Robert Koch Institute warns of whooping cough even in adults

Increasingly affected adults of whooping cough
Whooping cough (pertussis) is known as a childhood disease, but more adults are also affected by the persistent cough, which can last for weeks to months. The whooping cough does not go unnoticed with them, since the typical strong cough attacks are missing and the symptoms are overall less clear than in children. Adults often show an increased risk of infection because the vaccine protection and the immunity after a persistent illness last only limited time.

"Because of the limited duration of immunity both after natural disease and after complete vaccination, immunized children, adolescents and adults can re-infect again," warns the Robert Koch Institute (RKI) of the dangers of a whooping cough infection later in life. The vaccine protection should therefore be refreshed if necessary, according to the RKI. Two-thirds of all illnesses are found in people over the age of 19 years, which is why "the STIKO recommended since 2009 all adults vaccination with a pertussis-containing combination vaccine at the next due booster dose for tetanus and diphtheria". However, this recommendation has so far been implemented only insufficiently.

Pertussis infections increasingly affect adults. (Image: Coloures-pic / fotolia.com)

In autumn and winter more infections
Pertussis infections are more common in autumn and winter than in the rest of the year, according to RKI experts. They are caused by bacteria of the genus Bordetella pertussis (rarely by related species), which can be transmitted by droplet infection when coughing, sneezing or speaking. After a maximum of three weeks incubation the disease breaks out. In the course of a typical initial infection, flu-like symptoms such as runny nose, mild cough, weakness and only moderate or no fever usually appear. Then there are attacks of coughing (staccato coughing) followed by inspiratory pulling, which is accompanied by the typical wheezing. According to the RKI, this results from the "sudden inspiration against a closed glottis at the end of the seizure."

The cough attacks are often so severe that they accompany the onset of viscous mucus followed by vomiting. At night, the coughing fits are even more common than during the day. Overall, the disease can last for months.

Whooping cough in adults without typical symptoms
Infants often show no corresponding disease, reports the RKI. Apnea (respiratory arrest) is not the only symptom of concern. Also, infants have the highest risk of suffering serious complications. In unvaccinated infants less than six months old, hospital treatment is particularly common and nearly all deaths affect this age group, according to the RKI. In adolescents and adults, the course of the disease is usually less dramatic, but it lacks the typical signs of the disease, so that often remains unrecognized.

Even doctors do not initially think of whooping cough infection in patients who suffer from mild cough for a long time. Therefore, the RKI explicitly refers to the risk of infection in unvaccinated adults. "The vaccination rates must be improved," quotes the news agency "dpa" the infection expert of the RKI, Wiebke Hellenbrand. Although around 95 percent of pre-school children are vaccinated against the so-called pertussis, the vaccination rate among adolescents and adults is much worse.

Refresh vaccinations against whooping cough
According to the RKI, all persons who have not received a pertussis vaccine in the last ten years should be vaccinated if they are part of the health service or community service, women of childbearing age or close household contact persons (parents, siblings) and Caregivers of infants are. It is also important to check the booster dose against tetanus in principle, if necessary, a combination vaccine should be used.

Where no booster vaccinations take place, "one sees very clearly that we have more diagnosed cases in adulthood than in the past," cites the "dpa" the pulmonary specialist Thomas Voshaar of the German Society for Pulmonology and Respiratory Medicine. Therefore, every doctor should think of persistent cough also pertussis. If a whooping cough is diagnosed, the treatment options are also limited. Antibiotics often have little influence on the duration and severity of coughing attacks, reports the RKI. However, a medical relief of the Hustreizes done. (Fp)