In children, especially in babies, this disease can cause serious complications. Currently, 90% of cases occur in countries where vaccination is not offered
There pertussis It is abacterial infection highly contagious that mainly affects the respiratory tract, with potential serious complications Especially in babies and small children. In this article we will explain how this potentially dangerous disease is manifested and how it is possible to prevent it and cure it.
What is pertussis
There pertussisalso known as “Cane cough“Or“convulsive cough”, It is caused by Bordella Pertussisa bacterium that can affect the airways at all ages, especially in children under 5 years. It is a disease present globally, but now very rare in countries where childhood vaccination is widespread. Currently, 90% of pertussis cases occur in areas where vaccination is not offered, in these cases the pathology is very dangerous and in the little ones it can lead to serious complications.
When he enters the body, in fact, the bacterium of Pertosse adheres to the respiratory tract and releases toxic substances (such as the Pertosse toxin) which damage bronchi cells and cause an abundant accumulation of mucus.
Pertosso symptoms
The initial symptoms can be easily confused with those of any viral infection, it is therefore important to know how the pertussis and how to recognize it.
The disease develops in three phases:
- Catarrhal phase. The initial symptoms are colds, nose that colas, tearing and little dry cough, accompanied by general malaise and fever (not always present).
- Paroxysmalcharacterized by episodes of intense, rapid and violent coughs that persist uninterrupted for several minutes, often followed by oneinspiration franticwhat genre a sound similar to a “thin scream”. This is the most characteristic of Symptoms of pertussis in children (typically from 6 months to 5 years). These attacks are more common during the night. During a cough access, children can present a purple complexion of the lips and fingers (cyanosis), sweating or apnea. At the end of the cough, vomiting or loss of consciousness can be manifested.
- Convalescence phase. The cough is progressively attenuates, but a course of weeks or months is possible for complete healing.
The three phases gradually follow one another, without a clear passage between them, and the symptoms can overlap during the course of the disease.
In older children and in adults, the symptoms of pertussis They are often characterized by a persistent cough without the characteristic “scream”, and can go unnoticed or to be exchanged for bronchitis. It is important to identify the pertussis in the early stages to avoid contagion and the most serious complications in vulnerable subjects.
How long does it last?
Pertosso is one long and debilitating disease. The total duration may vary, but in general it follows these timing:
- Incubation of 1-3 weeks (normally 7-10 days).
- Catarrale phase that lasts about 1-2 weeks (normally 7-10 days) and is the most contagious period of the disease.
- Paroxysmal phase, which can last 2-6 weeks.
- Convalescence phase, which lasts about 2-3 weeks, but weeks or months may be needed for healing.
In younger children, the duration of the acute phase can be more prolonged, and complications can require prolonged medical care. In some cases, residual cough can last up to three months, influencing sleep and quality of life.
Pertosso: the diagnosis
Diagnosing pertussis is not always simple, especially in its initial stages. The pediatrician bases the diagnosis on:
- Anamnesisthat is, the collection of information on symptoms and contact with affected subjects.
- Objective examinationthat is, the evaluation of the type of cough and the general conditions of the child. The clinical suspicion and an accurate visit are sufficient to start therapies. In other words, the doctor can decide to put a diagnosis even without further investigations.
- Laboratory test. Naso-fooling swab is the most specific test to detect the presence of the infection. In more late cases, serological tests can be carried out to search for the immune response.
- Blood tests. An increase in white blood cells (especially lymphocytes) can support a pertussis diagnosis in doubtful cases.
An early diagnosis allows you to promptly start the antibiotic treatmentreducing the risk of complications and the spread of the disease. For these reasons, it is always important to consult your trusted pediatrician when you have a doubt.
Is the pertussis contagious?
Yes, immediately after the incubation phase, Pertosse it is highly contagious. The bacterium is transmitted through the drips of saliva dispersed in the air when an infected person takes care, sneezes or speaks.
- Period of contagiousness. A person with pertussis is contagious above all at the beginning of the infection, from the catarrhal phase until about three weeks after the start of the paroxysmal phase, unless they begin adequate antibiotic therapy. With appropriate treatment, contagiousness is reduced to about five days.
- Contagion prevention. Avoid contact with infected people, frequently washing your hands and guaranteeing the correct vaccination coverage are fundamental strategies to reduce the spread of the bacterium. The timely use of antibiotics in suspicious cases or in close contacts of affected people helps to limit the spread of the pathology.
Pertussis and children
In children, above all in the babies, pertussis It can cause serious complicationsincluding pneumonia, otitis and, rarely, neurological complications such as convulsions. Children who have not completed the doses of vaccination are the most vulnerable.
In case of suspected pertussis, it is essential to immediately contact the pediatrician for a diagnosis and timely treatment. In severe cases, shelter may be necessary to monitor breathing and provide intensive medical support.
Pertussis in adults
In adults, Pertosse shows milder symptoms, often exchanged for chronic cough or persistent bronchitis. However, it is important to recognize it to avoid transmitting the bacterium to infants or unchanged people.
Adults with an weakened immune system or that have not received vaccination calls are more at risk of developing severe forms. For this reason, the vaccination references are recommended above all for those who have contacts with infants or work in the health sector.
Pertosso: Care and therapy
There Pertosse therapy It is useful both to relieve symptoms and to provide support against cough and breathing difficulty. Antibiotic therapy is essential, but it is more effective if started in the early stages of the disease. If started when the symptoms are conclaimed, the clinical response is slower and limited.
The most used antibiotics are:
- Macrolids (such as azithromycin or clarithromycin).
- Trimetoprim-Sulfametossazolo (in cases of allergy to macrolides).
Antibiotics do not immediately eliminate cough, but reduce contagiousness and prevent further complications. As in the other forms of infection of the high respiratory tract, also in the pertussis Some may be useful natural remedies (the so -called “grandmother’s remedies”), such as the aspiration of nasal secretions, honey and correct hydration. However, it is important to remember that these precautions do not replace the specific therapies prescribed by the doctor.
Hospitalization is suitable for pneumonia patients, breathing difficulties (hypoxia), neurological complications or inability to feed and hydrate independently. In these cases, parenteral nutrition (intravenous) and the administration of oxygen may be necessary.
Children under the year of age, who have not completed the doses of vaccination and therefore do not yet have the antibodies for pertussisare the most at risk of serious complications and are often hospitalized regardless of the severity of symptoms. Babies, in particular, should be managed in intensive care, since they can develop sudden cardiopulmonary complications.
Pertosso vaccine
The vaccine is the most effective means of preventing pertussis.
In Italy, Pertosse vaccine is part of the exavalent (i.e. the vaccine against diphtheria, tetanus, pertussis, Haemophilus influenzae type B, polio and hepatitis B) administered in the first months of life, and is present in the subsequent references. The Pertosse vaccination calendar provides:
- First dose at 3 months.
- Second dose at 5 months.
- Third dose at 11-13 months.
- Calls at 5-6 years and 12-16 years.
The Side effects of the Pertosse vaccine They are generally mild and short -lived. The most common are redness and swelling at the point of injection. Within 24 hours, fever can also appear, with a duration of maximum one to two days. They are possible sleepiness and loss of appetite, while the inconsolable cry is less frequent. The serious reactions are very rare.
Since antibodies pass from the mother to the fetus through the placenta, to all pregnant women, the pertussis vaccine is strongly recommended Especially in the third quarter, so as to protect the newborn in the first months of life. Pregnancy vaccination is safe and effective and contributes to protecting babies, which are the most vulnerable to the complications of pertussis.
