Whooping cough for how long a child is contagious. Whooping cough: features of the course and methods of infection

Whooping cough - acute infection, transmitted by airborne droplets and characterized by a long course with the presence of specific stages.

The name of the pathology comes from the French word coqueluche, which means a strong paroxysmal cough. Indeed, the main symptom of the disease is painful coughing attacks (the so-called reprises), which occur against the background of a relatively satisfactory general condition of the patient.

Some statistics

Whooping cough is ubiquitous, but is diagnosed more frequently in urban areas than in rural areas. This is due to a number of reasons: a large crowding of the population in large metropolitan areas, environmentally unfavorable urban air, and more scrupulous diagnostics (in towns and villages, often erased forms are not diagnosed due to less epidemiological alertness).

Like other respiratory infections, whooping cough is characterized by a seasonal incidence with an increase in the frequency of recorded cases of infection during the transitional periods (autumn-winter and spring-summer).

Epidemiological data indicate the presence of a kind of mini-epidemics of whooping cough that occur every three to four years.

In general, the incidence of whooping cough in the world is quite high: up to 10 million people fall ill every year, while for 600 thousand patients the infection ends tragically. In the pre-vaccination period in the USSR, about 600,000 people fell ill every year, and about 5,000 died (mortality averaged more than 8%). The highest was the mortality from whooping cough among children of the first year of life (every second child died).

Today, thanks to widespread long-term vaccination, the incidence of whooping cough in civilized countries has declined sharply. However, it should be noted that the whooping cough vaccine does not provide immunity to parapertussis infection, which is transmitted similarly and clinically proceeds as mild form whooping cough

AT last years the incidence of whooping cough among adolescents has increased, doctors attribute these figures to a general decrease in immunity, violations of the rules for vaccinating children, as well as an increase in the number of cases of parents refusing to be vaccinated.

Pertussis causative agent and transmission routes

Whooping cough is an infection transmitted by airborne droplets from a sick person to a healthy person. The causative agent of pertussis is the whooping cough bacillus Borde-Jangu (bordetella), named after the scientists who discovered it.
Pertussis bacillus Borde-Jangu has a "relative" - ​​parapertussis bordetella, which causes the so-called parapertussis - a disease whose clinic repeats whooping cough that occurs in mild form.

Bordetella are unstable in the external environment and quickly die under the influence of high and low temperatures, ultraviolet radiation, and drying. So, for example, open sunlight destroys bacteria in one hour, and cooling - in a matter of seconds.

Therefore, handkerchiefs, household items, children's toys, etc. do not pose an epidemic danger as transmission factors. Special sanitary treatment of the premises in which the patient stayed is also not carried out.

The transmission of infection usually occurs through direct contact with the patient (staying at a distance closer than 1.5 - 2 m from the patient). Most often, inhalation of particles of mucus that have fallen into the air when coughing occurs, however, the pathogen can be released into environment and when sneezing, talking, etc.

The maximum danger in epidemiological terms is the patient in the first week of spasmodic cough (during this period, the causative agent of whooping cough is isolated from 90 to 100% of patients). In the future, the danger decreases (in the second week, bordetella is isolated by about 60% of patients, in the third - 30%, in the fourth - 10%). In general, infection is possible through contact with a person with whooping cough ranging from last days incubation period up to the 5-6th week of the disease.

With whooping cough, there is also a bacteriocarrier, that is, a condition in which a person releases into the environment dangerous bacteria, and he does not feel any signs of the disease. But the bacteriocarrier in whooping cough is short-lived and has no special significance for the spread of the disease. A great danger is the mild and erased forms of whooping cough, when a periodically coughing child or adult remains in the team.

Whooping cough is a disease that is commonly referred to as the so-called childhood infections. The proportion of children among whooping cough cases is about 95-97%. The greatest susceptibility to infection occurs between the ages of 1 and 7 years.

However, adults are also not immune from the development of whooping cough. According to some reports, the probability of infection of adults in a family with a sick child can reach 30%.

At the same time, in adults, the disease often occurs in an erased form. Often such patients are mistakenly diagnosed with chronic bronchitis and unsuccessfully treated for a non-existent disease. Therefore, doctors advise with a prolonged cough, especially in cases where it occurs with painful attacks, to pay attention to the epidemiological situation - whether there was any contact with a child who coughed for a long time.

Patients who recover from whooping cough have lifelong immunity. However, as with vaccination, immunity to whooping cough does not exclude parapertussis, which is clinically indistinguishable from mild whooping cough.

The gateway of infection in whooping cough is the upper respiratory tract. The pertussis bacillus inhabits the mucous membrane of the larynx, trachea and bronchi, this is prevented by class A immunoglobulins secreted by the epithelium - they make it difficult for bacteria to attach and contribute to their speedy removal from the body.

Functional immaturity of the mucous membranes of the upper respiratory tract in young children results in whooping cough predominantly affects this age group. The infection is especially severe in children of the first two years of life.

Attached to the epithelium, bacteria begin to secrete special substances - toxins that cause an inflammatory reaction. The small bronchi and bronchioles are most affected. The pathogen does not penetrate inside the cells, therefore pathological changes minimally expressed - there is plethora and edema of the surface layers of the epithelium, sometimes desquamation and death of individual cells. At accession of a secondary infection development of erosions is possible.

After the death and destruction of bacteria, pertussis toxin enters the surface of the mucous membrane, which leads to the development of a spasmodic cough.

The mechanism of occurrence of a specific cough in whooping cough is quite complicated. First, cough tremors are associated with direct irritation of epithelial receptors by pertussis toxins, then an allergic component associated with the release of specific substances - inflammatory mediators - joins. There is a spasm of the bronchi and bronchioles, so that the cough begins to resemble clinical picture asthmatic bronchitis.
In the future, due to constant irritation vagus nerve, in the central nervous system, a focus of congestive excitation develops in the area of ​​\u200b\u200bthe respiratory center, and the cough takes on a specific paroxysmal character.

It is the presence of a central mechanism that causes coughing attacks to occur when exposed to a wide variety of stimuli of the nervous system (bright light, loud sound, strong emotional stress, etc.).

Nervous excitation from a stagnant focus can spread to neighboring centers in medulla oblongata- emetic (in such cases, attacks of convulsive coughing end with painful vomiting), vasomotor (a coughing attack leads to fluctuations blood pressure, increased heart rate, etc.), as well as other subcortical structures with the development of seizures resembling epilepsy.

In very young children, excitation can spread to the respiratory center with the development of various respiratory rhythm disturbances, up to apnea (stopping breathing).

Strong prolonged often recurring bouts of coughing lead to increased pressure in the vessels of the head and neck. As a result, swelling and cyanosis of the face, hemorrhages in the conjunctiva of the eyes develop. In severe cases, hemorrhages in the brain tissue may occur.

Clinical periods of whooping cough

Clinically, during whooping cough, the following periods are distinguished:

• incubation;
• catarrhal cough;
• spasmodic cough;
• permissions;
• convalescence (restorative).

Incubation period with whooping cough is from 3 to 20 days (on average, about a week). This is the time required for the upper respiratory tract to be populated with whooping cough.

catarrhal period begins gradually, so that the first day of the disease, as a rule, cannot be established. A dry cough or coughing appears, a runny nose with a slight viscous mucous discharge is possible. In young children, catarrhal phenomena are more pronounced, so that the onset of the disease may resemble SARS with copious discharge from the nose.

Gradually, the cough intensifies, patients develop irritability and anxiety, but general state remains quite satisfactory.

Period of spasmodic cough begins from the second week from the onset of the first symptoms of infection and lasts, as a rule, 3-4 weeks. This period is characterized by paroxysmal cough. Older children may report warning signs of an attack, such as a scratchy throat, a feeling of pressure in the chest, and feelings of fear or anxiety.

Characteristic cough
Attacks can occur at any time of the day, but are most often disturbed at night. Each such attack consists of short but strong coughing shocks, interspersed with convulsive breaths - reprises. Inhalation is accompanied by a whistling sound as the air forcefully passes through the spasmodically constricted glottis.

