Patients most affected by whooping cough are children between the ages of 10 and 14 years. The Catalan Pediatric Society requires a reminder dose at 14 years of age: within Spain, it is only given in Asturias (at 13 years of age).
“Sometimes we see a cough that is not typical for whooping cough and we have to do a PCR test and give antibiotics in case of whooping cough, because the result takes about five days,” explains Carlos Losana, pediatrician at CAP Poblenou. “Since children and adolescents are vaccinated, the picture is not typical, and sometimes you are surprised: a cough that you thought was due to a cold, when you do a PCR for being in contact, you see that the child has whooping cough. In other cases, there is suspicion,” Lusana says. “Very high because the cough is quite suggestive.”
In addition to the pertussis epidemic, the joint task forces are also seeing “a fair number of cases” of bronchitis and viral respiratory diseases, as well as bacterial pneumonia. “Pertussis complicates the diagnosis of other respiratory viruses,” he says. “And you can see the increase in work these weeks.” The initial stage is to prescribe a larger amount of azithromycin than usual, which is easy to take: one dose daily for three to five days, depending on the regimen chosen, Dr. Losana says.
For her part, the President of the Catalan Pediatric Society, Anna Gatel, points out that since the reminder dose for whooping cough is given at six years of age (after doses at 2, 4 and 11 months), antibodies decrease. Once the child reaches the age of ten. This is why the group between the ages of 10 and 14 is the group that “remains completely unprotected.”
Therefore, the Catalan Pediatric Society requires that another reminder dose be given at the age of 14 years, something that only Asturias in Spain does, at the age of 13 years. Although whooping cough does not usually lead to “complications” (“only in young children”), it is certainly “underdiagnosed,” Gatell believes.
Viruses last longer
“We have a lot of activity. It's not whooping cough that stresses us out in the long run, it's digestive illnesses, like vomiting and diarrhea, and respiratory illnesses, like influenza, Covid, or respiratory syncytial virus,” says Chaffee. Cantero, family doctor at CAP Igualada Urbà. Cantero points out that the feeling among the medical community is that viruses have been around “much longer” than in other years. He points out that “Covid overshadowed other viruses for three years, and now we see everything, and everything becomes longer.”
As happened in March 2020 with Covid (the Udena Basin was the first Catalan region to self-isolate), this time Igualada was the first region affected by a whooping cough outbreak. Along with Valles Oriental and Valles Occidental, Central Catalonia is currently the region most affected by the disease.
The family doctor concludes, “We are still seeing the same cases as a month ago. It is a fairly persistent cough that causes a feeling of shortness of breath and can be accompanied by a sharp voice in the patient.”
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