Whooping cough

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I – Introduction:

A- Definition of whooping cough:

Health Care

Whooping cough, also known as “convulsive cough”, is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. This disease is characterized by violent and prolonged bouts of coughing that can cause difficulty breathing, vomiting and extreme fatigue. Whooping cough can affect people of all ages, but it is especially dangerous for infants and young children. Indeed, the disease can lead to serious complications such as pneumonia, seizures, brain damage and, in the most serious cases, death. Pertussis is mainly transmitted through the air, when an infected person coughs or sneezes, spreading the bacteria through the air. The disease can also be spread by direct contact with nasal or oral secretions from an infected person. Although there is an effective vaccine to prevent the disease, whooping cough continues to be a public health problem in many parts of the world.

B- Presentation of the subject:

Pertussis is a highly contagious respiratory disease that can have serious health consequences, especially in infants and young children. Although it was considered a childhood disease, whooping cough can affect people of all ages. Symptoms of the disease include violent coughing, wheezing, difficulty breathing and vomiting, which can last for several weeks. The disease is caused by bacteria called Bordetella pertussis, which is mainly spread through the air when an infected person coughs or sneezes. Although whooping cough can be treated with antibiotics and proper medical care, the best way to protect against the disease is vaccination. Unfortunately, whooping cough continues to be a public health problem in many parts of the world, particularly in countries with limited access to vaccination or insufficient vaccination coverage. Therefore, it is important to raise awareness about whooping cough, its symptoms, modes of transmission and the importance of vaccination to prevent the disease and its complications.

C- Importance of vaccination:

Vaccination is the most effective way to prevent whooping cough. Whooping cough vaccines are usually given as part of childhood immunization programs, and infants are given a series of doses at regular intervals to boost their immunity against the disease. Whooping cough vaccines are also available for older children and adults, especially those in close contact with infants and young children. Vaccination is essential to prevent the spread of disease and reduce the risk of serious complications, especially in infants and young children whose immune systems are more vulnerable. It is important to emphasize that vaccination is not only important to protect vaccinated people, but also to protect the population as a whole by reducing the circulation of the virus in the community. Despite the effectiveness of vaccines, vaccination coverage remains insufficient in some regions of the world, which contributes to the persistence of pertussis as a public health problem. It is therefore essential to continue to raise awareness of the importance of vaccination and to promote access to effective vaccination programs to prevent whooping cough and other infectious diseases.

II- The causes and symptoms of whooping cough:

A- Causative pathogen:

Whooping cough is caused by bacteria called Bordetella pertussis. This bacterium is highly contagious and spreads through the air when an infected person coughs or sneezes. Whooping cough bacteria can also be transmitted through direct contact with nasal or oral secretions from an infected person. Bordetella pertussis is a gram-negative bacterium that attaches to the cilia of cells in the respiratory system, causing inflammation of the airways. The toxins produced by the bacteria also disrupt normal cilia function, leading to mucus buildup in the airways and bouts of violent coughing. Bordetella pertussis is highly contagious and can spread rapidly in unvaccinated or under-vaccinated populations. It is important to emphasize that Bordetella pertussis is only responsible for human whooping cough and is not transmitted from animals to humans or vice versa. Continued research on the bacterium Bordetella pertussis is important to better understand the disease and to develop more effective vaccines and treatments to prevent and treat whooping cough.

B- Modes of transmission:

Whooping cough is a highly contagious disease that is mainly spread through the air when an infected person coughs or sneezes. Respiratory droplets containing pertussis bacteria can be inhaled by an uninfected person, resulting in transmission of the disease. Whooping cough bacteria can also be transmitted by direct contact with nasal or oral secretions from an infected person, such as when a person touches their nose or mouth after touching a contaminated surface. Pertussis transmission is particularly common in communities where vaccination coverage is insufficient or when the disease is reintroduced into a community from infected people in other areas. It is important to note that people with whooping cough are contagious for about three weeks after symptoms start, even if they are on treatment. Therefore, it is essential to take steps to prevent transmission of the disease, including getting vaccinated and avoiding close contact with sick people.

