Whooping cough is not to be feared, it is preventable, controllable and treatable!

Recently, the topic of "whooping cough" has been on the hot search list of various social media platforms, attracting public attention to whooping cough.

The "National Notifiable Infectious Disease Epidemic Overview" report regularly released on the official website of the National Disease Control and Prevention shows that from January 1 to February 29, 2024, 32,380 cases of whooping cough were reported nationwide, which is nearly 23 times the same period in 2023.

"Whooping cough" has become a hot topic.

What exactly is this “ghost”?

What is whooping cough?

Whooping cough is an acute respiratory infectious disease caused by Bordetella pertussis. It is a Class B infectious disease stipulated in the Law of the People's Republic of China on the Prevention and Control of Infectious Diseases. It is characterized by paroxysmal spasmodic coughs accompanied by special cock-like echoes. The course of the disease can last up to 2 to 3 months, so it is called "whooping cough". However, the course of whooping cough is not necessarily exactly 100 days. It can be as short as a few days or as long as two months, and is generally 4 to 6 weeks.

Source of infection

Pertussis patients, latently infected persons and asymptomatic carriers are all sources of infection. The infection is strongest from the end of the incubation period to 2-3 weeks after the onset of the disease.

Mode of transmission

It is mainly spread through respiratory droplets. The general population is susceptible to whooping cough, but infants and young children are the most susceptible. Atypical or mild patients play a more important role in the spread of this disease. Many adolescents and adults with coughs are latent or carriers of Bordetella pertussis. Infants are mostly transmitted from family members, so it is important to isolate family members.

Susceptible population

The general population is susceptible. Since vaccination does not produce lifelong antibodies, protective antibodies can only last for 4-5 years. In addition, due to mutations in bacterial genes, changes in lifestyle and environmental changes, no matter whether the vaccine is fully immunized or naturally infected, it cannot provide lifelong immunity and there is a possibility of reinfection.

Clinical manifestations of whooping cough

The clinical characteristics of whooping cough are paroxysmal, spasmodic coughs and cock-crow-like inhalation roars. After infection, there is a 1-2 week incubation period, and then typical whooping cough symptoms appear. The course of the disease can be divided into three stages: catarrhal stage, spasmodic cough stage, and recovery stage.

1. Catarrhal stage

Symptoms of upper respiratory tract infection include runny nose, sneezing, tearing, sore throat, paroxysmal cough, etc. There is usually no fever, or a transient fever in the early stage. The amount of bacteria excreted during this period reaches a peak, and it is highly contagious. It lasts for 1 to 2 weeks.

2. Spasmodic cough stage

It manifests as paroxysmal spasmodic coughs, accompanied by an inspiratory cock-crow-like echo at the end of the cough, which repeats many times until sticky phlegm is coughed up, which is mild during the day and severe at night, affecting sleep. The number of spasmodic coughs increases as the disease progresses. Vomiting, facial and eyelid edema, conjunctival hemorrhage, epistaxis, and intracranial hemorrhage often occur after coughing. Coughing in newborns and infants under 6 months old often causes cyanosis, apnea, convulsions, bradycardia or cardiac arrest. This period generally lasts 2 to 6 weeks, and can also last for more than 2 months.

3. Recovery period

The spasmodic cough gradually eases, the cough intensity decreases, the number of attacks decreases, the cock-crow-like echo gradually disappears, and the paroxysmal spasmodic cough symptoms can last for weeks or months. Newborns and infants under 6 months of age are often accompanied by complications, with pneumonia being the most common, but may also be complicated by atelectasis, pneumothorax, mediastinal emphysema, subcutaneous emphysema, pulmonary hypertension, asphyxia, and encephalopathy.

How to care for someone with whooping cough?

Spasmodic Cough Care

Nebulized drugs can be inhaled to dilute sputum, and Chinese medicine can be applied to acupoints to promote coughing up sputum. Infants and young children should be prevented from suffocation. When coughing, the child can be assisted to lie on his side, sit up or hold him up, pat his back to promote sputum discharge, wipe oral and nasal secretions at any time, and suction sputum when necessary.

Diet care

Eat more high-fiber and fresh vegetables and fruits for a balanced diet. Because spasmodic cough often leads to vomiting, in order to ensure the nutritional supply of the child, nutritious, easily digestible, and non-irritating food must be given, with small amounts and frequent meals. Feeding should not be too fast, and movement should be reduced after eating to avoid vomiting.

How to prevent whooping cough?

Although Bordetella pertussis is highly contagious, it can be inactivated by high temperature of 56°C for 30 minutes, sunlight exposure for 1 hour, and drying for 3-5 hours. It is sensitive to ultraviolet rays and general disinfectants, so reasonable prevention methods can completely block the spread of whooping cough.

Control the source of infection

Respiratory tract isolation should last at least 5 days after effective antibiotic treatment. For patients who are not given effective antibiotic treatment in time, the isolation period is 21 days after cough spasm.

Cut off the transmission route

Strict implementation of respiratory isolation is an important part of prevention. Keep indoor ventilation, expose clothes to the sun, wash hands frequently, and wear masks.

Vaccination to improve immunity

Get vaccinated on time. my country's vaccine policy stipulates that 4 doses of DTP triple vaccine (including pertussis, diphtheria and tetanus) should be administered at 3, 4, 5 and 18 months of age. Failure to vaccinate or incomplete vaccination is a risk factor for children to be infected with pertussis!

How is whooping cough treated?

The first choice of antibacterial treatment for pertussis is macrolide antibiotics, such as azithromycin, erythromycin, roxithromycin or clarithromycin, etc. Mild patients can be treated with oral medication, while severe patients require hospitalization.

Source: Banan District Second People's Hospital

Author: Lu Xuening

Review experts: Zhang Ling, Du Guo

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