Whooping cough symptoms in vaccinated children. Whooping cough in children: symptoms and treatment. Catarrhal period of whooping cough

Signs of whooping cough in a child can be very different. In some cases, children suffer from the disease as if playfully and complain only of a slight cough. They rarely require specific treatment, so they receive all the necessary help at home. But much more often it is impossible to get rid of whooping cough using these methods, since the disease is quite severe. Treatment with folk remedies does not have a noticeable therapeutic effect, so it is necessary to use medications in combination with a strict quarantine regime. If whooping cough develops extremely rapidly in a child and there is a real threat to life, powerful antibiotics are used. Such drugs cannot be called harmless, so treatment takes place in a hospital setting.

How to treat whooping cough in children? The answer to this question depends entirely on the stage of the disease and the severity of clinical manifestations. Consequently, if the diagnosis is finally confirmed by laboratory tests, one of the most important factors determining the treatment regimen is the symptoms of whooping cough present in a young patient. This is what we will talk about today.

Pediatricians identify three main stages in the development of the disease, each of which requires its own approach to therapy. Therefore, the approach common in domestic clinics, according to which any infectious disease or even a mild rash of unknown nature must be treated with powerful antibiotics, is fundamentally wrong.

Stages of whooping cough:

• Incubation. It is almost impossible to notice the first signs of whooping cough without an in-depth examination. Children do not show any special complaints, and mild malaise is most often attributed to banal overwork.
• Catarrhal. It is characterized by symptoms characteristic of many colds. Such patients are most often diagnosed with ARVI and recommended bed rest, warm drinks and paracetamol. This treatment does not bring any visible effect, so after 10-14 days, whooping cough in children smoothly passes into the second stage.
• Paroxysmal. Symptoms at this stage are most pronounced, but conventional antibiotics, even the latest generation, have practically no effect on whooping cough bacillus. Most of all, patients suffer from repeated coughing attacks, which often repeat every 30-40 minutes. Noticeable relief occurs after a few weeks.
• Stage of reverse development of symptoms. If treatment for whooping cough is chosen correctly, the body begins to gradually recover. Patients are bothered by a chest cough, but attacks are repeated less and less every day. The rash on the face and neck gradually disappears, and therapeutic measures most often take place in familiar home conditions. Depending on the severity of the disease and the state of immunity, this period can last from 2 to 6 weeks.
• Recovery phase. In some cases, this period can last up to six months. The child feels healthy, but his immunity has not yet recovered from the illness. Any specific remedies for whooping cough are used extremely rarely, and all efforts of doctors and parents are aimed at maintaining immunity and protecting the fragile body from negative environmental factors.

Symptoms of whooping cough in children

As we have already found out, they depend on the stage of the disease. Their interpretation must be taken as responsibly as possible. The mass approach to this issue, which is often practiced in our district clinics, is far from the most correct solution. And that's why:

• A medicinal method of therapy, especially if the use of potent antibiotics is expected.
• Whooping cough in vaccinated children can sometimes give a similar clinical picture, but within a few days the severity of the symptoms quickly subsides. Therefore, the use of standard treatment methods in this case does not make any sense.
• Prescribing any medications without analyzing the child’s medical record can lead to the most dire consequences.
• Whooping cough in newborns requires a completely different approach, since the baby’s body is still completely fragile.

Attention! If for one reason or another you doubt the prescribed treatment regimen, ask for another doctor. By law, you have every right to do this.

Incubation period

There are no specific symptoms of whooping cough at this stage. Consequently, any clinical manifestations are most often absent, and a correct diagnosis can only be made after sensitive laboratory tests. If the doctor you contacted still insists on inpatient treatment, ask him to once again state his arguments. Remember that a slight malaise is most likely due to overwork or a cold, and a rare cough is due to a draft in the classroom (kindergarten, nursery) or a glass of cold juice you drank the day before.

Catarrhal period

Bordetella pertussis is already present in the body, but its activity is relatively small. Whooping cough can produce acute, pronounced symptoms in children under one year of age, but in most cases they are erased and less pronounced. The typical duration of the catarrhal stage is 1-2 weeks, although in rare cases it can last longer (especially if the child has already been vaccinated).

• General condition is satisfactory.
• The temperature is most often normal or low-grade (maximum 37.1-37.5 degrees).
• The cough is unproductive, sometimes obsessive. As a rule, it bothers the child in the evening and at night, but no sputum discharge is observed.

