Beware of the Outbreak! Whooping Cough (Pertussis) Symptoms and Prevention

Pertussis is one of the respiratory diseases that has recently become prevalent among children living in groups. Pertussis is a contagious disease that can be easily transmitted when an infected person coughs or sneezes. It is highly contagious, with one patient being able to infect 12 to 17 people. In the United States, the cumulative number of patients this year has nearly tripled compared to a year ago, and a clear increase is also being observed in many parts of Europe, including Korea and the United Kingdom. In the case of unvaccinated people, babies in particular have paroxysmal coughs and then make a whoop (inspiratory sound) when they take a long breath, so this disease is often called “Whooping cough.” In particular, pertussis can cause serious illness and even death in newborns under 6 months of age. Let’s learn about pertussis, which can threaten the lives of our children, as well as the causes and symptoms of pertussis, and about pertussis vaccination.

Pertussis: Causes, Transmission Methods, Why It's Deadly for Infants?
Common Symptoms of Pertussis and How to Differentiate it from a Cold
Effective Prevention Strategies for Whooping Cough
The Role of Vaccination in Preventing Whooping Cough
When is Whooping Cough Most Prevalent?

Pertussis: Causes, Transmission Methods, Why It's Deadly for Infants?

Pertussis is a respiratory disease caused by a bacterium called Bordetella pertussis. This bacterium attaches to the cilia (small hair-like structures) of the respiratory tract, causing inflammation and releasing toxins that damage the respiratory mucosa. This causes the characteristic severe cough and seizures associated with this disease. The incubation period of pertussis is usually 7 to 20 days, and initially, mild cold symptoms such as a runny nose, conjunctivitis, watery eyes, mild cough, and fever appear, but the cough gradually worsens and a 'whoop' sound can be heard at the end of the cough. In addition, as the cough worsens, the face becomes red, the eyes become bloodshot, and vomiting occurs, and the characteristic paroxysmal cough lasts for more than 2 weeks. If the paroxysmal cough worsens, complications such as pneumonia and emphysema can occur, and in this case, the mortality rate is high in infants under 6 months of age. As the recovery period begins, the severity and frequency of coughing and vomiting gradually decrease.

Pertussis is transmitted from person to person through respiratory droplets. When an infected person coughs, sneezes, or speaks, droplets containing the Bordetella pertussis bacteria are released into the air. These droplets can be inhaled by others nearby. Close contact with an infected person in a home, school, or daycare setting, and in crowded areas, increases the risk of transmission. Pertussis is still a highly contagious disease, with a secondary infection rate of up to 80% within a household, although vaccination has significantly reduced the incidence of pertussis. It is also a fatal disease in young children, so accurate diagnosis through testing is necessary.

Pertussis is particularly dangerous for infants and young children for several reasons. Infants are particularly vulnerable before they have completed the primary immunization series (DTaP vaccine), which begins at 2 months of age and is administered in multiple doses. In addition, infants have an immature immune system, making it difficult for them to fight off the infection. Coughing attacks caused by pertussis can be very severe in infants and can cause complications such as apnea, pneumonia, seizures, and encephalopathy (brain disease). Pertussis remains a serious public health problem, especially in infants, who are at greater risk for serious complications and death. About 1 in 5 hospitalized infants develop pneumonia and sadly 1 in 100 die. Vaccination is the most effective measure to prevent the spread of pertussis and protect vulnerable populations. Public health efforts continue to emphasize the importance of vaccination and awareness to control and ultimately eliminate this deadly disease.

Common Symptoms of Pertussis and How to Differentiate it from a Cold

Whooping cough can initially resemble a cold. Here’s how to tell the difference between whooping cough and a cold:

Severity and duration of cough:
Whooping cough: The cough is severe, persistent, and occurs in fits and starts. It can last for weeks or months and is often accompanied by a “whooping” sound.
Colds: The cough is usually mild to moderate and lasts about a week to 10 days. It is not as intense or long-lasting.

