Whooping cough symptoms and treatment. Symptoms of Whooping Cough in Children and Basic Treatments

Whooping cough, caused by the bacterium Bortadellapertussis, begins like a typical cold with a cough. Most often this happens in late winter or early spring. Over the course of several days, the cough becomes progressively worse, and eventually the child begins to have coughing fits. During such attacks, the child becomes difficult to breathe, his face becomes red or purple. Quite often the attack comes to an end with vomiting. Feature: convulsive cough, consisting of a series of coughing shocks in one breath, following without interruption one after another; then inhalation occurs, which has a whistling sound. Attacks are repeated mainly at night. (In infants, nine or more shocks in one breath can cause suffocation and death. Attacks take place in a cool room or in the air, so in the old days, sick children were constantly taken out into the street. If you make a mistake in diagnosing and treating such a cough with warming, you can kill a child (There is ample evidence that the whooping cough pathogen in an airplane is killed by rapidly crossing space at high altitude.)

During attacks, a characteristic barking sound is heard - this is the second stage of whooping cough, which can last for weeks or months. Coughing exhausts the child, increasing his susceptibility to other infections.

One of the preventive measures to prevent this disease is vaccination. The abbreviation DTP stands for pertussis, diphtheria and tetanus vaccine. Because vaccines sometimes cause serious complications, including brain damage and death, many parents refuse to vaccinate their children. Also, the vaccine is not 100% effective, so whooping cough may be more common than expected. Not all children who get whooping cough become so seriously ill. An important factor is the immunity of the child. The younger the child, the higher the chance of complications. They are especially common in children under 3 years of age.

Whooping cough is spread primarily through droplets of saliva that are expelled when coughing and sneezing. If your child has been in contact with someone who has whooping cough, start preventive treatment(The incubation period of the disease is from 2 to 15 days. - Ed.). Thus, you will reduce the severity of the disease. It's time to strengthen the immune system and start taking antimicrobial herbs before the onset of the catarrhal stage of the disease. Antibiotics have practically no effect on the causative agent of the disease, and coughing is caused by substances that are released from dead bacteria. However, the use of medications helps to avoid secondary infections such as pneumonia. Older children and adults can do without antibiotics, but small and weak children should not refuse them.

AT Chinese medicine whooping cough is called the hundred-day cough, and there is also a description of it as a disease called "enlightening cough". It is believed that this disease leads the child through spiritual trials, from which he comes out more calm and patient.

Many parents whose children have been ill with whooping cough confirm this. Perhaps whooping cough and other diseases occur against the background of some mental and spiritual causes that we are not aware of. Nevertheless, whooping cough torments and exhausts both the child and the parents, who at all times must keep him well and try to reduce the frequency and severity of coughing fits. Although whooping cough is rarely life-threatening, it is very debilitating in children.

The causes of death are complications - pneumonia, encephalopathy, hemorrhages in the membranes and the substance of the brain.

WHEN TO SEEK MEDICAL HELP

In young children, coughing can cause choking. If you see that the child is ill, immediately call " ambulance».

During whooping cough, there are times during the day when your presence is sorely needed by the child. He needs support during attacks, although he may feel fine between them. If there is no strong wind, the child needs to walk in the fresh air. If you are the primary caregiver for your child, make sure you have time to rest. In such cases, it is better to sleep in the same room with the child or even in the same bed - then both yours and his sleep will be more peaceful.

Note that a child who has had whooping cough may develop a barking cough during a common cold. This is normal and does not mean a return of the disease. After whooping cough remains strong immunity.

The most common cases of whooping cough are children of preschool age.

The disease is called whooping cough because it is caused by pertussis bacteria that attack the inner surface respiratory tract(bronchi and bronchioles), causing their severe inflammation and narrowing. The characteristic symptom is a severe cough. If the infection is not recognized in time, the bacteria can spread to people in close contact with the infected person through its secretions.

Children under one year of age are at high risk of developing whooping cough into severe breathing difficulties and life-threatening forms of the disease. Since the child has difficulty breathing, he takes deep, quick breaths between coughing fits. During breaths (especially in older children), you can often hear a noisy sound - that is why the disease got its name (whoop in English means “cry”, cough - “cough”.). During a strong cough, pertussis bacteria are released into the air, as a result of which the disease spreads to other people who are susceptible to infection.

Symptoms and signs of whooping cough in children

The first manifestation of the disease is a cough. There is a runny nose of a mucous nature. It is at this time that the child is most contagious.

Gradually the cough gets worse. During this period (lasting 2-3 weeks) spasmodic coughing attacks are observed, which are a hallmark of whooping cough. They consist of reprises - a series of successive exhalations in the form of separate respiratory shocks and a convulsive whistling breath. The inhalation is followed by an exhalation, consisting of jerky movements. At the time of the attack, the child is in a state of excitement. On the sclera and conjunctiva of the eyes, petechial hemorrhages may occur, lacrimation appears, the tongue protrudes, does not fit in the mouth. In infants, respiratory arrest often occurs, as well as convulsive twitching of the muscles of the whole body at the height of the attack. In young children, the cough may simply be persistent; as a rule, it is accompanied by vomiting. This cough can last 3-4 weeks. Complications of whooping cough are false croup, bronchitis. From straining when coughing in young children can form umbilical hernia. If you find signs of whooping cough in a child, you should consult a doctor to avoid complications. With whooping cough, an extremely high leukocytosis up to 20 X 109-70 X 109 / l is often found in the blood, as in blood cancer.

Often, for a week or two, whooping cough manifests itself as a common cold. After this, the cough gets worse, and older babies may start to have a characteristic “noisy sound” when they inhale. During this stage (which can last for two weeks or longer), the child often becomes short of breath and may develop blue around the mouth. He may also develop tearing, increased salivation, and vomiting. Babies with whooping cough feel exhausted and develop complications such as susceptibility to other infections, pneumonia, and seizures. For some babies, whooping cough can be fatal, but the baby usually gets better in 2-4 weeks. The cough may persist for several more months and recur with subsequent respiratory infections.

The onset of the disease is gradual, the course is cyclic. The catarrhal period lasts 1-2 weeks, in vaccinated and adults it can be extended up to 3 weeks, in children under 6 months it is shortened to 3-5 days. The only symptom is an unproductive, often obsessive cough, especially at night and in the evening. Gradually, the cough takes on a paroxysmal character, which marks the transition of the disease into a spasmodic period. Coughing fits acquire a characteristic pattern: during one exhalation, a series of 5-10 coughing shocks follows, then a breath whistling due to a spasm of the glottis follows - a reprise. An attack may be preceded by a sore throat. During an attack, hyperemia and cyanosis of the face appear, the cervical veins swell, sweating increases. The attack ends with the separation of viscous mucous sputum, in children it may be accompanied by involuntary defecation and urination, often vomiting. After an attack, apnea may develop. Hemorrhages in the sclera are possible. The face becomes pale, puffy. With percussion of the lungs, a box sound is determined, breathing during auscultation is hard. Patients have disturbed sleep, they become irritable. In mild cases, this period may be absent.

According to the severity of the course, the disease varies from erased, mild to severe forms. With an erased form, a long dry cough is observed, which intensifies at night without characteristic attacks. At mild form disease, the frequency of attacks does not exceed 15 times a day. With a moderate form, the frequency of attacks is 25 times a day, the catarrhal period can be shortened to several days. Outside the attack, signs of hypoxia are observed: cyanosis of the lips, tachycardia, hemorrhagic manifestations are possible.

