Yesterday (March 28th) afternoon.
Topic # whooping cough reappearance # Rushing to hot search
Some netizens commented that
I have been coughing for days.
I suspect that I have whooping cough.
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Since the beginning of spring, with the extinction of influenza and mycoplasma, another respiratory disease that has not existed for many years has been mentioned again-whooping cough.
According to the "National Epidemic Situation of Legal Infectious Diseases" published by the National Bureau of Disease Control and Prevention in official website on a regular basis, from January 1 to February 29, 2024, 32,380 cases of whooping cough were reported nationwide, nearly 23 times that of the same period in 2023 (1,421 cases). It is worth noting that among the more than 30,000 cases of pertussis, there were 13 deaths.
Unusual signs have aroused the vigilance of the disease control department. At a recent conference, Shen Hongbing, deputy director of the National Bureau of Disease Control and Prevention and director of the China Center for Disease Control and Prevention, pointed out that "the current prevention and control of whooping cough in China should be paid attention to."
According to reports, adults and adolescents with inconspicuous symptoms have become the main body of infection for infants and young children. Moreover, even though the DTP vaccine (made of pertussis vaccine, diphtheria toxoid and tetanus toxoid, which can prevent pertussis, diphtheria and tetanus at the same time) still maintains a high vaccination rate, pertussis still shows a trend of making a comeback. Academic circles believe that this phenomenon is called "pertussis reappearance"
resurgence）”。
Pertussis is becoming more easily found.
Recently, pediatricians have noticed that there are more and more children with whooping cough in clinic.
Gao Zheng, a pediatrician at Zhuozheng Medical (Shanghai), said that during the period around New Year’s Day, children with clinical characteristics of whooping cough were encountered. "After checking and verifying by targeted sequencing of pathogens, it was found that it was’ whooping cough’ or it would scare us. Because of the clinical history, this child who came to see a doctor is likely to have become a source of infection at this time. "
Yao Ting (pseudonym), director of the Department of Infectious Diseases in a first-tier city children’s hospital, also felt that since last year, the number of children with whooping cough has increased significantly, as has the surrounding prefecture-level cities. Among the patients, the symptoms of older children are sometimes atypical; The baby’s cough is more serious, especially at night, "almost choking with cough."
In fact, since 2014, the incidence of whooping cough in China has shown an upward trend.
Reported incidence of whooping cough in some provinces of China from 2004 to 2019.
(From official website, Chinese Medical Association)
Some disease control people believe that the improvement of testing ability may be an important factor affecting the increase of pertussis prevalence data.
A grass-roots health worker recalled that when he participated in an academic report a few years ago, it seemed that only a few hospitals in a city could carry out the etiological detection of whooping cough. Today, hospitals with a small scale have the ability to carry out the etiological detection of whooping cough. Even if they can’t detect it themselves, they can send it to a third-party institution for help.
Let infants and young children before DTP vaccination
In a high-prevalence environment of whooping cough.
The risk is enormous
Many clinicians said that severe or fatal cases of whooping cough were still concentrated in unvaccinated infants. However, the family cluster disease makes the mode of transmission from adults to infants more and more severe.
Chang Rongshan, an epidemiologist, said that the hidden danger of the change of epidemic characteristics of whooping cough lies in the fact that adolescents and adults with whooping cough often have mild symptoms because of their sound immune system, so it is difficult to attract attention. But it is these neglected teenagers and adults with pertussis that are becoming an important and dangerous source of infection, threatening vulnerable babies.
What are the symptoms of whooping cough
How to treat and care?
Let’s watch it together
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01
What is whooping cough?
Pertussis is an acute respiratory infectious disease caused by a kind of bacteria called Bordetella pertussis. Like other respiratory infectious diseases, whooping cough is transmitted by droplets in the mouth and nose, which is highly contagious. All ages are susceptible to infection, and the course of disease can reach 2-3 months. Please note that whooping cough is a Class B infectious disease and needs to be isolated.
02
What are the symptoms of whooping cough?
The whole course of whooping cough is divided into three stages. For your convenience, let’s list it with a chart.
△ Click on the image to view a larger image.
Some patients with pertussis have relatively mild symptoms and only show cough, but severe cough of infants under 6 months old may cause purple lips, apnea, convulsion, bradycardia or cardiac arrest, so parents and pediatricians should pay more attention to it.