C- Common symptoms:

Symptoms of whooping cough can vary with age and severity of illness. In infants and young children, initial symptoms may be mild and resemble a common cold, with mild fever, dry cough and runny nose. However, the cough quickly becomes more frequent and severe, and may be accompanied by difficulty breathing and vomiting. Coughing episodes can be so violent that they can cause extreme fatigue, nosebleeds or seizures. In adolescents and adults, the symptoms may be less severe, but the cough may persist for several weeks or even months. It is important to point out that some cases of pertussis may be asymptomatic or very mild, especially in vaccinated people. which can make the disease difficult to diagnose and control. When in doubt, it is essential to consult a doctor for an accurate diagnosis and appropriate treatment, and to prevent the spread of disease in the community.

III- Diagnosis of whooping cough:

A- Medical examinations:

The diagnosis of whooping cough is usually based on a combination of symptoms, medical history, and laboratory tests. A physical exam can help detect signs of illness, including the presence of coughing, wheezing, fever, and vomiting. The doctor may also take a sample of mucus from the patient’s nose or throat for bacterial culture or polymerase chain reaction (PCR) testing to confirm the presence of Bordetella pertussis bacteria. In some cases, the doctor may also order a chest X-ray to assess the condition of the lungs and rule out other respiratory diseases. In infants and young children, the doctor may also monitor blood oxygen levels to make sure the child is getting enough oxygen. Medical examinations are essential to establish an accurate diagnosis and to help determine the most appropriate treatment for the patient. It is important to seek medical attention as soon as symptoms of whooping cough appear for proper diagnosis and treatment, and to prevent the spread of disease in the community.

B- Diagnostic criteria:

The diagnostic criteria for whooping cough vary according to age and the severity of the disease. In infants and young children, the diagnosis of whooping cough is based on the presence of persistent cough and episodes of inspiratory cough or coughing fit, with or without vomiting. Other signs of the disease may include cyanosis (blue discoloration of the skin) or pauses in breathing. In adolescents and adults, the diagnosis is often based on the presence of persistent cough for several weeks or months, particularly if the person has been in contact with an infected person or has not been vaccinated recently. The diagnosis can be confirmed by a laboratory test, which detects the presence of Bordetella pertussis bacteria in a sample of mucus from the patient’s nose or throat. It is important to point out that diagnosing whooping cough can be difficult, especially in people who have been vaccinated or in people with a mild form of the disease. It is therefore essential to consult a doctor as soon as symptoms appear to obtain an accurate diagnosis and appropriate treatment.

C- Differentiation with other respiratory diseases:

Symptoms of whooping cough can be similar to those of other respiratory diseases, which can make diagnosis difficult. For example, cough is a common symptom of whooping cough, but it can also be present in other conditions such as bronchitis, pneumonia, and respiratory syncytial virus (RSV). The differentiation of pertussis with other respiratory diseases is therefore essential to establish an accurate diagnosis and provide appropriate treatment. Medical examinations such as bacterial culture and laboratory tests can help distinguish whooping cough from other respiratory illnesses. In some cases, a chest X-ray may be needed to assess the condition of the lungs and rule out other respiratory diseases.

IV- Treatments for whooping cough:

A- Antibiotics:

Antibiotics are often used to treat whooping cough, especially in infants and children. Antibiotics can help reduce the duration and severity of illness, as well as prevent it from spreading to other people. The most common antibiotics used to treat whooping cough are erythromycin and azithromycin. However, the use of antibiotics to treat whooping cough is controversial, especially in adolescents and adults. Some studies have shown that antibiotics have no significant effect on the duration or severity of illness in adolescents and adults, and may even have unwanted side effects. It is important to point out that antibiotics cannot completely cure whooping cough and are not effective against symptoms such as cough. Symptomatic treatments such as cough suppressants, expectorants, and analgesics can be used to relieve cough symptoms and improve patient comfort. It is therefore essential to discuss the appropriate treatment options for whooping cough with a doctor.

