Home Hygiene Whooping cough. Evidence-Based Patient Guide

Hygiene

Whooping cough. Evidence-Based Patient Guide

A common disease among children, characterized by high level contagiousness, poses a real threat to children under 3 years of age. , characteristic of the disease, lead to a large list of complications for children. The disease is difficult to diagnose at an early stage, because all signs point to a common cold, so parents should know what whooping cough is in children, the symptoms and treatment that the child will need.

How does infection occur?

Whooping cough is the causative agent of the disease and is transmitted from a sick person or a healthy carrier of the bacterium to a healthy child through the air. The most dangerous person is in the initial stages of the disease, when a slight deterioration in health does not indicate whooping cough, and the virus is already spreading into the external environment.

How is it transmitted:

secreted when coughing;
spreads by sneezing and talking;
with saliva (for the youngest this may be slobbered toys).

Damage radius 2.5 meters. The disease spreads especially actively in enclosed spaces; isolated cases of whooping cough in children are rare. Depending on the group of vaccinated children, the infectiousness ranges from 70 to 100%.

Important! High risk Infants under 3 months and unvaccinated babies are susceptible to infection, since the transfer of antibodies to whooping cough from mother to child does not occur.

Can a vaccinated child get whooping cough?

After the illness, the child develops lifelong immunity to whooping cough. In rare cases, reinfection occurs in adulthood, but the disease is mild. The immunity developed after vaccination is not so strong, so even a vaccinated child can get sick, however, he will survive the disease more easily than an unvaccinated one.

How contagious is a sick child?

The disease is characterized by a high level of contagiousness. Infected child begins to spread the bacterium around itself even in the catarrhal stage of the disease, that is, the first 10-12 days and actively spreads it until about the 20th day of the disease, then the likelihood of infection decreases.

How bacteria behave in the body

The way the pertussis bacillus enters a child’s body is through the mucous membrane of the mouth and nose. After the infection penetrates, it begins to produce a toxin that irritates the nerve endings and affects other respiratory organs: bronchi, trachea, etc. Irritated nerve endings send signals to the brain about the need to eliminate the irritant from the respiratory tract, and then a cough begins.

Gradually, the body begins to react to any external stimuli: bright light, water, food, laughter, screaming, stressful situation. Along with irritation of the cough center of the brain, neighboring ones are also irritated. The child becomes capricious, irritable, refuses to eat, and may vomit.

Remember!

The bacterium is not resistant to the external environment and is easily transmitted in enclosed spaces. The incidence does not depend on seasonality, however, its peak occurs in the autumn-winter season, when children spend more time together at home, in the garden, playrooms, etc.

Parapertussis and whooping cough difference Both diseases have infectious origin and are difficult to distinguish from each other. Parapertussis has symptoms similar to whooping cough, however, the disease itself is milder. It usually affects children between 3 and 6 years of age. It is characteristic that the parapertussis microbe is more resistant to antibacterial drugs

and has increased viability.

Infection and disease development follow the same principle. Whooping cough affects children at any time of the year; parawhooping cough is characterized by seasonality: autumn and winter. With parawhooping cough, complications occur extremely rarely, and there have been no cases of death.

Symptoms of the disease

The development of the disease involves its passage through several stages, each of which is characterized by certain symptoms.

Stages of disease development:
Incubation period. Can range from 3 to 20 days, usually 5-9 days. During this period, the pertussis stick is fixed on the walls of the bronchi, without causing any signs of disease. Catarrhal period. Usually this is 1-2 weeks, when the causative agent of the disease begins to produce toxins that poison circulatory system
Paroxysmal (spasmodic) period. The period extends for 2-4 weeks, in infants it can last 2-3 months. Coughing attacks become constant, the brain reacts to any, even minor, pathogens.
Resolution period (1-4 weeks). The immune system is activated and, with the support of medications, defeats the disease. The cough is not so strong, attacks occur less and less often until they finally stop.

A characteristic symptom of the disease is a cough during whooping cough; how can you distinguish it from a regular cough? It is expressed by a series of 5-10 strong coughs occurring in one breath, followed by a deep breath, accompanied by a whistling sound. In the acute phase of the disease, the number of attacks can reach 50 per day. The cough associated with whooping cough is called “cock cough.”

In infants, the picture of the disease may differ. manifest themselves sharply, since they often do not have the catarrhal stage of the disease, and there is an instant transition to paroxysmal cough.

How is whooping cough transmitted to infants?

From parents, grandparents and other adults in contact with the baby. Adults usually do not even know about the nature of the disease; they simply notice a prolonged dry cough.
Through slobbery toys or close contact with another baby.
From older brothers and sisters who brought the disease from kindergarten or school.

Attention! The attack may be accompanied by short-term cessation of breathing, cyanosis or redness of the face, and vomiting. Instead of coughing attacks, sneezing attacks may occur, after which blood flows from the nose.

