After the new crown epidemic, children have become the main susceptible group to respiratory infectious diseases, following the wave of mycoplasma pneumonia infection in the second half of last year, recently, "whooping cough has caused 13 deaths this year" ranked first in the hot search.
In recent years, the number of pertussis cases reported in many countries around the world has shown an upward trend, and the mainland is no exception. Although the mainland has included pertussis vaccine in its immunization program since 1978, the number of pertussis cases has been on the rise in recent years after decades of low levels. This phenomenon has aroused widespread attention and discussion in the medical community.
Whooping cough is characterized by a severe cough that lasts for several months and mainly affects children and infants. According to the latest data released by the National Bureau of Disease Control and Prevention, a total of 17,105 cases of whooping cough were reported in February 2024, 7,979 more cases than in December last year and nearly 32 times that of the same period in 2023 (538 cases). Meanwhile, a total of 13 pertussis deaths have been reported in the first two months of this year, more than in 2018 to 2023 combined.
"Recently, the number of whooping cough cases has indeed increased compared to last year, some children have been coughing for a month or two, have a crampy cough, severe cough is red, and some children need to be hospitalized. Wang Yingshuo, director of the outpatient department of the Children's Hospital of Zhejiang University School of Medicine, told the "medical community".
In addition, doctors in Anhui, Shanghai, Beijing, Chongqing and other places also said that similar conditions were observed. "We have a lot of whooping cough patients in our inpatient unit. In previous years, there were few cases in a year. The chief physician of the infectious disease department of a tertiary hospital said.
Clinical manifestations and diagnosis of whooping cough
The typical clinical manifestations of whooping cough can be divided into three stages: catarrhal phase, spasmodic cough phase and recovery phase.
01. Catarrhal phase: mainly manifested as low-grade fever, cough, runny nose and other cold-like symptoms, which last for about 1~2 weeks;
02. Spasmodic cough stage: It is the most characteristic stage of whooping cough, the patient will have paroxysmal spasmodic cough, accompanied by inspiratory chicken crowing or dog barking sound, and when the cough is violent, it may lead to dyspnea, vomiting and even suffocation;
03. Recovery period: It is the stage when the cough gradually decreases and the condition tends to be relieved.
Diagnosis of whooping cough is based on clinical symptoms, history, and laboratory findings. The doctor will make a comprehensive judgment based on the patient's clinical manifestations and routine blood results, and can also confirm the diagnosis of whooping cough through laboratory means such as serological examination and nucleic acid testing.
However, because the clinical manifestations of whooping cough are similar to those of other respiratory diseases, they are prone to misdiagnosis or underdiagnosis, which also increases the risk of pertussis transmission.
Vaccination: an important measure to prevent whooping cough
The most effective means of preventing whooping cough is vaccination. However, although the mainland has included the pertussis vaccine in the immunization program, the resurgence of pertussis in recent years raises questions about the effectiveness of the vaccine. In fact, the protective effect of the pertussis vaccine is indeed influenced by a variety of factors.
First of all, the lack of persistence of vaccine immunity is an important reason. Over time, the immunity created by the vaccine wanes, making individuals susceptible to pertussis infection.
Secondly, the vaccination rate is also a key factor affecting the protective effect. If vaccination rates are not high, an immune barrier in the population cannot be formed, increasing the risk of disease transmission. In addition, factors such as the timing and dose of vaccination may also affect the protective effect of the vaccine.
Therefore, in order to effectively prevent pertussis, we need to increase the vaccination rate and ensure that every child receives the pertussis vaccine on time. At the same time, it is also necessary to strengthen vaccine research and development to improve the protective efficacy and durability of vaccines. In addition, for patients who have been vaccinated but still have pertussis, doctors should treat and manage them individually on a case-by-case basis.
How can pertussis be prevented?
Timely and full vaccination with pertussis-containing vaccines is the most economical and effective means to prevent pertussis, which can effectively reduce the risk of infection and severe cases. According to the current pertussis-containing vaccine immunization schedule in mainland China, children should receive one dose of pertussis-containing vaccine at 3, 4, 5 months and 18 months of age. School-age children should be vaccinated with pertussis-containing vaccines in a timely and full manner, and unvaccinated children should be vaccinated as soon as possible.
Develop good habits
Maintain good hygiene, wash hands frequently, ventilate frequently, cover your mouth and nose with your elbow or tissue when coughing or sneezing, and pay attention to reasonable work and rest and appropriate physical exercise.
Wear masks scientifically
Wearing a mask is an important measure to prevent respiratory infections and can effectively reduce the spread of pathogens. Parents with respiratory tract infection symptoms such as cough should wear masks when taking care of infants and young children in close contact to reduce the risk of infection of infants and young children.