Pertussis is a highly contagious respiratory disease of bacterial origin. Generally not serious, it is characterized by a strong cough . It evolves slowly over a few weeks and can last almost two months. The incubation period, that is, the time between infection with the bacteria and the first symptoms, can be 20 days. The bacterium mainly attacks the trachea and bronchi, where mucus accumulates. The body tries to evacuate these secretions by coughing. The bacterium also generates inflammation of the airways that makes breathing difficult.
In infants, pertussis can have very serious consequences, such as pulmonary or neurological complications. It can even be fatal.
Today there is a pertussis vaccine . Before its use in the 1960s in France and Canada, whooping cough was a very common childhood illness that children passed on. Today, the contamination is more between an adult who is not up to date in his vaccination and a young child who has not yet received all doses of vaccine or who has not been vaccinated.
Despite the existence of a vaccine, there are an estimated 50 million cases and 300,000 pertussis deaths worldwide each year.
Causes whooping cough
Pertussis is caused by a bacterium called Bordetella pertussis . When a person is infected, it can in turn infect people around him by simply coughing or sneezing. The sick person is very contagious at the beginning of his illness.
Complications of whooping cough
The complications most often concern infants and especially infants less than 6 months of age. They may have an ear infection, difficulty breathing, and weight loss due to severe vomiting, pneumonia, dehydration, kidney failure, convulsions or even brain damage. These serious complications remain rare but require rapid hospital care.
In older children and adults, complications are even rarer and less severe. It can be a cracked rib, an abdominal hernia, a nosebleed or swelling of the face.
Diagnostic of whooping cough
Early diagnosis is sometimes difficult to establish since the first signs resemble any symptoms caused by a typical respiratory infection such as a cold, flu or bronchitis. The doctor can later recognize whooping cough with his characteristic cough .
To confirm the diagnosis, the doctor can perform tests to detect the presence of Bordetella bacteria in the nose or throat of his patient (cell sampling with a cotton swab for analysis). A blood test can also detect whooping cough. In case of infection, the number of white blood cells is abnormally high, sign that the body is fighting.
The first symptoms of whooping cough appear most often 7 to 10 days (but may take up to 3 weeks to appear) after the entry of the bacteria into the body. They last between one to two weeks:
- A runny or stuffy nose
- Red and watery eyes
- Fever (mild or not present)
- A dry cough
- Sore throat
The symptoms may then worsen, causing prolonged and severe coughing.
This cough can then cause:
- Thick mucus
- Redness in the face
- A great tiredness
- A sharp whistling sound when the patient takes a breath after a coughing fit (this is called cock crow ) although it is not automatic. Infants do not have cock singing.
People at risk
Adolescents and adults whose last vaccination was more than 10 years old and infants less than six months old are the most affected by Bordetella bacteria . It should be known that the disease is more severe in infants.
The risk factor for a case of pertussis is the lack of vaccination.
The prevention of whooping cough goes through vaccination . Some pertussis vaccines may also protect against diphtheria (= upper respiratory tract infection caused by bacteria) and tetanus, but also for some, also against polio or hepatitis B.
In France, the vaccination schedule recommends vaccination at 2, 3 and 4 months of age, followed by recalls at 16-18 months and 11-13 years. A reminder is recommended to all adults who have not been vaccinated against pertussis for more than 10 years.
In Canada, vaccination of infants against pertussis is routine. Vaccination is given at 2, 4 and 6 months of age and between 12 and 23 months of age (usually 18 months). The booster dose of the vaccine should be given at 4 to 6 years of age and every 10 years thereafter.
In France as in Canada, the focus is today on the importance of recalls for adolescents and adults. Immunity provided by the vaccine fades after about ten years.
Finally, it is recommended that pregnant women, and more broadly all adults in contact with young children, be vaccinated against pertussis.
Medical treatments of whooping cough
Infants with pertussis must be hospitalized because complications at this age can be particularly serious. Of antibiotics intravenously administered their will. The mucus can be aspirated to release the airways. The hospital finally allows the child to be monitored closely.
The people affected are usually isolated , whooping cough is a very contagious disease. The relatives of the sick person may also take preventive antibiotic treatment if they have not had a pertussis booster for more than 5 years.
Treatment for older people involves taking antibiotics to get rid of the bacteria that causes the disease and to accelerate healing. They also limit the spread of the bacteria.
There is no very effective treatment for cough caused by whooping cough. It is advisable to rest, drink a lot and eat more frequently but smaller meals to avoid vomiting that may follow coughing fits. It can be effective to moisten the room in which the sick person is staying. Moisture can clear the bronchi and facilitate breathing.