Summary
Highlights
Dr. Gary Sy introduces pertussis, also known as whooping cough, noting that the Tagalog term is 'ubong dalit' or 'tus perina.' He highlights the rarity of this disease until recently, largely due to vaccinations. The discussion stems from a recent outbreak declared in Quezon City, with 23 cases and 4 fatalities as of March 21, and rising cases also observed in Pasig. This rise is attributed to a decrease in vaccinations during the 2020-2022 pandemic period.
Pertussis is a highly contagious respiratory tract infection caused by bacteria, specifically Bordetella pertussis. It spreads through respiratory droplets from coughing or sneezing. While often mild in adults, it is a serious illness for infants, especially those under two years old, due to their weaker immune systems. Its former name, '100-day cough,' reflects its prolonged duration.
After an incubation period of 7-10 days (sometimes up to 21 days), pertussis progresses through three stages. The initial stage (catarrhal stage, 1-2 weeks) presents with mild cold-like symptoms: runny nose, low-grade fever, and mild cough. The second stage (paroxysmal stage) involves rapid, severe hacking coughs followed by a high-pitched 'whoop' sound, often leading to vomiting and thick mucus accumulation, damaging the cilia in the airways. The third stage (convalescent stage) is a slow recovery period, with coughing becoming less frequent.
Infants under 12 months who are unvaccinated or incompletely vaccinated are at the highest risk. Adults and teenagers usually have milder cases. Severe coughing can lead to complications in adults like bruised ribs, painful muscles, hernias, and broken blood vessels in the skin or eyes. In infants, particularly those under six months, serious complications include pneumonia, slowed or stopped breathing, dehydration, weight loss, seizures, and potentially brain damage, with pneumonia being the most common cause of death.
Vaccination is the best prevention. The pertussis vaccine (typically combined with diphtheria and tetanus, DPT) is given in a series of five injections starting at 2 months, 4 months, 6 months, and then booster shots around 15-18 months and 4-6 years old. Booster shots are also advised for adolescents and adults, as protection lasts about 10 years. Pregnant women are encouraged to get vaccinated between 27-36 weeks to protect their newborns. Antibiotics can be given as prophylaxis to individuals exposed to pertussis (healthcare providers, pregnant women, infants, immunocompromised individuals, and household contacts) and are effective for treatment, especially if administered in the first few days of symptoms. Common antibiotics include erythromycin, azithromycin, and clarithromycin.