There is a cough that not only makes people scream and can't breathe, but this torture may last for months - it is whooping cough. As one of the legal Class B infectious diseases, whooping cough is highly contagious and has been one of the important causes of infant death around the world, threatening the health of infants and young children. So what is whooping cough? What are the dangers of whooping cough and how to prevent it?
Recently, the new media "People's Good Doctor" client, a new media client of the People's Daily, invited Zheng Hui, deputy director of the vaccine preventable bacterial ward at the Immunization Program Center of the China Center for Disease Control and Prevention, Deng Jiqiu, director of the Infection Department of Shenzhen Children's Hospital, and Liu Zhaoqiu, director of the Prevention and Health Department of Tsinghua University's First Affiliated Hospital, to explain in detail the knowledge and preventive measures related to whooping cough to help babies stay away from the infection of whooping cough.
What is whooping cough?
Deng Jiqiu said that pertussis is an acute respiratory infectious disease caused by bautes pertussis, which mainly infects ciliated epithelial cells of the human respiratory tract after transmission through droplets. Whooping cough is extremely contagious, with an R0 value of up to 12~17, that is, every 1 infection case will infect an average of 12~17 people (without intervention). Whooping cough has now risen to the third largest Class B infectious disease that can be prevented by vaccines in my country (second only to hepatitis B and tuberculosis).
After infection with Bacillus pertussis, the incubation period is 9-10 days (6-20 days). The patient initially developed symptoms of catalactia such as coughing. Within 1-2 weeks, paroxysmal spastic cough appeared, with a typical "chicken crow" inhalation roar. In typical cases, night cough is particularly severe and often accompanied by vomiting. Babies under 3 months of age are prone to symptoms such as cyanosis, shortness of breath, and suffocation. Therefore, when a baby experiences shortness of breath, hypoxia, poor eating, or vomiting symptoms of unexplained causes, especially if the family members are already coughing, you should be extra vigilant and seek medical treatment in a timely manner. When visiting the doctor, you should clearly inform the doctor of the symptoms of coughing among some family members.
What harms will be caused after infection with pertussis?
Deng Jiqiu said that after adults or older children are infected with whooping cough, their clinical symptoms are relatively mild, mainly manifested as chronic cough, pharyngeal discomfort, etc., but younger children, especially infants and young children, are prone to severe morbidity and have multiple complications. For example, more than 60% of infants and young children under 3 months of age are infected with pertussis and pneumonia, and some may be associated with pertussis encephalopathy, accompanied by convulsions and even pulmonary hypertension, which may even lead to death in severe cases. From this we can see that the younger the age, the greater the risk of complications after infection with whooping cough, the more serious it is.
What are the pathogenesis and transmission characteristics that should be paid attention to in my country’s pertussis?
Zheng Hui said that as a strong infectious disease, whooping cough has always attracted much attention from China and even the world. According to statistics, in 2014, about 24 million children worldwide were infected with whooping cough, causing about 160,000 deaths. A 2019 Global Childhood Burden (Children Under 10) study shows that whooping cough has become the ninth largest disease burden.
Pertussis, as a vaccine preventable disease, has seen a significant decline in the incidence rate after being vaccinated on a large scale around the world. However, in recent years, in some countries with high vaccine coverage, those with pertussis have continued to be low and the incidence of pertussis has increased significantly after a long period of time, that is, those withering cough reappears.
According to the analysis of monitoring data, the incidence of pertussis in my country is mainly children, especially children under one year old, accounting for about 60%-70% of all cases. At the same time, among children under one year old, infants and young children younger than 5 months old account for about 70%. It can be seen that the incidence of young children in my country is still a relatively prominent phenomenon. On the other hand, with the widespread application of pertussis vaccine, the population of whooping cough has shown a tendency to transfer from younger children to older children or adolescents and adults. However, because the symptoms of adults and adolescents are atypical or mild, they have not attracted attention, which may be underestimated in adults and adolescents.
Deng Jiqiu said that judging from clinical data, pregnant women and newborns in China generally lack pertussis antibodies, especially some newborns basically cannot detect pertussis antibodies. In addition, as we grow older, the level of pertussis antibodies in adolescents and adults continues to decline, which makes the risk of infection with pertussis continue to increase. After infection, it is easy to be ignored due to atypical or mild symptoms, but it is still highly contagious, which has made more and more adolescents and adults the main source of infection with pertussis in infants and young children. At this time, we say that its transmission model has changed from the transmission between children and children to the transmission between adolescents or adults to children.
Vaccination is the most effective measure to prevent whooping cough
Zheng Hui said that as a vaccine can prevent diseases, we now have a powerful weapon - Vaccination: Vaccination is the most effective measure to prevent whooping cough. According to the recommendation of the World Health Organization: the pertussis vaccine should be vaccinated as soon as possible, the first shot should be started at 6 weeks of age, and at the latest no later than 2 months of age. Currently, 90% of countries around the world adopt an immunization strategy of the first injection of no more than two months of age.
The first shot of the pertussis vaccine in my country is to start vaccination at 3 months of age. At the same time, my country is also actively exploring the feasibility of forwarding the first shot of the pertussis vaccine to 2 months of age on the basis of the current immunization strategy.
Liu Zhaoqiu said that since those whooping cough is more harmful to infants and young children of small moth age, we need to get those whooping cough vaccine as soon as possible. In clinical vaccination, it is necessary to choose a combined vaccine containing pertussis ingredients that can be vaccinated at 2 months of age based on sufficient information.
The importance of receiving pertussis vaccine as soon as possible and the full course of
Zheng Hui said that it can be seen from the incidence data that the incidence rate of children who have not been vaccinated throughout the course of vaccine has increased significantly. After completing the first dose of vaccination, its effective performance reaches 45%. Only by completing 3 doses of vaccines can the protection effectiveness be improved to about 98%. Therefore, it is recommended that all children of appropriate age complete vaccination as soon as possible within the scope specified in the procedure. At the same time, if the timely vaccination is not possible due to epidemic prevention and control or physical condition, after the epidemic is relieved and the health of the child allows, an appointment should be made as soon as possible to complete the relevant vaccine re-use. During re-use, only the unfinished doses are required, and there is no need to start the full vaccination again.
Deng Jiqiu added that from a clinical perspective, as a high-incidence group, once the disease occurs, the burden of disease is very serious and will cause a series of complications. It is recommended that infants and young children be vaccinated as soon as possible and throughout the process. If the baby cannot be vaccinated in time due to physical reasons, it is recommended to complete the relevant vaccine re-injection in time after the baby's condition stabilizes. It may involve some infants and young children with special health status. In the past, such children did not dare to get vaccinated, but due to the particularity of autoimmunity, such babies have a higher risk of infection, and they need vaccine protection more. The 2021 edition of the "National Immunization Program Vaccine Children's Immunization Procedure Description" released by the National Health Commission pointed out that premature babies, children with infectious diseases, etc., can be considered vaccinated if the disease is stable, the disease is in remission, and no biological agents are used. But at the same time, we must also analyze the specific situation and follow the guidance of medical staff.
Get the pertussis vaccine as soon as possible and throughout the process, which can help infants and young children to establish an immune barrier better and earlier, and stay away from the risk of pertussis infection.
Source: People's Daily Health
