of Health) protects her from contracting whooping cough. It allows her to transfer the maximum and optimal amount of antibodies through the placenta to the fetus. In this way, the newborn receives good temporary protection against the disease – until he is vaccinated as part of the childhood immunization routine with a drop of milk.

The vaccine is recommended during every pregnancy, regardless of the number of doses the woman has received in the past, including in previous pregnancies, or if she has had pertussis in the past.

If for some reason the mother-to-be was not vaccinated during pregnancy, she must be vaccinated within 3 months of giving birth to prevent her and the newborn from contracting the disease.

If I got whooping cough – do I have a lifelong vaccine?

No. Therefore, even those who have pertussis should be vaccinated with the routine vaccines, and if they come into close contact with a pertussis patient, they must receive preventive antibiotic treatment.

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