Why is whooping cough dangerous?

Prolonged hypoxia manifests itself in a child as impaired blood supply to the brain and myocardium, which can lead to impaired brain activity, deafness, epilepsy, structural changes in the heart (dilation of the ventricles, atria).

Incorrect or late treatment can cause complications:

pleurisy;
emphysema;
asthma with frequent attacks of suffocation during colds.

The danger of attacks for the smallest lies in the restriction of oxygen access to the brain, leading to hypoxia, attacks of suffocation, convulsive conditions, lesions of the brain structure. Babies can develop a hernia from constant coughing attacks.

Important! Paroxysmal cough is dangerous fatal outcome.

Diagnosis of the disease

Quick diagnosis and promptly started treatment can shorten the period of illness and relieve children under 3 years of age from the consequences. Whooping cough can be diagnosed in several ways.

How to test for whooping cough:

serological analysis blood (blood is taken from a vein) for the presence of antibodies;
bacterial culture of separated mucus (sputum);
throat swab;
PCR diagnostics.

In addition to taking tests, the doctor examines the general clinical picture illness, clarifies information about the child’s contact with a sick person 2-3 weeks before the development of symptoms of the disease.

How to treat whooping cough

Babies up to one year old are treated in a hospital hospital due to the high likelihood of developing hypoxia, suffocation attacks and death.

What measures should include treatment of children for whooping cough:

complete isolation of the sick child;
the atmosphere at home is quiet and calm;
carrying out wet cleaning, frequent ventilation of the room;
taking vitamins to strengthen the immune system;
the use of antibiotics and antitussives for treatment.

Remember!

Specific medications to treat whooping cough are prescribed by your doctor.

Drugs used in the treatment of whooping cough:
Antibiotics aimed at destroying the causative agent of the disease. To prevent the growth of bacteria: Ampicillin, Erythromycin, Levomycetin. Sumamed is prescribed against a specific pathogen.
In infants and in the early stages, gammaglobulin or hyperimmune serum is prescribed.
In the spasmodic period, neuroleptics are prescribed: Atropine, Aminazine.
Antitussives: Sinekod, Codelac. For the little ones: Neocodion, Codipront.

Mucolytics: Ambroxol, Bromhexine, Bronchicum. Walking in the fresh air is beneficial for sick people and is allowed for children with mild to moderate forms of the disease. Held, breathing exercises vibration massage

chest.

Treatment with folk remedies When the disease is mild or moderate, the doctor may allow additional treatment.

traditional methods Simple and:

effective recipes
Chop and cook 5 medium cloves of garlic in a glass of unpasteurized milk. Boil the garlic for 5-7 minutes. Taken for 3 days in a row every 3 hours.
Dry in the oven or in a frying pan 3 tbsp. l. sunflower seeds, chop them, pour a mixture of water and honey (300 ml of water and 1 tbsp. honey). Boil and cook until half the liquid has evaporated. The cooled and strained broth is taken one day in small sips.
Mix honey and freshly squeezed horseradish in a 1:1 ratio, take 1 tsp. 2 times a day.

Fresh nettle juice is taken 3 times a day, 1 tsp. Treatment folk remedies does not cancel drug therapy

disease, but only complements it.

The only effective preventive measure is vaccination against whooping cough. Free domestic vaccination is carried out in all city clinics; parents can choose and contact private clinic to carry out the procedure.

Isolating a sick child for up to 30 days can prevent infection of other children and adults. In a kindergarten or school, quarantine is established for 14 days. Children and adults may be prescribed a prophylactic course of antibiotics.

You should not self-medicate if your child has a cough, runny nose, or fever, which are mistakenly taken for symptoms. colds. You should consult a doctor as soon as your child feels unwell.

From whooping cough, as well as from some others dangerous infections, there is a vaccine. However, some children vaccinated with this vaccine get sick.
What mothers of vaccinated and unvaccinated children need to know about whooping cough, we asked a pediatrician, allergist, immunologist, assistant at the Department of Clinical Immunology and Allergology with a course in pediatric immunology at the National medical university them. A. A. Bogomolets Maya Ishchenko.

Whooping cough is infection respiratory tract, caused by the bacteria Bordetella pertussis (whooping cough). The infection is transmitted by airborne droplets. The disease is characterized by the fact that it affects cough center.

Character of the course
The main symptom of whooping cough is a severe hacking cough, especially at night. During the first two weeks, clinical manifestations make it difficult to distinguish the disease from a regular acute respiratory viral infection. But the characteristic whooping cough, which appears by 2-3 weeks, is not difficult for an experienced doctor to recognize. With whooping cough, the temperature may not rise or rise only slightly. During the periods between coughing attacks, the child may feel quite tolerable. Anyone who has had whooping cough receives immunity for life.

