The European Center for Disease Prevention and Control (ECDC) warned yesterday that the number of whooping cough cases in Europe has multiplied by more than ten compared to 2021 and 2022 and that “children under six months of age are the ones “They are at higher risk.” According to ECDC data, Spain is the eighth EU country that has recorded the highest incidence in 2024.
What is whooping cough? Also called pertussis or whooping cough, it is a highly contagious respiratory infection. It was very common, and a major cause of infant mortality, until the introduction of vaccines to prevent it in the mid-20th century. Unlike other common respiratory infections, which are caused by viruses, whooping cough is caused by bacteria. Specifically, from the species Bordetella pertussis.
What symptoms does it cause? Its most characteristic symptom is a persistent cough that can last after the infection has cleared and can last between two and three months. In its initial phase, after an incubation period of between one and two weeks, the symptoms resemble those of a common cold: nasal congestion, cough, sneezing, possible low-grade fever… Infants, the most vulnerable population group, can having difficulty breathing without coughing.
How is it spread? Contagion occurs through the air through droplets that an infected person emits when coughing, sneezing or even talking. A person can be infectious from the onset of symptoms until about four weeks after the onset of cough. After this period, you can no longer be contagious because you have already eliminated the bacteria from the body, although the cough persists.
How serious is it? In adults, the infection is usually bothersome but not serious and resolves within a few weeks. In children under one year of age who are not immunized, or incompletely immunized, it can cause pneumonia, seizures and brain damage. In this age group, whooping cough is fatal in one in every 300 cases, according to data from the US Centers for Disease Control and Prevention (CDC). In Catalonia, 22 people have been hospitalized for whooping cough in the first three months of the year, of which sixteen were under one year old, the Health Department has reported. Four have needed admission to the ICU.
How to protect young children? “Vaccination is the best defense against whooping cough,” declares Antoni Trilla, epidemiologist at the Hospital Clínic in Barcelona. In Spain, the vaccination schedule provides for babies to receive three doses at 2, 4 and 11 months, and a fourth dose at six years. The pertussis immunogen is part of the DTPa vaccine, which also protects against tetanus and diphtheria. To protect newborns during the first weeks of life, pregnant women are advised to get vaccinated to transmit antibodies to the fetus through the placenta. “It is the way to protect newborns against a serious disease against which, otherwise, they have no defense,” says Trilla. In Spain, 88.5% of pregnant women were vaccinated in 2023, the highest rate recorded by the ECDC.
Do you have treatment? Since it is an infection caused by bacteria, it is treated with antibiotics. For treatment to be effective, it should be started as soon as possible after the onset of symptoms. Antibiotics are not recommended if the cough has started more than three weeks ago since, in that case, the body has most likely already eliminated the infection. There are no specific treatments for coughing fits from whooping cough.
How do I know if the cough I have is whooping cough? “You can have a cough for many reasons and the majority of people who have a cough do not have whooping cough,” reassures Antoni Trilla, from the Clínic hospital. “But if you have a recent cough that lasts for weeks, or if there has been a case of whooping cough in our environment and we start to have a cough, then it is advisable to consult a doctor or nurse.”
How many cases are there now in Spain? It is impossible to know because the vast majority of cases go undiagnosed and unreported. According to ECDC data, 91 cases per million inhabitants have been registered in Spain in February 2024. This figure does not report on the real incidence of infection, but it allows us to compare the current situation with that of previous periods (it is the highest figure). high in recent years) and with that of surrounding countries (it is higher than those of Portugal, France, Italy or Germany). “It is a very high number, it means that we have many cases,” Trilla assesses.
Why are cases increasing? The incidence of whooping cough usually increases cyclically every three to five years. The phenomenon is attributed to the fact that the population’s immunity drops after several years with few infections, which creates the conditions for the bacteria to re-emerge. The figures currently recorded in Europe are close to those recorded in 2016 and 2019. Since then, measures to prevent respiratory infections during the pandemic may have favored less transmission of whooping cough and a greater decline in herd immunity .
Will infections decrease soon? “It is an endemic disease that is transmitted throughout the year, but especially in spring and early summer,” reports Fernando Moraga-Llop, from the Spanish Association of Vaccinology. Therefore, the current epidemic wave, which began in autumn 2023, is expected to continue for a few more weeks.