In a severe form of the disease, the frequency of attacks is 30 times or more per day, the catarrhal period is shortened to 3-5 days. Sleep and appetite are disturbed. Coughing attacks are long, often accompanied by apnea. Shortness of breath, cyanosis, signs of encephalopathy are noted.

Of the complications, bronchitis and pneumonia caused by secondary flora are most often observed. They are characterized by the appearance of fever, intoxication, purulent sputum and corresponding radiological data. Encephalopathy is characterized by the development of convulsive syndrome, loss of consciousness.

Whooping cough begins with symptoms of an acute respiratory illness: not high temperature, dry cough, runny nose, sneezing. Gradually, within two weeks, all symptoms, except for cough, disappear. And the cough, despite the treatment, does not decrease, but, on the contrary, intensifies. In the future, it manifests itself in the form of attacks that occur mostly at night.

Cough with whooping cough is the most important sign on the basis of which this disease can be suspected.

Gradually, the attacks become less frequent and eventually the cough disappears.

When Should You Call Your Pediatrician?

Whooping cough infection begins to show up as a common cold. You should suspect a child who may have whooping cough if they have one of the following conditions:

baby in early age who does not yet have all the vaccinations, had contact with a person who has a chronic cough or this disease;
the child's cough becomes stronger and more often, or the lips and fingertips turn blue / darken;
after bouts of coughing, the child feels exhausted, eats poorly, sometimes vomits and/or looks sick.

Diagnosis in children

Diagnosis is based on the presence of paroxysmal persistent cough in the absence of fever, intoxication. Great importance has, contact with the patient, lack of data on vaccination, a characteristic blood picture (hyperleukocytosis up to 30-40x109 / l and more, lymphocytosis). The diagnosis can be confirmed by bacteriological examination of mucus from the posterior pharyngeal wall, and positive results most often obtained in the catarrhal period of the disease.

Differential diagnosis is carried out with diseases accompanied by persistent cough: ARVI, especially rhinosincitial infection, mycoplasma infection, ornithosis, bronchitis, tracheitis.

Treatment of whooping cough in children

The baby needs a special treatment:

if there is no temperature, doctors recommend long walks in the air;
the room where the baby sleeps should be ventilated more often, the air temperature should be maintained slightly lower than usual;
It is better to feed the child little by little, but often with more high-calorie foods.

It's believed that the best remedy whooping cough prevention - vaccination (DTP vaccine). Children under 6 months of age are given anti-pertussis immunoglobulin.

Most infants under six months of age with whooping cough, and slightly less than half of older children, are initially treated as inpatients. This more intensive care reduces the likelihood of complications. Complications can include pneumonia, which occurs in up to 25% of children with whooping cough before the age of one.

In the hospital, your child may need to suck out thick secretions. Doctors will monitor his breathing and he may need supplemental oxygen. For several days, the child is isolated from other patients to avoid the spread of infection.

Whooping cough is usually treated with antibiotics for two weeks. This treatment is most effective if started early in the illness, before the coughing fits begin. Antibiotics may prevent the spread of whooping cough, but they cannot prevent or cure the cough itself. Because cough medicines can't stop your child from having seizures, your pediatrician may recommend other home remedies for cough control. Use a humidifier with cool water to help soothe your child's inflamed lungs and airways. In addition, the humidifier will help thin the secretions of the respiratory tract. Ask your pediatrician how best to drain these secretions and make your child's breathing easier. Also ask your doctor if the rest of the family needs to take a course of antibiotics or active immunizations to avoid getting the disease.

Children under 1 year of age, as well as all patients with whooping cough complications, are hospitalized. In other cases, you can treat the patient at home. Cool, fresh air is needed in the room where the patient is located. Eliminate all possible irritants that could cause a coughing fit. It is recommended, in addition to antibiotics, to use a specific antipertussis gamma globulin, antiallergic drugs are prescribed.

Immunity after whooping cough is unstable, so re-infection is possible.

With whooping cough, the cough is accompanied by a loud characteristic sound, which was the reason for this name of the disease. In French, whooping cough means "cock crow".

Traditional medicine for whooping cough in children

At the beginning of the course of the disease, it is better to simplify the diet: cook cereals, steamed vegetables, soups. Add small amounts of legumes chicken meat and fish. If the course of whooping cough is prolonged and greatly weakens the health of the child, protein food is necessary to maintain vitality. In the first stages of illness, do not force the child to eat a lot if he is not hungry. Loss of appetite is a completely natural reaction of the body.

If the appetite does not improve over time, you can give the child a few drops of dandelion root tincture or agrimony to stimulate feeding activity. Dilute 10-20 drops of tincture in warm water. This solution is taken several times a day until appetite appears. During illness, you need a warm drink, fortifying teas and decoctions.

If you suspect that your child has contracted whooping cough, start herbal treatment right away. Combine several different items.

Homeopathic remedies. Homeopathic remedies are easy to use. Usually children like to suck on sweet pills. For whooping cough, homeopathic aconite 6x or 30x and homeopathic belladonna 6x or 30x can be used. The homeopathic remedy Pertussin 30x is especially useful for coughs. The usual dose is 3-5 pills every 2 hours in severe cases and 4 times a day when improved. If after a few doses you do not notice any improvement, try another homeopathic remedy.

Echinacea. Give echinacea in tincture form but 20-60 drops every few hours for acute stage and 10-30 drops 3 times a day in the recovery period.

Vitamin C. This vitamin can be given at 250-500 mg 2 times a day. Include foods rich in this vitamin in your diet: leafy vegetables and broccoli, strawberries, rose hips, alfalfa sprouts and lemons.

Garlic. Raw garlic can be given crushed with 1 teaspoon of honey, or you can make garlic lemonade. Let the child eat a few cloves of garlic a day if he does not develop digestive disorders.

Teas. For whooping cough, teas made from chamomile, lemon balm and other soothing herbs are useful.

syrups. Syrups are a concentrated form, so they allow you to give more active ingredients at a lower dose. Due to the sweet taste, syrups are ideal for young children.

Expectorant tea. Red clover flowers have a mild expectorant and antispastic effect. In addition, they purify the blood. Marshmallow root promotes expectoration and reduces inflammation and irritation of the bronchi, lungs and throat.

1 tablespoon dry thyme
1 tablespoon red clover flowers
1 tablespoon marshmallow root
1 liter boiling water 1/4 cup honey

Mix herbs in a glass jar. Pour boiling water, cover and leave for 2 hours. Strain and add honey. Give your child 1 tablespoon to 1/2 cup at a time, up to a total of 1 liter daily

Tonic. When hot, this tonic has a healing effect on inflammation of the upper respiratory tract, and when cold, it is a pleasant summer tea.

2 parts dried red clover flowers
2 parts dry mullein leaves
2 parts coltsfoot
2 parts calendula flowers
1 part lemongrass
1 part rose hips
1 part fennel seeds

Thyme (thyme). The germicidal properties of thyme are especially helpful for lung infections. Essential oils, which give it a characteristic aroma, clear the respiratory tract and alleviate the general condition of the child. Thyme is an expectorant, analgesic, digestive aid. Add thyme infusion or a few drops essential oil in bath water. This is an excellent remedy for young children, as they do not like to drink medicine, but they love to bathe. If necessary, you can give your child a bath 2 times a day.

