By Evangeline T. Capuno
First, it was in Quezon City. Then, in Pasig. And then in Iloilo. Now, whooping cough – also known as pertussis – is hogging the headlines as outbreaks have become commonplace in Luzon and the Visayas. It will just be a matter of time before whooping cough cases will also be reported in Mindanao.
During the first 10 weeks of 2024, at least 453 cases were already tallied by the Department of Health (DOH). In the previous years of the same period, cases were less than a hundred: 52 cases in 2019, 27 cases in 2020, 2 cases in 2022, and 23 cases in 2023.
Known as “tuspirina” or “ubong-dalahit” in Filipino, the health department describes the disease characterized by the high-pitched sound made at the end of the cough as “highly contagious.”
Pertussis is caused by the bacteria Bordetella pertussis. “The bacteria may be spread through droplets and indirect contact with articles freshly soiled with the discharges of infected persons,” DOH said. Studies have shown that up to 1 in 20 adults with a cough that lasts for more than two or three weeks may have pertussis.
Infants who are infected with pertussis must be monitored regularly to avoid potentially dangerous complications due to lack of oxygen. Studies have shown that half of infants who are infected with the pertussis bacteria require hospitalization. Of those hospitalized, 1-2% are most likely to die from infection.
The US Centers for Disease Control and Prevention said the serious complications of pertussis among infants include brain damage, pneumonia, seizures, bleeding in the brain, apnea (slowed or stopped breathing), and convulsions (uncontrollable, rapid shaking).
Even after starting treatment, infants are at the highest risk of whooping cough-related deaths, pointed out the website, healthline.com.
Older children and adults are likewise to experience complications. These include difficulty sleeping, urinary incontinence (loss of bladder control), pneumonia, and rib fracture.
Children and adults generally recover quickly with early medical intervention.
Managing pertussis
Generally, pertussis is usually treated with antibiotics. “(These drugs) may shorten the period of communicability from 7 days after exposure to 3 weeks after onset of typical paroxysms, to only 5-7 days after onset of therapy,” the health department said.
Pertussis can be prevented by vaccination. The Penta/5-in-1 vaccine, also known as the DTaP/IPV/Hib vaccine, is one of the first vaccines that every infant should have. It is available in health centers throughout the country.
“It’s a single injection which protects them against five serious childhood diseases,” the DOH said.
The five illnesses are diphtheria, tetanus, pertussis (whooping cough), polio, and Hib (Haemophilus influenzae type b).
The CDC recommends vaccination for infants at 2 months, 4 months, and 6 months. Booster doses are recommended to be given after one year old, 4-6 years old, and at 11 years old.
“The effectiveness of vaccines decreases over time,” writes Lindsey Konkel for healthline.com. “Adults who were vaccinated against pertussis as children can get whooping cough as their immunity, or protection against the disease, begins to fade.”
As such, adults are advised to make an appointment with their healthcare provider if they think they may have come into contact with someone with pertussis, even if they haven’t developed a chronic cough.
Stages of illness
Doctors divide whooping cough into three stages, the healthline.com says. These are:
Stage 1: The earliest stage may last one to two weeks. During this time, symptoms are similar to the common cold. A person is highly contagious during this time.
Stage 2: Severe, violent coughing spells develop during this stage. Between coughing spells, people often gasp for breath, salivate, and get teary-eyed. Vomiting and exhaustion may follow severe coughing fits.
This stage usually lasts one to six weeks but may last as long as 10 weeks. A person remains contagious up until about two weeks after the coughing starts.
Stage 3: In this final stage, the cough commences to lessen. A person is no longer contagious at this time. This stage typically lasts two to three weeks. Because the person is more susceptible to other respiratory infections, including common cold, recovery may take longer if other illnesses begin to coexist.
Due to the increasing number of whooping cough cases in the country, the supply of Penta vaccine in the health centers have become limited. But Health Undersecretary Eric Tayag said the department is now doing quick procurement of 5-in-1 vaccines for pertussis.
However, Filipinos have to wait until June this year for the additional doses of vaccines against pertussis to arrive. Once they arrive, the vaccines will immediately be distributed to the affected areas in the country, Dr. Tayag said.
Meanwhile, the Philippine College of Physicians urged vulnerable groups, especially children and the elderly, to wear face masks and get vaccinated against pertussis. – ###
