Pertussis is a bacterial disease transmitted by airborne droplets from a sick person to a healthy one. Bacteria during coughing fly out of the respiratory tract of the infected and through the nasal cavity penetrate the bronchial mucosa of a nearby person. There they irritate the receptors and cause an unrestrained cough, literally turning into vomiting.
Vaccinations for whooping cough are starting to be done at 3 months of age, together with vaccinations from diphtheria and tetanus - usually a DTP vaccine is used. Of the three components of the pertussis vaccine, it is most difficult to bear. And it often happens that weakened children or children who previously had pronounced reactions to the vaccination are vaccinated with an ADA drug that does not contain pertussis.
The timely vaccination allows 80% to reduce the risk of the disease, and if the infection still occurs, the disease proceeds more easily.
Causative agent of pertussis
Why does pertussis occur, and what is it? So called infectious, very contagious disease that affects the respiratory system and the nervous system, and is accompanied by characteristic attacks of convulsive cough. The causative agent of whooping cough is Borde-Zhang( whooping cough), transmitted from the sick to the healthy airborne drop, with a cough.
Pertussis can be of three main subtypes - aggressive and seriously leaking first type of infection, and more favorable and of moderate severity - the second and third types of rods. However, in the development of whooping cough, the age and previous state of health of the child also play an important role.
Diseases :
- incubation period - 2-14 days,
- initial or catarrhal period - 2-14 days,
- period of convulsive coughing - from 1 month or more,
- recovery - 1-2 months.
It is transmitted by whooping-cough by airborne droplet, spreading from its owner by 2.5 meters to the sides. Through the care items, the wand is not transmitted, and susceptibility to pertussis is 70 to 100%, depending on the degree of density of the groups and the length of stay in the team. Pertussis can be infected at any age from the period of newborns, especially children are often ill during the cold season - from November to March, when they practically do not walk and sit at home or in the kindergarten. The incidence of morbidity is approximately every three to five years, the transferred pertussis gives lifelong persistent immunity.
At the age of up to a year, whooping cough is very difficult, the death rate is high - 50-60% of those who are ill among unvaccinated children. After the vaccination against pertussis, the disease, if it develops, then proceeds not so pronounced, without characteristic seizures.
Symptoms of whooping cough
The incubation period of whooping cough is 6-20 days( usually 7 days).In the case of pertussis in a child, the main symptom are seizures of severe spasmodic cough, repeated for a long time( see photo).
However, the first signs of whooping cough in children resemble the usual ARI: malaise, decreased appetite, a slight runny nose, a rare dry cough, an increase in temperature( most often up to 37-37.5 degrees, in some cases up to 39 degrees).
Day after day, cough increases, on the 12-14 day of the disease, it is spasmodic, paroxysmal. At night, coughing attacks tend to get more frequent, preventing the baby from sleeping peacefully. Depending on the course of the disease, seizures can last for 4-5 minutes and repeat up to 20 times a day. At the end of a bout of coughing, a child may complain of pain in the chest and abdomen. In some cases, the disease is accompanied by vomiting.
The disease occurs in three stages( catarrhal, paroxysmal and recovery stage).In general, the disease lasts 6-8 weeks.
- Cataract .The general condition of the child remains without pronounced changes. Body temperature can rise to subfebrile digits( 37.5 ° C).There is a dry cough, worse in the evening and at night. Cough gradually becomes obtrusive, gradually passes into paroxysmal. There may be a runny nose, a decrease in appetite, anxiety and irritability. Symptoms resemble pharyngitis, laryngitis, tracheitis. The heavier the disease, the shorter the catarrhal stage. So in children in the first year of life, the duration of the catarrhal period is 3-5 days, in older children - up to 14 days.
- Paroxysmal .Signs of acute respiratory infections are absent altogether, and cough becomes intrusive, spasmodic. This occurs in the second or third week of the disease. It is at this stage that it is possible to recognize whooping cough in a child by a characteristic cough. An experienced pediatrician, like a cough, will immediately determine whether it is pertussis or not. And for this there is no need for any diagnosis, laboratory research. Signs of pertussis in the vaccinated child at this stage are much softer. It often happens that whooping cough is transferred without diagnosing: coughed, and everything went without any treatment.
