Pertussis in newborns: how to recognize it

An insistent cough, which literally takes your breath away and can cause very serious complications in children.

Pertussis is an extremely contagious infectious disease: it is transmitted by droplets of saliva emitted by a sneeze, a cough, or even just talking.

They are at risk of being infected, without any distinction of age, all those who have not been vaccinated (or who are only partially), but also those who have had this disease many years before a new contact with the bacterium that causes it.

However, the greatest dangers are children under one year of age.

Recognizing it at its onset is not always easy but, once the acute phase begins, the intense and frequent coughing attacks, associated with the so-called “inspiratory scream”, make its diagnosis easier.

It’s very contagious, but…

Pertussis is a respiratory infection caused by a bacterium, Bordetella pertussis, which acts through the secretion of four different toxins responsible for the symptoms of this pathology, the most characteristic of which is convulsive cough.

Contagion is more likely in the first phase of the disease (called catarrhal), during which whooping cough is often mistaken for a trivial flu or a bad cold, and is therefore difficult to diagnose.

Once the symptoms have been recognized, and the suspicion confirmed with laboratory analysis of nasopharyngeal secretions, it is however advisable to promptly start antibiotic treatment, usually based on erythromycin.

Unlike other infectious diseases, once you contract the disease, you are not immune forever, as the antibodies produced by the body are able to protect against this bacterium only for a limited period.

Pertussis vaccine is not mandatory

Preventing infection, however, is possible: there is in fact a well-tolerated vaccine, defined as acellular as it consists of fragments of the bacterium Bordetella pertussis.

In Italy this vaccination is not among the mandatory ones, but it is strongly recommended: generally the first administration takes place around 3 months, and is followed by three boosters, respectively at 5 and 11 months and around 5-6 years, which allow you to remain immune over time.

If the parent agrees to add this optional vaccination, a trivalent vaccine is proposed, which also includes those against diphtheria and tetanus (DTPa).

The three stages of the disease

Once in contact with the bacterium, an incubation period begins that can also be quite long: the symptoms can in fact arise even after 2-3 weeks from infection, but usually occur after about ten days.

The disease is then divided into three phases. Let’s see what their respective characteristics are.

Symptoms Duration
Catarrhal phase Symptoms very similar to those of a classic airway infection higher, such as malaise, cold, a mild dry cough and only in some cases fever. As the days go by, the cough becomes more and more insistent. It is At this stage antibiotic treatment is most effective About 1-2 weeks
Paroxysmal or convulsive phase At this stage, the most typical symptom occurs, namely attacks of Very frequent coughs, which almost take your breath away. It is in fact element Distinctive of this pathology the so-called “inspiratory scream”, or the sound emitted to painstakingly catch your breath after these violent coughing, which can also cause vomiting or subconjunctival and nosebleeds In the absence of treatment, this phase can last from a few weeks, up to over two months (in China they even call it the cough of 100 days)
Convalescence phase Coughing attacks tend to subside, becoming less intense and less frequent, and the patient’s condition gradually improves 2 weeks

Dangers for newborns

When newborns, or children under one year of age, are infected by the pertussis bacterium, this pathology can also become very dangerous, and should therefore not be neglected or underestimated.

The greatest dangers are newborns in the first few months of life, when they have not yet received the first dose of vaccine or who are only partially vaccinated: the most frequent complications are due to bacterial superinfections, which can give rise to otitis, pneumonia or bronchitis.

In a small percentage of cases the nervous system is also affected, both because of apnea due to coughing attacks, which do not allow adequate oxygenation in the brain, and for the direct action of toxins released by the bacterium.

It is in these cases that whooping cough can cause permanent neurological damage or even death of the baby.

Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.

The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.

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