Whooping cough

Content

  • What is whooping cough
  • Symptoms of pertussis
  • Complications of pertussis
  • Diagnosis of pertussis
  • Treatment of pertussis
  • Prevention of pertussis



  • What is whooping cough

    Whooping cough - this is a dangerous infectious
    airways disease, which is caused by
    specific bacteria Bordetella pertussis
    (Pertussis coli, bacillus Bordet-Zhang)., Pathogen
    -
    small, ovoid, Gram-negative bacilli,
    are unstable in the environment. Entrance gate
    infection
    - Upper respiratory tract, where it vegetates pertussis
    wand. It is characterized by acute respiratory catarrh
    ways and attacks of spasmodic cough. Congenital
    immunity due to maternal antibodies do not
    develops. The probability of infection in contact
    It is 90%. Very dangerous for children younger than 2 years old.
    Since the appearance of the characteristic cough to distinguish
    pertussis infections from other hard for one
    of the week
    infected manage to infect their surroundings.

    Most sick children of preschool
    age.
    The incubation period lasts from 7 to 14 days. Infection
    It is going airborne. A patient is contagious from
    1
    up to 25 days zaboolevaniya. The duration of the infectious period
    can be reduced by timely conduct
    antibiotic therapy.

    Whooping cough is endemic throughout the world. In each
    the disease becomes a particular locality
    epidemics at intervals of 2-4 years.
    About half of the cases occur in children under 2 years.
    The first disease usually does not leave natural
    immunity for life, but re-infection (if
    she is
    takes place) proceeds easily and often
    recognized.

    The disease lasts about 6 weeks
    is divided into 3 stages: prodromal (catarrhal)
    and paroxysmal stage of recovery.


    Symptoms of pertussis

    After infection begins prodromal
    (Catarrhal) period: 1-2 weeks indicated
    runny nose, sneezing, occasionally moderate increase
    temperature (38-38,5) and a cough that does not decrease
    from antitussives. Gradually cough
    amplified, it becomes paroxysmal form
    especially at night.

    Whooping cough
    Starting with the third week begins
    paroxysmal period, during which there is
    typical spasmodic cough: a series of fast 5-15
    cough shock, followed by a short whistling
    breath. After a few normal breaths can
    Start a new paroxysm. During the paroxysms
    released copious amounts of viscous mucous
    glassy phlegm (usually infants and young children
    her
    swallow, but sometimes marked her office in the form of
    large bubbles through the nostrils). Characterized by vomiting,
    occurs at the end of the attack or vomiting movements,
    caused by the discharge of thick mucus. During the attack
    coughing patient's face reddens or turning blue; language
    protrudes to failure, it is possible trauma
    Nizhnik bridle on the edge of the incisors; sometimes there
    hemorrhages under the mucous membrane konyunkitivy
    eyes.

    After the attack the child is tired. In severe
    cases, deteriorating general condition.

    The number of seizures increased by
    During disease. Some children are not attacks
    Often, others are up to 50 per day.

    In infants, there is no common
    whooping cough attacks. Instead they after several
    cough shocks may occur short-term
    respiratory arrest, which can be dangerous for
    life.

    Depending on the frequency of cough
    attacks and the severity of other symptoms distinguish
    mild, moderate and severe forms of pertussis.
    Observed and erased forms of pertussis, in which the
    spastic nature of the cough is not expressed. This form
    observed in children who have received vaccinations, and
    at
    adults.

    Step recovery begins with
    the fourth week; paroxysms are not as
    frequent and severe, rarely end with vomiting, the patient
    It feels better and looks better. Central
    disease duration - about 7 weeks (3
    weeks to 3 months). Paroxysmal cough may
    reappear during neskolkihmesyatsev; as
    Typically, it provokes SARS.



    Complications of pertussis

    Especially hard, with considerable
    mortality, pertussis occurs in infants
    life; infants are often observed bouts
    apnea,
    pneumonia, atelectasis (25%), seizures (3%)
    encephalopathy (1%).

    Among other complications observed sharp
    laryngitis (inflammation of the larynx) with stenosis of the larynx
    (False croup), bronchiolitis, nosebleeds,
    stop breathing, umbilical, inguinal hernia.

    Dangerous is a lung disease
    (Pneumonia), especially in infancy
    (15% probability).