The attack ends with coughing up the characteristic viscous transparent sputum. The appearance of vomiting, impaired breathing and heartbeat, the development of seizures indicate the severity of the course of the disease.

During an attack, the child's face swells, in severe cases, acquiring a bluish tint, the veins of the neck swell, the eyes become bloodshot, tear and salivation appears. A characteristic feature: the tongue protrudes to the limit, so that its tip is bent to the top, while, as a rule, the frenulum of the tongue is injured on the incisors mandible. In a severe attack, involuntary urination and fecal discharge are possible.

Complications of persistent cough
In the absence of complications, the child's condition between attacks is satisfactory - children play actively, do not complain of appetite, body temperature remains normal. However, over time, puffiness of the face develops, and a sore covered with a whitish coating appears on the frenulum of the tongue damaged by teeth - a specific sign of whooping cough.

In addition, hemorrhages under the conjunctiva are possible, and there is often a tendency to nosebleeds.

Resolution stage
Gradually the disease progresses in the resolution stage. Coughing attacks occur less frequently, and gradually lose their specificity. However, weakness, coughing, irritability persist for a long time (the resolution period is from two weeks to two months).

convalescence period may last up to six months. This period is characterized by increased fatigue and emotive disorders (capriciousness, excitability, nervousness). A significant decrease in immunity leads to increased susceptibility to acute respiratory infections, against which an unexpected resumption of a painful dry cough is possible.

Whooping cough severity criteria

There are mild, moderate and severe forms of typical whooping cough.

With a mild form, coughing fits occur no more than 10-15 times a day, while the number of cough shocks is small (3-5). Vomiting after coughing, as a rule, does not occur, the general condition of the child is quite satisfactory.

In moderate whooping cough, the number of attacks can reach 20-25 per day. Seizures have average duration(up to 10 coughing shocks). Each attack ends with vomiting. In such cases, asthenic syndrome develops quite quickly (general weakness, irritability, loss of appetite).

In severe cases, the number of coughing attacks reaches 40-50 or more per day. Attacks last for a long time, proceed with general cyanosis ( skin acquire a bluish tint) and gross respiratory disorders, convulsions often develop.

In severe whooping cough, complications often develop.

Whooping cough complications

All complications of whooping cough can be divided into three groups:

• associated with the underlying disease;
• development of an autoimmune process;
• accession of a secondary infection.

With strong prolonged attacks of coughing, the supply of oxygen to the brain is significantly disrupted - this is associated both with bronchospasm and respiratory rhythm disturbances, and with impaired blood flow in the vessels of the head and neck. The result of hypoxia can be such brain damage as encephalopathy, manifested by convulsive syndrome and signs of irritation of the meninges. In severe cases, hemorrhages occur in the brain.

In addition, a strong cough against the background of spasm of the bronchi and bronchioles can lead to a violation of the filling of the lungs with air, so that emphysema (bloating) occurs in some areas, and atelectasis (collapse of lung tissue) occurs in others. In severe cases, pneumothorax develops (accumulation of gas in the pleural cavity due to rupture of the lung tissue) and subcutaneous emphysema (penetration of air from the pleural cavity into subcutaneous tissue neck and upper body).

Coughing attacks are accompanied by an increase in intra-abdominal pressure, therefore, in severe cases of whooping cough, umbilical or inguinal hernia, rectal prolapse.

The most common secondary infections are pneumonia and suppurative otitis (inflammation of the middle ear).
Sometimes autoimmune processes develop, which occur as a result of a long-term inflammation with a pronounced allergic component. Cases of transition of whooping cough to asthmatic bronchitis and bronchial asthma have been registered.

Atypical forms of whooping cough

Atypical forms of whooping cough - abortive and erased, as a rule, are observed in adults and / or vaccinated patients.
With an erased form, characteristic coughing fits do not develop, so a persistent dry cough that is not eliminated by conventional antitussives is a sign of the disease. Such a cough can last for weeks or even months, without, however, worsening the general condition of the patient.

The abortive form is characterized by an unexpected resolution of the disease 1-2 days after the onset of the first whooping cough-specific coughing fits.

Whooping cough in patients from different age groups

The characteristic clinical picture of whooping cough develops, as a rule, in children older than one year and adolescents. Adults carry whooping cough in an erased form.

In children of the first year of life, whooping cough is especially difficult and is often complicated by the development of secondary pneumonia.

In this case, the periods of the clinical picture have a different duration: incubation period reduced to 5 days, and catarrhal - up to one week. At the same time, the period of spasmodic cough is significantly lengthened - up to two to three months.

In addition, during bouts of spasmodic coughing, infants do not have reprises, a coughing fit often ends with a temporary cessation of breathing and a convulsive seizure.

Diagnosis of whooping cough

In case of persistent paroxysmal cough, lasting more than a few days, you need to visit a general practitioner (therapist), if it is a child, then you need to see a pediatrician.

Doctors' consultations

At the appointment with a general practitioner or pediatrician.
At the appointment, the doctor will find out your complaints, he may be interested in whether there was any contact with coughing patients (especially with whooping cough), whether pertussis vaccination was carried out. It may be necessary to listen to the lungs and conduct a complete blood count. For greater certainty of the diagnosis, the doctor will send you for a consultation with an ENT doctor or an infectious disease specialist.

At the appointment with an ENT doctor
The doctor will be interested in the condition of the mucous membrane of the larynx and pharynx. To do this, the doctor will examine the mucous membrane of the larynx using a special reflective mirror or flashlight.
Signs of whooping cough during examination will be swelling of the mucosa, the presence of hemorrhages in them, and a slight mucopurulent exudate.

At the appointment with an infectious disease doctor
The doctor will listen to your complaints. May ask about possible contacts with coughing and whooping cough patients. The final diagnosis is usually based on the results laboratory tests, to which the infectious disease specialist will send you.

Laboratory diagnosis of whooping cough

General blood analysis
Reveals common signs of inflammation in the body.

1. Increased level of leukocytes
2. Increased level of lymphocytes
3. ESR is normal

Bacteriological research
The material is taken in several ways: when coughing, the secreted scanty sputum is collected and placed on a nutrient medium.
Another way is a smear from the pharyngeal mucosa. It is made in the morning on an empty stomach or 2-3 hours after a meal.

The collected material is placed in a special nutrient medium. However, the result will have to wait a long time, 5-7 days.

Serological tests

Direct hemagglutination reaction (RPHA), indirect hemagglutination reaction (RIHA) This method of blood testing allows you to detect antibodies to the causative agent of whooping cough. The result can be positive (confirmation of the diagnosis of whooping cough) or negative (exclusion).

ELISA (enzymatic immunoassay) Now there are express tests that allow to identify whooping cough by ELISA. The result can be positive (confirmation of the diagnosis of whooping cough) or negative (exclusion)

PCR (Polymerase chain reaction) Allows you to identify the pathogen within a few days. The result can be positive (confirmation of the diagnosis of whooping cough) or negative (exclusion).

Whooping cough treatment

Does a patient with whooping cough need bed rest?

With a mild course of the disease, bed rest is not indicated for a patient with whooping cough. On the contrary, the patient needs frequent walks in the fresh air, during which it is advisable to avoid noisy, irritant-rich places. Since moist air helps to reduce the frequency of seizures, it is better to walk with the baby near water bodies if possible.

Cough is more easily tolerated in the cold, so it is necessary to ventilate the room often, to prevent drying out and overheating of the air (ideally, the temperature in the patient's room should not be higher than 18-20 degrees Celsius). It is advisable to use humidifiers. So that the child does not freeze, it is better to dress him warmly.

How toys, puzzles and other distractions are used board games not aggressive in nature.
In addition, sufficient attention should be paid to the nutrition of the patient. Infants who are on breastfeeding, it is desirable to increase the number of feedings by reducing the amount of food taken at a time. Older children are recommended to drink plenty of alkaline drinks (juices, fruit drinks, tea, milk, alkaline mineral water).

When is hospitalization necessary?

