Whooping cough - a contagious infectious disease that occurs mainly in children.
Whooping cough is manifested defeat airways and attacks of spasmodic cough lasting several weeks.
Causes
Whooping cough is caused by a particular microbe - stick pertussis Bordetella pertussis. This gram-negative bacterium, it is fixed, stained with dyes. This microbe educates agglutinins.
The causative agent of pertussis is unstable in the external environment should be carried out immediately after the crop material intake. Microbes are sensitive to ultraviolet light and virtually all disinfectant solutions, to drying, to a high temperature. Pertussis bacterium is sensitive to many antibiotics - streptomycin, tetracycline group, chloramphenicol.
Pertussis is widespread in all countries, including those where widespread vaccination, but lower than the incidence in these countries. Mortality is approximately 0.6% of the total number of cases.
Whooping cough in children and adults
Most often suffer from pertussis, children under 14 years of age, the most severely affects children up to 3 years, and up to one year of whooping cough attacks in children can be deadly. Until the age of three whooping cough most often produces complications, including
pneumonia, bronchitis.In adults, whooping cough occurs as long without the typical cough attacks, and some flows in the form of an asymptomatic carrier of the microbe to spread it among others.
The source of infection for children can become other children and adults with atypical course of the disease and asymptomatic carriage.
Contact people get sick with a probability of 90%, if not vaccinated and are not immune. Most often people get sick in the winter and autumn, with the change of seasons.
development mechanism
The pathogen is introduced through the mucous membranes, where massive gives impulses to the brain. The result is irritation, which gives a convulsive seizures, spasmodic coughing in response to the slightest irritation.
Furthermore, there may be congestion in the cortex, causing autonomic reaction.
After suffering a pertussis remains proof lifelong immunity.
manifestations of pertussis
The incubation period lasts at pertussis from 2 to 14 days, usually weekly. Pertussis occurs in several stages:
- catarrhal stage
- stage of whooping cough,
- recovery stage.
1. In the period catarrhal symptoms appear that are characteristic of many colds - malaise, malaise. Children can easily be runny nose, mild fever, and cough. As the pertussis cough does not disappear, but only intensified, as the gain of cough in children is disturbed sleep and appetite, irritability occurs.
2. Convulsive fits of coughing nature occur by the end of the 2nd week of illness. Seizures occur spontaneously or after exposure to irritants.
Cough shock arise, one after the other almost without interruption, not giving to breathe and catch your breath. After cough shock pass, there is a sharp shaky breath with strong whistles - reprises. After it may be followed by the next series of cough shock. Such reprise per day may be from 10 to 50 and the number of cough attacks can be from 1-2 in mild cases to 10-15 in severe cases.
At the end of attack may extend lump viscous mucus or vomiting occur. In attacks due to deficiency of oxygen the baby's face may turn blue, become swollen, possibly swelling of veins on the face and neck. whites of the eyes can be injected, bleeding may occur in them.
In attacks of coughing tongue protrudes from the mouth, on the lips can be blood due to strain bridle. In severe attacks, and whooping cough at a young age may occur respiratory arrest and choking.
On average, coughing attack lasts about 1-2 minutes, seizures can be provoked by laughing or crying, sharp sound or light.
In adults, whooping cough flows by type of bronchitis with fits of hysterical dry cough, but without the typical reprise. The temperature may be normal, and the state of health is satisfactory, disturbed only cough.
Diagnostics
The basis of the diagnosis - a clinical picture with convulsive fits of coughing, but the exact diagnosis is perhaps only after the crops and finding in them the pertussis bacillus. Crops will show the presence of a microbe to 1 week, with a probability of about 95%, and in 3-4 weeks - only half of the cases. After 4 weeks, the microbe in the crops can not be separated.
Is used as the method of cough plates - on a petri dish patient coughs from a distance of about 10 cm, trying to catch the sputum cough of at least five aftershocks.
In retrospective serological methods may be used - the detection of antibodies to pertussis in increasing titers - more than 1:80. Also applicable immunosorbent assay - detect antibodies IgM and IgG antibodies from the second week of the disease.
treatment of pertussis
Severe course of pertussis - an indication for hospitalization in a hospital under the supervision of an infectious disease.
Light attacks is acceptable treated at home under the constant supervision of a pediatrician. Necessary to create a protective regime - darken the room, silence and humidified air. It is necessary to stay in the open air, the power of appetite.
In young children it is important to constantly suctioning mucus from the throat and nose, use an oxygen tent, humidified air.
In catarrhal period showed antibiotics - erythromycin or its analogs. Also in the early period shows the use of pertussis pertussis immunoglobulin course for 3 days by intramuscular injection.
In the period of spasmodic cough antibiotics do not reduce the strength of attacks.
The use of sedation and antitussives is very limited, they can not have a positive effect.
Do not use this yellow cards, cans and thermal procedures.
If breathing stops required intensive care and mechanical ventilation conduct.
Complications and prevention
On average, whooping cough lasts 6-8 weeks with attacks peak at 3-4 weeks. Gradually, the frequency of attacks diminishes.
Major complications - pneumonia germ, stenosis of the larynx, nasal bleeding, hernia formation, and asphyxia. In young children because of the lack of oxygen can occur encephalopathyConvulsions or seizures.
Basis of pertussis prevention - timely vaccination of children DTP 3, 4.5 and 6 months, with a further booster after a year. Vaccination pertussis generates resistance to 80%, and the remaining 20% takes pertussis in the lungs or nonhazardous form.