Why is whooping cough dangerous?

Whooping cough is most dangerous for children under one year of age. The infection can cause respiratory arrest and damage the nervous system, which can lead to developmental delays.
Whooping cough is dangerous over a long period of time: 6 months for unvaccinated people and 2 months for vaccinated people. Prolonged cough so exhausts the child and undermines his immunity that during the long recovery period it is easy to catch a secondary bacterial or respiratory infection, which will only confuse the picture of the disease.
After an illness, the memory of the cough center remains for a long time, and with the slightest cold the child suffocates from coughing.

Vaccinated children get sick too
The most effective preventative measure against the disease - vaccination. The vaccine contains antibodies to pathogens and is aimed at preventing the disease. After the mass introduction of vaccinations, many doctors believed so much in their effectiveness and in the fact that whooping cough infection has now been eradicated that they may “miss” the disease or mistake it for another. How does this happen? A child who gets whooping cough is first treated for a long time as having caught the virus, but after treatment with various drugs turns out to be ineffective, the search for other causes begins. At the same time, there is a danger that doctors will mistake whooping cough, for example, for allergic bronchitis and prescribe bronchoscopy, which is difficult for the child to tolerate.

So is there any benefit to the vaccine? In reality, not all vaccinated people get sick, but a certain percentage. In addition, as mentioned above, if an unvaccinated child can cough for up to six months, a vaccinated child will suffer for at least two months.

Diagnosis of whooping cough
Medical examination. Experienced doctor can accurately detect whooping cough by pressing on the root of the tongue with a spatula.
Bac sowing. You can reliably find out whether you had whooping cough if you do this test in the first days of the disease. But due to the fact that at the very beginning whooping cough is mistaken for a common respiratory infection, such an analysis is performed extremely rarely.
Blood test for immunoglobulin M to the causative agent of whooping cough. Using this test, you can determine antibodies to whooping cough that a child has contracted, but only if it is done in the first 3 weeks of the disease.
Blood test for immunoglobulin G to the causative agent of whooping cough. This analysis can be done 3 weeks after the disease. However, the presence of antibodies of the immunoglobulin G group may mean either a previous vaccination or a history of whooping cough at an earlier age, but not diagnosed.

How to treat?
Babies under one year old, as well as children with severe illness, are hospitalized. During treatment severe forms Whooping cough is treated with antibiotics that target the pathogen. At the same time, the effectiveness of treatment is affected by timely detection of the diagnosis, which, as we said above, often does not happen. After the 2nd week, the causative agent of whooping cough dies and only a cough remains, against which antitussive drugs are ineffective.

IN incubation period(14 days) the child should not play with other children, but walks in the fresh air, especially near ponds or fountains, help to cope with the cough more easily. Ventilation of the room and wet cleaning should be mandatory, since dry air and dust irritate the cough center and provoke new coughing attacks.

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Contents:

Where does whooping cough come from? How can a person become 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) that cause severe inflammation and irritation of the surface of the respiratory tract. Outwardly, this manifests itself as prolonged bouts of painful, dry cough.

Epidemiological studies have found that the infection that causes whooping cough can only spread among people. For this reason, a healthy person (adult or child) can only become infected with whooping cough from another person who has the disease.

As will be shown below in the chapter on the symptoms of whooping cough, quite often in adolescents and adults this disease occurs in mild form, in which a person only has coughing. People who get sick with 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 identify this infection. Because of this, people with whooping cough can infect other people around them with whooping cough for many weeks, not knowing that they are spreading a dangerous infection.

Whooping cough is transmitted by airborne droplets. This means that a healthy person can become infected with 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 to become infected with whooping cough it is enough:

Stay in the same room with a sick person for more than 1 hour;
Contact with saliva, sputum or nasal discharge of a sick person;
Talk to a sick person while staying less than 1 meter away;

How long is the incubation period for whooping cough?

Incubation period Incubation period- this is the period of time between the moment the 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 appear 1-3 days after infection with the virus). For other infections, the incubation period can vary from a few days (less often hours) to several weeks, months or years. with whooping cough can last from 5-7 days to 3 weeks.

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

A person with whooping cough becomes contagious as soon as the cough begins and may remain contagious for 2 to 4 weeks or more if not treated with antibiotics.

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

How long should you keep your child at home?

If your child gets whooping cough, he needs to stay home from daycare or school (quarantine) for at least 5 days if he is receiving antibiotic treatment, and for at least 3 weeks if he is not receiving antibiotics.

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

In medicine, the whooping cough vaccine is called DPT.

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

Observations on in large groups children who received all 4 doses of DPT showed that this vaccination 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 a lifetime, but only for a period of 4 to 12 years after receiving the last dose of the vaccine.