Rehabilitation treatment. After the worst period of the illness is over, continue to give the child remedies that strengthen the lungs and prevent complications.

OLD RUSSIAN RECIPE

Whooping cough is treated with great celandine (Chelidonium majus L.). This plant is a strong bactericidal, expectorant, antispasmodic and analgesic. It is necessary to observe the dosage and take breaks between doses. Celandine contains toxic substances that in small doses benefit the body, but in case of an overdose they can cause negative sensations.

Whooping Cough Prevention in Children

The best way to protect your baby from whooping cough is to get a DTP shot at two, four, and six months; booster immunizations are given between 12 and 18 months of age and before the child starts school. The DPT vaccine, which is called the "cell-free" type, protects the child's body from diseases such as diphtheria (D), tetanus (C) and whooping cough (AK). The current vaccine causes fewer side effects than those previously introduced. After this vaccine, the child is less likely to experience high fever, general restlessness, and is also likely to be less likely to be at risk of brain damage. The risk of a threat to the condition of the child's body in the case of whooping cough is much greater than the risk of a reaction of the body to the DTP vaccination.

Therefore, the American Academy of Pediatrics urges parents to introduce the entire course to the child. DTP vaccines, but be aware of the adverse reactions of the body that the vaccine can cause, as well as know the health conditions of the child, in the event of which the vaccine cannot be administered.

Severe complications from the DPT vaccine that should alert you and your pediatrician and indicate that further immunizations should not be given include:

an allergic reaction (urticaria or a rash that appears within a few minutes after the vaccine is given, or a state of shock);
an acute severe disorder of the central nervous system occurring within seven days of the administration of the vaccine, which cannot be explained in any other way.

In addition, there are certain adverse reactions that occur after the administration of the DTP vaccine, which serve as a warning for the introduction of subsequent doses of this vaccine. Since these reactions have not yet been proven to cause chronic injury to a child, you and your pediatrician must carefully weigh the risk of adverse reactions against the benefits of further vaccination.

Such adverse reactions serve:

high temperature reaching 40.6 ° C or higher;
constant incessant crying of the child;
manifestation of lethargy or severe pallor of the child;
unusual shrill crying of a child;
convulsions.

In addition to children with the reactions listed, some other children should not receive the initial dose of K-vaccine: any infant with a progressive neurological disorder or a neurological (nervous system) condition should not receive such a vaccine, as this increases the risk of developing a paroxysm.

Fortunately, the number of children affected by these rules is quite small. Don't make the mistake of refusing to vaccinate your child if their health is good. The benefits of vaccination far outweigh the risk of adverse reactions.

whooping cough is infection which is transmitted by airborne droplets. You can get infected only through a sick person - if saliva gets on the mucous membrane of the mouth or nose during coughing healthy person. In open space, the whooping cough bacillus does not survive, so it is impossible to get infected through common household items.

whooping cough - very serious illness manifested by violent bouts of coughing. Whooping cough is dangerous because during a spasm the lumen of the larynx can close and lead to respiratory arrest. Whooping cough is more common in children under 6 years of age, but there are also cases of whooping cough in adults. A few decades ago whooping cough was a deadly disease, it killed a huge number of young children. With the advent of mass vaccination, pertussis patients became less, and the disease became much easier to tolerate. The whooping cough vaccine is administered as part of the general DPT vaccination, and it is she who causes such a reaction as an increase in temperature, a general deterioration in well-being.

Whooping cough, getting into the body, begins to multiply actively. The waste products of this stick poison the body with toxins, which cause a severe cough. I would like to note that the cause of coughing is nerve impulses that are sent to the brain. Cough is not caused by inflammatory processes in the bronchi, so often when listening chest of a patient with whooping cough, the doctor makes the conclusion "Lungs are clean."

How long does the illness last

From the moment a person is infected to the appearance of the first symptoms, it takes from several days to several weeks. On average, the incubation period is one week. Symptoms gradually increase over 5-15 days. This is followed by a period of convulsive spasmolytic cough, which can last a month or more. Then the attacks become rare and not so intense. People say that whooping cough is a disease of a hundred days. This suggests that the disease lasts an average of three months, although often long-term symptoms in the form of a rare cough can last up to six months. Re-infection does not occur - a child who has been ill develops lifelong immunity.

whooping cough symptoms

Whooping cough is very common (especially in early stage development) are confused with SARS, acute respiratory infections, bronchitis and other respiratory diseases. Here are some of the typical symptoms of whooping cough.

Cough. This is the main and main symptom. Often, cough becomes a decisive factor in the diagnosis. A doctor can say for sure by one cough that it is whooping cough. The cough in this disease is debilitating, long, paroxysmal. A baby can have up to 50 coughing fits per day. During an attack, the child coughs incessantly, he does not have the opportunity to breathe. When the child inhales air again, a characteristic whistle is heard, which indicates swelling of the larynx.
During a strong cough, the child may vomit. This is due to excessive irritation of the back wall of the tongue.
In addition, there is a general intoxication of the body. The child becomes lethargic, apathetic, capricious, he loses his appetite.
In the initial stages of development of whooping cough may appear slight temperature, but it rarely rises above 38 degrees.
At the end of a coughing fit, sputum discharge can be observed - viscous, transparent, glassy.
During a coughing fit, the child's face turns red and sometimes even blue. Veins protrude on the neck, in the process of coughing, the frenulum may be damaged, the tongue is exposed during an attack, the whites of the eyes may turn red from tension.
Coughing fits during whooping cough are quite long, and can last about five minutes.

If a bacterial infection joins whooping cough, complications such as bronchitis, pneumonia, and laryngitis develop. From a strong cough, umbilical or inguinal hernia. But the worst complication is suffocation. Therefore, it is very important to properly treat whooping cough and be able to get rid of a coughing fit.

Whooping cough can be treated both on an outpatient basis and in a hospital - it all depends on the age of the patient and the severity of the course of the disease. If the patient is not even a year old, it is better to remain under the supervision of doctors in order to remove the condition of false croup at the right time and save the child from suffocation.

As drug treatment whooping cough is treated with antibiotics. Antibiotics are selected, the most sensitive to infectious bacillus. As a rule, these are ampicillin, chloramphenicol, aminoglycosides, macrolides. The course of treatment is 5-7 days. It is also very important to introduce a special gamma globulin against whooping cough into the body at the beginning of treatment.

In addition, symptomatic treatment is prescribed. First of all, these are antihistamines. They help relieve swelling of the larynx, which reduces the number and intensity of coughing attacks. In severe cases, a small patient is prescribed antispasmodics to relieve the intensity of coughing at night. Sedatives may also be given to reduce the number of nerve impulses that trigger the coughing fits. When a runny nose and nasal congestion appear, they are used vasoconstrictor drops, to bring down the temperature - antipyretics.

Antitussives and expectorants should not be taken or taken under the supervision of a doctor and with great care. The fact is that such drugs are aimed at removing sputum, that is, they stimulate a cough, which we are trying to get rid of.

The prognosis for patients with whooping cough is favorable. To date modern ways treatments are so effective that death occurs extremely rarely and only in old age. You can survive whooping cough, the main thing is to do it right.

How to relieve whooping cough in a child

Here are some tips to help you shorten the time your child is sick, as well as reduce the duration and intensity of coughing fits.

