Whooping cough: Causes, transmission, detection, treatment and prevention

Whooping cough (pertussis or whooping cough) is a highly contagious disease, caused by a bacterium called Bordetella pertussis. This bacterium binds to the villi (small, straightening like a hair) lining the inner part of the upper airway. Bacteria release toxins, injure villi and cause inflammation (edema).

Transmission

Whooping cough is a highly contagious disease that can only be detected in humans and is transmitted from person to person. People with pertussis often spread the disease by coughing or sneezing while in close contact with others, then these people breathe in pertussis bacteria. Many babies have pertussis due to infection from siblings, parents or caregivers who may not even know they have the disease. Symptoms of pertussis usually appear within 5 - 7 days after exposure, but sometimes it does not show for 3 weeks.

While pertussis vaccine is the most effective tool we have to prevent this disease , no vaccine is 100% effective. If pertussis is circulating in the community, the possibility that a person of any age who has been fully vaccinated can get this highly contagious disease. If you have been vaccinated, the infection is usually less serious. If you or your child has a cold that includes a cough or a cough that lasts for a long time, it could be whooping cough. The best way to know for sure is to see a doctor.

Photos of Bordetella pertussis microscope using Gram staining technique.(Photo: CDC).

Signs and symptoms

Whooping cough can cause serious illness for babies, children and adults. The disease usually begins with cold-like symptoms and may have a small cough or mild fever. After 1 to 2 weeks, the cough started. Unlike colds, whooping cough can show a series of coughs continuously for weeks.

In newborns, coughing may be minimal or even absent. Infants may have a symptom of "apnea". Apnea is a pause in your child's breathing. Whooping cough is the most dangerous disease for young children. Half of babies under 1 year of age with pertussis must be hospitalized.

Whooping cough can cause severe coughing and cough quickly, more and more, until the air comes out of the lungs and the child / you have to breathe in to make a loud squeal. A severe cough can make your child vomit and be very tired. Usually no squeaks and infections are usually milder (less severe) in teens and adults, especially those who have been vaccinated.

Early symptoms may last 1-2 weeks and usually include:

1. Runny nose.
2. Mild fever (usually mild during illness).
3. A mild cough or a winch.
4. Apnea - pause breathing (in newborns).

Because pertussis in the early stages does not seem to be much more than the common cold, so it is often less thoughtful and less diagnosed until more severe symptoms appear. The infected person is most contagious about 2 weeks after starting coughing. Antibiotics can reduce the spread of an infected person's time.

As the disease progresses, typical / classic symptoms of pertussis appear:

1. Many rapid coughs followed by high-pitched squeaks.
2. Vomiting.
3. Exhausted (very tired) after every cough.

Progress of whooping cough

Coughs can occur continuously for at least 10 weeks. In China, whooping cough is called "100-day cough disease".

Although your child / friend is often exhausted after each cough, your child / friend often shows a good sign of coughing. Coughs often become more common and more serious as the disease progresses, and may appear more often at night. The disease may be mild (less severe) and there is no typical hiss in children, teens and adults who have been vaccinated against pertussis.

Recovery from pertussis can be slow. Cough is lighter and less. However, coughing spells may return because of respiratory infections after several months after whooping cough.

Symptoms

Newborn and children

Whooping cough can cause serious and sometimes life-threatening complications in babies and young children, especially those who have not been fully vaccinated.

About half of all children under 1 year old who have pertussis must be hospitalized. The younger the child, the more hospital treatment will be needed. Among babies who are hospitalized for pertussis, there are:

1. 1 in 4 children (23%) have pneumonia (lung infection).
2. 1 or 2 out of 100 children (1.6%) will have seizures (severe tremor, difficulty controlling).
3. 2/3 (67%) will stop breathing (slow breathing or stop breathing).
4. 1 in 300 children (0.4%) will have encephalopathy.
5. 1 or 2 out of 100 children (1.6%) will die.

Bronchial obstruction in neonates with pneumonia due to pertussis.(Photo CDC).

Teenagers and adults

Teens and adults can also get complications from whooping cough. Complications are usually less serious at these ages, especially for people who have been vaccinated against pertussis. Complications in adolescents and adults are often caused by coughs themselves. For example, children / you may be unconscious, break your ribs in a violent cough. In one study, less than 5% of teens and adults with pertussis were admitted to hospital. Pneumonia (lung infection) is diagnosed in 2% of these patients. The most common complications of another study in pertussis adults are:

1. Weight loss (33%).
2. Loss of bladder control (28%).
3. Unconscious (6%).
4. Rib fractures due to severe cough (4%).

The child has broken blood vessels in his eyes and bruises on his face due to a lot of cough in whooping cough.(Photo: CDC).

Diagnosis and treatment

Diagnose

Whooping cough can be diagnosed by considering if your child / you have been exposed to whooping cough and by adopting the following checkups:

1. History / development of typical signs and symptoms.
2. Visit the entity.
3. The test involves taking a sample of secretions in the posterior wall of the throat.
4. Blood tests.