Treatment in a hospital is necessary for moderate and severe disease, as well as in the presence of concomitant pathology, which increases the risk of complications. Babies under the age of two are usually hospitalized for suspected whooping cough, regardless of the severity of the signs of the disease.

What medications and physiotherapy procedures are used for whooping cough?

As studies show, in the spasmodic period, the medical destruction of pertussis infection is impractical, since bordetella is already independently washed out of the body by this time, and coughing attacks are associated with a congestive focus of excitation in the brain.

Therefore, antibiotics are prescribed only in the catarrhal period. Ampicillin and macrolides (erythromycin, azithromycin) are quite effective, tetracyclines can be prescribed for children over 12 years old. These antibacterial agents are taken in medium doses in short courses.

Standard antitussive drugs for whooping cough attacks are ineffective. To reduce the activity of the focus of excitation in the brain, psychotropic drugs are prescribed - neuroleptics (chlorpromazine or droperidol in age dosages). Because these medications are sedative, they are best taken before bedtime or at night. For the same purpose, you can use a tranquilizer (Relanium - intramuscularly or orally at an age dosage).

In mild forms of whooping cough, antihistamines are prescribed to stop coughing attacks - pipolfen and suprastin, which have anti-allergic and sedative effects. Diphenhydramine is not used because this medicine causes dryness of the mucous membranes and may contribute to increased coughing.
In severe forms of whooping cough with a pronounced allergic component, some clinicians report a significant improvement with the use of glucocorticoids (prednisolone).

All of the above funds are taken until the spasmodic cough attacks disappear (usually 7-10 days).

In addition, inhalations of proteolytic enzymes - chymopsin and chymotrypsin are used to thin viscous sputum, and in severe coughing attacks, drugs that improve blood circulation in the brain (pentoxifylline, vinprocetine) to prevent hypoxia of the central nervous system are used.

Massage and breathing exercises are shown to improve sputum discharge. During periods of resolution and convalescence, general strengthening physiotherapy procedures and vitamin therapy courses are prescribed.

Alternative methods of treating whooping cough

In folk medicine, for the treatment of whooping cough, a remedy such as plantain leaves is traditionally used. The well-known plant has a pronounced expectorant and anti-inflammatory effect. To prevent coughing attacks and liquefy sputum, a drink is prepared from young plantain leaves filled with boiling water with honey.
Also folk herbalists it is advised to get rid of bouts of painful coughing with the help of ordinary onions. To do this, the husks from 10 onions should be boiled in a liter of water until half of the liquid boils away, then pour and strain. Drink half a glass three times a day after meals.

To liquefy sputum with whooping cough, an infusion of tricolor violet is also used: 100 g of grass is poured into 200 g of boiling water and infused for half an hour. Then filter and take 100 g twice a day.

Whooping cough is a contagious disease caused by the microbe Bordetella pertussis. You need to know how whooping cough is transmitted.

Some information about whooping cough

Whooping cough mainly affects children of preschool age, but recently this disease is increasingly affecting adults and adolescents. Newborns get sick with it if their mother's antibodies are not able to protect them from the virus.

The main symptom of whooping cough is a paroxysmal cough. At the beginning of the disease, the patient is most dangerous to others. The degree of contagiousness depends on how pronounced the cough is, since the release of infected substances from the respiratory tract occurs during attacks.

Infection is carried out as follows: coccobacteria enters the mucous membrane of the upper respiratory tract. When the patient breathes, the microbe moves further along the pathways, into their lower sections. The virus produces a toxin that has a negative effect on the mucous membrane. This causes a severe cough.

The disease has a typical atypical form. The first form is characterized by seizures. The second form appears in an erased form, the cough is normal. The typical form of whooping cough is divided into the following types: mild whooping cough, moderate and heavy. Each type is rated according to the frequency of seizures:

• mild - attacks occur up to 15 times a day;
• moderate - up to 25 times;
• heavy - up to 50 times.

The first symptoms of whooping cough begin to appear after 3-15 days from the moment of infection. On average, this period is from 5 to 8 days. The disease proceeds rather slowly. There are three periods of the course of the disease:

1. The first period is the onset of the disease. There is a dry cough, body temperature may rise slightly, a slight runny nose. For 1-2 weeks, the cough becomes more debilitating and paroxysmal. In infants, this period is much shorter, about a week.
2. The second period is characterized by bouts of coughing, which is jerky in nature. Inhalations are accompanied by a whistle, then a push on exhalation and again a breath with a whistle.
3. In the third period, the number of attacks increases significantly, up to 50 or even more per day. Seizures recur after short periods of time. The face of a sick child at such moments turns blue, the veins in the neck swell. There is tearing. When coughing, the head leans forward strongly, the tongue protrudes strongly from the mouth.

In children vaccinated against whooping cough, the disease is erased. Complications do not occur.

Ways of transmission of whooping cough

Like many infectious diseases, whooping cough has the main route of transmission - airborne. The source of infection is a sick person. In epidemic terms, the most dangerous are patients with an erased form. Most often these are adults. When talking, coughing or sneezing, the bacterium, along with the air, enters the respiratory organs of a healthy person.

Such transmission routes as household items or toys are rejected by medicine, since the Bordetella pertussis bacterium is unstable to the environment and dies instantly in it.

It is believed that you can get whooping cough through shared utensils or cutlery. But this is in very rare cases. Kissing is one of the causes of infection.

Bacteria entering human body, forms toxic substances. They actively irritate the respiratory tract. A bronchial spasm is formed, which results in a spasmodic cough. The brain reacts sharply to this, developing a cough reflex, which gradually turns into a frequent, paroxysmal one.

For others, the carrier of the infection is contagious from the first day of the disease for three weeks. In the initial stage, the disease does not exhaust a person, so he continues to lead a normal life, communicates with healthy people and infects them.

Gradually the cough gets worse. This period lasts about 10 days. Coughing attacks end with the release of sputum, which has a vitreous character. There may be vomiting.

Even after treatment, the patient has a slight cough for a long time. Recovery forms a strong immunity against the disease.

Newborns do not have a strong cough or it may be insignificant. But they may stop breathing. This disease is very dangerous for babies.

Whooping cough is also transmitted by bacterial carriage - a specific human condition characterized by the fact that harmful bacteria live in the body, are released into the environment, but their carrier does not feel any symptoms of the disease.

This form of transmission is not very typical for whooping cough and is not particularly common.

How is whooping cough diagnosed and treated?

If a child is exhausted by coughing, parents should take him to the pediatrician. At the reception, the doctor will examine the patient, interrogate for contacts with sick children. The lungs are usually auscultated and given general analysis blood. For greater reliability of the diagnosis, the patient is additionally examined by an ENT doctor and an infectious disease specialist. The first specialist examines the larynx and pharynx, and the infectious disease specialist, after examining and questioning the patient, will send him for laboratory tests.

In addition to a blood test, it is possible to prescribe a bacteriological study of sputum secreted by coughing and a smear from the mucous membrane. In special cases, there are serological studies. For example, a rapid test enzyme immunoassay allows you to immediately diagnose the disease. Treatment is based on research results. If the form mild illness, then the patient is not prescribed bed rest. It is believed that the child needs a walk, but not among a large crowd of people.

Frequent ventilation of the room where the patient is located is necessary, because cough is better tolerated with cold temperature air. If the child is cold, it is better to dress him warmer. The room needs to be humidified. A sick child should be inhaled and given a lot to drink. It can be juices, fruit drinks, milk, tea, etc.

If the form of the disease is severe or moderate, then patients are placed in a hospital, and babies under 1 year old are hospitalized with any form of whooping cough. Standard antitussive drugs are ineffective in combating this disease, so they are not prescribed. Good massage and breathing exercises help in sputum discharge. Destruction of infection medications not produced due to inappropriateness: the bacterium itself is washed out of the body. Antibacterial therapy is rarely used, mainly in the catarrhal period of the disease.

Traditional healers advise plantain leaf as an expectorant, which also has an anti-inflammatory effect. Plantain is used with milk and honey. Another means traditional medicine is onion. Helps with this disease and tricolor violet. It is insisted on boiling water and drunk several times a day.

