Whooping cough can cause both adults and children. Immunity from this respiratory infection is developed only after a person has had a single illness. In children, the manifestations are more severe, and complications can be very serious, even fatal. Vaccination done in the first months of life. It does not guarantee complete protection against infection, but in vaccinated children the disease is much more mild. Doctors recommend parents when caring for children with whooping cough to protect them as much as possible from any factors that provoke the appearance of choking cough.
Whooping cough features
The causative agent of this disease is pertussis bacillus (a bacterium called Bordetella). The infection affects the trachea and bronchi.
The respiratory tract is covered by the so-called ciliated epithelium, whose cells have “cilia” that ensure the movement of sputum and its excretion. When they are irritated by toxic substances secreted by pertussis pathogens, the nerve endings transmit a signal from the epithelium to the brain (to the site responsible for the occurrence of cough). Response – reflex cough, which should push out the source of irritation. Bacteria are firmly held on the epithelium due to the fact that they have special villi.
It is characteristic that the cough reflex is so fixed in the brain that even after the death of all the bacteria, the strong urge to cough continues to persist for several more weeks. The waste products of pertussis bacteria cause general intoxication of the body.
Warning: In humans, there is no innate immunity to this disease. Even a baby can get sick. Therefore, it is important to protect him from contact with adults who have a strong persistent cough. It may well be a sign of whooping cough, which in an adult, as a rule, has no other characteristic manifestations.
The susceptibility of a person is so great that if a baby gets sick, the rest of the family will get infected from it. Whooping cough lasts 3 months while the cough reflex exists. However, for about 2 weeks, the disease has almost no symptoms. If somehow it is possible to establish in the very first days that the pertussis bacterium is present in the body, then the disease can be quickly suppressed, since the dangerous cough reflex has not yet managed to gain a foothold. Usually, the symptoms of pertussis in children are found already at a severe stage. Then the disease continues until the cough gradually disappears on its own.
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How does the infection occur?
Most often, whooping cough is infected by children under the age of 6-7 years. Moreover, in children younger than 2 years the probability of infection is 2 times higher than in older children.
The incubation period for whooping cough is 1-2 weeks. For 30 days, the child should not attend the children’s institution, contact with other children, as whooping cough is very contagious. Infection is possible only through airborne droplets when in close contact with a sick person or bacillicarrier when he sneezes or coughs.
Outbreaks of the disease occur more often in the autumn-winter period. This is explained by the fact that pertussis bacteria quickly die under the rays of the sun, and the length of daylight hours in winter and autumn is minimal.
Forms of whooping cough
When infected with pertussis, the course of the disease may occur in one of the following forms:
- Typical – the disease develops consistently with all its inherent symptoms.
- Atypical (erased) – the patient coughs only slightly, but there are no strong attacks. For a while, the cough may disappear altogether.
- In the form of a bacteriocarrier, when the symptoms of the disease are absent, but the child is a carrier of bacteria.
This form is dangerous because other people may be infected, while parents are confident that the baby is healthy. Most often, this form of whooping cough happens in older children (after 7 years) if they have been vaccinated. The baby remains a bacteriocarrier also after recovery from typical whooping cough to 30 days from the moment of infection in its organism. Often, in such a latent form, whooping cough in adults (for example, employees of children’s institutions) appears.
The first signs of whooping cough
At the initial stage, the disease does not cause any particular anxiety to parents, since the first signs of whooping cough resemble the common cold. The baby has a strong chill due to increasing temperature, headache, weakness. A snot appears, and then an aggravated dry cough. Moreover, the usual means of coughing does not help. And only in a few days, symptoms of typical whooping cough may appear, which gradually increase.
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Periods of illness and characteristic symptoms of whooping cough
There are the following periods in the development of a child with whooping cough symptoms:
- Incubation. Infection has already occurred, but there are no first signs of the disease. They appear only on day 6-14 from the moment the bacteria enters the body.
- Premonitory. This is the period associated with the appearance of precursors of whooping cough: dry, gradually increasing (especially at night) cough, a slight increase in temperature. In this case, the child feels good. But this state lasts 1-2 weeks without change.
