Whooping cough - "100 daily coughs"... Dr. Gergana Nikolova in front of FACTS

In recent days we have been talking a lot about the spread of whooping cough in the country. Because of the many infected children under 1 year old, the Ministry of Health decided to allow the first vaccine to be given a month and a half after birth, and not, as it is now, after the second month. Among the additional measures being discussed is the provision of funds for laboratory tests and additional delivery of vaccines to pharmacies. What happened, how are we coping and what should we do? Dr. Gergana Nikolova, a general practitioner, spoke to FAKTI.

- Dr. Nikolova, where did this whooping cough come from?
- We were in isolation for a long time, we have a very strong anti-vaxxer movement, we have people with missed immunizations, we have a strong migrant flow. People move from one place to another, forced by various events, but their immunization status is not always clear, and individual plans must be made if there are missed vaccines. So there are many things.

- Did we bring whooping cough, or did the disease wake up in Bulgaria?
- It is everywhere, not only in Bulgaria. I would say that thanks to the excellent work of general practitioners, we are relatively little affected by what is happening in our neighboring countries.

- But still, against the background of what was in our country years ago, when we registered 3, 4, 5 to 10 cases a year, is it very different now?
- The fact that we had 3, 4, 5 people a year shows one thing very clearly – in Bulgaria, we have extremely good vaccination coverage, because we have a population that is covered at around 93% with the mandatory vaccinations that have been carried out. At the same time, countries around us achieve 50-60% vaccination coverage. This is the big difference in the number of patients.

- What a person can and should do right now to feel safer, more protected. And how long does the vaccine last, which is given to people who are now about 50 years old?
- In these people, the vaccine was administered a long time ago. Then another type of vaccine was administered - a live vaccine. But I don't see any point in people who are 50 years old starting to get vaccinated right now. I would urge children who have missed immunizations, children who have somehow missed vaccines, and pregnant women in their third trimester to do this. This is the vulnerable contingent. For pregnant women in the third trimester, we recommend getting the vaccine due to the fact that babies who are born can only be vaccinated in the second month. When the mother is vaccinated in the third trimester, the baby is born with the ability to protect itself if it encounters whooping cough before the vaccine is given in the second month. This is the essential thing to do. Otherwise, the big problem is that even now there are children whom we call to come for vaccinations, and they still have a runny nose, are still coughing or collapsed. I have children who are sick all year long and cannot come to be vaccinated.

- How does the child's body cope with the disease, what is different about it…
- Whooping cough, like any bacterial infection, is more severe in children. The reason is that their immune defense is not as strong as it is in a fully developed organism. Children grow up. Every disease – even the flu is more severe in children. It is even more severe in children who are not vaccinated or who are in infancy. You know that with whooping cough, the cough is serious. Whooping cough is also known as the “100 day cough”. The cough is excruciating, very pronounced, patients cannot sleep at night, and suffocation can occur. In younger children, this strong cough can lead to damage to the ribs, to changes in the lung that remain for life. This is the reason why the disease is present in the immunization calendar.

- What is the treatment?
- Whooping cough is caused by bacteria, and it is treated with antibiotics of a certain class for a sufficiently long period of time. When the antibiotic is started at the very beginning, then it has a better effect. We recommend that those children who have a pronounced cough seek the general practitioner, to check their immunization status for any gaps in the administered vaccines. If the child has missed the vaccine, there is currently a plan established in the RZI on how to act on these children. We also have a vaccine at 6 years old, at 12 years old. It is known what vaccine should be given, everything is built. Simply what we are appealing for is to vaccinate the children.