Whooping cough | Pregnancy, getting vaccinated or not getting vaccinated?
- POR Rubèn Baltà
- ME GUSTA
Whooping cough is a global health problem. It has been observed an increase in the number of cases. Furthermore, the infants end up in the hospital, have severe complications or even die at higher rates.
TRANSMISSION OF THE DISEASE
It has a high power of infectivity, with an attack rate of the 80% (in a susceptible person)
It is transmissible through the air, it reaches its maximum cycle before the appearance of the symptoms and it lasts two weeks after the clinical picture.
The incubation period is normally 7-10 days (range of 4-21 days).
There are 3 stages:
+ Stage 1 catarrhal: The most infectious, typically persists for 1 to 2 weeks and it’s indistinguishable from a common cold.
+ Stage 2 paroxysmal: onset of typical symptoms as paroxysmal cough access, sometimes followed by posttussive vomiting.
+ Stage 3 convalescent: temporary remission of symptoms that may be exacerbated by new respiratory tract infections.
In infants younger than 3 months have the highest risk for severe and life-threatening complications and death. About 75% of the cases in infants younger than 6 months need to be treated in hospital.
Based on using macrolides (erythromycin, azithromycin and clarithromycin), the treatment is more effective during the catarrhal stage. Intensity of the clinical picture, duration and contagiousness tend to diminish. Nevertheless, it has little effect on clinical and it is null if administered 2 weeks after the onset.
+ Maintain high rates of vaccination coverage in children, adolescents and adults and diminish the exposure in infants.
+ Eliminate the bacteria Bordetella pertussis (which causes Pertussis) from the potential contacts with chemoprophylaxis (early administration of macrolides).
The current timetable is at 2,4 and 6 months of life. Boosters at 15-18 months and 4-6 years.
A rising prevalence of whooping cough has been observed during the last years. Furthermore, it has been shown that 50% of infants with whooping cough contract the illness by contact with family members, mainly the mother. Vaccinating the mother and the main contacts protects the smallest and may reduce significantly the risk of exposure of the infant. Furthermore, the antibodies pass through placenta provides a passive protection against whooping cough in the first 6 months of life.
VACCINES DURING PREGNANCY
+ The most recent researches show that vaccination against whooping cough (DTaP) is advisable 1 week before giving birth and vaccination in the next pregnancy will be needed to ensure appropriate antibody levels in the infant.
+ The data collected by the European Center for Disease Control and Prevention indicates that has an effectivity of the 91% if administrated 7 days before giving birth.
+ Recommendations indicate that should be adequate to vaccine between 28 to 32 weeks of pregnancy.
Which are the recommended vaccinations during pregnancy and which are not?
+ Flu vaccine: 3rd trimester. It has high level on safety.
+ DTaP vaccine:
* Anti-Diphtheria: Diphtheria is considered a serious illness. Getting vaccinated during pregnancy the antibodies will pass back to the baby and will keep it protected before and after birth.
* Anti-Tetanus: focused on the protection of the mothers, especially the ones living in rural areas. Moreover, the antibodies pass back to the baby and will protect him even 6 months after birth.
* Anti-Pertussis: prevents the respiratory infection of the newborns during the first months of life. This infection can be severe or fatal in infants.
Basically are the ones that contain live attenuated viruses
+ Yellow fever
+ Oral polio
+ Anti- Chickenpos
Licenciado en Medicina y Cirugía por la UAB.
Especialista en Ginecología y Obstetricia por el Hospital Universitario Son Espases.
Apasionado del mundo de la salud de la Mujer tanto en los temas de la Ginecología, Obstetricia y Reproducción.
Intentando siempre innovar, cargado de energía y motivación.