This infectious disease in children can also be contracted by teenagers and adults

Recently, topics such as "whooping cough reappears" and "whooping cough has killed 13 people this year" have attracted attention.

According to data from the National Center for Disease Control and Prevention, in the first two months of 2024, the number of pertussis cases nationwide has surged to 32,380, nearly 23 times the number in the same period of 2023, close to the total number of the previous year, and 13 deaths have occurred. This disease, which was previously thought to be only for infants and young children, is gradually becoming "aging", and the incidence rate among teenagers and adults has also increased significantly. Do you know whooping cough? Why has the incidence of whooping cough suddenly increased recently?

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 and is a strictly managed infectious disease. The course of whooping cough is long, and a typical case may present with a cough lasting 2 to 3 months. Infants and young children without a history of immunization are at a higher risk of developing the disease.

Typical symptoms of whooping cough

Typical whooping cough goes through three stages: catarrhal stage, spasmodic stage, and recovery stage.

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 reaches its peak during this stage, and it is highly contagious. It usually lasts 1-2 weeks.

Spasmodic cough stage : manifested by paroxysmal spasmodic coughs, accompanied by high-pitched cock-like roars, repeated many times until sticky phlegm is coughed up, lighter during the day and heavier at night. The spasmodic cough is more prominent during sleep, affecting sleep.

In newborns and infants under 6 months old, coughing often causes cyanosis, apnea, convulsions, bradycardia or cardiac arrest. This period generally lasts 2-6 weeks, but can also last more than 2 months.

Recovery period : The spasmodic cough gradually eases, the cough intensity weakens, the number of attacks decreases, and the cock-like roar gradually disappears. The symptoms of paroxysmal spasmodic cough may last for weeks or months.

Why has the incidence of whooping cough increased sharply recently?

There are several main reasons for the recent resurgence of whooping cough:

1. The immune protection effect of the vaccine is weakened;

2. Genetic changes in Bordetella pertussis;

3. The emergence of macrolide-resistant Bordetella pertussis;

4. The widespread application of PCR experimental technology in disease diagnosis, the improvement of clinical doctors' awareness of infectious disease diagnosis, the improvement of infectious disease monitoring mechanisms, etc. have made the diagnosis of pertussis more sensitive.

What should you pay attention to when you cough?

To alleviate whooping cough, it is necessary to isolate the respiratory tract, keep the indoor air fresh, the temperature and humidity appropriate, and avoid factors that induce spasmodic cough.

1. Do not close doors and windows. Children with whooping cough may suffer from frequent and violent spasmodic coughing, which may lead to oxygen deficiency. Try to keep the air fresh and circulate indoors to provide more oxygen. When the air is dry, increase the humidity appropriately, such as using a humidifier or mopping the floor with a wet mop, to keep the indoor humidity at around 50%.

2. Do not stay in bed. Some parents think that activities will aggravate children's coughs. This is a misunderstanding. Letting children do some activities and games in a place with fresh air will often relieve coughs, but excessive fatigue should be avoided.

3. Avoid environmental irritants such as smoke and dust. If there are smokers at home, it is best not to smoke during the child's illness, or smoke outdoors. In addition, when lighting the stove or cooking, let the child avoid fumes. Also pay attention to avoid exposure to strong odors or chemicals (such as barbecue, hot pot, and even perfume) and potential allergens (dust, pollen, etc.).

4. Avoid contact with children with other diseases to avoid infection or other complications, because the resistance and immunity are relatively low at this time.

5. Avoid excessive stimulation. Try to arrange eating and taking medicine at the same time . Do not eat too much. Burp the baby after eating to prevent vomiting and aspiration.

Some misunderstandings about whooping cough

1. Can pertussis be controlled after the vaccine is available? According to the "National Immunization Program Vaccine Childhood Immunization Program and Instructions (2021 Edition)", there are a total of 5 doses of DTP vaccine, and the vaccination times are: 1 dose of DTP vaccine each at 3 months, 4 months, 5 months, and 18 months of age. The "Pertussis Diagnosis and Treatment Program (2023 Edition)" mentions that the level of protective antibodies usually decreases 3-5 years after vaccination, and the antibodies almost disappear after 12 years. If there is an epidemic, susceptible people still need to be vaccinated. If booster vaccination is not carried out, it is easy to be infected with pertussis again.

2. Whooping cough is caused by bacterial infection, so is it okay to actively use antibiotics? Azithromycin, erythromycin, clarithromycin and other macrolide drugs have always been recognized as the first choice for the treatment of whooping cough, but in fact, the resistance rate of Bordetella pertussis to macrolide antibiotics is high in China. Professor Yao Kaihu's research team suggested through experimental research that the current antibacterial treatment of whooping cough in China should be adjusted: for children with whooping cough over 2 months old, empirical treatment should no longer be the first choice of macrolide antibiotics, but TMP-SMZ (complex sulfamethoxazole) should be the first choice. However, individual situations vary, and different groups of people need to consult a doctor before using these drugs. And the use of drug treatment in the early stages of whooping cough will have better efficacy benefits.

3. Whooping cough is a children's infectious disease. Are babies infected by other babies? Whooping cough is a common infectious disease among children, just like measles and hand, foot and mouth disease. However, this does not mean that people of other age groups are completely "isolated" from the disease. Teenagers and adults can also get whooping cough. Moreover, because the symptoms are mild and atypical, many people do not realize that they may have whooping cough. In addition, they are not careful and unknowingly become potential sources of infection, which also increases the risk of infants getting whooping cough.

References:

[1] National Health Commission, State Administration of Traditional Chinese Medicine. Diagnosis and treatment of pertussis[J]. International Journal of Epidemiology and Infectious Diseases, 2024, 51(1): 1-3.

[2] Zhang Meng, Wu Dan, Li Yixing, et al. Challenges facing global pertussis prevention and control[J]. Chinese Journal of Epidemiology, 2023, 44(3): 491-497.

Popular science expert: Lin Miaomiao, member of Zhejiang Science Popularization Federation, attending physician of pediatrics at Wenzhou Central Hospital