- Spasmodic. There are attacks of convulsive cough associated with an attempt to push out what irritates the airways, it is difficult to breathe air. After several coughing breaths, a deep inhalation follows with a characteristic whistling sound (reprise) arising from a spasm of the larynx in the vocal cords. After this, the baby convulsively shudders several times. The attack ends with the discharge of mucus or vomiting. Attacks of cough with whooping cough can be repeated from 5 to 40 times a day. The frequency of their appearance is a characteristic of the severity of the disease. During an attack, the child’s tongue is stuck out, the face has a red-blue color. Eyes turn red, because of the pressure vessels burst. Possible stop breathing for 30-60 seconds. This period of the disease lasts about 2 weeks.
- Reverse development (resolution). Cough gradually subsides, seizures appear even 10 days, the pause between them increases. Then the severe symptoms disappear. The child still coughs for 2-3 weeks, but cough is normal.
Note: Infants suffer painful attacks not so long, but after several coughing movements, respiratory arrest may occur. Oxygen starvation of the brain causes diseases of the nervous system, developmental delays. Even death is possible.
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Complications of whooping cough can be inflammation of the respiratory system organs: lungs (pneumonia), bronchi (bronchitis), larynx (laryngitis), trachea (tracheitis). As a result of the narrowing of the lumen of the respiratory passages, as well as spasms and edema of the tissues, death may occur. Especially quickly bronchopneumonia develops in children under the age of 1 year.
Complications such as emphysema of the lungs (bloating), pneumothorax (damage to the lung wall and airflow into the surrounding cavity) are possible. Strong stress during an attack can cause the appearance of an umbilical and inguinal hernia, nosebleeds.
After pertussis, due to hypoxia of the brain, there is sometimes damage to the tissues of individual centers, as a result of which the child’s hearing or epileptic seizures occur. Convulsions are very dangerous, which also occur due to the disruption of the brain and can lead to death.
Due to stress when coughing occurs, damage to the eardrum, brain hemorrhage.
Diagnosis of pertussis in children
If whooping cough in a child is mild and atypical, diagnosis is very difficult. The doctor may assume that the malaise is caused by this particular disease, in the following cases:
- the child does not have a cough for a long time, the symptom only increases, while the runny nose and the temperature stopped after 3 days;
- expectorants have no effect, on the contrary, the state of health worsens after taking them;
- Between bouts of cough, baby seems healthy, he has a normal appetite.
In this case, to make sure that the patient has whooping cough, bacteriological seeding of a throat swab is done. The difficulty lies in the fact that the bacterium is sufficiently firmly held by the ciliary epithelium, is not displayed outside. The probability that even in the presence of pertussis pathogens can be detected in this way, it is reduced to zero if the child has eaten or brushed his teeth before the procedure. They will be completely absent in the sample if the baby was even given a minute dose of antibiotic.
A general blood test is also made, which allows detecting a characteristic increase in the content of leukocytes and lymphocytes.
Used methods for the diagnosis of pertussis sticks for blood analysis for antibodies (ELISA, PCR, RA).
There is a method of rapid diagnosis. The smear is processed with a special compound and examined under a microscope, which uses the effect of the glow of antibodies when illuminated.
Warning: If there are characteristic symptoms of whooping cough, the child must be isolated to avoid infecting other people. In addition, his situation may worsen after contact with patients with a cold or flu. Even after recovery, the body is weakened, the slightest hypothermia or infection causes the appearance of severe complications of whooping cough.
Signs of pneumonia
Inflammation of the lungs is one of the most common complications. Because parents know that whooping cough does not pass quickly, they do not always go to the doctor when there is a change in the condition of the baby. However, in some cases, the delay is dangerous, so you must necessarily show the child to a specialist. The alarming signs requiring urgent treatment include:
Temperature rise. If this happens after 2-3 weeks after the onset of whooping cough, the baby has not had a runny nose.
Increased cough after the condition of the child has already begun to improve. Sudden increase in the duration and frequency of attacks.
Rapid breathing between attacks. General weakness.
Treatment of pertussis in children
Whooping cough is mainly treated at home, except for cases when they get sick before the age of 1 year. They develop complications rapidly, you can simply not have time to save the baby. A child of any age is hospitalized if there are complications or breathing is observed during attacks.
First aid at home for pertussis cough
During a coughing attack, the baby should not lie down. It must be planted immediately. The temperature in the room should be no more than 16 degrees. It is necessary to turn off the heating completely and use a sprinkler to humidify the air.
It is important to calm the baby and distract with the help of toys, cartoons. Since the cause of cough is the excitation of the nerve center of the brain, fear and excitement provoke an increase in cough and spasm in the area of the respiratory tract. At the slightest deterioration of the condition, it is necessary to urgently call an ambulance.