It is for this reason that, several years after vaccination, many children (and even more so adults) can get whooping cough again (in a milder form than people who have never received the vaccine) 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 11-12 years) and adults (especially pregnant women).

What are the symptoms and signs of whooping cough?

Symptoms and signs of whooping cough depend on the age of the person who has it, whether they have been vaccinated against the disease, and what treatment they receive. Below we will explain this in detail

The first symptoms of whooping cough often resemble those of a common cold: runny nose, slight increase in body temperature (up to 38.5 C), sore throat, rare coughing, malaise.

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

Coughing attacks with whooping cough can be repeated several times an hour and occur especially often at night.

The cough of whooping cough can be so severe that after several attacks, the person with the disease may vomit or lose consciousness.

Medicine also describes cases where a person’s ribs broke during a strong cough.

When the coughing attack passes, a person infected with whooping cough can 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 last up to 6-10 weeks or even more.

In children and adults who have received a whooping cough vaccine, this disease can develop in the so-called “atypical” or “erased” form, in which the sick person is only bothered by a dry cough (without a runny nose, without fever), lasting several weeks. It should be noted that even with “erased” forms of whooping cough, despite the mild development of the disease, a sick person can infect other people around him with it (including children who do not yet have immunity to this infection and who may become ill with more severe forms of this disease ).

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 have an erased form of the disease and are unaware that they are the source of the infection.

The source of the disease is the whooping cough bacillus, it secretes a toxin that has an irritating effect on the nerve endings that are located in the mucous membrane of the upper respiratory tract, which leads to irritation and triggers the cough reflex, also getting into the blood, it has a general toxic toxic effect, primarily on central nervous system. This leads to contraction (spasm) of the smallest bronchi, larynx (glottis), twitching and even seizures similar to epileptic ones.

The pertussis bacillus quickly dies in the external environment, as well as under the influence of high temperature, direct sunlight, drying and using various disinfectant solutions. This explains the seasonality of the disease, most often in the autumn-winter period, in places with large crowds of people and transport.

The source of infection is a sick person, in any form, including possibly erased forms; patients are especially contagious, in initial period. Patients shed whooping cough for up to 30 days. It is transmitted through the air, by airborne droplets when coughing; infection can occur through contact with a sick person. Therefore, isolating the patient prevents the infection from spreading. Whooping cough at the beginning of the disease is very similar in symptoms to and can be confused with a viral infection. Most often, children under five years of age, children under six months, and even newborns are susceptible to the disease. After an illness, a stable immunity is formed, although some sources say only about five years. The infection enters through Airways: nose, mouth. If the child fell ill with whooping cough, the bacillus populates the mucous membrane, starting from the larynx and descending lower and lower, affecting all the lungs to the smallest bronchi and lung tissue. Even after the wand has died, its toxin continues to act on the brain, thereby irritating it, which contributes to the continuation of the cough. For diagnosing whooping cough in children, pediatricians prescribe for whooping cough, parawhooping cough, blood is taken from a vein twice, with an interval of 14 days. Let's take a closer look.

Diagnosis of whooping cough in children.

The incubation period is about a week, but can be longer, up to two weeks. During this time, the pertussis bacillus, getting on the mucous membrane of the upper respiratory tract, begins to multiply and send irritating signals to the brain. A dry, strong, debilitating cough appears. Signs are divided into periods.

In the first period

Body temperature may be moderately elevated or normal. A dry cough appears, a runny nose is possible, then the cough intensifies. The child’s well-being during this period was not affected. The duration of this period is from three to fourteen days. In small infants, the so-called first period is shorter, but in older children, on the contrary, it can be prolonged. The transition to the second period occurs gradually.

Diagnosis of whooping cough in children in the second period

The cough turns into a spasmodic cough and forms during exhalation, which prevents the baby from taking a breath, causing him to cough heavily. It occurs suddenly or after warning signs: sore throat, anxiety, chest pain. Then, on a deep breath, accompanied by a whistle (reprise), a whistling sound appears due to a spasm of the glottis, after which the attack continues. The child’s face may turn blue or red at this moment due to a lack of oxygen, blocked by coughing attacks. After a strong cough, there may be vomiting with viscous sputum. In severe forms of whooping cough, vomiting almost always occurs, but in mild forms it may not occur at all. The acute phase begins after 10-12 days of increasing cough. During an attack, the neck veins swell, the eyes become bloodshot, lacrimation appears, the tongue protrudes outward to the limit, its tip bends upward. Still possible involuntary urination and defecation (fecal incontinence). For more than two weeks, the symptoms of cough remain the same, then there is a slow mitigation of attacks and their reduction. During the break between coughing attacks, the child behaves as if in full health: he plays, his appetite does not suffer, he walks. There is an increase in leukocytes to high numbers, and ESR is normal or reduced.

