Whooping cough

The causative agent: Bordetella pertussis

In most cases, whooping cough is caused by the bacterium Bordetella pertussis. It multiplies in the respiratory mucosa of humans and locally destroys the mucous membrane by secreting toxins. The toxins can sometimes also lead to a deterioration in the local immune system. Although Bordetella pertussis causes the symptoms of whooping cough in most cases, there are also some other pathogens. These usually lead to a shorter clinical picture.

Infection with Bordetella pertussis

Bordetella pertussis is highly contagious . The bacteria are released into the air in small droplets when coughing, sneezing and speaking and can therefore reach people at a distance of up to 1 meter. After being infected, there is an incubation period of 9 to 10 days. During this time you are not yet contagious. The phase in which you can infect other people begins at the end of the incubation period, peaks in the first two weeks of illness and lasts up to 3 weeks after the onset of the last stage of the disease. The illness can last a few weeks, but can also stretch over several months. Therapy with antibiotics can limit the contagiousness to 3 to 7 days after the start of antibiotic use. Whooping cough can be found year-round, but is slightly more common in the fall and winter.

Symptoms of whooping cough in children

Whooping cough is one of the typical childhood diseases. Infants are most affected by this condition because they do not receive immunity to Bordetella pertussis from the mother. They are often directly infected by family members, for example the mother or older siblings. Because of this, pregnant women are vaccinated against Bordetella pertussis during pregnancy so that protection after birth is as high as possible and they cannot infect their newborn child.

The classic course of whooping cough includes 3 stages:

1. Catarrhal stage
The catarrhal stage is the first stage after the incubation period. This shows cold-like symptoms such as a runny nose or a light cough . There is no or only moderate fever and usually lasts 1 to 2 weeks.

2. Convulsium
stage The typical symptoms of whooping cough begin in the convulsive stage. Paroxysmal attacks of coughing are followed by an audible, drawing sound on inspiration. Often these fits of coughing cause choking up of thick mucus or even vomiting . In some patients, the coughing fits become more frequent at night. Here, too, there is no or only a slight fever . If fever develops during whooping cough, this is usually an indication that a second infection with bacteria has developed. The convulsive stage can last 4 to 6 weeks.

3. Stage decrementi
In the stage decrementi, the coughing fits slowly subside. This process can take 6 to 10 weeks.

Babies often have an atypical course of the disease . With them, the cessation of breathing without typical coughing fits is in the foreground and they have the highest risk of developing complications during the disease. Possible complications include:

• Pneumonia caused by other bacteria
• ear infections
• sinus infections
• The formation of umbilical or inguinal hernias
• Broken ribs from the strong coughing fits
• Bleeding in the eye or bleeding in the brain

whooping cough in adults

Since the immune protection lasts only 3.5 to 12 years after a vaccination, older children or adults can also develop whooping cough despite vaccination. This is often because many people forget their booster shots. In adults, whooping cough usually presents as a long-lasting cough . The cough is often not typically paroxysmal and does not cause vomiting, but the symptoms are highly acute and those affected often feel seriously ill.

Diagnosis of whooping cough

Since children often show the typical progression of whooping cough, your doctor can suspect whooping cough through a detailed discussion of the coughing fits and a physical examination. However, the diagnosis is only made after confirmation by a laboratory. Even in the case of classic symptoms, other causes of the symptoms should be ruled out and since an existing vaccination does not rule out whooping cough, people with classic symptoms of whooping cough or a long-lasting cough should receive a deep nasopharynx swab to enable a reliable diagnosis and to initiate the correct therapy . In adults, the disease is often misinterpreted as a flu infection, since it occurs mainly in children.

When should I go to the doctor?

Whooping cough is very contagious. If you suspect that you have been infected with whooping cough pathogens, you should see a doctor as soon as possible. Therapy with antibiotics can stop the spread of the pathogen. The suspicion of, or confirmation of, whooping cough must be reported to the health department in order to avoid further spread as far as possible.

What can you do about whooping cough?

Unlike other infectious diseases such as smallpox, whooping cough cannot be eradicated due to the short duration of vaccination. The goal is early and complete vaccination protection for infants and young children , since they are particularly badly affected by whooping cough. In addition, immunity should be boosted in preschool, adolescence and adulthoodto minimize transmission to other people. You can discuss whether you or your child are missing vaccinations with your treating pediatrician or family doctor and make up for them accordingly. It is important to ensure adequate vaccination during pregnancy to prevent transmission of Bordetella pertussis to the newborn. If it was not possible to vaccinate during pregnancy, you can be vaccinated retrospectively in the first few days after the birth.

If you have been diagnosed with whooping cough yourself, or if you suspect that you may have whooping cough, you should be careful not to enter any teaching, educational or care facilities or to get in contact with the people there. This way you can avoid infecting these people further. You should suspect whooping cough if you develop a cough after being in contact with someone who has been diagnosed with whooping cough.

How is whooping cough treated?

Bordetella pertussis is a bacterium. Whooping cough is therefore treated with antibiotics. Therapy has a particularly large impact if it is started as early as possible. In the best cases, you should be given the antibiotics before the first coughing attack appears, but starting therapy 1 to 2 weeks after the onset of symptoms is also useful. Treatment breaks the chain of infection by preventing you from releasing the pathogen into the environment. You should make sure you drink enough fluids. If you or your child have severe coughing attacks, it may help to eat smaller, more frequent meals to minimize the chance of vomiting.

Here’s how Med-Healths can help

Whooping cough has a very distinctive sound. Via Med-Healths you can send a video of a coughing fit directly to a doctor to confirm the suspicion of whooping cough. In addition, she or he can advise you on what to do if you or your child has whooping cough. You can get a sick note directly via Med-Healths in order to contain the spread of the whooping cough pathogen as much as possible.