Whooping cough: what is pertussis and why vaccinate?

Whooping cough: what is pertussis and why vaccinate?

Whooping cough (pertussis) is an infectious disease of the respiratory tract caused by bacteria. Its typical symptom is the cough that gives it its name, which manifests primarily at night as violent, wheezing, coughing attacks and shortness of breath. Whooping cough is a contagious disease that can be particularly dangerous for infants. Fortunately, the introduction of vaccination in the 1930s significantly reduced the high mortality rate. In this article, you will learn more about the disease, the symptoms of whooping cough and when vaccination is recommended.

What is whooping cough?

Whooping cough, also known as pertussis, is an infectious disease caused by Bordetella pertussis. The transmission takes place from person to person. The pathogen gets into our respiratory tract through droplet infection and can multiply there. Typically, there are nocturnal solid coughing fits in which those affected can hardly breathe.


Whooping Cough Symptoms: How Do I Know I Have Pertussis?

If you become infected with the pathogen Bordetella pertussis, the disease typically progresses in three stages:

  1. In the first stage, there are non-specific cold symptoms.
  2. In the second stage, the coughing fits typical of whooping cough occur. In medicine, these are also referred to as staccato coughs. Affected people cough several times with outstretched tongues before they take a deep, loud breath. The second stage, also known as the fierce stage, can last four to six weeks if left untreated.
  3. After that, in the third stage, the symptoms slowly subside.

Other symptoms of whooping cough can include:

  • slight fever
  • after a fit of coughing, vomiting, phlegm
  • bleeding in the eyes
  • nosebleeds
  • shortness of breath
  • Sniffles

The first symptoms begin after an incubation period of five to 20 days. After a whooping cough infection, you are often still contagious several weeks after the symptoms have ended

Diagnosis: Which blood values ​​are changed in whooping cough?

If pertussis is suspected, the disease can be detected in two ways. Firstly, about the blood. Here, one often finds an increase in white blood cells over 30,000/μl. This is known in medicine as leukocytosis.

In addition, specific antibodies against Bordetella pertussis can be detected from about three weeks after the onset of the disease. However, the blood evidence cannot be used if the last vaccination was less than twelve months ago. This is because the vaccination also produces antibodies. It is impossible to say whether the pathogen or the vaccination caused these.

The safest way to detect whooping cough is similar to a COVID-19 infection. The pathogen can be detected with the help of a deep nasopharynx swab, i.e. a sample taken from the nose and throat area, and a subsequent PCR. This test is the standard procedure for suspected whooping cough and enables a precise diagnosis.


How does whooping cough affect children and adults?

Whooping cough can occur in all age groups. Infants and young children are most commonly and severely affected. Unvaccinated children, in particular, have a higher risk of developing a severe course. Due to the vigorous coughing fits, those affected get too little air. In babies, this can be so severe that they need to be monitored in the hospital for a few days.

Babies, children, and adults can suffer consequential damage from whooping cough. Most often, pneumonia occurs because the immune system is weakened. In extreme cases, infants can experience seizures with possible long-term damage to the brain.

In adults, pertussis often presents as a long-lasting cough without other symptoms. Consequential damage is rarer here.

How often can you get whooping cough?

Once you have survived an infection with whooping cough, this does not protect you from being infected again. Protection against the disease, known as immunity, lasts only a few months. As a result, you can become infected with Bordetella pertussis several times.

Therapy: Is pertussis curable?

Whooping cough is very contagious, but the disease can be treated. If one recognizes recognizes that it is pertussis early on, using antibiotics is a good idea. The drugs of choice for treating the disease are the so-called macrolides.

Since the Bordetella pertussis bacterium can still be transmitted weeks after the symptoms have subsided, it is recommended that antibiotics be given, even if the disease is diagnosed later, so that the pathogen is not transmitted so easily.

Other options are available in addition to antibiotic treatment to fight the bacteria. The following measures can help with whooping cough:

  • adequate fluid intake
  • Oxygen supply with humidification of the breathing air
  • bronchodilator drugs ( e.g. salbutamol )
  • in severe cases, glucocorticoids

With early treatment, whooping cough heals without complications in many cases. In risk groups such as infants in particular, however, severe courses can also occur with early therapy.


Vaccination against whooping cough – who, when and how often?

Before vaccination against pertussis was introduced in the 1930s, more than ten thousand deaths per year were caused by this disease in Germany. Since the introduction of the nationwide obligation to report pertussis in 2013 until 2020, however, there were only two reported deaths in babies.

This significant decrease clearly shows how effective the vaccine is. Even if, in some cases, the disease can break out despite vaccination, the whooping cough is usually much milder.

Vaccination has thus proven to be the most effective way to combat whooping cough. But how often should you get vaccinated, and when is a booster needed? The Standing Vaccination Commission (STIKO) recommends primary immunization immunization for children within the first year of life. Three vaccine doses (four for premature babies) are administered according to a fixed vaccination schedule:

  • The first vaccination should be given at the age of two months.
  • The second vaccination dose is given eight weeks later, at four months.
  • The third dose should be given six months after the second vaccination, at the latest by the age of eleven months.

The pertussis vaccine is always given in combination with others. STIKO recommends the sixfold vaccine for small children, effective against pertussis, polio (child paralysis), tetanus, diphtheria, Haemophilus influenzae type B and hepatitis B.

How often does the pertussis vaccine need to be boosted?

The protection does not last a lifetime for both infected and vaccinated people. For this reason, STIKO recommends various booster vaccinations. Children up to 17 should be vaccinated twice after primary immunization, pre-school age and adolescence.

For adults, the STIKO advises a further one-time booster of vaccination protection, which should take place ten years after the last vaccination. The most common vaccine used in adulthood is Boostrix®. This contains active ingredients against pertussis but also against diphtheria and tetanus.

Vaccination during pregnancy – pros and cons

Young children are at the highest risk of getting a severe infection. Since a baby’s immune system is not yet fully developed in the first few weeks of life, the little ones are dependent on their mother’s protection. The newborn receives necessary antibodies at birth and through breast milk that protect the child from infections (“nest protection”).

For this reason, it is recommended that pregnant women be vaccinated against pertussis at the beginning of the third trimester. The antibodies produced by the mother can then be passed on to the newborn via the placenta and protect it during the first few months of life.

The most common side effect after vaccination is fever. This can still occur up to three days later. Serious side effects or complications in pregnant women, such as premature birth, ruptured membranes, preterm birth, or congenital disabilities associated with the vaccine, have all been ruled out in extensive international studies. For this reason, vaccination can be recommended during pregnancy, as it protects children from whooping cough.

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