Third period

The cough settles down, the sputum becomes mucous-purulent and all symptoms gradually disappear. This period lasts up to a month. Total duration The illness lasts up to 3 months; pediatricians also call it “a hundred-day cough.”

Forms of whooping cough.

Lightweight– the frequency of attacks is 5 – 15 times a day, the attacks end quickly, there is no vomiting, the child’s health is good.
Medium-heavy – the number of attacks is 15 – 24 times a day, each attack lasts longer and has several repetitions, quite often vomiting appears at the end of coughing attacks. The baby's general condition suffers, but not much.
The child fell ill with a severe form of whooping cough – the number of attacks is more than 30 times per day or more, the attacks are severe and sometimes last up to fifteen minutes and have 10 repetitions or more. Such attacks end in vomiting. In severe cases, the child refuses to eat, sleep disturbance occurs, and the child begins to lose weight.

But recently, an erased form of whooping cough has increasingly appeared, in which there is an absence of attacks typical of whooping cough. In these cases, a diagnosis is made: tracheitis or tracheobronchitis. Such forms are more often observed in vaccinated children. If vaccinated children become ill with whooping cough, they are more likely to develop mild and erased forms of the disease compared to unvaccinated children.

Complications.

Bronchopneumonia.
Pleurisy.
Epileptic convulsions (occur at the height of a coughing attack and can be repeated several times a day) during an attack in children under one year of age, respiratory arrest may occur.

Treatment.

The child is isolated
The premises must be sanitized
Maintaining air humidity where the patient is located
The temperature in the room is between 18 - 21 degrees
Influx of fresh air to reduce attacks and their intensity
Reduce physical activity
You can walk once a day, lasting one hour
Avoid solid foods to prevent vomiting
At frequent vomiting, give food in small portions, crushed into puree
Antibiotics are used in treatment (Ampicillin, Flemoxin), if there is intolerance to this group, then (Summamed), drugs are prescribed in tablets, when the child can swallow, if vomiting or spasmodic cough occurs, the child is transferred to intramuscular injection antibiotics, the course is 5 – 7 days.
Severe forms are treated in hospitals
Antitussives that suppress the cough reflex (Sinekod, Codelac)
Anti-inflammatory (Erespal)
Antiallergic to relieve swelling (Zyrtec, Zodek)
In case of oxygen deficiency, oxygen supply
Vitamin and mineral complex for immunity

Prevention of disease.

There is no innate immunity to whooping cough, antibodies are not transferred from mother to child, a newborn child can also get this disease, so prevention is only vaccination, which begins at three months with DPT vaccination (combined), since there is no monovaccine. To develop good, stable immunity, it is necessary to receive three DPT vaccinations at an interval of forty-five days. The first vaccination is at three months, the second at four and a half months, the third at six months and revaccination at 1.6 years. Good immunity persists for three years after revaccination, then weakens. There are also other vaccines that are used for vaccination against whooping cough, Infantrix, Bubo-Kok, Pentaxim.

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

How is whooping cough transmitted?

How can you get whooping cough? Do you 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 prolonged exposure to 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 your local pediatrician or a specialized clinic. Modern methods diagnostics allow you to determine the presence of infection in the body in minutes.

It largely depends on what drug is used. The DTP (adsorbed pertussis-diphtheria-tetanus) vaccine, which is familiar to many mothers and recommended for use in the Russian Federation, 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, which do not contain the pertussis component.

Risk of relapse

What is the probability that a child who has once been ill will “receive” the same diagnosis again and begin to cough violently? 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 standard and very effective treatment. As a result, their immunity begins to produce specific antibodies, which fight the bacterium Bordetella pertussis. Therefore, if a previously ill child is bothered by a cough, it is almost 100% likely not caused by whooping cough. And if there are other children in the apartment next to him, then they have practically no chance of contracting whooping cough.

Is it possible to diagnose whooping cough without additional research?

IN initial stage This development is extremely unlikely: whooping cough can be easily confused with ARVI or bronchitis. Because of this, therapeutic measures do not bring any noticeable results, but general state the child remains quite satisfactory. When does whooping cough enter the spasmodic stage, in which external manifestations become more pronounced, making the correct diagnosis does not present any difficulties.

What happens if whooping cough is not treated: complications

Is it true that the greatest health risk 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 temperature regime, a general improvement in well-being and a significant decrease in the severity of coughing attacks do not yet indicate that the child has recovered. Whooping cough is a very insidious infection, so you need to approach your doctor’s recommendations with all possible responsibility. The body of a baby who has barely survived a serious illness will not be able to effectively resist infection, since the immune system is extremely weakened. Moreover, the slightest violation of the regime can provoke extremely dangerous complications for health and life, which often have nothing to do with the lungs or the ear-nose-throat area.