It is a proven fact that attacks practically do not occur in the open air. Therefore, with a child with whooping cough, you need to walk often and for a long time (if he is in good health).
Be sure to ventilate the room as often as possible to ensure that the child has access to fresh air.
Wet cleaning of the room should be done daily to eliminate the provoking factor - house dust.
When you are sick, be sure to put a humidifier in the room. It will significantly reduce the frequency and intensity of seizures.
In the first days of the child, when there are still signs of intoxication of the body, it is necessary to provide the patient with bed rest. Instead of active games, read a fairy tale to your child, look at books.
Nutrition should be balanced and light. The child should eat often, but little by little. Avoid provoking factors - chocolate, spicy, smoked and fried foods.
If whooping cough is severe, you may need an oxygen mask. But usually this is practiced only in stationary conditions.
For the treatment of whooping cough at home, it is very good to use a nebulizer. This is a device that delivers steam in a concentrated form. When steam is inhaled, the mucosal edema subsides, the attack stops.
It is very important to maintain a calm environment in the house, since any nervous experience, crying, fear or emotional shock can trigger the onset of an attack.
If you get whooping cough infant, it should be left in a dark and cool room, away from provocative sounds and noise. This will reduce the number of coughing fits.
In winter, the batteries operate at full capacity, drying the air in the apartment. This is highly undesirable for a patient with whooping cough. If possible, you need to reduce the intensity of their work or ventilate the room more often and hang wet towels on the radiator.

These simple rules will help you ease the course of the disease and make whooping cough less debilitating.

If a coughing fit starts at night, try to help your child. You can give him a drink of warm water to soothe the mucous. Don't stop taking antihistamines so that the swelling does not increase. In addition, with a strong attack of coughing, you can let the baby breathe in an inhaler - it will become much easier for him. If you don't have an inhaler, get your child into the tub, turn on the hot water, and close the door. Tilt the baby towards the water so that he inhales the hot, wet steam. This will help you get over the cough.

A salt lamp may be helpful against a coughing fit during whooping cough. It is an ordinary lamp, which is covered with a ceiling made of mineral salt. When heated, the salt begins to release special ions that purify the air.

If the child is small, do not take risks - it is better to call an ambulance. A whooping cough attack can cause false croup and the child simply suffocates.

Folk remedies for whooping cough

Unfortunately, folk recipes ineffective against such an insidious and annoying disease. They can only be used in combination with conservative treatment. There are some herbs and preparations that will help reduce spasm, making seizures easier.

The Arnica plant is an herb that helps to stop barking and dry coughs, relieves agitation and spasm. A spoonful of a dry plant should be poured with a glass of boiling water and let it brew for a couple of hours. Arnica decoction should be brewed before night (because it is at night that most attacks occur). Keep the Arnica decoction warm so that if an attack occurs, give it to the child to drink. Usually half a glass is enough for the baby to calm down and fall asleep for at least 2-3 hours.

Here is a recipe for another effective collection against a choking cough. Mix marshmallow flowers, oregano grass, thyme, pine buds, plantain leaves, nettle and coltsfoot in equal proportions. Three tablespoons of the collection to anger with a liter of boiling water and leave for at least 6 hours. Drink a tablespoon every 3 hours, especially at bedtime. Active substances medicinal herbs soothe the mucous membrane of the larynx, relieve swelling, reduce the activity of nerve endings that cause spasm.

Whooping cough is a serious disease. It exhausts the child not only physically, but also mentally. Indeed, due to constant bouts of coughing, the baby cannot sleep normally, gets scared, cries. In this state, the mother must remain calm, follow the doctor's instructions and be an unshakable support and protection for the child. After all, if the mother is calm, and the baby is comfortable, then everything is going as it should. And the calm state of the crumbs reduces the number of spasms and seizures. Remember, prevention is the best protection, vaccinate your children on time!

Video: how to treat cough with whooping cough

Whooping cough

What is whooping cough

Whooping cough- is an infectious disease of the respiratory tract, which is caused by specific bacteria Bordetella pertussis (pertussis bacillus, bacillus Borde-Jangu), characterized by acute catarrh of the respiratory tract and bouts of spasmodic cough.

What provokes / Causes of whooping cough:

The causative agent of whooping cough(Bordetella pertussis) is a short rod with rounded ends (0.2-1.2 microns), gram-negative, immobile, stains well with aniline dyes. Antigenically heterogeneous. The antigen that causes the formation of agglutinins (agglutinogen) consists of several components. They are called factors and are designated by numbers from 1 to 14. Factor 7 is generic, factor 1 contains B. pertussis, 14 - 5. parapertussis, the rest are found in various combinations; for the whooping cough pathogen, these are factors 2, 3, 4, 5, 6, for parapertussis - 8, 9, 10. The agglutination reaction with adsorbed factor sera makes it possible to differentiate bordetella species and determine their antigenic variants. The causative agents of whooping cough and parapertussis are very unstable in the external environment, so sowing should be done immediately after taking the material. Bacteria quickly die when dried, ultraviolet irradiation, under the influence of disinfectants. Sensitive to erythromycin, chloramphenicol, antibiotics of the tetracycline group, streptomycin.

Whooping cough epidemiology
Whooping cough is widespread throughout the world. Every year, about 60 million people fall ill, of which about 600,000 die. Whooping cough also occurs in countries where pertussis vaccinations have been widely practiced for many years. For example, in the United States from 1980 to 1989. There were 27,826 cases of whooping cough, 12% of whom were 15 years of age or older. Probably, among adults, whooping cough is more common, but not detected, as it occurs without characteristic convulsive seizures. When examining individuals with a persistent persistent cough, 20-26% are serologically diagnosed with pertussis infection. The reservoir and source of infection is only a person (patients with typical and atypical forms whooping cough, as well as healthy bacteria carriers). Patients in the initial stage of the disease (catarrhal period) are especially dangerous. The infection is transmitted by airborne droplets. Upon contact with patients in susceptible people, the disease develops with a frequency of up to 90%. More often children of preschool age get sick. More than 50% of whooping cough cases in young children are associated with a lack of maternal immunity and possibly the absence of transplacental transmission of protective specific antibodies. In countries where the number of vaccinated children is reduced to 30% or less, the level and dynamics of the incidence of pertussis becomes the same as it was in the pre-vaccination period. Seasonality is not very pronounced, there is a slight increase in the incidence in autumn and winter.

Pathogenesis (what happens?) during whooping cough:

The gateway of infection is the mucous membrane of the respiratory tract. Pertussis microbes attach to the cells of the ciliated epithelium, where they multiply on the surface of the mucous membrane without penetrating into the bloodstream. At the site of the introduction of the pathogen develops inflammatory process, the activity of the ciliary apparatus of epithelial cells is inhibited and the secretion of mucus increases. In the future, ulceration of the epithelium of the respiratory tract and focal necrosis occurs. The pathological process is most pronounced in the bronchi and bronchioles, less pronounced changes develop in the trachea, larynx and nasopharynx. Mucopurulent plugs clog the lumen of the small bronchi, developing focal atelectasis, emphysema. There is peribronchial infiltration. In the genesis of convulsive seizures, the sensitization of the body to the toxins of the whooping cough is important. Constant irritation of the respiratory tract receptors causes coughing and leads to the formation of a focus of excitation of the dominant type in the respiratory center. As a result, typical attacks of spasmodic cough can also be caused by non-specific stimuli. From the dominant focus, excitation can also radiate to other parts of the nervous system, for example, to the vasomotor (increased blood pressure, vasospasm). Irradiation of excitation also explains the appearance of convulsive contractions of the muscles of the face and trunk, vomiting and other symptoms of whooping cough. Past whooping cough (as well as pertussis vaccines) does not provide lifelong immunity, so repeated whooping cough infections are possible (about 5% of whooping cough cases occur in adults).

