It is well known that pertussis put baby in danger. Vaccination has stopped the epidemics of whooping cough. But there is still room for improvement … especially for adults.
On the paper, the indices are precise: dry cough for more than fifteen days, fifths hindering the recovery of the breath and causing vomiting, all on bottom of “song of the cock”. In fact, it’s a lot more complicated. “The rooster’s rooster has given its name to pathology, but does not occur systematically. No more than vomiting or breathing difficulties. In addition, especially in babies under six months, cough is rarely characteristic, “says Dr. Andrés Pascual, co-head of the pediatric department of the Hospital Group West Lake Geneva (Ghol) in Nyon.
So, what to do? “To consult as soon as the cough becomes disabling, that it prevents from drinking or to eat properly, that it is associated with respiratory difficulties or when it lasts for more than fifteen days”, advises the specialist. First step led by the pediatrician or general practitioner: clinical examination and research of the contagious track if a loved one presents similar symptoms.
With each cough his remedy
Dry or oily, acute or chronic, coughs hide multiple origins to very specific remedies. Details of the causes of the most frequent fifths in children with Dr. Anne Mornand, a doctor in pediatric pneumology at the University Hospitals of Geneva (HUG).
INFECTIOUS COUGH | In the grip of a virus, the upper respiratory tract (ENT sphere) triggers a dry cough that can last for several weeks. The remedy: washing the nose with saline several times a day, especially before bedtime, and drops decongestant if the nose is clogged.
ASTHMA | The cough is dry, recurrent, often accompanied by a hissing sound, sometimes audible to the ear or auscultation, and difficulty breathing. Triggered by a virus, sports activity or exposure to an irritant, asthma is treated by bronchodilators and, if necessary, inhaled corticosteroids.
CHRONIC FATTY COUGH | Certain pathologies generate a fatty cough allowing to evacuate the mucus. But the episodes must remain punctual. In case of persistence over several weeks, it will be necessary to look for a more complex pathology, such as cystic fibrosis or dilatation of the bronchi.
Stalking the bacteria
If the signs suggest a case of whooping cough, it will be necessary, in most cases, to carry out a PCR (Polymerase Chain Reaction). Based on the collection of nasopharyngeal secretions, the technique reveals in a few days the presence of one or other of the bacteria causing pertussis : Bordetella pertussis (the most common) or Bordetella parapertussis. Except in cases of complications, the following is usually an antibiotic. To annihilate the bacteria present, of course, and, more surprisingly, to protect the patient’s entourage. “The prescription of antibiotics, especially in adults, is mainly done to shorten the duration of the infection and prevent the spread of this highly contagious disease,” says Dr. Pascual. On the side of the infected person, the improvement is generally already in progress: the bacterium involved disappears of itself in about three weeks. “Whooping cough, an ordinary microbial disease only very contagious? Not exactly, at least not in babies. If the epidemic affects each year around 10,000 people in Switzerland (with great variations depending on the year), you must know that one in 1000 children can succumb to it. The reason? “Coughing can be very violent and impede breathing. In infants, the disease can lead to respiratory arrest, says Dr. Pascual. There are also risks of complications such as pneumonia, seizures and brain damage. ”
In the youngest age, the cough is such that it can also prevent eating, drinking, sleeping. She ends up exhausting the little patient. The follow-up of infants with whooping cough is therefore particularly strict: “In parallel with the antibiotic treatment, any sign of dehydration, lack of oxygen in the blood or weakening warrants hospitalization to allow adequate care and supervision” says Doctor Anne Mornand, a doctor in pediatric pneumology at Geneva University Hospitals (HUG).
There is the flaw: vaccination. “Young children are the most vulnerable to whooping cough, but adults are often the ones who spread the disease,” says Dr. Pascual. Involved vaccines that are out of date. If no vaccine is strictly mandatory in Switzerland, the recommendations are strong on the side of the Federal Office of Public Health. For whooping cough, the schedule is precise: vaccination at 2.4, 6 months of life, then recall between 15 and 24 months, between 4 and 7 years, between 11 and 15 years, then between 25 and 29 years. Finally, the administration of a new dose is strongly recommended in any pregnant woman who has not received a vaccine for at least five years and in persons working with young children if the last booster is more than ten years old. In 2014,
Wait, moisturize and consult
Faced with her child with intense coughing, we dream of one thing: the magic syrup that will be able to stop the fifths in a single spoonful. The ideal prescription is much less spectacular. “Most viral coughs go by themselves in two or three weeks,” says Dr. Andrés Pascual, co-head of the Ghol Pediatrics Department in Nyon.
The remedies recommended during this period of time? “Patience and hydration,” says the pediatrician. Few syrups really work and many cough suppressants are to be banned because of their side effects. “As for honey? “Possibly, but not before 1 year of the child and only if the honey is pasteurized. It may have benefits in case of coughs and colds, but the dose to be used has not yet been established, “says Dr. Pascual.
The idea: to bet on a healthy environment – a room not too heated, well ventilated, without source of irritation (cigarette smoke, for example) – and simple gestures – to wash the nose in case of colds, to give to drink very regularly. And of course consult if the cough persists. “Cough is not a disease in itself, but a defense mechanism. The challenge is to find and treat your cause, “says Dr. Anne Mornand, a physician in pediatric pneumology at HUG.