B- Symptomatic treatment:

Supportive treatment is an important approach to relieving the symptoms of whooping cough. Cough suppressants, expectorants, and pain relievers are commonly used to treat cough and chest pain associated with whooping cough. Cough suppressants such as codeine and dextromethorphan can help reduce coughing by acting on the cough center in the brain. Expectorants such as guaifenesin can help loosen mucus in the airways and make it easier to cough out. Painkillers such as paracetamol and ibuprofen can help relieve pain and inflammation associated with coughs and respiratory infections. It is important to talk to a doctor before taking over-the-counter medications, because some medicines can interfere with other treatments or have unwanted side effects. In addition to drug treatments, it is important to get enough rest, drink enough fluids, and eat a healthy diet to help boost the immune system and promote healing.

C- Medical and non-medical care:

The management of whooping cough requires a holistic approach combining medical and non-medical treatments. In addition to antibiotics and symptomatic treatment, vaccination is the most effective method of preventing whooping cough and limiting its spread. It is therefore important to follow the recommended vaccination schedule for infants, children and adults, and to be vaccinated regularly to maintain protective immunity against the disease. Apart from medical treatments, it is important to take preventive measures to prevent the spread of disease, such as washing hands regularly, covering mouth and nose when coughing and sneezing, and isolation of infected persons. Finally, It is essential to provide emotional and psychological support to patients with pertussis, especially children and infants, as prolonged coughing and symptoms of illness can lead to fatigue, loss of appetite and sleep disturbances. A holistic approach to pertussis management can help improve treatment outcomes and prevent complications.

V- Whooping cough prevention:

A- Vaccination:

Vaccination is the most effective way to prevent whooping cough. Pertussis vaccine is usually given as a combination with other vaccines as part of the routine immunization program. Most countries have a recommended immunization schedule that includes a series of pertussis vaccine doses for infants and children. Whooping cough vaccines are generally safe and effective, with minor side effects such as local pain, redness and swelling at the injection site. The vaccine is also recommended for pregnant women to protect newborns, who are particularly vulnerable to whooping cough. Adults who work in healthcare settings or have contact with infants should also get regular vaccinations to help prevent disease transmission. Vaccination is essential to protect vulnerable populations, especially infants and children, against pertussis and to help prevent an outbreak of the disease.

B- Hygiene precautions:

Hygiene precautions are essential to prevent the spread of whooping cough. It is important to wash your hands regularly with soap and water or hand sanitizer, especially after coughing, sneezing or using the bathroom. People with the disease should cover their mouth and nose when coughing or sneezing, ideally with a tissue, and immediately throw the tissue in the trash. Frequently touched surfaces and objects, such as doorknobs, toys, and phones, should be regularly cleaned and disinfected to kill germs. People with whooping cough should be isolated until they are no longer contagious, which may take several weeks. to avoid spreading the disease to others. Also, people who have been in contact with people with whooping cough should be closely monitored and made aware of the symptoms of the disease. Hygiene precautions are important to reduce the risk of spreading whooping cough and should be followed by all people to prevent transmission of the disease.

C- Preventive measures for contact cases:

Preventive measures for contact cases of pertussis are essential to prevent the spread of the disease. Contact cases are people who have been in close contact with a person with whooping cough and who are at high risk of contracting the disease. Preventive measures for contact cases include vaccination, antibiotic prophylaxis and close monitoring of symptoms. Contact cases should be vaccinated against whooping cough to reduce the risk of contracting the disease. In addition, contact cases who have not been vaccinated or whose vaccination status is unknown should be vaccinated immediately. Contact cases should also receive antibiotic prophylaxis to reduce the risk of contracting the disease or spreading it to others. Contact cases should be closely monitored for symptoms of whooping cough, such as coughing and difficulty breathing, and notify a healthcare professional immediately if symptoms occur. Prevention measures for contact cases are important to reduce the risk of spreading pertussis and must be put in place quickly to prevent transmission of the disease.