Innate immunity due to maternal antibodies does not develop. The probability of infection by contact is 90%. Very dangerous for children under 2 years old.

The contagious period lasts from one week before the onset of cough and 3 weeks after. Since it is difficult to distinguish whooping cough from other infections before the onset of a characteristic cough, within one week, those infected have time to infect their surroundings.

The toxin secreted by the pertussis stick acts directly on the central nervous system, irritates the nerve receptors of the mucous membrane of the respiratory tract and activates the cough reflex, resulting in characteristic bouts of convulsive coughing. If neighboring nerve centers, vomiting occurs (characteristic of the end of a cough attack), vascular disorders (fall blood pressure, vascular spasm) nervous disorders(convulsions).

Whooping cough symptoms:

Incubation period lasts from 2 to 14 days (usually 5-7 days). The catarrhal period is characterized by general malaise, slight cough, runny nose, subfebrile temperature. Gradually, the cough intensifies, the children become irritable, capricious. At the end of the 2nd week of illness, a period of spasmodic cough begins. Attacks of convulsive coughing begin suddenly, manifested by a series of coughing shocks, followed by a deep wheezing breath - a reprise, followed again by a series of short convulsive jerks. The number of such cycles during an attack ranges from 2 to 15. The attack ends with the release of viscous vitreous sputum, sometimes vomiting is noted at the end of the attack. During an attack, the child is excited, the face becomes cyanotic, the veins of the neck are dilated, the eyes are filled with blood, the tongue protrudes from the mouth, the frenulum of the tongue is often injured, respiratory arrest may occur with the development of suffocation. In young children, reprises are not expressed. Depending on the severity of the disease, the number of attacks can vary from 5 to 50 per day.

The duration of the attacks is on average 4 minutes.

The period of convulsive cough lasts 3-4 weeks, then the attacks become less frequent and finally disappear, although the "normal" cough continues for another 2-3 weeks (resolution period). In adults, the disease proceeds without bouts of convulsive coughing, manifested by prolonged bronchitis with a persistent cough. Body temperature remains normal. General health is satisfactory. Erased forms of whooping cough can be observed in children who have been vaccinated.

Complications
Most frequent complication is pneumonia due to whooping cough or a secondary bacterial infection. Other complications include acute laryngitis (inflammation of the larynx) with stenosis of the larynx (false croup), bronchiolitis, nosebleeds, respiratory arrest, umbilical, inguinal hernia. Encephalopathy may also occur - a non-inflammatory change in the brain, which, due to the occurrence of seizures, can lead to death or leave behind permanent damage: deafness or epileptic seizures.

In adults, complications are rare.

Whooping Cough Diagnosis:

A reliable diagnosis in the catarrhal period can be made after receiving the results of bacteriological studies. The basis for the study in these cases is usually epidemiological data (contact with patients with whooping cough, lack of data on vaccinations, etc.). In the period of spasmodic cough, the diagnosis of whooping cough is much easier to make, since typical attacks appear. However, it should be borne in mind that sometimes coughing attacks similar to whooping cough may be due to other causes (adenoviral infection, viral pneumonia, compression of the airways during malignant neoplasms, infectious mononucleosis etc.), on the other hand, whooping cough can occur atypically without characteristic seizures (in vaccinated children, in adults). The main method of laboratory confirmation of the diagnosis is the isolation of the causative agent of whooping cough. The frequency of isolation depends on the timing of the sampling; on the 1st week of the disease, positive results can be obtained in 95% of patients, on the 4th - only in 50%, and starting from the 5th week, the microbe can no longer be isolated. Material from the nasopharynx is taken with a dry swab with immediate inoculation on cups with a selective nutrient medium. The “cough plates” method is also used, in which a Petri dish with a nutrient medium is placed in front of the coughing child’s mouth (at a distance of about 10 cm), held in this position for several seconds to catch 5-6 cough shocks. The inoculation dish was quickly closed with a lid and placed in a thermostat. During transportation, they are protected from cooling (wrapped in paper, cotton wool, a heating pad filled with hot water is placed in the container). However, in terms of the frequency of isolation of whooping cough pathogens, the “cough plates” method is significantly inferior to taking the material with a swab. Serological methods can be used for retrospective diagnosis, as well as in patients with negative results of bacteriological studies. Of the old methods, you can use RSK, RPHA, agglutination reaction. An increase in antibody titers by 4 times or more, as well as high antibody titers (1:80 and above) is considered diagnostic.

Recently, enzyme immunoassay has been successfully used to detect antibodies in serum (class M immunoglobulins) and in nasopharyngeal mucus (class A immunoglobulins). These antibodies appear from the 2-3rd week of illness and persist for 3 months. Differentiate in the catarrhal period of the disease from acute respiratory infections, in the period of spasmodic cough from other diseases accompanied by persistent cough at normal body temperature and the absence of signs of general intoxication.

Whooping Cough Treatment:

Treatment patients are carried out only in a hospital. Patients are provided with special conditions - the ward must be well ventilated, the air must be moistened with special humidifiers, air conditioners or wet towels. Severely ill infants should be placed in a dark, quiet room and disturbed as little as possible, since exposure to external stimuli can cause a severe coughing fit. For older children with mild forms of the disease, bed rest is not required. It is recommended that the patient stay in the fresh air, children practically do not cough outdoors.

Serious attention should be paid to nutrition, it is recommended to give food often, but in small portions. With frequent severe vomiting, intravenous fluids are necessary. For infants, suction of mucus from the pharynx is vital. Of great importance in whooping cough, especially in young children, with severe hypoxia is the widespread use of oxygen therapy (keeping in an oxygen tent).
Antibiotics are used at an early age, and in severe and complicated forms. During the catarrhal stage, erythromycin is the drug of choice.

Antitussives and sedatives should be used with caution or not used at all, tk. the effectiveness of expectorant mixtures and drugs that suppress coughs, as well as mild sedatives, is doubtful. Cough-provoking influences (mustard plasters, banks) should be avoided.

During respiratory arrest, it is necessary to clear the airways of mucus by suction and carry out artificial ventilation of the lungs.

Whooping Cough Prevention:

Vaccination is the only reliable means of specific prevention. Whooping cough vaccines: Pertussis-diphtheria-tetanus adsorbed liquid vaccine; Tetracoccus; Tritanrix (a vaccine to prevent whooping cough, diphtheria, tetanus and hepatitis B); Infanrix (AaDPT) (acellular vaccine for the prevention of whooping cough, diphtheria and tetanus).

All children from 3 months old are given a pertussis vaccination course, consisting of 3 injections of the DPT vaccine with an interval of 1.5 months. Revaccination is done 1.5-2 years after the vaccination course. Vaccination in 70-80% prevents the disease or it proceeds in a mild form.

Children under 7 years of age who have not had whooping cough and who have been in contact with the patient are subject to separation within 14 days from the moment of the last contact with the patient. All children who have been in contact with the patient are subject to examination for carriage.
Contact children under the age of 1 year and not vaccinated are administered normal human immunoglobulin(anti-measles) 3 ml 2 days in a row.

