The excessive increase in whooping cough cases, observed in recent months in Greece, which have reached “historically high levels (230 within 5 months)” can be attributed both to the low vaccination rates of women during pregnancy, and to the low rates administration of booster doses to the general population, reports the Hellenic Society of Infections.

The disease is characterized by epidemic outbreaks every 4 years or so and answers questions about whooping cough.

What is whooping cough?

Whooping cough is an infection of the respiratory system caused by a bacterium, Haemophilus pertussis (Bordetella pertussis). Whooping cough infection usually has 3 stages. The first stage, which lasts 1-2 weeks, is characterized by a strong runny nose and possibly an atypical, mainly nocturnal, cough. The second stage follows with a duration of 1-6 weeks and intense episodes of paroxysmal coughing. Finally, the decline stage which lasts 2-3 weeks and manifests itself with milder paroxysms of coughing.

How is pertussis spread?

Whooping cough is transmitted airborne by droplets or by direct contact with the secretions of the respiratory system. The incubation period of the disease is usually 7-10 days. Transmissibility among sick unvaccinated persons is estimated at 80%. Patients with whooping cough are contagious from the start of the catarrhal stage and for 2-3 weeks afterwards. Antibiotic treatment reduces transmissibility and eliminates it after at least 5 days.

Why do we worry about whooping cough?

Whooping cough flares up every 4 years or so and is a serious disease especially for infants. In addition to a respiratory infection, it can cause secondary pneumonia, encephalopathy, convulsions, focal neurological symptoms, otitis, dehydration and damage to the ribs from the continuous intense coughing. 90% of deaths caused by pertussis involve infants younger than 6 months.

Can whooping cough be prevented?

Whooping cough can be prevented by timely and complete vaccination coverage of the population. Infants are vaccinated starting at 2 months of age according to the approved vaccination schedule. Adults should get a booster dose of the vaccine every 10 years. A special case concerns pregnant women who must be vaccinated in every pregnancy between 27 and 36 weeks.

How does vaccinating pregnant women help prevent whooping cough?

Administration of a booster dose during pregnancy increases the antibody titer in the mother’s blood. IgG antibodies pass through the placenta to the fetus resulting in the newborn having passive immunity at birth. These antibodies protect the newborn until vaccination begins at 2 months of age.

What does a woman do if she is not vaccinated during pregnancy?

Vaccination at the time of vaccination is beneficial as maternal antibodies can be passed to the newborn through breastfeeding. In addition, booster vaccination of the mother indirectly protects the newborn in case the mother comes into contact with a case. Of course, it should be emphasized that vaccination in the midwife is not an alternative strategy but a necessary solution, as the time that elapses from the mother’s vaccination to the development of a sufficient titer of maternal antibodies (2-4 weeks) leaves the newborn unprotected.

Are there other prevention strategies?

Another way to protect the sensitive group of newborns is the cocooning technique, i.e. the vaccination of the environment that comes into contact with the newborn. This includes parents and extended family, as well as caregivers, cohabitants, and health professionals. This creates a barrier around the newborn that reduces – but does not eliminate – the risk of exposure to the disease.

Does vaccination of pregnant women have adverse effects on the fetus?

Vaccination of pregnant women against whooping cough has been carried out worldwide for decades. Numerous studies have been done and vaccination has not been associated with adverse pregnancy outcomes, birth defects or other problems in the newborn.

Who will prescribe the vaccine for me?

Competent for the prescription is the treating obstetrician – gynaecologist, pathologist, pediatrician, general or family doctor. The vaccine is given free of charge during pregnancy.