Treatment

Whooping cough is often treated with antibiotics and early treatment is important. Treatment may make the infection less serious if it is started early, before coughing attacks appear. Treatment also helps prevent transmission to close contacts (those who spend a lot of time around infected people). Treatment after 3 weeks of illness is almost no help because the bacteria have disappeared from your / your child's body, even if the child / you still have symptoms. This is because the bacteria have harmed the child's body.

There are several antibiotics that treat pertussis. If you or your child is diagnosed with pertussis, the doctor will explain how to treat the infection. There will be a separate article on antibiotic treatment recommended by the US Centers for Disease Control and Prevention (CDC) for the treatment of pertussis.

Whooping cough is sometimes very serious, requiring treatment at the hospital. Infants are most at risk of serious complications from whooping cough. See some pictures of babies being treated for pertussis in the hospital.

Infants are being treated for severe pertussis.(Photo: CDC).

If your child is treated for whooping cough at home

Do not give cough medicine unless directed by a doctor. Giving cough medicine may not help and it is usually not recommended for children under 4 years of age.

Managing whooping cough and reducing the risk of spreading the disease to others by:

1. Follow the doctor's procedure for using antibiotics.
2. Keep your home away from stimulants, as much as possible, as it can stimulate coughing, such as smoke, dust, and chemical vapors.
3. Use a clean and cool mist sprayer to help loosen secretions and soothe coughs.
4. Practice good hand washing.
5. Drink lots of fluids, including water, juice and soup, and eat lots of fruit to prevent dehydration (lack of fluids). Immediately notify the doctor of any signs of dehydration detected. Signs of dehydration include a dry and sticky mouth, drowsiness or tiredness, thirst, poor urination or less wet diapers, no tears when crying, muscle weakness, headache, dizziness or dizziness.
6. Eat small meals and regularly help prevent vomiting if any.

If your child is treated for pertussis in the hospital

Your child may need to help keep their airways clear, which may require suction of respiratory secretions. If necessary, it must be monitored closely for breathing and oxygen. Infusion may be necessary if your child has signs of dehydration or anorexia. Preventive measures, such as good hand hygiene practices and keeping surfaces clean, should be followed.

Preventive

Vaccines

The best way to prevent pertussis in babies, children, teens and adults is vaccination. Also, keep babies and people at high risk of complications from whooping cough away from infected people.

In the United States, pertussis vaccine for babies and children is recommended as DTaP. This is a combination vaccine that protects the body against three diseases: diphtheria, tetanus and pertussis. Currently in Vietnam, the vaccine used to prevent pertussis is Quinvaxem.

The protection of vaccines against these three diseases fades over time. Before 2005, only the booster (repeat) vaccine protected against both tetanus and diphtheria (called Td), and was recommended for teenagers and adults every 10 years. Today there is a booster vaccine for older children, teenagers, and adults that have a protective effect against three tetanus, diphtheria and pertussis (Tdap).

The easiest thing for adults to do is to inject Tdap instead of the next anti-tetanus Td nose that they plan to inject every 10 years. The dose of Tdap can be given earlier than 10 years, so it is a good idea for adults to talk to health care workers about what is best for their special situation.

Infection

If the doctor determines that the child / you has pertussis, the child / you will have natural (immune) protection for future infections. Some observational studies show that pertussis can provide immunity for 4 - 20 years. Because this immunity is reduced and there is no lifelong protection, periodic prophylaxis is recommended.

Antibiotic

Children under 12 months of age are at high risk of serious complications from whooping cough.

If you or a family member is diagnosed with pertussis, your doctor or local health care provider may recommend a prophylactic antibiotic (a medication that may help prevent bacterial diseases) for the Other family members to prevent the spread of the disease. In addition, other people outside the family who have contact with people with pertussis may receive prophylactic antibiotics depending on whether or not they are considered at risk of serious illness or if they are exposed. often with someone who is thought to be at high risk of serious illness. There will be a separate article on the use of antibiotic prophylaxis for pertussis after exposure.

Children under 12 months of age are at high risk of serious complications from whooping cough. Although pregnant women are not at increased risk for serious illness, pregnant women in the last three months will be considered to be at risk because they can expose their newborn babies. with whooping cough. You need to discuss whether or not you need to take prophylactic antibiotics with your doctor, especially if there is an infant or pregnant woman in your family or you plan to have an infant or woman with pregnancy.

Toilet

Like many respiratory diseases, whooping cough is spread through coughing and sneezing when in close contact with others, then they breathe in pertussis bacteria. Good hygiene practices are always recommended to prevent the spread of this respiratory disease:

1. Cover your mouth and nose with a dry paper when coughing and sneezing.
2. Unused used paper in the trash.
3. If you don't have a paper, then cough or sneeze more on your upper sleeve or elbow, don't cough or sneeze more into your hand.
4. Wash your hands often with soap and water for at least 20 seconds.
5. If soap and water are not available, rub your hands with alcohol.