Which doctors should you contact if you have whooping cough:

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Good day, dear readers!

In today's article, we will consider with you the whooping cough disease - in children and adults, as well as everything connected with it. So…

What is whooping cough?

Other symptoms of a spasmodic period:

Increased body temperature (subfebrile);
General malaise,;
, loss of appetite;
swelling of the face;
Cyanosis of the face and mucous membranes;
Apnea;
The appearance of hemorrhages in the sclera;
There may be a short loss of consciousness.

Whooping cough in children additionally manifests itself in the form of:

Increased nervousness and irritability of the child;
Blue face;
Expansion of veins in the neck;
Bloodshot eyes;
protruding tongue;
Sometimes - an injured frenulum of the tongue.

The duration of the attacks is on average 4 minutes.

Important! In vaccinated children, the disease can proceed in an erased form.

4. Permission period

Whooping cough becomes less frequent, then disappears, being replaced by single coughs;
Clinical manifestations of the disease disappear.

Whooping cough complications

lung atelectasis;
Acute (inflammation of the larynx);
False croup (stenosis of the larynx);
bronchiolitis;
nosebleeds;
Stop breathing;
Hernias (umbilical or inguinal);
encephalopathy;
Pulmonary heart;
hypoxia;
Suffocation.

Causes of Whooping Cough

The causative agent of whooping cough- Bacteria Bordetella pertussis (whooping cough bacterium Bordet-Gangu), named in 1906 in honor of their discoverers - the Belgian scientist J. Bordet and the French O. Zhangu.

The causative agent of whooping cough in a mild form- Bordetella parapertussis (parapertussis), which is very similar to Bordetella pertussis, but does not develop immunity to whooping cough.

The body's susceptibility to bacteria is up to 90%.

A weakened body contributes to an increase in the already high risk of getting sick.

Vaccination against whooping cough minimizes the body's susceptibility to whooping cough, but it is not always possible to completely prevent infection. If a vaccinated person becomes ill, then the disease proceeds mainly in a mild form without complications.

The causative agents of whooping cough and parapertussis are unstable in the external environment. They die when dried, ultraviolet irradiation, processing of disinfectants.

Whooping cough types

Whooping cough is classified as follows:

With the flow:

Typical- the development of the disease occurs in all 4 periods (described in the symptoms of the disease). Subdivided into:

Light form- characterized by no more than 15 attacks per day, which occasionally end in vomiting, a prodromal period of 10-14 days, slight cyanosis of the nasolabial triangle, swelling of the face, symptoms of emphysema;
Moderate form- characterized by 16-25 attacks per day for 5 or more weeks, with frequent reprisals, wheezing in the lungs, a prodromal period of 6-9 days, worsening of the patient's condition, lethargy, cyanosis and puffiness of the face, respiratory failure during the absence of coughing attacks,;
Severe form- characterized by 30 or more seizures (often prolonged) per day, a prodromal period of 3-5 days, deterioration in general health, weight loss, cyanosis, bouts of vomiting, apnea, tachypnea (outside of an attack), depression of consciousness, encephalopathy, convulsions, severe leukocytosis with lymphocytosis.

Atypical (erased)- the disease can proceed without a pronounced picture characteristic of whooping cough, incl. without whooping cough. Subdivided into:

Erased form;
subclinical form.

By development (pertussis periods):

1. Incubation period (2-14 days);
2. Prodromal (catarrhal) period (7-14 days);
3. Spasmodic period (4-6 weeks);
4. Resolution period (2-3 weeks).

Diagnosis of whooping cough

Diagnosis of whooping cough includes the following examination methods:

Anamnesis;
Examination of the patient;
Bacteriological examination of a smear from the nasopharynx for the presence of a pathogen;
The method of "cough plates" - placing a Petri dish with a nutrient medium at a distance of 10 cm from the mouth of a coughing child;
Detection of antibodies (immunoglobulins of classes A and M) using enzyme immunoassay.
Some clinics may use outdated diagnostic methods - RSK, RPHA, agglutination reaction.

Analysis for whooping cough (smears) must be taken quickly and placed in a special container that protects them from drying out and cooling, since, as we have already said, the whooping cough bacillus is very unstable in the external environment.

Whooping cough treatment

How to treat whooping cough? Whooping cough treatment includes the following items:

1. Hospitalization and treatment;
2. Drug treatment;
3. Physiotherapy treatment;
4. Diet.

1. Hospitalization of the patient and regimen

Persons with severe forms of the disease, prolonged bouts of whooping cough, complications of the disease are subject to hospitalization of the patient. This is especially true for small children, under the age of 2 years.

Children are also subject to hospitalization according to epidemiological indications, so as not to provoke mass outbreaks of infection - from closed children's institutions.

Patients need to be protected from negative psycho-emotional stress, stressful situations, as well as various external stimuli - bright light, loud sounds.

Beneficial effect on the body long walks in the air. Remember, coughing intensifies with dry and cold air, therefore, the room with the patient should also be ventilated as much as possible, and the air should be moistened with a humidifier or with wet towels and sheets in the room. Walking in the summer is best done in the early morning, when the air is still moist and cool.

Hospitalization is not needed for adults, children with a mild form of the disease, with the exception of the presence of complications of the disease.

2. Medical treatment

Important! Before use medicines be sure to consult with your doctor!

2.1. Antibacterial therapy

Since the cause of whooping cough is, its destruction must be carried out with the help of antibacterial drugs. The good news is that Bordetella pertussis and Bordetella parapertussis bacteria have practically no resistance to antibiotics, so they can be stopped quite easily.

Antibiotics for whooping cough- macrolides ("", "Clarithromycin", ""), 3rd generation cephalosporins ("Cefotaxime", "").

Penicillins against whooping cough and parapertussis are not effective.

In severe whooping cough and the inability to take antibiotics orally, preference is given to aminoglycosides, carbenicillin, levomecithin sodium succinate.

Once again, it should be noted that the intake of antibiotics does not need to be extended after the course prescribed by the doctor, even though the cough is still ongoing, because. cough after antibiotic therapy continues no longer due to the presence of infection in the respiratory tract, but due to the activity of the cough center.

2.2. Symptomatic therapy

To destroy pertussis and parapertussis toxin, anti-pertussis gamma globulin is administered intramuscularly for 3 days at a daily dose of 3 ml.

To liquefy thick sputum, which will improve its expectoration from the respiratory tract, and accordingly reduce the risk of complications, mucolytics are used - Ambroxol, Bromhexine, Acetylcysteine, "".

Important! It is forbidden to give mucolytics to children under the age of 2 years!

To relieve spasms in the bronchi and improve the bronchial well-proven - "Eufillin", "Relanium", "Seduxen".

To prevent diarrhea, antidiarrheal drugs are used - Mezim Forte, Smecta, Polyphepan, Imodium, Enterosgel, Hilak Forte.

Antiemetics are used against vomiting attacks - "", "Reglan", "".

With frequent and severe bouts of vomiting, it is necessary to inject fluid intravenously.

To prevent dehydration of the body, apply - "", "Hydrovit".

To prevent hypoxia (insufficient amount of oxygen in the body), which develops due to the difficulty of breathing, oxygen therapy, Phenobarbital, Dibazol, Piracetam are used.