- Resolution period( 2 to 4 weeks) .During this period, the body's immunity mobilizes its forces and with the help of antibiotics defeats the aggressor. The cough subsides, seizures become less frequent. Passes the "cock" character of coughing. The sputum composition changes - it becomes mucopurulent and gradually ceases to stand out. Over time, all the symptoms of the disease gradually go away and the baby recovers.
The severe course of whooping cough in children can lead to serious consequences and complications, in particular, hypoxia develops, as a result of which the blood supply to the brain and the heart muscle is impaired. With the wrong method of treatment of pertussis in children, there may be complications in the functioning of the respiratory system, pleurisy, emphysema, pneumonia develops. Also in the stagnant pulmonary tissue, other bacteria can develop.
The course of the disease in young children
Pertussis in young children is very difficult, the incubation period is shorter. The short catarrhal stage passes into a prolonged paroxysmal period.
A classic fit of coughing may not be, it is replaced by sneezing, anxiety, screaming, the baby adopts the embryo pose. Reprises, if any, are not clearly defined. There may be apnea( stopping breathing) during an attack or between attacks, especially when it is dangerous to sleep apnea. The younger children have a very high risk of complications.
How does whooping cough - photo
Analysis of blood for whooping cough
At an early stage, when pertussis symptoms in children are not yet expressed, the diagnosis of pertussis helps diagnose the disease. It is carried out by the bacteriological method, when a bacterial colony is grown from a phlegm in a nasopharynx and determines their species identity, or, if it is necessary to obtain a result in a short time, using the PCR method, which makes it possible to detect the presence of pertussis directly in the smear.
In addition, serological tests are used to show the presence of antibodies to pertussis in the blood or mucus.
Treatment of whooping cough in children
A greater number of sick children are treated at home, but under medical supervision. However, there are cases when hospitalization in a hospital is a vital necessity. These are:
- infants up to six months of life;
- is a complicated course of whooping cough;
- whooping cough in combination with other diseases;
- whooping cough in weakened children;
- all severe forms of whooping cough.
First of all, whooping cough requires quarantine( 25 days from the first day of illness).It is necessary that the disease is not further spread, except for this patient should not be exposed to other infections, so as not to get a complication. In this regard, protect other children from the sick and take all measures to prevent the spread of the disease.
Food and drink should be given to a child often, in small portions, and when vomiting - to reapply. The fresh air facilitates the attacks, so the kid needs to organize walks. Treatment should take place in a relaxed environment, as coughing attacks are provoked by nervous tension and emotional disruptions.
Treatment of whooping cough in children necessarily includes antibiotic therapy. From the correct choice of the drug depends on the duration of the disease and the severity of the condition of the baby. Also for the treatment of the disease, doctors prescribe the use of anticonvulsants, antitussives and expectorants, soothing drugs, homeopathic medicines.
If you do not treat whooping cough, then after 2-3 weeks it can develop into pneumonia. In addition, if a child has a severe form of whooping cough, there may be delays in the development of the nervous system( speech delay, distracted attention).
How to treat whooping cough in children - says Komarovsky
Pertussis in children and its symptoms, Komarovsky emphasizes, with mild illness, difficult to diagnose.
In the formulation of a timely and correct diagnosis, the pediatrician is helped by attention and observation. For everything to become clear, see the video "Pertussis: Symptoms in Children".Do not panic if you have pertussis, but do not lose your vigilance.
Prevention of whooping cough - only inoculation
The main measure for the prevention of whooping cough is vaccination. No matter how many opponents of compulsory vaccination against pertussis say, the fact remains: if the child is not vaccinated, the risk of getting sick is quite high, especially if the baby is actively in contact with other children. And this risk is steadily increasing simultaneously with the growth of refusals and unreasonable medical diversions from vaccinations.
Today, whooping cough is often diagnosed at later stages, which complicates treatment and leads to complications. There is one more, an administrative factor. If pertussis is found on the pediatrician's site, this is an emergency that requires filling out many papers, "clarifying the relationship" with the sanitary epidemiological station, etc. Therefore, the diagnosis of whooping cough is trying not to advertise.
Vaccination performed to a healthy( or almost healthy, not contraindicated) child is almost safe. The most frequent unpleasant effect from it is the temperature and pain at the place of administration of the vaccine, but these effects can be avoided if modern purified vaccines( such as Infanrix or Pentaxim) are used.