Let's try to find answers to some of them together.

How is whooping cough transmitted?

How can you get whooping cough? Do I need to be in close proximity to the patient to do this?

Whooping cough is transmitted exclusively by airborne droplets. Moreover, outside the body, the bacteria that cause it die very quickly under the influence of direct sunlight, so the distance to the patient should be minimal. Another option for infection is a long stay in the same room with other children, some of whom may be carriers of the bacteria. But if you have concerns, it is better to contact the district pediatrician or a specialized clinic. Modern methods diagnostics allow you to determine the presence of an infection in the body in minutes.

It largely depends on which drug is used. In the DTP (adsorbed pertussis-diphtheria-tetanus) vaccine familiar to many mothers, recommended for use in the Russian Federation, it is as follows: your child will receive four vaccinations in infancy: 3; 4.5; 6 and 18 months. Two more - at 7 and 14 years old. And then - re-vaccination of adults every 10 years. For them, ADS or ADS-M preparations are used, in which there is no pertussis component.

risk of recurrence

What is the probability that a child who has been ill once again “receives” the same diagnosis and begins to cough heavily? Is it safe to be in the same apartment with him?

Pediatricians are aware of cases of re-infection, but they are extremely rare. Children diagnosed with whooping cough in the Russian Federation receive a standard and very effective treatment. As a result, their immunity begins to produce specific antibodies that fight the bacterium Bordetella pertussis. Therefore, if a previously ill child is worried about coughing, it is almost 100% likely not caused by whooping cough. And if there are other children next to him in the apartment, then they have practically no chance of getting whooping cough.

Is it possible to make a diagnosis of whooping cough without additional research?

In the initial stage of development, this is extremely unlikely: whooping cough can be easily confused with SARS or bronchitis. Because of this, therapeutic measures do not bring any noticeable result, and the general condition of the child remains quite satisfactory. When whooping cough passes into a spasmodic stage, in which external manifestations become more pronounced, the correct diagnosis does not present any difficulties.

What happens if whooping cough is not treated: complications

Is it true that the greatest risk to health is not the disease itself, but the complications after it? Why do doctors often insist on hospitalization even when the child's condition is quite satisfactory?

Stabilization of the temperature regime, a general improvement in well-being and a significant decrease in the severity of coughing attacks do not mean that the child has recovered. Whooping cough is a very insidious infection, so you need to approach the doctor's recommendations with all possible responsibility. The body of a baby who barely survived serious disease, will not be able to effectively resist infection, since the immune system is extremely weakened. Moreover, the slightest violation of the regimen can provoke complications that are extremely dangerous for health and life, which are often not related to the lungs or the ear-nose-throat zone.

• Protracted bronchitis.
• Pneumonia.
• Otitis.
• Spasm of the bronchi or blood vessels.
• Pertussis encephalopathy. This is a severe lesion of the central nervous system, manifested by fainting, convulsions, visual and hearing impairments. If you notice any of these symptoms, seek medical attention as soon as possible.
• Hernia and prolapse of the rectum. The hacking, heavy cough is to blame for this, which can significantly increase intra-abdominal pressure.
• Atelectasis (collapse of the alveoli) of the lung. This condition often develops very quickly and leads to acute respiratory failure. How to deal with it? Call an ambulance immediately.
• Stroke and retinal detachment. Such conditions are explained by sharp pressure surges that occur as a result of a strong cough attack. The likelihood of such complications is extremely small, but if you encounter characteristic symptoms, you should not delay contacting a doctor.

Can you really die from whooping cough?

Rumors that this disease is fatal are very far from the real state of affairs. Even in the 19th century, when little was known about the potential for vaccination, the death rate from whooping cough did not exceed the number of cases per person. After the experiments of Edward Gener (he first vaccinated cowpox in humans in 1796) received medical recognition, and Louis Pasteur developed methods of vaccination against other diseases, the death rate from whooping cough dropped significantly - up to cases per person.

But if you take into account the newly born babies, the situation will no longer be so rosy. They do not yet have their own immunity from whooping cough, and they will receive their first vaccination only at 3 months. Moreover, if a low-quality vaccine is used (or its storage conditions are grossly violated), the likelihood of serious side effects will increase significantly.

In other words, if you followed all the recommendations of doctors during pregnancy, were revaccinated in a timely manner, made all the necessary vaccinations according to the schedule for the baby and did not expose his body to excessive stress, the probability of death will be extremely low.

How is whooping cough different from parapertussis?

Both of these diseases have a similar clinical picture, but it would be a big mistake to consider them as different manifestations of the same pathological process. If we discard subtleties of little interest to an ordinary person, then it will be possible to argue that parapertussis is a lite version of ordinary whooping cough. It proceeds much easier, does not give complications and does not always require any specific treatment.

• Pathogen: parapertussis (Bordetella parapertussis), which produces a toxin less powerful than Bordetella pertussis.
• Risk group: children 3-6 years old.
• Contagious period: no more than 14 days.
• Main symptom: cough (3-5 weeks). At the same time, the child most often maintains normal health, and fever and severe attacks with reprisals and vomiting are practically not observed.
• Incubation period: 7 to 15 days.
• Treatment: symptomatic.
• Duration of quarantine: 15 days.
• Active immunization: not available.
• Forecast: always (!) Favorable.
• Probability of re-infection: none.

Similarity to common whooping cough:

• potential source of infection;
• transmission routes;
• pathogenesis;
• methods and methods of diagnostics.

Is it possible to get whooping cough on the street

It is quite possible. You must understand that pertussis bacteria outside the body of the carrier is extremely unviable and dies very quickly. Therefore, the chance of infection on the street through accidental contact is quite small, although it still cannot be called zero.

If we talk about the possibility of infection in public places (theaters, schools, kindergartens, various sections and circles), where the duration of potential contact with the carrier of Bordetella pertussis is much longer, the situation will not be so rosy. In any room with insufficient ventilation and lack of direct sunlight, the bacterium can remain viable for a long time, as a result of which it will sooner or later "find" a new host.

But it does not at all follow from this that the baby needs to be kept at home all childhood, letting him go outside only on special occasions. If you do preventive vaccinations in a timely manner and teach your child to follow basic hygiene rules, the likelihood of infection can be significantly reduced.

reinfection

Is DTP a guarantee that a vaccinated child will never get whooping cough again? Does it make sense to refuse vaccination if whooping cough can still come back?

If your child has already had whooping cough, then doctors categorically do not recommend refusing routine DTP vaccinations. The fact is that the immunity that they provide is not stable. Sooner or later, he will no longer "recognize" Bordetella pertussis, and the likelihood of re-infection will increase significantly (on average, DTP lasts no more than 5-6 years). According to statistical studies, about 12% of all cases are adolescents over 15 years of age and adults, although whooping cough is considered exclusively a childhood disease.

It should be clarified that re-infection rarely leads to any serious consequences, and the disease itself is much easier. Therefore, you should not refuse preventive vaccinations: in any case, they “work”, as they significantly alleviate the symptoms.

Can whooping cough be treated with antibiotics?

There is no single answer to this question. The pertussis bacillus shows the greatest activity in the body of the carrier only during the first days. Therefore, if the child is given antibiotics at this time (remember, only a doctor should prescribe them!), Bordetella pertussis will be completely destroyed and the child will begin to recover quickly.

But the main problem of this method of treating whooping cough is that it is almost impossible to diagnose the disease at the very beginning of its development without laboratory tests. No cough, no specific symptoms, but visible clinical manifestations rather indicate ARVI or bronchitis. And if the district pediatrician has no particular reason to suspect whooping cough, he will prescribe ordinary vitamins or general strengthening agents for the small patient, which will not affect Bordetella pertussis in any way.

After 12 days, a paroxysmal period begins, characterized by severe coughing attacks. It can last quite a long time, sometimes up to 2-3 months. Antibiotics, even very strong ones, are practically powerless, which is why the prescribed treatment is most often symptomatic.