Paroxysmal period

The most difficult stage for the patient and his parents. At this stage, the child requires qualified medical care, which is not always possible to receive at home. The risk of complications is extremely high, and neglect of medical recommendations can lead to the most severe consequences. Whooping cough in an infant at the paroxysmal stage is most dangerous, so it requires round-the-clock monitoring.

• The cough becomes paroxysmal, and a series of painful shocks can last several minutes.
• Viscous whitish sputum begins to come out.
• A special, whistling breath appears (reprise).
• In rare cases, coughing may cause involuntary urination or bowel movements.

Characteristic external signs of an acute attack:

• protruding tongue;
• a puffy, reddened face, which after an attack becomes bluish-burgundy;
• blue lips;
• swelling of the neck veins;
• severe lacrimation;
• hemorrhage in the sclera;
• the appearance of small red dots all over the surface of the skin.

The general condition of the child outside (!) of an attack is usually satisfactory. If complications are absent or not very pronounced, they play with interest with their peers and do not refuse food.

Attention! During this period, with severe forms of whooping cough, shortness of breath, loss of appetite, rapid development of swelling and hemorrhage into the skin may occur.

Period of reversal of symptoms

Coughing attacks become less cyclical: now they are more likely to depend on excessive emotional or physical stress. But the emerging recovery process is extremely unstable: certain complications can arise at any time.

• Normalization of body temperature.
• Gradual extinction of catarrhal phenomena.
• Sputum production is possible only after the attack has ended.
• Dysrhythmia of breathing and rare attacks of apnea.

Laboratory test data:

• lymphocytosis;
• leukocytosis;
• decrease in ESR indicators;
• the ability to isolate the pertussis bacillus using the cough plate method;
• a fourfold increase in the titer of specific antibodies during serological testing.

Recovery period

There are usually no special manifestations of whooping cough during this period. But parents should remember that even cured whooping cough in children (there are no symptoms, the state of health is satisfactory, laboratory tests are normal) leads to a decrease in immunity. Therefore, the body needs some time to fully recover. During the recovery period, the child should be protected from excessive stress, although the need for bed rest is extremely rare.

Classification depending on the severity of the disease

As we have already found out, the symptoms of whooping cough depend on the stage of the disease, as well as on the general condition of the child at the time of infection. But to prescribe adequate and effective therapy, the doctor must find out the severity of a particular case. To do this, you need to consider the following parameters:

• intensity of coughing attacks;
• duration and frequency of apnea attacks;
• severity of hypoxia (cyanosis can be of 3 types: perioral, total or acro);
• existing disorders in the functioning of the cardiovascular system;
• cases of vomiting during coughing;
• any manifestations of encephalitis;
• possible complications.

Distinctive features of the mild form of whooping cough:

• satisfactory general condition;
• no more than 15 coughing attacks per day;
• slight swelling of the eyelids and face;
• signs of pulmonary emphysema, which can only be identified with an in-depth examination;
• conditions, the likelihood of manifestation of which is extremely low (isolated cases are possible): vomiting after an attack, mild cyanosis, hemorrhagic syndrome.

Distinctive features of the average form of whooping cough:

• noticeable deterioration in the general condition of the small patient;
• children become irritable and capricious;
• from 15 to 30 attacks per day;
• prolonged paroxysms;
• high probability of vomiting and various hemorrhagic elements;
• pale skin;
• pronounced perioral cyanosis;
• instrumental examination can reveal a specific shade of percussion sound, as well as wet or dry rales.

Distinctive features of severe whooping cough:

• the child’s condition is extremely serious;
• problems with sleep and appetite;
• possible sudden weight loss;
• more than 30 coughing attacks per day, accompanied by vomiting and breathing problems;
• perioral or acrocyanosis;
• obvious signs of damage to the cardiovascular system (dull heart sounds, enlargement of its boundaries, increased blood pressure);
• the risk of developing encephalopathy, which can cause seizures, impaired consciousness and paresis.

Whooping cough in young children under one year of age

The course of their illness may differ significantly, so we considered it necessary to separate this information into a separate block. And although only a doctor should treat children, it will be useful for parents to find out what the characteristics of whooping cough are in very young patients (they are most often diagnosed with a moderate or severe form).

Periods of the disease:

• incubation: short, no more than a week;
• prodromal: from 4 to 7 days;
• spasmodic cough: up to 2 months.

