Warnings about the increasingly frequent diagnosis of whooping cough cases are multiplying, and the approach of the cold season and the start of the school year increase the risk. The disease is treatable, but avoiding illness is preferable. Complications can be fatal.
Starting school increases the risk of illness. Photo: Archive
Whooping cough, or whooping cough, as it is also known, which more and more doctors say has made a sudden comeback today – “in my entire career I have had no cases/I have had a few casesi” is a frequently encountered statement – it is in fact a challenge that has already appeared for two or three years, says DSP Olt’s chief physician, epidemiologist Marinela Madan. The fact that more and more parents are choosing not to vaccinate their children (although vaccination with vaccines from the national program is mandatory) has led to such a situation. Another factor that contributes to the increase in the number of confirmed cases is better diagnosis, explains doctor Marinela Madan, for “Adevărul”.
How is whooping cough diagnosed?
Very young children, for whom the vaccination scheme for the prevention of this disease has not yet been completed, teenagers, but also adults with low immunity are the patients mainly affected by whooping cough. Although rare, even deaths can occur, usually in young children.
In the first days of illness, even up to two weeks, the symptoms are common to common respiratory infections and hence the late diagnosis: stuffy nose, mild fever, mild, occasional cough. Pauses in breathing (apnea) and cyanosis may also occur. When the cough has become violent and breathing difficulties appear, we should see a doctor urgently.
The diagnosis of certainty is made after confirmation by laboratory tests.
“The diagnosis means a bacteriological examination, which is an exudate, is collected from the patient’s throat, and a serological diagnosis, a blood sample. Now, there is a methodology. To obtain a correct diagnosis, for certainty, is the bacteriological examination, the exudate, which must be taken as a rule in the first 10 to 14 days from the onset of the cough. The serological diagnosis, which shows a dynamic increase in Bordetella pertussis antibodies (n. ed. – the bacterium that causes whooping cough), is really more handy, in the sense that if you don’t catch the patient in the first two weeks after the onset, the test remains positive for up to 4-6 weeks, throughout the long period of coughing, but with the risk that the further we move away from the moment of onset and the antibody titer decreases, then and here there is a risk that you will no longer have a diagnosis”,
explained Dr. Madan.
Age is no longer a criterion you can rely on, says DSP Olt’s chief physician, and this is because, although less frequently, cases of whooping cough have also been detected in adults.
“The age criterion is when he is a child up to 14 years old and you find in the anamnesis that he is incompletely vaccinated against whooping cough and then you think that this cough can also be whooping cough, but we must not exclude the diagnosis even in an adult , because, more recently, it has been shown that over time the post-vaccination antibodies are consumed. As man gets older, he consumes the antibodies that protected him in the first part of his youth and becomes vulnerable. And then the health policy says that it is recommended that every 10 years every responsible adult should get a dose of the vaccine,” completed the doctor Marinela Madan.
When the vaccine is given
The first dose of the vaccine that also has the pertussis component is given when the baby is two months old (acellular diphtheria-tetanus-pertussis vaccine (dTpa) which provides protection against diphtheria, tetanus, pertussis). At four months the second dose is administered, at 11 months the third, at 5-6 years a new dose of vaccine is administered, followed by revaccination at 14 years. Adults should be revaccinated every 10 years to continue to be protected. Vaccination should all the more be taken into account by adults if they are part of the entourage of a vulnerable person (very small unvaccinated or incompletely vaccinated child considering age, unvaccinated adult suffering from chronic diseases, etc.).
The vaccine is one that has passed the test of time, it has already been administered for decades and has proven its effectiveness. “They are combination products, which are good. They are benign products, they do not cause reactions, they are with inactivated viruses, they have no incompatibilities with the administration of other doses”,
states Dr. Marinela Madan. The family doctor plays an important role here, according to DSP Olt’s chief physician, and this is because the family doctor is the one who must “to have the wisdom to promote these preventive measures”and on the other hand to come to the patient’s support so that the latter reaches the act of vaccination.
The head of the Infectious Diseases section of the Slatina County Emergency Hospital, doctor Oana Obretin, confirms that recently patients diagnosed with convulsive cough, children, who had a good evolution, were hospitalized in the section. In all cases, it was about unvaccinated children, from vulnerable communities, with many children, also from such communities coming from the overwhelming majority of measles cases.
“If these children were vaccinated we should not be afraid. But they don’t vaccinate their children,” says Dr. Obretin. After the diagnosis, if for the doctors in the hospital it is important to treat the patients – and under the treatment the patients had a good evolution -, for the specialists who supervise public health the important thing must be the intervention in the outbreak, says the doctor Oana Obretin. The treated patients, although they are experiencing cough symptoms for several weeks, are no longer contagious, the doctor added.
Doctor Oana Obretin also explains that, untreated, this condition can even be life-threatening, complicating severe pneumonia and respiratory failure.
