Updated Friday, February 2, 2024-08:27

  • Infectious Public Health confirms an outbreak of whooping cough in Guadalajara, with 124 affected

Frequent, serious and contagious

. This is the letter of introduction of whooping cough, a disease that has infected 124 people in Guadalajara, mostly children. This infection attacks the respiratory system and, sometimes, due to its symptoms, it goes unnoticed without complications. But in

babies under six months old

, particularly those three who have not yet been vaccinated, whooping cough

poses a risk

due to its complications. Yesterday, the

General Directorate of Public Health of Castilla-La Mancha confirmed that there is an outbreak of whooping cough in Guadalajara with 124 affected

For this reason, the


of pregnant women in Spain

, implemented throughout the country since 2016, contributes to the reduction of serious illness in infants, particularly in the first three months of life. The Spanish Society of Pediatric Infectology and the Spanish Association of Pediatrics collect a series of characteristics and guidelines to address cases of whooping cough.

What is whooping cough?

Whooping cough or pertussis is a

respiratory infection caused by the bacteria

Bordetella pertussis (B. pertussis)

. It is an endemic infectious pathology worldwide, with a cyclical epidemic pattern and highly contagious.


contagion capacity is high

(80-100% attack rate), and it can occur from sick or asymptomatic people.

Its only known reservoir is human

and is

transmitted by air


It affects all age groups, with significant morbidity and mortality in children under three and four months. It is a

notifiable disease


To know more


Public Health confirms an outbreak of whooping cough in Guadalajara, with 124 affected

  • Editorial: EFE Guadalaajara

Public Health confirms an outbreak of whooping cough in Guadalajara, with 124 affected

Whooping cough is an endemic infection with a cyclical epidemic pattern, with peaks every two to five years. Up to

90% of cohabitants and 50-80% of school contacts can be infected

after exposure.

76% of whooping cough cases occur in children under 14 years of age

and 15% are diagnosed in adults between 25 and 54 years of age, as stated in the 2055-2020 report of the National Epidemiological Surveillance Network (Renave) of the National Center of Epidemiology (CNE) of the Carlos III Health Institute (ISCIII).

How many cases and outbreaks of whooping cough are there per year?


2010, the incidence of whooping cough has increased worldwide

, both in countries with low and high human development index, including those with high vaccine coverage. The cases occurred mainly in adolescents, adults and infants who had not started or completed the primary vaccination.

Since 2005, fewer than 60 deaths have been recorded

. Between 2005 and 2020, 43,534 cases of whooping cough were reported. For all age groups except those under one year of age, more cases of whooping cough are reported in women than in men.

Between 2005-2019,

the maximum incidence was recorded in the last epidemic wave (2014-2019) with a peak in 2015

. The drastic reduction in the incidence of whooping cough in 2020 in all age groups is an unexpected epidemiological phenomenon, a consequence of the Covid-19 pandemic.


2021 and 2022, almost 400 infections were added

. And, in

2023, a total of 1,597 cases have been reported to Renave

. An increase in cases has been registered compared to those declared annually in the 2020-2022 pandemic period, with 761, 147 and 250 cases respectively. The number of cases reported last year is even lower than in pre-pandemic years.

What are the incubation and contagion periods like and how long do they last?

The incubation



9-10 days

(with a maximum interval between 6-20 days).

The period of

transmissibility or contagion is long

. It is very contagious, especially in the early catarrhal phase. A person with whooping cough is contagious from the beginning of this stage until the first two weeks after the onset of paroxysmal cough (approximately 21 days) or

up to five days after starting effective antibiotic treatment


How do you prevent infection with the bacteria responsible for whooping cough?


in pregnant women has been shown to be the most cost-effective measure

to prevent serious cases in infants, which has radically reduced the number of cases in Spain. Neither natural infection with

B. pertussis

nor vaccination confers prolonged immunity.

In Spain, as stated by the ISCIII, vaccination against whooping cough began in the 1960s with the DTP (diphtheria, tetanus and whooping cough) vaccine. Adverse reactions associated with the DTP (whole-cell pertussis) vaccine prompted the development of acellular vaccines that, in principle, maintained effectiveness and improved safety.

Since 2005, only the acellular pertussis vaccine (DTPa) has been administered

. The pertussis vaccination schedule included in the vaccination schedule has been modified over the years.

Currently, a schedule with four doses

is administered

: 2 months, 4 months, 11 months and 6 years. Additionally, to reduce severe disease in infants, administration of

one dose of dTpa vaccine to pregnant women

beginning at the 27th week of gestation is recommended.

Primary vaccination coverage has remained very high over the last few decades, exceeding 95% since 2000. Vaccination coverage with dTpa in pregnant women exceeds 85%, as stated in the latest ISCIII report.

What are the most suspicious symptoms?

Whooping cough occurs with

attacks of whooping cough

(paroxysmal cough) that usually end in a

long inhalation accompanied by a high-pitched whistling sound

(respiratory stridor, that is, gasping for air).

The clinical presentation varies with age, and in adolescents and adults, the disease is usually mild. In infants under six months, the disease presents a higher risk of complications (

pneumonia and encephalopathy

) and mortality.

It should be suspected in patients with cough in fits of more than 14 days, which may end in stridor

or inspiratory "cough"


How is the infection detected?


diagnosis is frequently delayed

, because its clinical symptoms are generally nonspecific: it begins like a cold.

In infants, symptoms may include

apnea pauses

with and without cyanosis and/or

posttussive vomiting

(caused by continued coughing).

The diagnostic technique of choice is

PCR in aspirate-lavage or nasopharyngeal exudate

, as in Covid. Admission should be considered in infants younger than four and six months or if complications are suspected.

How is whooping cough treated?

Treatment with

macrolides (antibiotic)


B. pertussis

from the nasopharynx and reduces the risk of transmission, as long as it is started within the first 21 days after the onset of symptoms.


cough can persist for up to three months

, because there is no effective symptomatic treatment.

A contact study

should be carried out

, initiating prophylaxis in the straits and reviewing the vaccination schedule, to assess completing the vaccination schedule and/or booster dose.

Suspected, probable or confirmed cases

should be isolated

, avoiding contact with young children (especially those who have not yet received the primary vaccination series) until five days after the start of antibiotic treatment.

People who do not receive antibiotic treatment should be in

respiratory isolation for 21 days from the onset of paroxysmal cough

or until it disappears.