03
What tests do you need to do for the diagnosis of whooping cough?
1.
Blood drawing: "Finger blood" blood routine will increase white blood cells in the early stage, but it cannot be diagnosed. The accuracy of "venous blood" pertussis antibody is high, but the result is slow, which takes 7-14 days.
2. Detection of nucleic acid by nasopharyngeal swab: "poking nose" or "scraping throat" to detect the DNA of whooping cough has high accuracy and quick results, and the report is usually issued in 1-4 days.
3. Chest X-ray: The lung infection caused by pertussis can be detected. Compared with other pathogens, the probability of pneumonia caused by Bordetella pertussis is less.
04
How to isolate whooping cough?
Pertussis is a national legal class B infectious disease and needs to be isolated.
Pertussis is highly contagious. When coughing or sneezing, Bordetella pertussis spreads rapidly with droplets. Patients who have not been treated with antibiotics are most contagious within 3 weeks of onset. Effective antibiotic treatment can shorten the bacteria discharge period.
Isolation period: untreated patients were isolated for 21 days after onset.
Five days after treatment with sensitive antibiotics.
05
I have been vaccinated against pertussis. Why did I get it again?
First of all, the current pertussis vaccine is not durable enough, and most school-age children and adults have passed the vaccine protection period. This is the most important reason.
Secondly, children and adolescents often show chronic cough after infection, and adult cases can not be paid attention to because of atypical symptoms or occult infection, thus becoming the source of infection for infants and young children, making the infection easier to spread.
Although whooping cough cannot produce lifelong immunity. However, vaccination can reduce the risk of severe illness and death, and it is still the most economical and effective means to prevent and control whooping cough, which is very necessary.
06
Does whooping cough really take a hundred days?
That’s not true.
From the three stages of whooping cough, we can see that the first and second stages usually last for four to eight weeks, and the recovery period is uncertain. Most patients can "end the battle" within two months.
Therefore, whooping cough may not last for 100 days, and certainly it will not come to an abrupt end in 100 days, and it needs active treatment.
07
How is the vaccination plan for whooping cough arranged?
China has implemented the planned immunization since 1978. At present, the combined pertussis-diphtheria-tetanus vaccine (DTP vaccine) is applied to pertussis. Infants and children should be vaccinated with one dose of DTP vaccine at 3 months, 4 months, 5 months and 18 months respectively.
Parents, please note that at present, the DTP vaccine used in China can only be used for children under 7 years old, so there is no vaccine for preventing pertussis for adolescents and adults aged 7 and above.
08
How to treat pertussis?
At present, oral medication is recommended, and macrolides are the first choice. If macrolides are resistant, compound sulfamethoxazole is recommended.
△ Click on the image to view a larger image.
09
Can it be treated with traditional Chinese medicine?
Sure.
National Health Commission and the State Administration of Traditional Chinese Medicine jointly issued the whooping cough diagnosis and treatment plan (2023 edition), which clearly mentioned the treatment plan of traditional Chinese medicine and shared it with you. Of course, Chinese medicine pays attention to "seeing, hearing and asking questions", and the specific prescription adjustment still depends on face-to-face consultation with Chinese medicine practitioners.
△ Click on the image to view a larger image.
10
How to care at home?
The general principle is: rest more! Less excitement!
1. Environmental care: ventilation, proper indoor temperature and humidity, and avoidance of various stimuli that induce convulsions and coughs.
Avoid scaring and disturbing: the environment is quiet, avoiding unnecessary stimulation, so as not to cause paroxysmal spasm and cough; Less reprimand, more comfort, less excessive attention to spasmodic cough, and avoid patients’ psychological tension.
Avoid odor stimulation: keep the indoor environment fresh and avoid odor stimulation such as smoke and oil smoke.
It is advisable to keep patients in a good mood; Adequate rest should be ensured.
2. Diet care: balance diet nutrition and ensure the supply of nutrition; Eat a small amount and eat more slowly.
Suitable for digestible and non-irritating foods, such as noodles, rice porridge, steamed eggs, etc.
Avoid cold, spicy and greasy food.
Comprehensive gossip, health consultation, @ China CDC, Yan Chai Hospital
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