Questions and answers about whooping cough

The death of three babies due to whooping cough in less than a month in Cuenca and Andalusia has put the focus on a disease that was believed to be controlled. The three victims, a girl who died in September at the Virgen del Rocío Hospital in Seville, a child who did not survive the infection at the Maternal and Child Hospital of Malaga on October 20 and another baby from Cuenca who died that same month but whose death has transpired today, had not been immunized since they had less than two months , age established in the vaccination schedule to receive the first dose of the vaccine.

These new cases are the result of the resurgence of the disease in recent years that had already warned the Spanish Association of Pediatrics (AEP), aggravated by the global shortage of the vaccine that has intensified since last summer. The mother of the deceased baby in Malaga had requested immunization when she was pregnant to protect her child (from week 27 of pregnancy, the antibodies pass to the fetus through the placenta), but the vaccine was denied due to lack of availability of the drug. To avoid as much as possible that this happens again, the Ministry of Health today reported the purchase of 60,000 doses of pertussis vaccine to ensure supply in Spain. But why is it crucial to get vaccinated? The AEP answers the key questions about pertussis and its prevention.

Why should a baby be vaccinated against whooping cough?

Although pertussis generally attacks children and young people, infants under three and four months old are the most vulnerable group , since the first dose of the vaccine is not given until two months of age. Babies and young children are more likely to be hospitalized because they are at a higher risk of developing complications. In fact, almost all children under three months and close to 70 percent of those under one year of age need hospital admission when they contract the disease. Complications are the leading cause of death; It is estimated that every year around 15 babies die in Spain due to whooping cough , a figure similar to that of other countries in our area.

How to protect a baby until the first dose of the vaccine is received?

Vaccination of the mother in the final stage of pregnancy, specifically, from week 27 of pregnancy , is the most effective way to protect the newborn; The transmission to the fetus of antibodies through the placenta will protect you until you receive the first dose of the vaccine, which is administered at two and four months of age. In this way both the mother and the newborn are protected.

Is the vaccine safe for pregnant women?

The AEP ensures that pertussis vaccine is safe and well tolerated by pregnant women. This vaccine, known as Tdpa, and which also offers protection against diseases such as tetanus and diphtheria , is an inactivated vaccine, so there is no theoretical risk to either the mother or the fetus .

How to prevent the disease if the mother has not been vaccinated?

Whether the mother has received the vaccine in the last weeks of pregnancy, which is optimal, or if she has not, the AEP advises vaccination of the baby’s environment. Parents, siblings, grandparents and caregivers should be vaccinated at least two weeks before the baby is born. Health personnel in contact with the infant should also be immunized, and different studies have shown that, in up to 83 percent of cases, the source of infection in the infant is a person living in the same home.

How does pertussis affect children?

Mild fever, diarrhea , rhinorrhea and, as the name suggests, a strong cough that can cause vomiting and episodes of asphyxia are the most frequent clinical manifestations of the disease that, in its initial stage, can be confused with a common cold . In general, three phases are established:

• Incubation period : lasts between one and two weeks and is asymptomatic.
• Catarrhal or initial period : lasts two weeks with non-specific catarrhal symptoms such as rhinitis , sneezing, low-grade fever, tearing, mild, dry and irritative cough.
• Period of convulsive or asphyctic state : lasts between four and six weeks. The cough becomes convulsive and makes breathing difficult. Due to these crises, small subconjunctival hemorrhages, petechiae on the face, loss of consciousness, urinary incontinence , rectal prolapse, and so on may occur .
• Period of convalescence or remission : lasts from one to three weeks. Cough crises, also called “fifths”, are becoming less frequent until they disappear.

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