VI- The situation of whooping cough in the world:

A- World statistics:

Pertussis is a vaccine-preventable respiratory disease, but it remains a public health problem in many countries around the world. According to the World Health Organization (WHO), pertussis is responsible for almost 160,000 deaths per year worldwide, mainly in infants under six months who are not yet protected by vaccination. The regions most affected by pertussis are sub-Saharan Africa and Southeast Asia, where health systems may be insufficient to ensure adequate vaccination coverage. However, whooping cough can also occur in high-income countries, especially in adolescents and adults who have not been vaccinated or whose immunity has waned over time. In 2020,

B- Epidemiological situations by country:

The prevalence of whooping cough varies greatly between countries and regions of the world. According to WHO data, the countries most affected by whooping cough are often those where vaccination coverage is insufficient. In sub-Saharan Africa, pertussis is endemic, with a high mortality rate among unvaccinated infants. In Southeast Asia, the disease is also common, with a high mortality rate among children under five. In high-income countries, whooping cough is less common, but it can affect specific population groups, such as adolescents and adults whose immunity has waned over time. In Europe, some countries have reported an increase in the number of pertussis cases in recent years, particularly in infants under six months of age.

C- Risk factors:

Several risk factors can contribute to the occurrence of whooping cough. First of all, non-vaccination or incomplete vaccination is a major risk factor. Infants and young children whose immune systems have not yet matured are most vulnerable to illness and can develop serious complications. Also, close contact with someone infected with whooping cough can increase the risk of transmission. Health professionals, teachers and parents of young children are therefore more at risk. Teenagers and adults whose immunity has waned over time may also be at risk for whooping cough. People with chronic respiratory diseases, such as asthma, may be at increased risk for complications from whooping cough.

VII- Conclusion  :

A- Summary of key points:

Whooping cough is a highly contagious infectious respiratory disease caused by the bacterium Bordetella pertussis. Symptoms include a severe and prolonged cough, wheezing and shortness of breath, often accompanied by vomiting. Vaccination is the most effective way to prevent the disease. Infants and young children are most vulnerable to the disease, which can lead to serious and even fatal complications. Diagnosis is based on clinical criteria and laboratory tests, such as culture of the bacteria or PCR. Treatment for whooping cough includes antibiotics to kill the bacteria and supportive care to relieve symptoms. Preventive measures include vaccination, hygiene precautions, medical and non-medical management, as well as preventive measures for contact cases. Statistics show a high incidence of whooping cough worldwide, with periodic outbreaks in many countries. Risk factors include non-vaccination or incomplete vaccination, close contact with an infected person, and certain chronic respiratory diseases or lifestyle factors such as smoking.

B- Importance of awareness and prevention:

Whooping cough can be a serious illness, especially for infants and young children, but also for the elderly or those with chronic conditions. Awareness of the disease and prevention are therefore essential to prevent its spread. Awareness campaigns can help inform the public about the seriousness of the disease and ways to prevent it, such as vaccination and hygiene measures. Healthcare professionals also play an important role in the prevention and treatment of the disease, by quickly identifying cases of whooping cough and providing adequate care to infected patients. The parents, Caretakers and teachers can also help prevent whooping cough by ensuring children are immunized and taking steps to prevent transmission of the disease. In short, awareness and prevention are essential to reduce the number of pertussis cases and protect the health of vulnerable people.

C- Future prospects for the fight against whooping cough:

The fight against whooping cough has made significant progress in recent decades, in particular thanks to vaccination. However, there are still challenges to overcome, such as the need to develop more effective vaccines and to better understand immunity against the disease. Research into next-generation vaccines, such as acellular vaccines and DNA vaccines, is ongoing to improve the efficacy and duration of protection offered by current vaccines. Additionally, efforts are underway to improve diagnostic methods and symptomatic treatments to reduce disease transmission and improve clinical outcomes for patients with pertussis. Ongoing disease surveillance and implementation of effective vaccination programs are also essential to prevent the spread of whooping cough. In sum, the future prospects for whooping cough control are encouraging thanks to advances in research and prevention, but it is essential to maintain efforts to eradicate this disease.

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