Note: As the doctors emphasize, any means are good for stopping and preventing an attack, as long as they evoke positive emotions in the baby. Watching children’s TV shows, buying a doggie or new toys, going to the zoo makes the brain switch to the perception of new impressions, reduce the sensitivity to irritation of the cough center.
How to ease the condition and speed up recovery
A sick baby needs to walk every day to prevent brain hypoxia and improve breathing. At the same time, it is necessary to remember that he can infect other children. Especially useful are walks along the bank of a river or lake, where the air is cooler and humid. It is not recommended to walk much, it is better to sit on the bench.
The patient can not be nervous.
The attack can provoke improperly organized food. Feed the baby often and little by little, mostly liquid food, as chewing also causes coughing and vomiting. As Dr. E. Komarovsky explains, a baby, frightened by a previous attack while eating, even inviting to the table often reflexively causes a pertussis cough.
Warning: In no case is it recommended to self-medicate, use “grandmother’s remedies” to get rid of cough. The nature of cough in this case is such that warming and infusions do not relieve it, and an allergic reaction to plants can lead to a state of shock.
In some cases, having consulted in advance with a doctor, you can use the people’s advice to alleviate the state when you cough. For example, folk healers recommend for children over 13 years old to prepare a compress from a mixture of equal amounts of camphor and eucalyptus oil, as well as vinegar. He is advised to lay on the chest of the patient all night. It helps ease breathing.
Whooping cough is usually found at a stage where the cough reflex, which is the main danger, has already developed. However, antibiotics do not help.
At the stage of the appearance of precursors of the disease, the child is given only antipyretic medication if a slight rise in temperature occurs. It is impossible to give him expectorants when a dry, paroxysmal cough appears, as the movement of sputum will cause increased irritation of the respiratory tract.
Antibiotics (namely, erythromycin, which does not adversely affect the liver, intestines, and kidneys) are used to treat children with whooping cough at an early stage, while strong coughing attacks have not yet appeared.
They are taken more often as a preventive measure. If someone who is a member of the family gets sick with whooping cough, then taking an antibiotic will protect children from the action of the bacteria. He kills the germ before the cough develops. The antibiotic will also help to prevent adult family members caring for a sick baby.
In conditions of increased severity of the patient whooping cough is hospitalized. The hospital uses tools to eliminate respiratory failure and oxygen starvation of the brain.
If a child enters the hospital at the first stage of the disease, then the task is to eliminate germs, stop apnea attacks (stop breathing), relieve seizures, and eliminate spasms in the bronchi and lungs.
To enhance the body’s resistance to pertussis, gamma globulin is introduced at an early stage. Vitamins C, A, group B are prescribed. Sedatives are used (valerian, motherwort infusions). Treatment of antispasmodics is used to relieve spasm and convulsions: calcium gluconate, belladonna extract.
Antitussive drugs do not have sufficient action for whooping cough, but for painful attacks under the supervision of a doctor, they are given to children to facilitate the release of sputum. Among the drugs used are ambroxol, ambrobene, lasolvan (to liquefy sputum), bromhexin (stimulator of mucus removal), aminophylline (relieves spasms in the respiratory organs).
In the treatment of children from whooping cough, antiallergic drugs are also used, and in severe cases tranquilizers (seduxen, Relanium).
To reduce the frequency of attacks and reduce the likelihood of apnea, psychotropic drugs (aminazin) are used, which also have an antiemetic effect. Respiratory arrest is prevented by administering hormonal drugs. At the end of the spasmodic period, massage and breathing exercises are prescribed.
In order to prevent complications, oxygen therapy is used, and sometimes artificial ventilation of the lungs.
Video: Erythromycin for whooping cough, the importance of vaccination, cough prevention
Since whooping cough is very contagious, when cases of the disease are detected in the children’s institution, all children and adults who have been in contact with the patient are examined and preventively treated. Erythromycin is used to kill whooping cough bacteria, as well as injections of gamma globulin that stimulates the production of antibodies.
Especially dangerous is infection with pertussis in infants. Therefore, it is necessary to limit the child’s stay in crowded places and communication with unfamiliar children and adults. If a child is brought from the maternity hospital, while one of the family members is sick, it is necessary to completely eliminate his contact with the baby.
The main preventive measure is vaccination. It reduces the risk of infection. In the case of the disease, whooping cough is much easier.