This year, 13 people have died, and some children coughed up and bleed from their eyes!

Recently, there have been cases of pertussis in the pediatric departments of some hospitals, and the once-contained whooping cough has a great tendency to make a comeback. On March 30, #百日咳今年已致13人死亡#登上热搜 and sparked heated discussions.

It was reported that some children were diagnosed with whooping cough because they coughed too badly, resulting in conjunctival bleeding and congestion around the eyes.

Whooping cough has killed 13 people this year

According to the "National Overview of the Epidemic of Notifiable Infectious Diseases" regularly released on the official website of the National Bureau of Disease Control and Prevention, from January 1 to February 29, 2024, 32,380 cases of pertussis were reported nationwide, of which 5 died in January and 8 died in February.

In the same period last year (January 1 to February 28, 2023), the number of reported cases of whooping cough nationwide was 1,421 and there were no deaths. In terms of numbers alone, the number of cases this year has increased by nearly 23 times compared to last year. The total number of pertussis cases was less than 40,000 for all of last year.

"Cough for 100 days?" "What will happen after 100 days?" Here's what you need to know about whooping cough↓↓↓

If you have whooping cough, do you really want to cough for 100 days?

Pertussis is an acute respiratory infection caused by Bordetella pertussis (also known as B. pertussis) and is highly contagious. Before the widespread use of vaccines, pertussis was one of the most common childhood diseases and one of the leading causes of infant and young child mortality worldwide.

Initially similar to a cold, atypical cases may be asymptomatic or have only a mild cough and a low-grade fever. Clinically, it is characterized by paroxysmal, spasmodic cough and inspiratory roar. The course of the disease can last for 2~3 months, hence the name whooping cough.

According to the data of "Popular Science China", as early as the 7th century, Chao Yuanfang, a physician in the Sui Dynasty, recorded the disease of "cough for 100 days", which may refer to whooping cough. By the 17th century, the disease was named "pertussis", a name derived from the Latin word meaning "severe cough".

These names reflect 2 key clinical features – severe and prolonged cough.

In addition, pertussis is also a highly contagious respiratory disease, caused by the pertussis bacterium (Bordetella pertussis), this gram-negative coccus only infects humans, and the incubation period after exposure is 1~3 weeks, usually 7~10 days. Sick people and carriers are the main source of infection, mainly through droplets (cough) and can also be transmitted through close contact.

Before the pertussis vaccine, it could be said that whooping cough was a devastating disease with a high infant mortality rate. After the general vaccination of the population against pertussis, the incidence of infection decreased sharply, but as in the years before vaccination, periodic epidemics still occur every 2~5 years.

How is whooping cough transmitted?

Humans are the only reservoir of Bordetella pertussis, and pertussis patients, latent infections, and carriers are the source of infection.

For infants and young children, parents or people living with Boretteella pertussis infection are the most important source of infection.

The incubation period of whooping cough is 5~21 days, generally 7~14 days, and it is contagious from the beginning of the incubation period to 6 weeks after the onset of symptoms, especially the most contagious from the end of the incubation period to 2~3 weeks after the appearance of cough symptoms.

Pertussis is mainly transmitted by droplets, such as coughing and sneezing to spread the bacteria into the air, and susceptible people inhale the infected droplets.

Who gets whooping cough?

People are generally susceptible to whooping cough, but infants and young children are more sensitive. Due to factors such as being under the age of immunization or having an incomplete immunization history and being frail, infants under 1 year of age are at high risk of pertussis and are prone to severe consequences due to pneumonia.

In countries where vaccines are widely available, an increasing number of cases of whooping cough are being detected in older children and adults.

What are the symptoms of typical whooping cough?

Clinically, it is characterized by paroxysmal, spasmodic cough and a chicken-like tail at the end of the cough. Paroxysmal, spasmodic cough attacks are characterized by frequent and uninterrupted short coughs of more than 10 or dozens of sounds, until exhausted and then inhaled deeply. Because the larynx is still spasmodic during inhalation, a large amount of air rushes through the spasmodic glottis, producing a special high-pitched inhalation sound like a rooster crow, followed by the next spasmodic cough, and so on until thick sputum is coughed up.

When the cough is severe, nosebleeds, hemoptysis, subconjunctival hemorrhage, and even intracranial hemorrhage may occur. The light ones are several times a day, and the heavy ones are dozens of times a day, mostly at night.

Stimuli such as running, eating, getting cold, smoking, crying, and checking the pharynx can trigger a spasmodic cough attack. Children without secondary infection usually have a normal body temperature and no fever.

Neonates and infants often do not have the typical spastic cough and present with paroxysmal breath-holding cyanosis that can suffocate to death.

“百日咳再现”是反常现象？

Since the vaccine, the incidence of whooping cough has dropped dramatically. However, in recent years, the incidence of whooping cough has been on the rise, and this phenomenon is known as "whooping cough resurgence".

Is the "recurrence of whooping cough" an abnormal phenomenon? Some experts believe that "the 'recurrence of whooping cough' has been said for 10 years, but it is still at a low level of epidemic. The significant increase in cases this year compared to last year is mainly due to the fact that most other respiratory infections have shown a significant downward trend during the pandemic, so there is no comparison with the same period last year. ”

In view of the reasons for the significant increase in the incidence of pertussis among adolescents and adults, some experts pointed out that the diphtheria, tetanus, and pertussis vaccine currently used in the mainland can only be used for children under 7 years old, and there is no available vaccine to prevent pertussis for adolescents and adults aged 7 and above.

How to prevent whooping cough?

1. In daily life, everyone should maintain good personal hygiene habits, wash hands frequently, cover coughs or sneezes, pay attention to the combination of work and rest, reasonable work and rest, and participate in physical exercise appropriately to enhance their own resistance.

2. Especially when taking care of infants and young children, if adults have symptoms such as cough, wear masks in time, strengthen hand hygiene, and avoid infection to children.

3. Vaccination is the most economical and effective measure to prevent whooping cough. At present, the vaccine for the prevention of pertussis in Beijing is acellular diphtheria-pertussis vaccine (pertussis, diphtheria, tetanus combined vaccine). The age of vaccination is 3 months, 4 months and 5 months of age, and one dose is given for basic immunization, and one and a half years old is given for booster immunization.

If a child has received other combination vaccines containing pertussis vaccine according to the vaccine instructions, he or she can be considered to have completed the corresponding dose.

Children aged 3 months to 5 years who have not completed the prescribed doses of diphtheria-pertussis vaccine need to be vaccinated with the first three doses at an interval of not less than 28 days each, and the interval between the fourth dose and the third dose should not be less than 6 months.

The child was vaccinated when he was a child, how did he get infected?

Usually, the level of protective antibodies decreases after 3~5 years of vaccination, and the antibodies almost disappear after 12 years.

Therefore, in the event of an epidemic, susceptible groups still need to be boosted, and the mainland is currently developing a pertussis-containing vaccine that can be used by children over 6 years old and adults. Recently, whooping cough has "returned", and everyone is also calling for an update of the vaccination strategy as soon as possible.

(References: official website of the National Bureau of Disease Control and Prevention, Popular Science China, Xinhua News Agency, CCTV News, Beijing News, Beijing Center for Disease Control and Prevention, etc.)

Topic host|Reporter Chen Wanyun