Whooping cough is one extremely contagious disease affecting the respiratory tract, caused by a bacterium called Bordetella pertussis.
Whooping cough is transmitted from an infected individual to a healthy one through the droplets of saliva or mucus expelled by coughing or sneezing.
This disease has several stages:
- incubation period that can last on average 7-10 days;
- catarrhal phase: the first symptoms of whooping cough are similar to those of a cold: a few lines of fever, frequent nasal discharge, mild cough and can last up to two weeks. It is the most contagious period;
- paroxysmal phase: it can last up to 10 weeks. The cough becomes more and more violent, with rapid succession beats ending with a deep, noisy inhalation, the typical inspiratory scream, and the expulsion of phlegm. There cough is very annoying, especially at night, and is associated with breathing difficulties, vomiting and cyanosis. Infants <6 months have paroxysmal cough without the inspiratory scream;
- convalescent phase: lasts 2-3 weeks, with a progressive reduction of cough and an improvement in general condition.
Newborns and infants in the very first months of life are in great danger, because they have not yet started their vaccination process.
The complications of whooping cough in young children are many:
- pulmonary, such as pneumonia and bronchitis;
- neurological, such as pertussis encephalopathies and seizures;
- subconjunctival hemorrhages and in the nose, ear infections ed hematomas, caused by coughing;
- nutritional, due to the constant coughing that persecutes the patient.
How is whooping cough treated?
Only early antibiotic therapy, during the incubation period or in the first days of illness (in which, however, as mentioned, the diagnosis is very difficult), it can mitigate the course. When the typical violent coughing fits have begun, the therapy can still serve to reduce or eliminate the contagiousness, but not to change the course of the disease.
To try to avoid dehydration that can be favored by vomiting that often follows coughing fits, it may be appropriate breastfeed babies often but for a few minutes or propose small and frequent bottle feedings if they take formula milks.
In the hospital
the 63% of cases of pertussis causes hospitalization of children less than 1 year old. The majority of these hospitalizations concern infants less than 3 months old.
It is necessary to think about hospitalization in infants and young children if they have:
- major respiratory disorders: tachypnea (very fast breathing), expiratory groan and use of accessory muscles with intercostal or jugular retractions;
- cyanosis or apnea, with or without cough (bluish discoloration of the skin and mucous membranes, a sign of circulatory or respiratory disorders);
- inability to feed;
- appearance of signs of dehydration (dry diaper, streaked eyes, absence of tears);
Hospitalized infants are administered intravenous fluids so as to avoid the risk of dehydration; respiratory function is carefully monitored and antibiotics are taken.
Prevention is the best weapon
Very safe and effective in reducing the spread of the disease is theadherence to the vaccination program, in both children and adults. In particular, for pregnant women, pertussis vaccination is strongly recommended during the third trimester, ideally from the 27th to the 36th week and at each pregnancy, to protect future newborns, who are particularly at risk of complications in the first few. weeks of age, when they are too young to start the vaccination course. In the country, vaccination during pregnancy is recommended and offered free of charge by the national health system.