    Also, a serious complication
    encephalopathy, non-inflammatory changes in the brain
    the brain, which may as a result of seizures
    cause death or leave behind a persistent
    damage, deafness or seizures.

    In adults, complications are rare.

    Mortality is high in developing
    countries.
    In developed countries, pertussis and mortality
    complications reaches 0.04%.



    Diagnosis of pertussis

    The basic method - abjection
    (Bacteriological method). On the 1st week of disease
    Positive results can be obtained in 95%
    patients
    4 - 50% only.

    The difficulties encountered in identifying
    mainly in the form erased. must
    differentiated from acute respiratory infections, bronchitis. confirmation
    diagnosis of pertussis is a selection of sticks
    tracheobronchial secretions; for retrospective
    Diagnosis in the later periods of use
    serological methods (agglutination, RSK,
    RIHA).



    Treatment of pertussis

    Treatment is carried out only small children
    in the hospital. Patients provide special conditions -
    Chamber should be well ventilated, the air must
    be
    moistened special humidifiers, air conditioners, or
    wet towels. Seriously ill infants
    recommended to be placed in a darkened, quiet room and
    how can disturb less, as the impact of
    external
    stimuli may cause severe coughing fit. For
    older children with milder forms of the disease bed
    mode is required. It is recommended to stay patient
    on
    outdoors, children outdoors virtually
    cough.

    Whooping cough
    Serious attention should be paid to
    nutrition, food is often recommended to give, but small
    portions. If you frequently need to introduce severe vomiting
    intravenous fluid. For infants is vital
    suctioning of mucus from the throat. Of great importance in
    whooping cough, especially in young children, with
    expressed hypoxia phenomena is widely used
    Oxygen therapy (oxygen content in the tent).

    young children with severe and moderate
    forms of the disease, or the presence of complications appointed
    antibiotics: erythromycin, 5-10 mg / kg per reception 3-4
    fold
    per day; ampicillin orally and / m25-50 mg / (kg day) 4
    receiving treatment 8-10 days. Assign also
    30-40 mg tetracycline for 10-12
    days.
    combination is used in severe cases of two
    antibiotics. In the early stages of the disease is effective
    pertussis gamma globulin (3-6 ml daily 3
    consecutive days).

    In severe and complicated forms of pertussis
    Prednisolone is used. In order to reduce spastic
    phenomena and cough attacks prescribe antipsychotic
    means -aminazii, propazin. If hypoxia is shown
    oxygen therapy, apnea - continuous artificial
    ventilation. When prolonged repair appoint
    stimulating therapy (plasma transfusions, injections
    immunoglobulin, physiotherapy,
    vitamins).

    Cough and sedatives
    should be used with caution or not at all apply,
    because the effectiveness of expectorants medicines and drugs,
    suppressing cough, lung and sedatives
    questionable. Avoid impact,
    provoking
    cough (mustard, banks).

    During cessation of breathing is necessary
    clear the airways of mucus through its suction
    and perform artificial respiration.



    Prevention of pertussis

    The only reliable means of
    specific prevention is vaccination. Vaccines
    Pertussis: The vaccine pertussis-diphtheria-tetanus toxoids adsorbed liquid; Tetrakok;
    Tritanriks
    (Vaccine against whooping cough, diphtheria, tetanus
    and
    Hepatitis B); Infanrix (DTaP) (acellular vaccine
    for
    prevention of whooping cough, diphtheria and tetanus).

    All children from 3 months course is held
    vaccination against whooping cough, which consists of 3 injections
    DTP vaccine with an interval of 1.5 months. revaccination
    make
    1.5-2 years after the course of vaccination. Vaccination
    70-80% disease prevents or it occurs in
    mild form.

    patient isolation lasts 30 days
    onset of the disease. Children under 7 years of age, the former
    at
    contact with patients without a history of previous pertussis and
    unvaccinated, imposed a quarantine period of 14 days
    the moment of patient isolation. If the insulation is not carried out,
    this period is extended to 25 days from the day of the disease.
    Final disinfection is not performed. All children,
    have been in contact with the patient, to be
    survey
    Carrier.

    The contact children under the age of 1 year and
    not
    grafted administered for the prevention of normal
    human
    immunoglobulin (measles) to 3 mL of 2 consecutive days.

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