In this situation, doctors recommend at the first sign of a cold to still consult a doctor. Modern methods laboratory diagnostics can detect whooping cough in less than an hour. And if immediately after confirming the diagnosis to give baby easy and a safe antibiotic (such as erythromycin), it will suppress the reproduction of bacteria and make the healing process much faster.

Disease risk for adults

Is it possible to catch whooping cough if you have already graduated from school and are raising children yourself? Why can the risk of infection persist for almost a lifetime?

Theoretically, this is possible (especially if the patient's defenses are weakened), but the likelihood of this is extremely small. The immunity provided by standard vaccines is not very durable - only 5-6 years. Therefore, doctors recommend that after this period, repeated vaccinations not only for children, but also for adults.

Can a child play sports with whooping cough?

Questions

Q: Is it possible to get whooping cough again?

Can you get whooping cough again?

Yes, such cases do occur. The fact is that vaccination immunity develops for a period of 5 to 12 years, after which it begins to decline, and susceptibility to the disease increases.

Learn more on this topic:

Search for questions and answers

Form for supplementing a question or feedback:

Please use the search for answers (Database contains more than answers). Many questions are already answered.

Can you get whooping cough multiple times?

Whooping cough is a serious dangerous disease which is caused by a bacterial infection. The disease is transmitted by airborne droplets. Whooping cough most often affects children and adolescents. Main feature whooping cough - characteristic cough.

Children under the age of 2-3 years are most difficult to tolerate this disease, in young children complications may occur in the form of: otitis media, bronchitis, pneumonia, encephalopathy, apnea attacks, seizures. Due to severe coughing, hemorrhage in the brain can occur.

After the disease, persistent natural immunity is developed, the likelihood of re-illing with whooping cough is very small.

The whooping cough vaccine does not give permanent immunity, for this reason a second vaccination is needed.

whooping cough can be ill repeatedly and even after inoculation with DTP, where K is whooping cough. vaccination does not protect against the disease in general, but against severe forms of the disease in which a fatal outcome is possible

Whooping cough.

List of posts in the topic "Whooping cough." forum Parent meeting> Children's health

The children of friends were diagnosed with whooping cough today, we talked a week or two ago, their children have been very sick for a week now.

What should we do? the whole family has a cough and runny nose, I have the strongest, the child has the weakest. Describe to me, pliz, the symptoms of whooping cough, after how long should I go to donate blood?

And is it possible to get sick twice, my mom proves that I was already sick 😉

What we have now, my son has light snot, there is no cough at all, I have in the morning severe runny nose, weak since lunch and so every day, cough without attacks 2-3 times a day, voice is dead, my husband just has a sore throat and a taste of metal, I have the same thing.

Does this sound like the onset of whooping cough?

The last communication with a sick child was last Saturday, she had a fever on Saturday evening, we started to snort on Sunday afternoon, before that we met around September, from what date is quarantine considered, can we infect someone now? our nanny came down this Wednesday with our own symptoms, what does it look like, and when the child can go outside, we walked quietly until Friday (until we found out their diagnosis).

whooping cough is contained in in large numbers in the patient's sputum. Together with the smallest drops of sputum released during coughing, whooping cough pathogens enter the air, and from there into the respiratory tract of a healthy person. Sometimes whooping cough germs settle on toys, utensils and other items that the patient uses. If these items are then used by a healthy child, he will become infected with whooping cough. Small children are especially easily infected in this way, who take everything they come across by mouth.

A person with whooping cough is especially contagious at the onset of the disease, he remains contagious for 5-6 weeks.

Whooping cough affects children at any age, but most often in the younger - up to 5 years. A child who has whooping cough does not get sick again.

Severe attacks usually last 1-2 weeks, then the child begins to gradually recover. On average, children get sick for 5-6 weeks, and some for 2-3 months. Whooping cough lasts a long time if it is complicated by pneumonia or exacerbates tuberculosis.

In the warm season, a child with whooping cough should be kept outdoors all day. In winter, he must spend 4-8 hours in the air at a temperature not lower than -12 °. expedient and daytime sleep organize in the air, while the child should be warmly dressed, covered with a warm blanket. It is even better to use a warm quilted or fur bag.

If pneumonia has joined the whooping cough, the child should also be taken out into the air. This contributes to an easier course of the disease.

As a rule, a child with whooping cough, when he is carried away by some activity, does not cough. Therefore, it is necessary to strive in every possible way to interest the child in toys, pictures, to make him not be afraid of a coughing fit. It is very important not to irritate a child with whooping cough: any injustice towards him, refusal to comply with a request, force-feeding or dressing cause an increase in painful coughing fits and worsen the course of the disease. If others are nervous, react painfully to a coughing attack in a child, then the patient also becomes restless, which negatively affects his condition. Parents need to remember this.

The food of a child with whooping cough should contain many vitamins. Therefore, he needs to be given more fruits and berry juices, berries and vegetables rich in vitamins.

If coughing attacks are accompanied by vomiting, then the child loses part of the food eaten. Therefore, we must try to feed him more often - every 2-3 hours in small portions, give tasty and varied food.

Especially it is necessary to protect children from whooping cough in the first months of life. If in a family where there is Small child, the elder falls ill with whooping cough, it is necessary to place the patient in the hospital or send him to relatives who do not have children.

If a child with whooping cough cannot be provided at home necessary care or he has serious complications, you need to send him to the hospital.©

And still, at night began to be written! he has not been written for a long time, check the kidneys everything is ok. child 2.7 years old

a week and a half - snot, even went to the garden, everything is ok. On Friday, a cough appeared, and even vomited once, but not with thick sputum, but with what he had just eaten and drunk, and diarrhea (infrequent, but diarrhea). On Sunday evening, the temperature went up to 39. Now snot-cough, the temperature is still holding.

Maybe or is it SARS so vile?

my daughter coughed for a long time, several times a night, but for a total of 2-3 hours and at the end she vomited with transparent snot, without food, there was no temperature at all, it all lasted 2 months

the doctors first sent us, from the pediatrician to the ENT, and they didn’t find anything, because there was a completely normal child in a non-night cough, and when they sent us to an allergist ......

about the project

All rights to the materials posted on the site are protected by copyright and related rights and cannot be reproduced or used in any way without the written permission of the copyright holder and putting an active link to home page portal Eva.Ru (www.eva.ru) next to the materials used.

We are in social networks

Contacts

Our website uses cookies to improve the performance and efficiency of the website. Disabling cookies may cause problems with the site. By continuing to use the site, you agree to our use of cookies.

A detailed explanation of whooping cough in children and adults: what it is, why this disease is dangerous, what symptoms and signs it manifests itself, necessary tests and examinations, treatment, vaccination.

INFORMATION ABOUT THIS VERSION OF THE ARTICLE

Last revision date: 05/23/2013

Volume: 10 pages For one page, the volume of text is approximately equal to the volume of one book page.

HOW WAS THIS ARTICLE WRITTEN?

This article is written in accordance with our vision of the role that objective information can play in making personal medical decisions. Learn more about the article writing process and about the authors.

ASSESSMENT OF READERS AND CONTACT WITH AUTHORS

(New) Please indicate how happy you are that you found this article and/or leave your feedback.

What is whooping cough? Can he be dangerous?

Whooping cough is a contagious disease in which a sick person develops a painful cough.

In adolescents and adults, especially if they have previously been vaccinated against this disease, whooping cough does not cause any serious complications and usually ends in full recovery.

At the same time, for children of the first year of life, whooping cough poses a serious danger, especially if a child becomes ill with whooping cough in the first 6 months of life, if a child who is born becomes infected with whooping cough. ahead of time, or a child who has not received a vaccination against this infection on time.

In newborns and infants, whooping cough can cause sudden death due to respiratory arrest and heart failure. Of 100 children who get whooping cough in their first year of life, 1-2% die.

Every year, more than 50 million people worldwide fall ill with whooping cough, of whom about 300,000 die, most of them children. early age.

Where does whooping cough come from? How can a person get infected with it?

The causative agent of whooping cough is a microbe (bacterium), which in medicine is called Bordetella pertussis (bordetella pertusis).