Prolonged 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 impairment. If you notice any of these symptoms, seek medical help as soon as possible.
Hernias and rectal prolapse. An annoying, severe cough is to blame for this, which can significantly increase intra-abdominal pressure.
Atelectasis (collapse of alveoli) of the lung. This condition often develops very quickly and leads to acute respiratory failure. How to deal with this? Call an ambulance immediately.
Stroke and retinal detachment. Such conditions are explained by sudden surges in pressure resulting from a severe coughing attack. The likelihood of such complications is extremely low, but if you encounter characteristic symptoms, you shouldn’t delay seeing 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 virtually nothing was known about the potential for vaccination, the mortality rate from whooping cough did not exceed one per person. After the experiments of Edward Gener (he first inoculated cowpox into humans in 1796) were recognized by doctors, and Louis Pasteur developed methods of vaccination against other diseases, the mortality rate from whooping cough decreased significantly - to the level of human cases.

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

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

How is whooping cough different from parawhooping cough?

Both of these diseases have a similar clinical picture, but it would be a big mistake to consider them different manifestations of the same thing. pathological process. If we discard subtleties that are of little interest to the average person, then it can be argued that parawhooping cough is a lite version of ordinary whooping cough. It is much easier, does not cause complications and does not always require any specific treatment.

Pathogen: parapertussis bacillus (Bordetella parapertussis), which produces a toxin less potent than Bordetella pertussis.
Risk group: children 3-6 years old.
Contagious period: no more than 14 days.
Main symptom: cough (3-5 weeks). In this case, the child most often remains in normal health, and fever and severe attacks with repeated episodes and vomiting are practically not observed.
Incubation period: from 7 to 15 days.
Treatment: symptomatic.
Duration of quarantine: 15 days.
Active immunization: not carried out.
Prognosis: always (!) favorable.
Chance of re-infection: none.

Similarities with common whooping cough:

potential source of infection;
transmission routes;
pathogenesis;
methods and methods of diagnosis.

Is it possible to get whooping cough on the street?

It is quite possible. You must understand that the pertussis bacterium outside the host’s body is extremely unviable and dies very quickly. Therefore, the chance of infection on the street through casual 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 clubs), where the duration of potential contact with a Bordetella pertussis carrier is much longer, the situation will not be so rosy. In any room with insufficient ventilation and the absence 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 throughout his entire childhood, only being allowed out into the street. special occasions. If you get preventive vaccinations in a timely manner and teach your child to follow basic hygiene rules, the likelihood of infection can be significantly reduced.

Re-infection

Does DTP guarantee that a vaccinated child will never get whooping cough again? Does it make sense to refuse vaccination if whooping cough may still return?

If your child has already had whooping cough, then refuse routine vaccinations. DTP doctors categorically not recommended. The fact is that the immunity they provide is not permanent. Sooner or later, it 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 milder. Therefore, refuse preventive vaccinations it’s not worth it: they “work” in any case, as they significantly alleviate the symptoms.

Can whooping cough be treated with antibiotics?

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

But the main problem with this method of treating whooping cough is that diagnosing the disease at the very beginning of its development without laboratory tests almost impossible. No cough specific symptoms absent, but visible clinical manifestations rather indicate ARVI or bronchitis. And if the district pediatrician doesn’t have special reasons If he suspects whooping cough, he will prescribe the little patient ordinary vitamins or tonics that will not affect Bordetella pertussis in any way.

After the 12th day, 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, turn out to be practically powerless, which is why the prescribed treatment is most often symptomatic.

In this situation, doctors recommend consulting a doctor at the first signs of a cold. Modern laboratory diagnostic methods make it possible to identify whooping cough bacillus in less than an hour. And if immediately after confirming the diagnosis you give easy for baby And safe antibiotic(for example, erythromycin), it will suppress the growth of bacteria and make the healing process much faster.

Disease risk for adults

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

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

Can a child play sports with whooping cough?

Questions

Question: Is it possible to get whooping cough again?

Is it possible to get whooping cough again?

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

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Is it possible to get whooping cough several times?

Whooping cough is serious and dangerous disease, which is called bacterial infection. The disease is transmitted by airborne droplets. Whooping cough most often affects children and adolescents. The main symptom of whooping cough is a characteristic cough.

Children under the age of 2-3 years are most susceptible to this disease; young children may experience complications in the form of: otitis media, bronchitis, pneumonia, encephalopathy, apnea attacks, and convulsions. Severe coughing can cause bleeding in the brain.

After suffering from the disease, a strong natural immunity is developed, the likelihood of getting whooping cough again is very small.

The whooping cough vaccine does not provide lasting immunity; for this reason, repeated vaccination is required.

You can get whooping cough more than once and even after receiving DPT vaccination, where K is whooping cough. The vaccine does not protect against the disease in general, but against severe forms of the disease that can lead to death.

