Long course and highly contagious

　　Whooping cough is an acute respiratory infectious disease caused by Bordetella pertussis. It often manifests as repeated severe coughing, and the course of the disease can last for 1 to 2 months or even longer, so it is called whooping cough.

　　The long course of the disease is the most common perception of whooping cough. Its typical manifestation is paroxysmal spasmodic cough. The cough occurs suddenly and violently, but there are often no obvious abnormalities between attacks. It should be reminded that for infants under 3 months old who have not yet reached the age for pertussis vaccination, the disease is more harmful; this age group can present with sudden suffocation or cyanosis, and may not necessarily have typical cough symptoms. It is easy to be missed or misdiagnosed. Pertussis in young infants is easily complicated by pneumonia, encephalopathy, pulmonary hypertension, and can even lead to death. Currently, the majority of reported severe cases and deaths from whooping cough occur in these young infants. Children younger than 6 months of age and those who have not been vaccinated against pertussis account for a higher proportion of hospitalized pertussis cases.

　　Whooping cough is highly contagious and is mainly transmitted through droplets. In the field of infectious diseases, we often use the R0 value (basic infection number) to evaluate its infectivity. A rough understanding is "how many people can a person infect if he gets sick?" The R0 value of B. pertussis is 12~17, which is comparable to the measles virus (R0 value 12~18) that many parents are dismayed by. This also reminds us that we must pay attention to it.

Adults are not “insulated” from the disease

　　In terms of age of onset, whooping cough is more common in infants and young children, with children under 5 years old having the highest susceptibility rate. However, this does not mean that other age groups are completely "insulated" from the disease. Clinically, it has been found that adolescents and adults can also suffer from whooping cough. Moreover, because the symptoms are mild and atypical, many people do not realize that they may have whooping cough, and due to neglect of precautions, they unknowingly become potential sources of infection, ultimately leading to an increased risk of infants contracting whooping cough.

Antibiotics of choice for treatment

　　For a long time, macrolide antibiotics such as erythromycin and azithromycin have been the first choice for antibacterial treatment of whooping cough. It should be noted that the current domestic pertussis pathogenic strains are seriously resistant to macrolides such as erythromycin, and the bacterial clearance effect of clinical antibacterial treatment is not as good as before. Immunization is a very important measure to ensure that vaccinated children do not become seriously ill or die. Therefore, prevention is the best and planable early treatment option.

　　Author: Beijing Children's Hospital Affiliated to Capital Medical University

　　Yao Kaihu, researcher at Beijing Institute of Pediatrics

　　Review: Experts from the National Health Science Popularization Expert Database

　　Wang Quan, chief physician at Beijing Children's Hospital Affiliated to Capital Medical University

　　Planning: Wang Ning

　　(Healthy China WeChat public account)