Whooping cough

March 8, 2012

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Whooping cough   - An acute infectious disease of the nature in which the body is manifested mild intoxication,   Acute qatar airways And periodically there are bouts of whooping cough. Disease causes specific bacteria Bordetella pertussis   (so-called Pertussis coli . Wand Bordet-Zhang ). The causative agent has a short rod shape, which has rounded ends. In the external environment, the bacteria are unstable, quickly pertussis killed during drying, ultraviolet irradiation, using disinfectants. It is also very sensitive to bacteria levomitsetinu . erythromycin . streptomycin . Antibiotic tetracycline group .

The world today is very widely spread pertussis .  So, every year this disease becomes ill about sixty million people .  In addition, pertussis is often diagnosed and the inhabitants of those countries, where for many years carried out vaccination against the disease .  Experts admit that pertussis occurs most often in adults, but it is not always detected because the disease occurs without convulsive fits of coughing .  The source of infection of the disease is exclusively a man: it may be ill, both typical and atypical form of pertussis, healthy people - carriers of the bacteria .  The greatest danger to others in terms of infection, patients are at an early stage of the disease .  Pertussis is transmitted by airborne droplets .  Most often, whooping cough in children is manifested in preschool age .  Such a wide spread of the disease in this age group occurs due to the lack of sufficient levels of maternal immunity .  If the number of children vaccinated, less than 30%, in such countries, the incidence of whooping cough compared with the situation in the period dovaktsinalny .  For this disease is not characterized by seasonality, but also in autumn and winter, there is a definite increase in the number of cases .

Features pertussis

The infection enters the body through the mucous membranes of the respiratory tract. Pertussis germs attached to the cells of the ciliated epithelium, and then begin to multiply on the mucosa, while not penetrating into the bloodstream. At the spot where the pathogen penetrated, becomes inflamed, mucus secretion becomes more pronounced, inhibits the functioning of the ciliated epithelial cells of the device. Next on the airway epithelium ulceration occurs and manifests focal necrosis .

The most significant pathological processes manifested in the bronchi and bronchioles. Due to the blockage of the lumen of the small bronchi mucopurulent cork patient arises emphysema . focal atelectasis . Due to stimulation of the receptors of the respiratory tract of the patient are constantly worried about the cough. After treatment of whooping cough do not develop life-long immunity, so people can get sick again. The situation is similar with the pertussis vaccine.

Given that the cough does not appear immediately after infection and before the appearance of the characteristic whooping cough is very difficult to distinguish from other infectious diseases, in the first days of infection carriers can infect others.

Symptoms of whooping cough

When pertussis infection, the incubation period can last from 2 to 14 days, but most often it lasts for seven days. In catarrhal period, which begins pertussis symptoms at once the general state of malaise. The patient complains of a runny nose, cough, low-grade temperature. In the process of developing the disease pertussis coli produces toxins that act on the nervous system, stimulating the nerve receptors of the respiratory mucosa. Consequently, the cough reflex is triggered, and the person suffers from bouts of typical whooping cough. Sometimes the process affects the nerve centers located nearby. Then, in response to such irritation may be vomiting, occurring mainly after coughing, vascular disorders of character, nerve disorders, which are manifested convulsions.

If the child develops whooping cough, symptoms gradually become more diverse. For example, a sick child exhibits irritability, becomes capricious. Spasmodic cough appears at the end of the second week of illness. For whooping cough is characterized by a sharp, sudden onset. First, there is a series of aftershocks cough, then the child inhales air with a whistling sound, then again manifest convulsive cough shock. During the attack of such cycles can be from two to fifteen. When the attack is over, there is an allocation of glassy viscous sputum, and in some cases it continues to attack of vomiting. During the attack a sick child is very excited, his face becomes cyanotic, in the neck veins dilate, the eyes can nalitsya blood, tongue protruding from the mouth. Occasionally during coughing develops suffocation   and there comes a cessation of breathing. Similar attacks continued for about four minutes and repeated five times to fifty times per day, depending on how hard passes pertussis. Symptoms occur about three to four weeks, then the number of daily attacks on the decline, and the cough becomes ordinary. Whooping cough in children lasts a few weeks, however, attacks whooping cough is no longer observed.

At the same time in adults with whooping cough whooping cough does not occur. Whooping cough runs like bronchitis In which there is a stubborn persistent cough. At the same time the body temperature does not change, the person feels well. Whooping cough in children, which were carried out vaccinations, usually manifests itself in a latent form.