Whooping cough.

List of messages 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 and 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, mine is the strongest, the child has the weakest. Please describe to me the symptoms of whooping cough, how long does it take to donate blood?

And is it possible to get sick twice, my mother proves that I’ve already been sick 😉

What we have now, my son has mild snot, no cough at all, I have it in the morning severe runny nose, weak since lunch and like this every day, cough without attacks 2-3 times a day, voice is dry, my husband just has a sore throat and a metallic taste, I have the same thing.

Does this sound like the beginning of whooping cough?

The last contact with the sick child was last Saturday, she had a fever on Saturday evening, we started sniffling on Sunday afternoon, before that we met around September, from what date do we count quarantine, can we infect someone now? our nanny fell ill this Wednesday with our same symptoms, what does it look like and when the child can go outside, we walked calmly until Friday (until we found out their diagnosis).

The causative agent of whooping cough is contained in large quantities in the patient’s sputum. Together with the smallest drops of sputum released when coughing, the causative agents of whooping cough enter the air, and from there into the respiratory tract of a healthy person. Sometimes whooping cough germs settle on toys, dishes and other items used by the patient. If these items are then used healthy child, then he will become infected with whooping cough. Young children are especially easily infected in this way, as they put everything they come across in their mouths.

A patient with whooping cough is especially contagious at the beginning of the disease; he remains contagious for 5-6 weeks.

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

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

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

If pneumonia is associated with whooping cough, the child should also be taken out into the air. This contributes to a milder course of the disease.

As a rule, a child with whooping cough does not cough when he is engaged in some activity. 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 attack. It is very important not to irritate a child suffering from whooping cough: any injustice towards him, refusal to fulfill a request, force-feeding or changing clothes causes an increase in painful coughing attacks and worsens the course of the disease. If those around you are nervous and 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, the child loses some of the food eaten. Therefore, you should try to feed him more often - every 2-3 hours in small portions, give him tasty and varied food.

Children should especially be protected 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 a hospital or send him to relatives who do not have children.

If a child with whooping cough cannot receive the necessary care at home or develops severe complications, we need to send him to the hospital.©

And yet, I started peeing at night! He hasn’t written for a long time, check your 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 something that I had just eaten and drunk, and diarrhea (infrequent, but just diarrhea). On Sunday evening the temperature rose to 39. Now I have a sniffle and cough, the temperature is still holding.

Maybe or is ARVI so disgusting?

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 clear snot, without food, there was no temperature at all, all this lasted 2 months

The doctors first sent us from the pediatrician to the ENT specialist and didn’t find anything, because I had absolutely no nighttime cough normal child, and when they sent me to an allergist......

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

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Date of last revision: 05/23/2013

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

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What is whooping cough? Could he be dangerous?

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

In adolescents and adults, especially if they have previously received a vaccination against this disease, whooping cough does not cause any serious complications and, as a rule, ends in complete recovery.

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

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

Every year, more than 50 million people worldwide fall ill with whooping cough, of whom about 300 thousand die, most of whom are young children.

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

The causative agent of whooping cough is a microbe (bacterium), which is medically called Bordetella pertussis.

As will be shown below in the chapter on the symptoms of whooping cough, quite often in adolescents and adults this disease occurs in a mild form, in which the person only has a mild cough. People who get sick with 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 identify this infection. Because of this, people with whooping cough can infect other people around them with whooping cough for many weeks, not knowing that they are spreading a dangerous infection.

It is believed that to become infected 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 respiratory tract infections, such as influenza, the incubation period is 1-3 days (that is, the first symptoms of the disease appear 1-3 days after infection with the virus). For other infections, the incubation period can vary from a few days (less often hours) to several weeks, months or years. with whooping cough can last from 5-7 days to 3 weeks.

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

A person with whooping cough becomes contagious as soon as the cough begins and may remain contagious for 2 to 4 weeks or more if not treated with antibiotics.

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

How long should you keep your child at home?

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

The whooping cough vaccine is medically called DTP.

Observations of large groups of children who received all 4 doses of DPT showed that this vaccination 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 a lifetime, but only for a period of 4 to 12 years after receiving the last dose of the vaccine.

In this regard, in some countries, DTP vaccination is recommended not only for children, but also for adolescents (at the age of 18 years) and adults (especially pregnant women).

What are the symptoms and signs of whooping cough?

The first symptoms of whooping cough often resemble those of a common cold: runny nose, slight increase in body temperature (up to 38.5 C), sore throat, rare coughing, malaise.

Coughing attacks with whooping cough can be repeated several times an hour and occur especially often at night.

The cough of whooping cough can be so severe that after several attacks, the person with the disease may vomit or lose consciousness.

Medicine also describes cases where a person’s ribs broke during a strong cough.

