PETALING JAYA: It starts like a common cold – and can lead to death. Whooping cough is on the rise, with 23 deaths up to August this year, out of 329 cases.
Also known as pertussis, it is highly contagious. One infected person can infect up to 17 people.
“Pertussis spreads easily mainly through droplets produced by coughing or sneezing. The disease is most dangerous in infants, and is a significant cause of disease and death in this age group,” the World Health Organisation (WHO) said.
It said more than 151,000 cases of the disease, caused by a bacteria Bordetella Pertussis, were reported in 2018 alone.
Beginning with nasal congestion, a runny nose, red and watery eyes, a mild fever and a dry cough, the symptoms, if left unchecked, could be a precursor to pertussis or the whooping cough.
“Pneumonia is a common complication, and seizures and brain disease occur, but rarely,” it added.
WHO said infected patients are most contagious for up to three weeks from the onset of the cough.
Infected children would usually have coughing spells, which last between four and eight weeks, and antibiotics are used to treat the infection.
WHO said that while immunisation was one of the most successful public interventions against pertussis, the Covid-19 pandemic had brought setbacks to the diphtheria-pertussis-tetanus (DTP) immunisation coverage.
“However, from a global perspective, recovery is on the horizon. In 2022, DTP immunisation coverage has almost recovered to 2019 levels,” it said.
General paediatrician Dr Ruzanna Saihani said there were three stages to pertussis – the catarrhal stage (one to two weeks), paroxysmal stage (two to eight weeks) and the convalescent stage.
In the catarrhal stage, pertussis is similar to a viral upper respiratory infection with mild cough, low grade fever and coryza, which present symptoms such as a runny nose.
The paroxysmal stage causes a cough that is very distinctive from regular coughs. The coughing spells increase in severity and there is difficulty in expelling thick mucus.
“This may cause a child to gag and appear to be struggling for breath. Long inhalation efforts are accompanied by a high pitched ‘whoop’ at the end of paroxysms.
“The patients may also be vomiting, with the paroxysmal attacks usually occurring at night which can go up to 15 attacks per day.
“During the convalescent stage, the cough subsides over several weeks to months,” she said.
Consultant paediatrician and Immunise4Life programme technical committee chairman Datuk Dr Zulkifli Ismail said pertussis causes prolonged severe coughs and has complications.
“There are also complications related to the coughing bouts like rib fractures, pneumonia, convulsions or encephalopathy (inflammation of the brain),” he said.
“Sleep is also disturbed. Encephalopathy, although rare, can lead to mental retardation,” he added.