Once in the human body, this bacterium produces toxins (poisonous substances), which cause severe inflammation and irritation of the surface of the respiratory tract. Outwardly, this is manifested by prolonged bouts of painful, dry cough.

In the course of epidemiological studies, it was found that the infection that causes whooping cough can only spread among people. For this reason, a healthy person (adult or child) can only get whooping cough from another person who has the disease.

As will be shown below in the chapter on whooping cough symptoms, quite often in adolescents and adults this disease is mild, in which the person has only a mild cough. People who get this form of whooping cough often believe that they have a common cold and therefore rarely go to the doctor, and even in those cases when they do go to the doctor, they are not always prescribed tests that can establish this infection. Because of this, people with whooping cough can spend many weeks infecting other people around them with whooping cough, not knowing that they are spreading a dangerous infection.

Whooping cough is transmitted by airborne droplets. This means that a healthy person can contract this infection by inhaling particles of mucus and saliva that are released into the air when a sick person sneezes or coughs.

It is believed that for infection with whooping cough it is enough:

How long is the incubation period for whooping cough?

Incubation period The incubation period is the period of time between the moment an infection enters the human body and the moment the first symptoms of the disease appear.

For many viral infections respiratory tract, for example, for influenza, the incubation period is 1-3 days (that is, the first symptoms of the disease occur 1-3 days after infection with the virus). For other infections, the incubation period can vary from a few days (rarely hours) to weeks, months, or years. with whooping cough it can last from 5-7 days to 3 weeks.

When does a person with whooping cough become contagious and how long does it remain contagious?

A person with whooping cough becomes contagious as soon as the coughing fits start and may remain contagious for the next 2-4 weeks or more if not treated with antibiotics.

People who start antibiotic treatment (see below for which antibiotics are active against whooping cough) are no longer contagious within the first 5 days of treatment.

How long should a child be kept at home?

If your child has whooping cough, he should stay at home and not visit Kindergarten or school (quarantine) for a minimum of 5 days if receiving antibiotics and a minimum of 3 weeks if not receiving antibiotics.

Why do adults and children who have been vaccinated against this disease get sick with whooping cough?

The whooping cough vaccine is medically known as DTP.

According to the national vaccination schedules adopted in Russia and in many other countries, DPT vaccination is given to children in the form of 4 doses, aged 3 months, 4.5 months, 6 months and 1.5 years.

Observations of large groups of children who received all 4 doses of DTP showed that this vaccine is really effective and makes about 80-85% of children who received it immune to whooping cough (in the remaining 15-20% of children, the vaccine forms immunity, allowing the development of only mild forms of the disease ).

However, studies have shown that immunity against whooping cough does not last for life, but only for a period of 4 to 12 years after the last dose of vaccination.

It is for this reason that many children (and especially adults) can get whooping cough again (in a milder form than people who have never received the vaccine) several years after vaccination and become spreaders of this infection.

In this regard, in some countries, DTP vaccination is recommended not only for children, but also for adolescents (aged) and adults (especially pregnant women).

What are the symptoms and signs of whooping cough?

The symptoms and signs of whooping cough depend on the age of the affected person, whether they have been vaccinated against the disease, and what treatment they receive. We will explain this in detail below.

The first symptoms of whooping cough often resemble those of a common cold: runny nose, slight fever (up to 38.5 C), sore throat, occasional cough, and malaise.

1-2 weeks after the onset of these symptoms, when it seems to a person that he has already almost recovered, the main symptom of whooping cough appears: a dry, choking cough that comes in the form of attacks lasting for 1-2 minutes.

Whooping cough attacks can recur several times an hour and are especially common at night.

Whooping cough can be so severe that after a few bouts, the sick person may vomit or pass out.

In medicine, cases are also described when, during a strong cough, a person's ribs broke.

When the coughing fit subsides, a person infected with whooping cough may look normal and feel practically healthy.

A few weeks after the onset of the disease, the cough begins to subside. In general, whooping cough cough can persist for up to 6-10 weeks or even more.

In children and adults who have been vaccinated against whooping cough, this disease can develop in the so-called "atypical" or "erased" form, in which the sick person is only bothered by a dry cough (no runny nose, no fever), lasting several weeks. It should be noted that even with "erased" forms of whooping cough, despite easy development disease, an ill person can infect other people around him (including children who do not yet have immunity to this infection and who can become ill with more severe forms of the disease).

In addition to whooping cough, some other dangerous diseases, including pulmonary tuberculosis, in which a person needs special help, can be the cause of a prolonged dry cough.

Symptoms and signs of whooping cough in young children

Most often, newborns, infants and children of the first years of life become infected with whooping cough from their parents, brothers or sisters who fell ill with an erased form of the disease and are unaware that they are the source of the infection.

We have already said above that in young children the development of whooping cough can be extremely dangerous, therefore, at the slightest likelihood that a child could get this infection, he should be shown to a doctor.

You may suspect that your child has whooping cough if you notice the following symptoms and signs:

• The child breathes heavily and strangely, as if he were short of breath;
• The child has attacks of dry cough, after which it is difficult for him to breathe or after which he stops breathing

What tests and examinations can a doctor prescribe to detect whooping cough?

Whooping cough is diagnosed and treated by infectious disease doctors.

To check for whooping cough, your doctor may order the following tests:

If these tests show that a person is indeed infected with whooping cough, the doctor will have to prescribe special treatment for him and all people who have come into contact with him.

What is the treatment for whooping cough?

All people infected with whooping cough should be treated with antibiotics. Without this treatment, they can remain contagious for a long time (4 weeks or more) and infect many healthy people around you (including children in whom this infection can cause severe complications).

What antibiotics should be taken?

If you or your child is found to have whooping cough, your doctor will be able to suggest antibiotic treatment such as Erythromycin, Azithromycin, Clarithromycin, Biseptol (co-trimoxazole, trimethoprim-sulfamethoxazole).

For newborns and children of the first year, Azithromycin is considered the safest. Children older than 2 months who cannot tolerate azithromycin may be given trimethoprim-sulfamethoxazole. The same drug is used in the treatment of whooping cough resistant to Azithromycin.

Possible treatment regimens for whooping cough in adults may include:

• Azithromycin: 500 mg on the first day, then 250 mg daily for 4 more days;
• Clarithromycin: 500 mg twice a day for 7 days;
• Erythromycin: 500 mg 4 times a day for 14 days;
• Trimethoprim-sulfamethoxazole (co-trimoxazole): 2 tablets 2 times a day for 14 days;

In some rare cases, while taking antibiotics or a few weeks after treatment is completed, a person may develop a dangerous intestinal infection symptoms of which may include abdominal pain and watery diarrhea.

If you're experiencing similar symptoms, see our article Diarrhea Associated with Antibiotic Treatment for our recommendations.

Why does a cough persist after starting antibiotic treatment? Does this mean that the treatment is not working?

In whooping cough, it is not the microbes themselves that cause the cough, but their toxins, which can persist in the respiratory tract for several weeks.

Antibiotics can kill bacteria but are not effective against the toxins they have already produced. In this regard, if antibiotic treatment is started after the onset of a cough (that is, after the microbes have had time to produce toxins), then the cough will continue for several more weeks.

What can be done to ease whooping cough cough?

Numerous studies have shown that conventional cough medicines are practically ineffective for whooping cough and may even harm people who take them.

Because of this, doctors use other medicines, such as corticosteroid hormones (in small doses as short courses of treatment), to relieve whooping cough. antihistamines(such as suprastin), salbutamol, or pertussis immunoglobulin.

If you have a severe cough, be sure to discuss with your doctor what medications you may be taking.

Based on their experience with whooping cough, some experts believe that medications such as zafirlukast and montelukast (used in the treatment of asthma) can relieve whooping cough, but there is currently no scientific evidence to support this assumption.

Recovery from whooping cough can be quite long. As you recover, the cough will become rarer and weaker, however, for a long time after recovery, the airways of a person who has been ill with whooping cough remain extremely sensitive, which is why a strong cough can appear even after a mild cold.