Elevated body temperature in children is removed with the help of cool compresses on a water-vinegar basis, wiping the forehead, temples, and wrists.

Whooping cough treatment also includes an additional intake.

In some cases, your doctor may prescribe antihistamines.

2.3. In severe whooping cough, apnea apply:

Hormonal drugs (glucocorticoids) that reduce the inflammatory process, stop apnea, reduce the frequency and duration of whooping cough, prevent encephalic disorders, improve hemodynamic parameters - "Hydrocortisone" (daily dose 5-7 mg / kg), "Prednisolone" (daily dose 2 mg / kg) for 2-3 days, after the dose is gradually reduced;
Carrying out oxygen therapy in oxygen tents;
Stimulation of the aerobic type of cellular or tissue respiration;
Some doctors transfer sick children to long-term automatic artificial lung ventilation (ALV).

2.4. At the first or mild signs of brain disorders (symptoms of encephalopathy)

It is necessary to carry out emergency therapy, which consists of the use of:

Hormonal drugs (glucocorticoids) - "Hydrocortisone", "Prednisolone";
Diuretics - Diacarb (daily dose 10 ml / kg), Lasix (daily dose 0.3-0.4 mg / kg);
Anticonvulsants - "Seduxen" (daily dose of 0.3-0.4 mg / kg);
Nootropics (improve cerebral circulation by dilating blood vessels, preventing oxygen starvation, stimulate the brain) - "Piracetam" (daily dose of 30-50 mg / kg in 2 doses), "Cavinton" (daily dose of 5-10 mg in 3 doses), "Pantogam" (daily dose of 0.75-3 G).

Important! If convulsions continue after emergency care, the patient is transferred to the intensive care unit of a medical institution.

3. Physiotherapy treatment

For the treatment of whooping cough, the following physiotherapy procedures may additionally be prescribed:

Aerosol therapy;
Breathing exercises;
Massage;
Suction of pathological secretions from the respiratory tract, especially in the case of young children.

4. Whooping cough diet

The whooping cough diet implies a sparing diet with the use of foods enriched with vitamins and.

The number of meals - 5-6 times a day.

Cooking mode - steaming, stewing, boiling.

Food should be crushed so as not to burden the stomach.

In a severe form of the disease, portions should be small with small intervals between meals.

In case of vomiting after eating, children should be supplemented 10-15 minutes after the vomiting attack.

Babies are given barbiturates 15 minutes before feeding.

In the case of the acute phase of the disease and pronounced symptoms of hypoxia, infants are fed with expressed milk using a pipette.

Important! Before use folk remedies against whooping cough, be sure to consult your doctor!

Garlic with milk. Finely chop or pass 5 medium cloves through a garlic press, pour them with a glass of boiling water and put on fire. Bring the product to a boil, boil for 5 minutes, then cool and take several times a day. Many traditional healers use this remedy for the treatment of whooping cough in children at home.

Onion. cut into small pieces onion, put it in a 500 ml jar and fill it with 4 tbsp. spoons of sugar. When the onion releases juice, the resulting syrup should be taken several times a day, 1 teaspoon.

Naphthalene. Pour a little naphthalene into double-folded gauze, tie a bundle around the child's neck with a string. At night, the bag must be removed and placed next to the head so that the child can constantly breathe the product.

Fir oil. It is used for poor sputum discharge. Drop 1-2 drops of fir oil to the child on the upper chest and back, then lightly rub it into the skin. Improving circulation as well as inhaling an essential oil that has antimicrobial, sedative, and more medicinal properties will help to clear the respiratory tract from pathological secretions.

To enhance the effect, fir oil can be used as the basis for an aroma lamp.

Mumiyo. Dissolve 0.1 g of mummy in 50 g of warm water. The resulting mixture should be drunk in the morning on an empty stomach. The number of receptions is 10 times, within 10 days, every day 1 time.

Licorice. Grind 350 g, fill it with 1 liter of water and put on fire. Bring the product to a boil, boil it for about 8 minutes, then cover and let it brew for 1 hour. When the decoction becomes warm, strain it and take 1-2 teaspoons 3 times a day. You need to take the decoction in a warm form, so warm it up slightly before taking it.

Astonishment. As we wrote at the beginning of the article, whooping cough may still persist for more than one day after the infection has stopped, due to the continued activity of the irritated cough center. To prevent coughing, it is necessary to switch the activity to another center, which is facilitated by a strong positive experience of the child, for example, taking an airplane flight, driving him in the cab of a truck, giving him a puppy or kitten. The longer the positive experiences are, the faster the child will recover. By the way, it is not necessary to buy a puppy or a kitten, they are usually in in large numbers"exists" in animal shelters, so donate happy life future member of your family.

Whooping cough prevention includes:

Compliance;
Avoiding hypothermia of the body,;
The use of foods enriched with vitamins and trace elements;
In the autumn-winter period, avoid closed places with large crowds of people;
Separation of children after contact with a carrier of infection and monitoring their health for 14 days;
Vaccination.

Whooping cough vaccination

It must be said right away that the whooping cough vaccine does not give a 100% guarantee of safety against the appearance this disease. Doctors note that this vaccination basically only minimizes the possibility of getting sick, and if infection does occur, then the course of the disease proceeds mainly in a mild form without complications. Of course, there are exceptions everywhere.

To date, there are the following vaccines for whooping cough:

"Infanrix" - acellular vaccine against whooping cough and tetanus;
"Tritanrix" - a vaccine against whooping cough, tetanus, diphtheria and;
"Tetrakok" - a vaccine against whooping cough, diphtheria, tetanus and;
"DTP" - adsorbed pertussis-diphtheria-tetanus vaccine. According to numerous sources and reviews, this vaccine has a lot of complications, so many doctors recommend using other vaccines.

After the first vaccination, after 1.5-2 years, revaccination is done.

Immunity to infection is more resistant than after vaccination.

Which doctor should I contact for whooping cough?

Whooping cough - video

Whooping cough in children is an infectious disease characterized by a spasmodic paroxysmal cough that persists for a long time. Children in the first year of life are the most vulnerable. Unlike most other childhood droplet infections, whooping cough affects even newborns. As a rule, by the age of 4-5, stable immunity is formed, due either to an infection or vaccination.

Specific prevention of whooping cough in children is carried out by routine vaccination. The course consists of three intramuscular injection DPT vaccines 45 days apart.

Causes and risk factors

Whooping cough in children is caused by the gram-negative bacterium Bordetella pertussis, which is very unstable in the external environment. When exposed to disinfectants in normal concentration, it dies almost instantly. Straight sunlight deprives him of viability after 60 minutes.

Source: medaboutme.ru

Whooping cough is a typical anthroponotic infection. Its source is sick people and bacteria carriers. Whooping cough in older children and adults usually proceeds in an erased form, which poses a serious epidemiological danger. Patients are contagious to others from 1 to 25 days of illness. When conducting antibiotic therapy, the duration of the infectious period may be reduced.

The spread of infection occurs exclusively by airborne droplets during coughing (through an aerosol of infected sputum). In view of the extreme instability of the bacillus Bordetella pertussis in environment contact-household way of transmission of infection is not observed. Given that the infected aerosol spreads over a short distance (no more than 2 meters), infection of children with whooping cough occurs only when they are in close enough contact with patients.

