Whooping cough (pertussis) is not a typical childhood disease like measles or mumps. Eight out of ten of whooping cough patients are over 18 years old, and one in three is even older than 45. However, very few of those affected know that they have whooping cough at all. The disease manifests itself completely differently in adults than in children and is therefore often confused with other respiratory diseases.
Whooping cough: symptoms – even in adults.
While small patients suffer from severe coughing attacks accompanied by shortness of breath at night, wheezing breath sounds and sometimes vomiting, wheezing and vomiting are absent in adults. The only indication of whooping cough in adults is often a bad cough that lasts for several weeks. Sometimes sufferers also complain of a scratchy throat or sweating. It’s no wonder that few people think of whooping cough when they experience these symptoms. However, experts recommend always being alert to persistent coughs and at least taking whooping cough into consideration. “In the case of a long-lasting cough and especially nighttime cough attacks, adults should always think of whooping cough,” says Professor Christel Hülße of the State Office for Health and Social Affairs of Mecklenburg-Western Pomerania from Rostock.
Whooping cough more common in adults than thought
Together with German and American colleagues, Ms. Hülße studied the prevalence of pertussis in adults. For this purpose, the scientists evaluated data from 809 patients over the age of 18 who had visited a physician because of cough. The astonishing result of the study: every tenth patient who had coughed for more than seven days was actually suffering from whooping cough. The disease is thus much more common in adults than previously thought.
Complications of pertussis
In adults, pertussis is generally milder than in children and is not life-threatening. However, even in adults, the disease is by no means harmless. Complications occur in one in four:
- For example, whooping cough can cause weight loss, less commonly pneumonia, seizures and brain bleeding.
- Adults with pertussis sometimes also can not hold their urine and become incontinent.
- Sometimes the coughing fits are so severe that ribs and hernias or herniated discs occur.
- Sudden hearing loss or damage to blood vessels are also possible.
High costs due to whooping cough
All this is not only bad for the sufferers, but also costs quite a lot of money. The persistent cough often leads to work absences. Another cost factor: elaborate examinations such as bronchoscopies are often performed in doctors’ offices until the diagnosis of whooping cough is finally established. All in all, the treatment of a single whooping cough patient devours at least 540 euros.
Whooping cough is contagious
Whooping cough is triggered – in children as well as adults – by the bacterium Bordetella pertussis. That is why the disease is also called pertussis. Under the microscope, the bordetellae look rather harmless – small, immobile rods surrounded by a mucus shell. But these tiny creatures have what it takes: they attach themselves to the mucous membranes of the respiratory tract with their sticky surface. There they multiply and release toxins that then trigger the actual disease. The pathogen is passed from person to person by coughing, sneezing or through the air we breathe (droplet infection). Bordetella is highly contagious. 70 to 80 percent of people who come into contact with the pathogen for the first time and are not protected by vaccination become infected and contract pertussis.
Infected adults – danger to infants
Of particular concern is that adults who cough for weeks can pass their pathogens to infants with whom they have contact. The big problem: Unlike for adults, pertussis is a truly threatening disease for infants. In very young children who do not yet have vaccine protection against pertussis, the disease can cause respiratory failure and permanent damage, or even death. Most adults are unaware of the danger they pose to infants and young children around them – simply because it doesn’t even occur to them that whooping cough could be hiding behind their persistent cough.And yet it is a bitter reality: adults with pertussis are the main source of infection for young children. Fifty to 70 percent of infants who contract the disease are infected by their parents or grandparents.
Vaccine protection for infants
Infants who have not been vaccinated against pertussis in the first year of life according to the recommendations of the Permanent Vaccination Commission at the Robert Koch Institute (STIKO) are particularly at risk. However, even regularly vaccinated infants do not have full vaccination protection against pertussis until after the third or fourth partial vaccination (depending on the vaccination schedule) – i.e. at the earliest from the eleventh month of life. Before then, they are at the mercy of the dangerous brads without protection.