Can you get whooping cough again? What can I do to avoid getting sick again?

We have already said above that after vaccination, strong immunity against whooping cough lasts only for 4-12 years. The same can be said about the immunity that remains after illness. For this reason, a person who has been ill with whooping cough can get it again in a few years.

In order to prevent pertussis infection, experts recommend receiving DTP vaccine to all people every 10 years.

What should other family members do if someone gets whooping cough?

All family members who may have been in contact with a person with whooping cough should receive prophylactic antibiotic treatment.

Because whooping cough can be easily transmitted from one person to another and can cause severe consequences in some people, experts now believe that all people who may have been in contact with a person with the disease should receive preventive treatment. For example, if a child falls ill, then, in addition to family members, all his classmates and teachers should undergo preventive treatment.

Children under 1 year of age, pregnant women in the third trimester of pregnancy, people with reduced immunity

people who are infected with HIV or have AIDS,

people who have diabetes

people who have cancer and are taking cancer treatment (chemo, radiotherapy),

people who are taking treatment with glucocorticoid drugs or other drugs that reduce the activity of the immune system (for example, methotrexate, azathioprine, mercaptopurine, etc.),

people who have had a transplant internal organs and are taking medications that suppress transplant rejection,

people who are sick chronic diseases internal organs: chronic kidney failure, chronic hepatitis, cirrhosis, heart failure. and people who have serious lung disease (such as asthma) should receive prophylactic treatment for whooping cough even if they have not been in direct contact with a person with the disease, but have been in close contact with another person who may have contracted it.

Do people who have previously been vaccinated against whooping cough need to undergo prophylactic treatment?

Even if a person has previously been vaccinated against whooping cough, they still have a risk of contracting the disease again. For this reason, even if someone who has been in contact with a person with whooping cough has received all vaccinations against this infection, they should still receive prophylactic antibiotic treatment.

If a person has never received a whooping cough vaccine, then at the same time as prophylactic antibiotic treatment, he should also receive a vaccination.

All women should be vaccinated against whooping cough during every pregnancy to protect the newborn baby.

We have already said above that whooping cough can be especially dangerous for children of the first year of life, especially in the first months after birth.

In 2012, data from one US study was published showing that of more than 2,200 cases of whooping cough reported that year in the US, more than 2,200 cases were in infants, of whom 15 died. In about 40% of cases, children contracted whooping cough from mothers who had a mild form of the infection.

In order to protect newborns from whooping cough, it is currently recommended that all pregnant women get the whooping cough vaccine (DTP) in the third trimester, between 27 and 36 weeks of pregnancy.

Thanks to such a vaccination, antibodies quickly appear in the body of a pregnant woman, which pass into the body of a developing child and will protect him from whooping cough in the first months after birth, until he can receive the first dose of DTP vaccination.

You should get the whooping cough vaccine even if you have received all the recommended doses of DTP in the past.

There are currently no whooping cough vaccines that can be given to children immediately after birth. In this regard, protecting the child through vaccination of the mother is the only solution so far.

It will be right if, in addition to the pregnant woman, all other people who will often contact the child during the first months of his life (for example, father, grandparents) will receive a whooping cough vaccine (DTP). They must be vaccinated no later than 2 weeks before the birth of the child.

Is the whooping cough vaccine safe during pregnancy?

Currently DTP vaccination considered safe for pregnant women. Until now, there have been no cases of its negative impact on the course of pregnancy or on the development of the fetus.

Do I need to repeat the vaccination during every pregnancy?

Due to the fact that after vaccination the concentration of antibodies against whooping cough in the mother's body gradually decreases, for optimal protection of newborn babies, women are recommended to be vaccinated at the end of each pregnancy.

• Center of Disease Control and Prevention (CDC). Pertussis (Whooping Cough)
• Altunaiji, S.M. et al., 2012. Antibiotics for whooping cough (pertussis). Evidence-Based Child Health, 7(3), pp.893–956.
• Bjornson, C.L. & Johnson, D.W., 2013. Group in children. Cmaj, 185(15), pp.1317–1323.
• Luiz Rachid Trabulsi, M.B.M., 2008. Bordetella pertussis. Microbiologia., pp. 257–261.
• Snyder, J. & Fisher, D., 2012. Pertussis in Childhood. Pediatrics in Review, 33(9), pp.412–421.
• Gall SA. Prevention of pertussis, tetanus, and diphtheria among pregnant women, postpartum women, and infants. Clin Obstet Gynecol. 2012;55(2):.

How happy are you that you found this article?

Dasha Sargsyan on the need for changes in the relationship between doctors and patients

How modern ideas about marketing explain the existence of pseudoscientific manipulation

Notes to the books by Seth Godin “All marketers are liars” and Alexey Vodovozov “The reasonable patient. Pitfalls of “medical” diagnostics that everyone should know about”

Cancer Prevention Foundation: evidence-based cancer screening in Russia

The activities of the Cancer Prevention Foundation allow consumers to medical services receive care in accordance with the standards and principles of evidence-based medicine.

How not to prevent a child from growing up to be a happy and self-confident person and a new paradigm of relations between patients and doctors

An indicator of mental health is a feeling of the unshakable and unconditional value of one's own personality, inherent in it by birthright, and recognition of the unconditional value of the personality of other people.

Healthy Skepticism

Notes to the book by Asya Kazantseva “Someone is wrong on the Internet!”. Recommendations and tools for searching and assessing the quality of medical information.

Raising the bar for medical information

Criteria and questions that consumers can use to assess the quality of health information.

help patients and doctors make informed and informed medical decisions

to help patients and physicians build effective and morally justified relationships: a collaboration based on mutual recognition of their unique roles and a fair division of responsibility, the main task of which is to formulate and achieve the medical goals of the patient.

The Smart Consumer Guide to Health Services and Information consists of 3 parts:

PRINCIPLES OF MEDICAL DECISION-MAKING FOR PATIENTS AND THEIR FAMILIES

COMMON ERRORS IN THE INTERPRETATION OF MEDICAL INFORMATION AND THE POSSIBILITY TO AVOID THEM

Protection against cardiovascular diseases

Cancer Protection

Contraception

If you'd like to receive one message every few months about new articles and about important changes to the published content that we make as we process new data, sign up for our free newsletter.

Article last revised: 9T15:06:55+02:00 .

about the project

The object of our work is the systematic analysis of scientific information to transparently present information about the benefits, harms and limitations of medical services and strengthen the ability of patients and their families to participate in important medical decisions.

Children can get whooping cough only from a sick person. If this child is not diagnosed in time and he continues to remain in the children's team, then many children can become infected from him.

The source of infection is mainly older children (over 3 years old), who usually communicate extensively with children of all ages. Sometimes children who have received prophylactic whooping cough vaccines get the disease in a very mild form, without the typical coughing spells with "sunsets", and parents do not even suspect that they have whooping cough. However, contact with such patients can cause real whooping cough in unvaccinated children, and sometimes in a severe form. Therefore, a child who has a cough should be isolated from other children as soon as possible to avoid infection.

More rarely, children can get whooping cough from adults, most often from mothers who usually have atypical, milder form of whooping cough, but who are nonetheless contagious to children.

Whooping cough is caused by a special microbe - the bacillus Borde - Zhangu, named after the scientists who discovered it. This microbe is very unstable and quickly dies from sunlight, high temperature etc. That is why whooping cough cannot be contracted from third parties or from objects used by the patient, as is observed with other infectious diseases such as diphtheria, scarlet fever, etc.

A sick child, when coughing, which is the main symptom of whooping cough, sprays far around him the smallest droplets of sputum and mucus from the nasopharynx, which contain whooping cough pathogens that live and multiply in the upper respiratory tract of the patient. If these droplets are inhaled by a nearby healthy child, they usually get whooping cough.

After a meeting of a healthy child with a sick whooping cough, the disease does not occur immediately. Some time passes (4-14 days). This is a latent period after which the disease develops actively.

In the early days, the cough does not yet have a character typical of whooping cough, and parents think that the child has caught a cold. However, a child with whooping cough in this initial period of the disease is already contagious to other children, and if he continues to remain among them, as is most often the case, then many more children can become infected from him.

