Pertussis
Immunoprophylaxis
Pertussis is menacing this spring
According to the official website of the National Bureau of Disease Control and Prevention, a total of 32,380 cases of whooping cough were reported nationwide from January 1 to February 29, 2024, 24 times that of the same period in 2023 (1,337 cases), of which 13 cases unfortunately died. Not only on the mainland, but also in other countries, the pertussis epidemic is worsening. Pertussis cases have been increasing since 2023, with the first death in the second half of 2023, and worsening pertussis outbreaks in the Philippines, the United Kingdom, Serbia, Croatia, Denmark, Israel and the Czech Republic, which has reported the worst outbreak of pertussis in recent years. The rise in the incidence of a disease that has been prevented by vaccination since infancy deserves the attention and vigilance of all of us.
01
What kind of disease is whooping cough?
Pertussis is an acute respiratory infection caused by Bordetella pertussis, and humans are the only reservoir of Borettebacterium pertussis. Pertussis is mainly transmitted by droplets, it is highly contagious, it can be infected at any age, infants and young children are more sensitive, and infants, especially infants of small months, often have a poor prognosis after infection; the typical clinical symptoms of whooping cough are paroxysmal spasmodic cough, accompanied by the end of inhalation like a rooster crow, cough worsens at night, can be accompanied by vomiting, and is easy to be combined with pneumonia and encephalopathy, which is the main cause of death. The course of the disease can reach 2-3 months, so it is called "whooping cough". Infant cases, those with a history of vaccination or whooping cough have atypical symptoms after infection, among which infant cases do not have typical spastic cough after infection, and are prone to cyanosis, shortness of breath, apnea and even suffocation.
If an adult has cough for more than 2 weeks, 30%-50% of them are whooping cough, and they should be vigilant to prevent transmission to children. Pertussis is a national statutory Class B infectious disease and needs to be isolated and treated. For those who have not been treated, the patient will be isolated for 21 days after the onset of the disease, and 5 days after treatment for those who have been treated with sensitive antibiotics.
02
Why is pertussis reappearing globally?
Since 1974, when DTP combined vaccination was introduced globally, the incidence of pertussis has decreased significantly, however, over the past 10 years, the incidence of pertussis has gradually increased in developed countries with high vaccine coverage, such as Europe and the United States, known as "pertussis resurgence". Possible factors include the following: 1) increased awareness and concern of medical personnel about whooping cough, 2) pertussis surveillance in some provinces, resulting in increased sensitivity of reports, 3) the application of PCR and other laboratory testing techniques leading to more cases being detected, 4) vaccination rates declining in some areas, 5) the duration of protection after vaccination is short, generally not more than 6 years, 6) antibiotic resistance, etc.
03
Vaccination remains a powerful weapon of prevention
Pertussis-containing vaccine is the most cost-effective means of preventing pertussis and can effectively reduce the risk of infection and severe cases. At present, the vaccine for pertussis in mainland China is the "diphtheria-tetanus" vaccine, that is, the pertussis-diphtheria-tetanus combined vaccine. According to the National Immunization Program Vaccine Childhood Immunization Schedule and Instructions (2021 Edition), there are a total of 4 doses of diphtheria-pertussis vaccine containing pertussis, and the vaccination age is 3 months, 4 months, 5 months, and 18 months. Pertussis does not produce lifelong immunity, whether vaccinated or naturally infected, but vaccination can reduce the risk of severe disease and death. The diphtheria-pertussis vaccine currently used in mainland China can only be used in children under 6 years of age, so there is no available vaccine to prevent pertussis for adolescents and adults aged 6 years and older.
Although there has been an increase in whooping cough cases in the mainland, everyone, especially parents, should not be too nervous. In order to effectively prevent pertussis, it is necessary to take your children to receive the diphtheria-pertussis vaccine in time, and usually take children, especially infants, to shopping malls, supermarkets and other places where there are many people and the air is not moving. Children infected with whooping cough are prone to lack of oxygen due to frequent and severe spastic coughs, so try to keep the air fresh and circulated indoors to supplement oxygen. Because of its long illness, it consumes a lot of children's bodies, so it is necessary to have enough nutrition and rest, and do not refuse to exercise. Whooping cough may not last for 100 days, and of course it will not stop abruptly in 100 days.