May 16, 2024 Author: Carlos Palos Whooping cough is an infectious and contagious respiratory disease . The disease is endemic throughout the world, with peaks every 3-5 years. It is also called pertussis; It is caused by the bacterium Bordetella pertussis; It is mainly characterized by a very severe and persistent cough, which can compromise breathing and lead to convulsions; Serious cases, which may be fatal, can be effectively prevented by vaccination; Whooping cough in vaccinated people has only mild symptoms; The vaccine has been part of the Portuguese National Vaccination Program since 1966 and the first dose is administered at 2 months of age. Pregnant women should receive a booster vaccination. Symptoms and evolution of the disease Whooping cough has three characteristic phases: Catarrhal phase , which lasts 1-2 weeks and is characterized by symptoms related to an upper respiratory infection, with sneezing, runny nose, stuffy nose, dry and slight cough, low fever. Paroxysmal phase , which lasts 2-6 weeks, when symptoms of upper respiratory infection become milder, but cough worsens. Cough is more intense and more frequent at night and gets worst with crying and swallowing, and the following may be present: Choking and vomiting; Difficulty breathing; Bluish appearance of the skin and lips (cyanosis). There may also be swelling of the tongue and a noise that resembles a scream during inspiration after a coughing fit. Convalescence phase when the cough improves, becomes less intense and less frequent, but can persist for months. Noise during inspiration and vomiting disappear Some cases may not follow this disease pattern, especially: Newborns and infants up to 4 months of age, unvaccinated or who have only received one dose of the vaccine, in whom the disease can be particularly serious. Vaccinated children, young people and adults, where the disease pattern is not as marked and the symptoms are much milder. Transmission of whooping cough Whooping cough is very contagious. It is transmitted easily from person to person through droplets expelled when sneezing and coughing, as well as through contact with objects contaminated by infected secretions. Anyone, at any age, can become infected with Bordetella pertussis , particularly if they have not been vaccinated. The incubation period is on average 7-10 days, with limits that can vary between 5 and 21 days. Contagion is more important in the first phase of the disease (catarrhal). Therefore, it is suggested that people who come into contact with known cases wear a surgical mask, do not share the same space, and wash their hands after coming into contact with patients. Diagnosis and treatment When whooping cough is suspected, some tests are usually carried out to confirm or exclude the disease: A test for Bordetella pertussis in a sample obtained by swab of the nasopharynx; Blood tests; Chest x-ray. As the disease is caused by bacteria, is treated with antibiotics . Treatment is most effective in the initial stages after carrying out an analysis to identify the bacteria: During the incubation period, after confirmation of the infection; In the catarrhal phase, it decreases or eliminate symptoms; In the paroxysmal phase, it does not change the symptoms. In addition to antibiotic treatment, whooping cough treatment also includes: Rest; Hydration, particularly if vomiting is frequent; Adapting meals to avoid triggering vomiting; It is common for babies up to one year old with whooping cough to need to be admitted to hospital for treatment. Prevention whooping cough Preventing cough consultation begins with strict adherence to the National Vaccination Program . The whooping cough vaccine includes 5 doses, administered between 2 months and 5 years of age, with multivalent vaccines (they are also intended to protect against other diseases). In addition, all pregnant women must receive a booster vaccination between the 4 th and 32 nd week of all pregnancies to protect newborns. Other measures: Frequent hands washing; Protection of mouth and nose when sneezing or coughing; Do not contact babies and children while undergoing treatment for whooping cough; If there is a child at home with whooping cough, ensure that everyone else in the home is vaccinated. Whooping cough in Portugal According to data for 2023, in Portugal vaccination coverage with the 5 th dose of whooping cough vaccine reached 95% and it is estimated that 85% of eligible pregnant women have been vaccinated. However, there was an increase in the number of new cases of whooping cough in our country , with more cases being reported in the first four months of 2024 (200 cases) than in the whole year of 2023 (22 cases) and in the last year before the pandemic (66 cases in 2019). This increase in the number of cases appears to affect several countries in the European Union / European Economic Area. Most confirmed cases in Portugal occurred in pediatric age (86%): Mainly in children aged 10-13 years (21%) and under the age of 1 year (20%). 22% of pediatric cases occurred in children without evidence of vaccination or with an incomplete vaccination schedule and 8 cases (5%) in infants below vaccination age. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