According to the instructions of the Ministry of Health of the USSR, a patient with whooping cough is considered contagious within 30 days after the onset of spasmodic cough or 40 days from the onset of coughing. But sometimes whooping cough can be delayed up to 3-4 months in those patients who suffer from inflammation of the respiratory tract, or aggravated by the addition of other infections, such as measles, influenza. Therefore, a sick child with a prolonged cough should be carefully examined in order to decide whether he can be admitted to a child care institution. This question is decided only by the attending physician. But compared to the flu, measles, chicken pox whooping cough is less contagious: they require closer contact to become infected than with these diseases. Due to this, not all children who come into contact with the patient fall ill with whooping cough, while, for example, almost all children who have had even the most fleeting contact with the patient, as a rule, fall ill with measles.

In the process of whooping cough, the body produces protective substances against microbes - antibodies. Therefore, as a result of an illness, a child usually develops immunity to whooping cough. Thus, in the vast majority of cases, children who have had whooping cough do not get sick again. If this happens, it is relatively rare. It should be noted that some mothers mistakenly take such cases as a recurrence when, 2-3 months after a recent whooping cough, under the influence of some other disease (for example, influenza), convulsive coughing attacks resume with renewed vigor. In these cases, we must speak of the so-called recurrence of whooping cough, not mixing it with a recurrence of whooping cough.

The absence of absolute susceptibility to whooping cough and the possibility of infection only through close contact with the patient facilitate the fight against the spread of whooping cough, provided that parents pay sufficient attention to this disease and properly conduct all preventive measures, which will be discussed below.

Whooping cough is an infectious disease that affects both children and adults. It is caused by coccobacteria. Whooping cough is transmitted by airborne droplets (with air flow). by the most hallmark whooping cough is a paroxysmal cough.

General information about whooping cough

The source of the disease is a sick person who becomes dangerous to others on average 5-8 days after infection. The infectiousness of the patient is especially high at the beginning of a paroxysmal cough, then it gradually decreases. The degree of contagiousness depends on the severity of the cough, which contributes to the ejection of infected respiratory secretions. Most often, children aged 2 to 5 years get sick (children's whooping cough). In recent years, adolescents, adults and children of the first months of life predominate among the sick. The high susceptibility to whooping cough in children from the first days after birth (more often in newborns and infants) is explained by the fact that antibodies carried from the mother do not protect the baby from the disease.

The causative agent of whooping cough enters the mucous membrane of the respiratory tract, then when breathing it penetrates deeper (into the lower respiratory tract). The main pathogenic effect in the development of the disease belongs to the toxin (produced by the pathogen), which, acting on the mucous membrane of the respiratory tract, causes coughing.

Distinguish between typical and atypical whooping cough. The typical type of disease includes cases of illness with coughing fits. Atypical whooping cough is considered its erased form. With erased forms, the cough is normal.

Typical forms of whooping cough can be mild, moderate, or severe. The criteria are the frequency of coughing attacks per day.

With a mild form, the frequency of attacks is up to 10-15 per day. The general condition is not disturbed, vomiting is rare.

In the moderate form of whooping cough, the number of coughing fits reaches 15-25. A coughing fit is accompanied by a slight blue of the lips, sometimes ending in vomiting.

In severe whooping cough, the number of attacks is more than 25 per day, sometimes 40-50 or more. Attacks are accompanied by a general blue skin with respiratory failure. The child's well-being is sharply disturbed: he is irritable, sleeps poorly, loses his appetite.

whooping cough symptoms

The period from the moment of infection to the appearance of the first symptoms is from 3 to 15 days, with an average of 5-8 days. During the course of the disease, three periods can be distinguished. Whooping cough is slow.

First period. The disease begins gradually. There is a dry cough, headache, sometimes a slight increase in body temperature and a slight runny nose. The general condition of the child is usually not disturbed, he often continues to visit the children's institution. Within 1-2 weeks, the cough gradually increases, becomes obsessive and then paroxysmal. The duration of this period is about 2 weeks. In severe cases, especially in infants, it is shortened to 5-7 days.

Transition to the next period accompanied by the appearance of coughing fits: coughing shocks quickly follow each other on exhalation, in a series. Then an inhalation occurs, accompanied by a whistling sound, then again coughing shocks on exhalation and a whistling breath, etc. At the beginning of this period, coughing attacks are rare, then they become more frequent and intensify, reaching a maximum at 2-3 weeks from the onset of this period of illness. Depending on the severity of whooping cough, the number of coughing attacks during the day ranges from single to 40-50 or more per day. Coughing fits may recur at very short intervals. During an attack of coughing, the child's face turns red, turns blue, the veins of the neck swell, the eyes water, as if filled with blood, the head stretches forward, the tongue protrudes to the limit. In severe cases, during an attack, there are nosebleeds, fever (fever), involuntary urination, and passing of feces. Coughing fits end with the release of viscous viscous sputum and vomiting. Immediately before an attack, older children are anxious, they try to find support. In the interictal period with mild and moderate whooping cough, the general condition of the child is not disturbed. Children remain active, play, appetite is preserved. In severe, often recurring attacks, children are lethargic, irritable. The duration of this period is from 2 to 4 weeks. Then the coughing fits gradually weaken, and a period begins during which patients cough less often, sputum is separated more easily. During this period, lasting from 1.5 to 2-3 months, the cough becomes common.

Whooping cough in vaccinated children usually proceeds in an erased form. At the same time, there is a slight, uncharacteristic, but prolonged cough (up to 5-7 weeks) and slightly shortness of breath. There are no complications.

The course of whooping cough in children under the age of 1, especially in newborns, is much more severe. Symptoms appear as early as 4-5 days after infection. In newborns, the disease can begin immediately with coughing fits. Children of the 1st year of life are very sensitive to a lack of oxygen, so they have more seizures than adult children. The condition of children during an attack is usually severe, sleep is disturbed, hand trembling, twitching in a dream are noted.

Whooping cough prevention

Vaccination is important for prevention. Primary vaccination is carried out for children at 3, 4.5 and 6 months, revaccination (re-vaccination) - after 1.5-2 years. A child with whooping cough must be separated from peers for 25-30 days from the moment of illness. For children under the age of 7 who have been in contact with patients and have not previously had whooping cough and have not been vaccinated (if they do not have a cough), a quarantine is established for a period of 14 days from the moment of the last contact with the patient. If a sick child is treated at home, children under the age of 7 years who did not have whooping cough, who were in contact with him, are subject to separation, which stops after 25 days from the onset of coughing in the first sick child.

Whooping cough complications

Damage to the nervous system - there may be convulsions, nosebleeds, hemorrhages on the skin and in the mucous membrane of the eye. The most common complications are due to the layering of a bacterial infection (pneumonia may develop). whooping cough can become chronic disease if it is not fully cured. Also dangerous consequences may occur when a pregnant woman develops whooping cough. This is bad for the development of the fetus. Therefore, at the first signs of this disease, you should immediately consult a doctor.

Diagnosis of whooping cough

Whooping cough during a coughing fit is not difficult to diagnose. Difficulties arise in the diagnosis of whooping cough at the onset of the disease. In these cases, one should focus on a persistent obsessive cough and the occurrence of vomiting during coughing. Laboratory results are required to confirm the diagnosis.

Whooping cough treatment

Young children, as well as all patients with severe whooping cough and complications are subject to hospitalization.

Early use of antibiotics contributes to a significant relief of coughing attacks, reducing their number and shortening the duration of the illness. The course of treatment is from 5 to 7 days. Apply antihistamines (suprastin, tavegil) in normal doses. In severe cases, hormones are used. In addition, it is necessary to use drugs that thin viscous sputum (inhalation). In the treatment of patients with whooping cough great importance have a properly organized regimen and care. Throughout the disease, the sick child is shown cool air, which has a calming effect on nervous system and leads to a reduction and weakening of coughing fits.

A nutritious diet should be provided. With frequent vomiting, the child should be supplemented.