When the coughing attack passes, a person infected with whooping cough can 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 last up to 6-10 weeks or even more.

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

Symptoms and signs of whooping cough in young children

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

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

The child breathes heavily and strangely, as if he does not have enough air;
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 order to detect whooping cough?

Infectious disease doctors diagnose and treat whooping cough.

To detect 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 the people who came into contact with him.

What treatment is needed 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 I take?

If you or your child is diagnosed with whooping cough, your doctor will be able to offer you treatment with antibiotics such as Erythromycin, Azithromycin, Clarithromycin, Biseptol (co-trimoxazole, trimethoprim-sulfamethoxazole).

For newborns and children of the first year, Azithromycin is considered the safest. For children over 2 months of age who cannot tolerate Azithromycin, trimethoprim-sulfamethoxazole may be prescribed. 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 another 4 days;
Clarithromycin: 500 mg 2 times 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 several weeks after completing treatment, a person may develop dangerous intestinal infection, symptoms of which may include abdominal pain and watery diarrhea.

If you notice similar symptoms, review our recommendations in the article Diarrhea Associated with Antibiotic Treatment.

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

With whooping cough, the cough is caused not by the microbes themselves, but by 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 cough appears (that is, after the microbes have had time to produce toxins), the cough will continue for several weeks.

What can you do to relieve coughing from whooping cough?

Numerous studies have shown that conventional cough medicines have little to no effect on whooping cough and may even harm people who take them.

Therefore, to relieve cough caused by whooping cough, doctors use other medications, such as corticosteroid hormones (in small doses in short courses of treatment), antihistamines(such as suprastin), salbutamol, or anti-pertussis immunoglobulin.

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

Based on their experience in treating whooping cough, some experts believe that medications such as zafirlukast and montelukast (used in the treatment of asthma) can relieve cough from 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 less frequent and weaker, however, for a long time after recovery, the airways of a person who has had whooping cough remain extremely sensitive, which is why a severe cough can appear even after a mild cold.

Is it possible to get whooping cough again? What to 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 remaining after an illness. For this reason, a person who has had whooping cough may become ill with it again after a few years.

To prevent whooping cough infection, experts recommend getting 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 undergo preventive treatment with antibiotics.

Because whooping cough can easily spread from one person to another and can cause severe consequences in some people, experts now believe that preventive treatment should be given to all people who may have come into contact with a person with this disease. For example, if a child gets sick, 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 The category of patients with immunodeficiency (weakened immunity) includes:

people who are infected with HIV or have AIDS,

people who have diabetes,

people who have cancer and are receiving treatment for cancer (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 an internal organ transplant and are taking medications to suppress transplant rejection,

people who are sick chronic diseases internal organs: chronic renal failure, chronic hepatitis, cirrhosis, heart failure. and people who have serious illnesses lungs (for example, asthma) should receive preventive treatment for whooping cough even if they did not have direct contact with a person with this disease, but were in close contact with another person who could become infected from him.

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

Even if a person has previously received a whooping cough vaccine, they remain at risk of becoming infected with the disease again. For this reason, even if someone who has been in contact with a person with whooping cough has received all their vaccinations against this infection, they should still receive preventative antibiotic treatment.

If a person has never received a whooping cough vaccine, then simultaneously with preventive treatment with antibiotics, he should also receive the vaccine.

During every pregnancy, all women should receive the whooping cough vaccine to protect their newborn baby.

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

In 2012, data from an American study was published showing that of the more than 15 cases of whooping cough reported in the United States that year, more than 2,200 cases occurred in infants, of which 15 children died. In approximately 40% of cases, children became infected with whooping cough from mothers with a mild form of infection.

To protect newborn babies from whooping cough infection, it is now recommended that all pregnant women receive the whooping cough vaccine (DTP) in the third trimester, between 27 and 36 weeks of pregnancy.

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

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

Currently, there are no whooping cough vaccinations that can be given to children immediately after birth. In this regard, protecting the child through vaccination of the mother is the only solution for now.

It would be correct if, in addition to the pregnant woman, all other people who will have frequent contact with the child during the first months of his life (for example, father, grandparents) also receive the whooping cough vaccine (DTP). They must receive the vaccine no later than 2 weeks before the baby is born.

Is the whooping cough vaccine safe during pregnancy?

Currently, the DTP vaccine is considered safe for pregnant women. So far, there have been no reported cases of its negative impact on the course of pregnancy or on the development of the fetus.

Do I need to repeat the vaccine during each pregnancy?

Because the concentration of whooping cough antibodies in the mother's body gradually decreases after vaccination, women are recommended to be vaccinated at the end of each pregnancy for optimal protection of newborns.

Center for 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. Croup 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, postpartum women, and infants. Clin Obstet Gynecol. 2012;55(2):.

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