Whooping cough in children under one year of age: features and symptoms

• reprises are less pronounced and occur relatively rarely;
• slight secretion of sputum (babies simply swallow some of it);
• unsatisfactory general condition even between attacks;
• significant decrease in appetite;
• development slowdown;
• temporary loss of speech and motor skills;
• high risk of damage to the nervous system;
• slight likelihood of subconjunctival bleeding;
• quiet and mild cough (most often in newborns and premature babies);
• cerebrovascular accident;
• apnea (up to SIDS - sudden infant death syndrome);
• early nonspecific complications.

We especially note that specific antibodies to whooping cough are detected quite late: at 4-6 weeks of convulsive cough.

Whooping cough in vaccinated children

If the child has managed to receive the DTP vaccine, the symptoms in most cases will be blurred, and the risk of any complications is significantly reduced. Pediatricians also note...:

• ...significant reduction in the likelihood of getting sick: 4-6 times;
• ...decrease in incubation period: from 7 to 15 days;
• ...development in 86% of cases of a mild form of whooping cough;
• ...rare vomits and reprises;
• ...an extremely low probability of any hemorrhagic manifestations and swelling;
• ...mild course and quick recovery.

Differential diagnosis

What symptoms distinguish whooping cough from the same cold or acute respiratory viral infection? What to do if a child begins to rash and the temperature rises: give him antipyretics or go to an infectious diseases hospital? Only a doctor can accurately determine this, since some clinical manifestations can only be identified after an exhaustive examination.

Differences from colds (catarrhal period):

• the cough gets worse every day and is practically untreatable with standard means;
• there are no visible changes in the lungs;
• other catarrhal phenomena are mild (slight runny nose, slight hyperemia of the mucous membranes);
• the infectious syndrome is expressed very little or completely absent;
• there are no signs of damage to other organs and systems;
• characteristic changes in blood composition: lympho- and leukocytosis, decreased ESR;
• laboratory tests confirm the presence of pertussis bacillus.

Differential diagnosis during the spasmodic period (possible options):

• tuberculous bronchoadenitis;
• mediastinal tumors;
• acute tracheobronchitis;
• cystic fibrosis (bronchopulmonary form);
• foreign body in any part of the respiratory tract;
• pneumonia.

conclusions

Whooping cough is a very dangerous and poorly predictable infectious disease, but if you follow the schedule of preventive vaccinations and promptly consult a doctor, in most cases it ends in complete recovery. However, parents should clearly understand that only a doctor should treat him.

Can whooping cough prevention prevent infection? If a child is vaccinated on time, the chance of getting sick is extremely small, so we do not recommend refusing DTP. If there are cases of illness in a school or kindergarten, it is better to refrain from visiting these institutions for a while.

Whooping cough is an acute infectious disease with airborne transmission, accompanied by spasmodic paroxysmal cough.

This disease is widespread throughout the world, occurring even in countries with widespread vaccination against whooping cough.

In adults can occur without characteristic attacks, accompanied only by a prolonged cough.

Whooping cough is caused by the bacterium Bordetella pertussis. Among the toxins this bacillus contains is pertussigen, which causes the main symptoms of whooping cough. The pertussis bacillus is very sensitive to environmental influences: after 2 hours it dies in direct sunlight, after 15 minutes - when the temperature rises above 50 o C.

Source of whooping cough infection– a sick person or a bacteria carrier. Infection occurs by airborne droplets through close contact within a radius of 2-2.5 m. After suffering from whooping cough, re-infection is possible, but it is extremely rare. Newborns and children under one year of age have the greatest risk of contracting whooping cough, since they do not yet have their own antibodies to whooping cough, and maternal antibodies last for 1-1.5 months.

Under one year of age whooping cough is very severe, the mortality rate (death) is high - 50-60% of cases among unvaccinated children. After vaccination against whooping cough, if the disease develops, it is not as pronounced, without characteristic attacks.

The microorganism, entering the respiratory tract, multiplies on the mucous membrane, which becomes inflamed. In this case, mucopurulent plugs close the lumen of the small bronchi. The body reacts to pertussis toxins as if they were antigens, and immune inflammation develops.

Continuous irritation of the respiratory tract receptors contributes to the appearance of paroxysmal cough, and overexcitation of the cough center in the brain occurs, where a dominant is formed. In this regard, whooping cough can be caused by any irritant. Next to the cough center in the brain there is also a vomiting center. Excitement is easily transferred to him, and vomiting occurs. The same transition of excitation is associated with the development of attacks of muscle spasms of the body and face.