Susceptibility to whooping cough in children is high. After the disease, a stable immunity is formed, usually lifelong. However, in old age, the intensity of immunity can weaken, which explains the sometimes observed cases of recurrent illness.

When infected, the pertussis stick enters the mucous membrane of the upper respiratory tract and affects the cells of the ciliated epithelium of the bronchi and larynx. The pathogen does not penetrate into deeper tissues and does not spread throughout the body. In the process of life, it produces toxins that cause the development of a local inflammatory reaction.

Severe whooping cough in children can be complicated by hemorrhages under the mucous membranes, into the thickness of the tissues internal organs and the brain, as well as the development of emphysema, lung atelectasis, pneumothorax.

After the death of pertussis bacilli and the destruction of their membranes, endotoxin is released, which provokes bouts of spasmodic coughing. In the future, in children, a focus of excitation is formed in the medulla oblongata, and the cough becomes central genesis. As a result of this, a coughing fit can be provoked by various irritants, for example, a long conversation, strong laughter, pain, touch. Excitation from the cough center can also pass to neighboring centers medulla oblongata. Therefore, after a coughing attack, vascular spasm, increased blood pressure, and reflex vomiting are sometimes observed. With a strong attack of coughing, children often experience clonic or tonic convulsions.

Pertussis endotoxins and the enzyme adenylate cyclase produced by it contribute to the weakening immune system, which, in turn, increases the risk of forming a long-term bacteriocarrier or secondary infection.

Whooping cough symptoms in children

The incubation period for whooping cough in children lasts from 3 to 15 days. In the clinical picture of the disease, several successive periods are noted:

catarrhal (prodromal);
spasmodic (convulsive) cough;
permissions.

The prodromal period lasts from 2 to 10 days. It is characterized by a runny nose with severe mucosal rhinorrhea and a moderate dry cough. General state remains satisfactory, signs of intoxication are not observed. Gradually there is an increase in cough, it takes on a paroxysmal character and intensifies at night.

The main symptom of whooping cough in children is whooping cough. Its appearance indicates the transition of the disease to the next stage. Coughing attacks become frequent and intense, acquire a spastic character.

In children of the first years of life, whooping cough can cause the development chronic diseases lungs, including bronchiectasis.

Older children note symptoms-harbingers of an impending attack:

anxiety;
chest discomfort;
sore throat.

Spasmodic narrowing of the glottis causes the appearance of an elongated whistling breath, the so-called reprise. In fact, the attack is an alternation of reprises and convulsive cough exhalations. It ends with the discharge of vitreous mucous viscous sputum or reflex vomiting.

Attacks often occur at night and early in the morning. Due to significant tension on the conjunctiva, oropharyngeal mucosa and skin small hemorrhages (petechiae) appear on the face.

Body temperature remains within normal limits. If it increases, this is evidence of the addition of a secondary bacterial infection.

The period of convulsive cough lasts 3-4 weeks, after which whooping cough in children gradually passes into the resolution phase. The attacks gradually lose their spasmodic character, become shorter, the interval between them lengthens and after a while they completely stop. The duration of the resolution period ranges from several days to several months. This is explained by the fact that even after the subsidence of the main symptoms, general asthenia and increased nervous excitability of the cough center persist for a long time.

In vaccinated individuals, the disease can proceed in an erased form. In this case, a long-lasting cough, which is practically not amenable to therapy, becomes a sign of whooping cough in children. The spasmodic nature of the cough is mild. Vascular spasms, vomiting and reprises are absent.

During medical examination in the focus of infection, cases of subclinical whooping cough in children can be detected, a sign of which is only a recurrent cough.

The use of antitussive drugs with a central mechanism of action is contraindicated. Mucolytics and expectorants are ineffective, so they are also not prescribed.

In the abortive form, whooping cough in children stops at the stage of catarrhal manifestations. There are no attacks of convulsive cough, regression clinical signs happens very quickly.

Diagnostics

Diagnosis of whooping cough in children is based on the characteristic clinical picture. Confirmation of the diagnosis is carried out by methods laboratory diagnostics based on the detection of whooping cough or its antigens:

inoculation of pharyngeal mucus on selective media (casein-charcoal agar or glycerin-potato agar with the addition of blood) - inoculation should be carried out in the first days of the disease before starting antibiotic therapy;
detection of antigens of whooping cough in the pharyngeal mucus by the RIF method;
detection of antibodies to pertussis antigen (RSK and passive hemagglutination, ELISA);
latex microagglutination reaction in child saliva samples.

With whooping cough in children, there are also certain changes in the general blood test, which indicate an infectious process occurring in the body (lymphocytic leukocytosis, a slight increase in ESR).

On a chest x-ray, increased transparency of the lung fields (a sign of emphysema), flattening of the dome of the diaphragm and increased lung pattern with the appearance of reticulation are determined.

Whooping cough in children requires differential diagnosis with other respiratory diseases (ARVI, bronchitis, tracheitis, pneumonia).

Treatment of whooping cough in children

Treatment of whooping cough in children in most cases is carried out on an outpatient basis. Hospitalization is indicated only in severe cases of the disease and the addition of a secondary infection.

The patient should be isolated in a separate room, in which wet cleaning and airing are carried out several times a day.

Banks and mustard plasters are contraindicated, their use can provoke a strong cough attack.

Children of the first year of life remain on breastfeeding. At an older age, a dietary table No. 13 according to Pevzner is prescribed. The goals of diet therapy are:

increasing the body's resistance to infection;
stimulation of protective forces;
reduction of intoxication;
creating optimal conditions for the immune system.

The diet includes:

dried white bread, lean cookies;
weak fish and meat broths, vegetable and meat puree soups, slimy cereal soups;
steam cutlets, meat soufflé, meatballs;
steam fish cakes, fish aspic;
fermented milk products (ryazhenka, acidophilus, kefir, cottage cheese, sour cream);
cheese and cheese;
protein steam omelette, soft-boiled eggs;
semi-liquid viscous cereals;
berries and fruits (soft, ripe and sweet);
some types of sweets (honey, jam, jam, meringue, mousses, jelly, marshmallow, marmalade);
vegetable and butter;
tea with lemon, rosehip infusion.
compotes, fruit drinks, diluted fruit and vegetable juices;

Exclude from the diet:

fresh rye and wheat bread, rich pastries;
strong and fatty broths;
fatty meats and fish, sausages, smoked meats;
legumes;
canned food, pickles and marinades;
spicy cheeses, cream, whole milk;
hard-boiled eggs, scrambled eggs;
cereals from corn, pearl barley, yaks and millet;
vegetables with coarse fiber (mushrooms, rutabaga, white cabbage, radish, radish, turnip);
cakes and pastries;
cocoa and chocolate.

In the catarrhal period, the treatment of whooping cough in children is carried out with antibiotics (macrolides, aminoglycosides) for a week at an average therapeutic dosage. In the first days of the disease, a specific anti-pertussis gamma globulin can be prescribed to children simultaneously with antibiotics.

Unlike most other childhood droplet infections, whooping cough affects even newborns.

prolonged stay of the child in the open air (in calm weather and air temperature not lower than -10 ° C;
administration of sedatives and antihistamines.

Antipsychotics may be prescribed for severe coughing fits.

The use of antitussive drugs with a central mechanism of action is contraindicated. Mucolytics and expectorants are ineffective, so they are also not prescribed. Banks and mustard plasters are contraindicated, their use can provoke a strong cough attack.