Characteristics of cough:
Whooping cough: Coughing fits can lead to vomiting, fatigue, and cyanosis. The “whooping” sound is a key indicator, but babies under 6 months of age, teenagers, and adults may not make the “whooping” sound.
Colds: The cough does not usually cause vomiting or severe fatigue. There is no “whooping” sound.

Onset of symptoms:
Whooping cough: It starts with cold-like symptoms in the catarrhal phase and progresses to severe coughing fits in the paroxysmal phase.
Colds: Symptoms are generally mild, including a runny nose, mild cough, and sore throat.

Associated symptoms:
Whoop cough: May include apnea in infants, vomiting after coughing, and severe fatigue. Symptoms may be more persistent and last longer.
Cold: Includes mild symptoms such as sore throat, sneezing, mild fever, and headache, and usually resolves within 1-2 weeks.

Effective Prevention Strategies for Whooping Cough

The most effective way to prevent the disease is to get vaccinated. The DTaP vaccine, which protects against diphtheria, tetanus, and pertussis, is recommended for infants, children, and adults. Infants are vaccinated at 2 months, 4 months, and 6 months, with a booster dose at 4 to 6 years of age. Adolescents and adults should get a booster dose of Tdap to maintain immunity. Pregnant women should get vaccinated during pregnancy to protect their newborns. Everyone who comes into close contact with an infant, such as parents, siblings, grandparents, and caregivers, should be vaccinated against pertussis.

Widespread vaccination also helps protect people who are too young to be vaccinated or who cannot be vaccinated for medical reasons. It minimizes the spread of the disease by reducing the overall incidence of pertussis in the community. Unvaccinated infants and young children should avoid crowded places. People with pertussis should avoid close contact with infants and pregnant women. Encourage practices such as frequent handwashing with soap and water or using hand sanitizers. Disinfect items contaminated with the patient's secretions. Early diagnosis and antibiotic treatment of pertussis can reduce the severity of symptoms and prevent the spread of the disease. Individuals suspected of having pertussis should seek medical attention immediately.

The Role of Vaccination in Preventing Whooping Cough

The most effective way to prevent whooping cough is through vaccination. The vaccine stimulates the body's immune system to produce antibodies against the Bordetella pertussis bacteria. These antibodies help prevent infection and reduce the severity of the disease if the individual is exposed to the bacteria. The main vaccines used to prevent whooping cough are the DTaP vaccine for children and the Tdap booster for adolescents and adults. These vaccines are important in reducing the incidence of whooping cough, minimizing the severity of the disease in those who do get it, and preventing outbreaks. Infants are at highest risk for serious complications and death from whooping cough. Prenatal vaccination (Tdap) provides passive immunity to newborns, protecting them until they can be vaccinated themselves. Individuals who get whooping cough after being vaccinated generally have fewer complications and a milder form of the disease than those who are not vaccinated. Vaccination reduces the prevalence of whooping cough in the community, which reduces the risk of developing the disease. This is especially important in settings where the disease is spread through close contact, such as schools and daycare centers.

When is Whooping Cough Most Prevalent?

Pertussis can occur at any time of the year, and seasonal variation is not as pronounced as with other respiratory infections, such as the flu. Pertussis has a cyclical pattern, with peaks in incidence every three to five years. Peaks often occur in late summer and fall. This is because people spend more time indoors, have poor ventilation, and coincide with an increase in other respiratory illnesses, such as colds and flu. However, the timing of pertussis outbreaks can vary by region and climate. Some areas may have outbreaks during different seasons. Urban areas may have higher transmission rates because of their higher population density and more person-to-person contact. Conversely, rural areas may have lower rates but still experience significant outbreaks.

Source:
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2. Pertussis (Whooping Cough) - Department of Health.
https://doh.gov.ph/list-of-diseases/pertussis-whooping-cough/.
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https://www.msn.com/en-us/health/condition/Pertussis/hp-Pertussis?source=conditioncdx.