Complications of pertussis

The most common complication of pertussis in children and adults develop pneumonia . This disease provokes effects of pertussis bacillus or it becomes a secondary bacterial infection. In addition, complications of this disease are laryngitis   with stenosis of the larynx (the so-called false croup) bleeding   nose, bronchiolitis, trouble breathing, inguinal . umbilical hernia . Furthermore, due to whooping cough may occur encephalopathy . This change in the brain of non-inflammatory nature. In the process of encephalopathy can be convulsions. As a result, possible death or serious damage: the patient may experience intermittent seizures occur or permanent deafness. All complications occur mostly in children, in adults they are less fixed.

Diagnosis of Pertussis

To establish the correct diagnosis in the catarrhal period of pertussis is necessary to carry out bacteriological tests. Such studies are usually appointed after learning specialist epidemiological data. Thus, the basis for the appointment of such analyzes can be recent contact with an infected patient, the lack of the necessary vaccinations, etc. At the same time, if the patient is already shown spasmodic cough, the diagnosis of pertussis is much easier. But the diagnosis of the doctor is required to draw attention to the fact that similar bouts of coughing in some cases occur in the patient and due to other reasons not related to whooping cough. So, like a cough sometimes manifested in adenoviral infection . pneumonia . infectious mononucleosis , in the presence of malignancies That compress the airways. It also happens that whooping cough runs atypically, that is typical coughing fits do not appear at all. This is characteristic of the disease for adults and for children who have been vaccinated.

There is a main method for the determination of the diagnosis in this case - is a laboratory selection pertussis. At the same time, the sooner the material is taken for research at the patient, the greater the likelihood of obtaining positive results. Material for the study comes from the nasopharynx. Also for taking material for research in the child before the coughing patient set Petri dish with nutrient medium. After catching a few coughs cup shocks delivered to the laboratory in an incubator.

Today also frequently applied enzyme immunoassay method that can detect antibodies in serum and nasopharyngeal mucus. It is important to differentiate pertussis in catarrhal period of acute respiratory infections, and at a time when manifested spasmodic cough, from diseases for which there are typical persistent cough, high temperature and the lack of signs of intoxication.

Treatment for whooping cough

It is important that the treatment of whooping cough, which occurs in severe form, was carried out exclusively in a hospital. Hospitalized compulsorily children under one year, because during coughing they often occurs respiratory arrest. For full treatment necessary to provide special conditions in the room: we need good ventilation, humidification. Treatment of pertussis in infants involves placing them in a darkened quiet room. The child is often not bother, because any stimulus can provoke very strong cough. If the disease in older children is held in the form of light, it is possible to dispense with compliance with bed rest. Consequently, in this case it is possible to treat disease without hospitalization. Care should be taken to the child as long as possible to be outdoors, because there is almost no cough occur.

Meals need to be organized so that children receive meals and often in small portions. If vomiting constantly disturb the patient, the doctor prescribes intravenous fluids. It is important that infants produced suctioning mucus from the throat. Also, young children, provided pronounced hypoxia appointed oxygen therapy. To do this, the patient kept in a special oxygen tent.

Young children in severe pertussis, and in case of complications of the disease is often prescribed a course of antibiotics. At catarrhal stage for the treatment of whooping cough is often used erythromycin.

In the treatment of whooping cough also introduces a specific pertussis gamma globulin . It must be administered intramuscularly for three days.

Funds have antitussive and sedative effects, should not be used at all or should be taken to use them with great caution. Funds that trigger coughing, such as banks, mustard, should not be used at all.

If the patient stops breathing occurred, should be quickly clear the airway, to suck the mucus from them and hold ventilation.

The healing process, even with antibiotics takes a long period of time. Patients with pertussis should stay in the isolation of 25 days from the beginning of the disease, if two results of bacteriological tests were negative. If such research is not carried out, the insulation should last no less than thirty days.

There are folk remedies that are used to relieve symptoms of patients with whooping cough. It packs of garlic and honey, which is placed on the chest, decoctions of herbs (thyme herb, the roots of primrose spring, flowers elderberry fruit of anise, pine buds, leaves a mother-and-stepmother, herb oregano and others.).

Prevention of pertussis

As a reliable prophylactic use against pertussis vaccination . Today, several types of applied Vaccine Vaccination begins with the age of three months. After being subjected three courses of vaccination (vaccination intervals between one and a half months) after about two years revaccination. According to specialists vaccination helps prevent the disease in about 70-80% of cases. And the children who received the vaccine and infected with the disease, whooping cough is mild.

It is important to immediately examine the children, who were in contact with patients.