Whooping cough

Synonyms in a broader sense

Medical: Pertussis

Summary

Whooping cough is not always a childhood disease. It is caused by bacteria that damage the surface of the airways. The transmission, i.e. the infection, occurs from person to person via droplet infection.

There are three stages of this disease, the middle of which is characterized by coughing fits. The first, most inconspicuous initial stage, however, is also the stage in which the highest risk of infection for others exists. Complications are also possible.

The therapy is done with antibiotics. To avoid whooping cough as much as possible, babies should be vaccinated at the age of 3 months. Unfortunately there is no safe lifelong protection through the vaccination.

Causes

Whooping cough is caused by bacteria called Bordatella pertussis. The bacteria multiply exclusively on the surface of the respiratory tract. The pathogen itself and the toxins released by it cause damage to this surface.

More precisely, the so-called ciliated epithelium is damaged. The ciliated epithelium normally serves to transport foreign bodies (e.g. dust) out of the body. This happens particularly effectively when coughing.

The fine hairs always beat in the direction in which the dirt should be carried, i.e. outwards. The bacteria are transmitted by droplet infection, for example when coughing or sneezing. The transmission only occurs from person to person. In about 70 percent of cases, the disease then breaks out. Small children are most at risk.

Incubation period

The incubation period for whooping cough is generally about five to twenty days, but usually ten to fourteen days. It is the time between infection and outbreak of the disease. During this time, the pathogen begins to multiply in the body of the infected person without causing symptoms (the infected person is “asymptomatic”). As a rule, other people are not yet expected to be infected during the incubation period. The risk of infection, however, usually starts when the first symptoms appear.

Course and symptomsComplaints

After the incubation period, whooping cough disease proceeds in three stages according to a classical scheme. These stages can be observed in almost all cases in children infected with whooping cough. In adults and infants, it may not be possible to make a clear division into stages.

The three stages: Further general information can be found in our article on coughing in children

• Prodromal or catarrhal stage” This stage begins about 5 to 14 days after infection and manifests itself as a common infection. Here the danger of infection is highest, because the infection can hardly be recognized as whooping cough. In most cases, those affected suffer from the typical cold symptoms (rhinitis, cough, sore throat) and moderate fever (below 40°C).

  In rare cases, conjunctivitis of the eye may occur. The stage lasts one to two weeks. The first stage is also characterized by the fact that at this time the largest amount of bacteria is in the affected person’s system.

  The risk of infection is greatest in this stage, but in the later stages there is practically no risk. Also a therapy with antibiotics is only useful in this stage. Later, the bacteria have usually already been fought by the immune system of the person affected and only the bacterial poison and the damage already caused cause the symptoms.

• Stage convulsivum The coughing attacks typical of whooping cough begin in the second stage: first a deep inhalation, followed by several coughing attacks.

  The face first becomes red, then bluish. The impression is created that the patient is threatening to suffocate, before air is sucked in again with loud, dragging breaths. These cough attacks occur mainly at night.

  There is no longer any fever, as the bacteria have usually already disappeared from the patient’s organism. The symptoms are probably caused by the damage already done to the lungs and airways. Since the bacteria have already been fought, there is usually no longer any danger of infection, and even antibiotic therapy can unfortunately no longer alleviate the symptoms or accelerate recovery.

  Many of the complications of whooping cough have to do with the severe coughing attacks. By sticking out the tongue when coughing, for example, it is possible that a tongue ulcer develops if teeth are present.Due to the violent coughing attacks, even the smallest vessels of the conjunctiva can burst, but these are harmless in themselves. The convulsivum stage usually lasts for four to six weeks.

  Infants under 4 months of age are particularly at risk of life-threatening attacks of respiratory arrest!

• Stage decrementi (“decreasing”) The transition to the third stage is smooth. Gradually, the symptoms improve. For example, coughing attacks become less frequent and weaker.

  This is due to the slow repair of the lungs and the affected cells. However, it can take quite a long time until the symptoms have subsided completely and the affected person is completely healthy again. Usually the decrementi stage lasts three to four weeks, but at least one week and usually no longer than ten weeks.