Symptoms of whooping cough in children

The incubation period averages 5-8 days, but can last from 3 to 14 days.

Stages

Catarrhal

The general condition of the child remains without significant changes. Body temperature may rise to subfebrile levels (37.5 o C). A dry cough appears, worsening in the evening and at night. The cough gradually becomes obsessive and gradually becomes paroxysmal. There may be a runny nose, decreased appetite, restlessness and irritability. The symptoms resemble those of pharyngitis, laryngitis, and tracheitis. The more severe the disease, the shorter the catarrhal stage. Thus, in children in the first year of life, the duration of the catarrhal period is 3-5 days, in older children – up to 14 days.

Paroxysmal

Begins 2-3 weeks from the onset of the disease. This stage is characterized by the presence of spasmodic coughing attacks (paroxysms).

Outside of the attack, the child feels well and behaves normally. Children feel the approach of an attack, the younger ones show anxiety and run to their mother, the older ones may complain of a sore throat. After this, coughing attacks begin. Short coughing bursts appear one after another, making it difficult to breathe.

When it becomes possible to inhale, usually after 10-12 pushes, air enters the respiratory tract with a loud whistle. This moment is called a reprise. An attack consists of several series of coughing impulses with repetitions, usually from 3 to 6. During an attack, the child’s face turns red or blue, the veins in the neck swell, and the tongue with its tip raised is protruded forward as much as possible.

During an attack there may be convulsions, loss of consciousness, spontaneous urination and defecation. At the end of the attack, a large amount of thick, viscous sputum is released, and vomiting may occur.

Any irritant can cause an attack: bright light, fuss around the child, sharp noise, violent emotions (crying, fear, laughter, excitement).

An increase in body temperature during this period is not typical.

Severity

• Lightweight– the number of paroxysms is from 8 to 10 per day, they do not end with vomiting, the child’s general health is good;
• Average– the number of paroxysms is about 15 per day, accompanied by vomiting; outside of an attack, children are lethargic, capricious, sleep and appetite are disturbed; the face is somewhat puffy, the eyelids are swollen, there may be redness of the eyes;
• Heavy– the number of paroxysms is more than 20 per day, can increase to 30. The skin is pale with blue discoloration of the nasolabial triangle, there may be damage to the frenulum of the tongue. In very severe cases, a disorder of cerebral circulation may develop with convulsions, fainting, and there may be a cerebral hemorrhage;
  This stage can last more than 8 weeks, but towards the end the attacks become less pronounced and prolonged;
• Reverse development. Lasts up to 4 weeks. At this time, the attacks soften, occur practically without vomiting, and the child’s general condition and well-being improves.
• Get well. During the recovery period, the child remains susceptible to various infections, against which the cough may return. This period lasts up to 6 months.

Atypical forms of whooping cough

• Erased. Characterized by the presence of a prolonged obsessive cough, which is practically untreatable with conventional means. There are no classic coughing attacks. This form of whooping cough is typical for children vaccinated against whooping cough.
• Abortive. In this case, the paroxysmal stage lasts several days, after which the cough goes away.
• Asymptomatic. Identified by examining contact persons in whooping cough outbreaks.

Whooping cough in young children

Whooping cough in young children it is very difficult, the incubation period is shorter. The short catarrhal stage turns into a long paroxysmal period.

There may not be a classic coughing attack; it is replaced by sneezing, restlessness, screaming, and the child assumes the fetal position. Reprises, if any, are not clearly defined. There may be apnea (stopping breathing) during an attack or between attacks; sleep apnea is especially dangerous. Younger children have a very high risk of developing complications.

Complications

Whooping cough is especially severe in children in the first six months of life; mild forms are not found under the age of 3 months. Children in this age group have a high risk of mortality (death).

Complications:

• Apnea (which can lead to sudden death);
• Atelectasis of the lung;
• Convulsions;
• Lung rupture and emphysema;
• Bronchiectasis;
• Encephalopathy – changes in the brain of a non-inflammatory nature, which can lead to subsequent epileptic seizures and deafness;
• Bronchopneumonia;
• Bronchitis;
• Rupture of the eardrum, rectal prolapse and hernia.

Acute respiratory diseases (especially influenza) adversely affect the course of whooping cough, causing severe bronchopulmonary complications.

Diagnostics

The main method in diagnosis Whooping cough is bacteriological - the isolation of the causative agent of whooping cough.

During the catarrhal period, it is quite difficult to recognize whooping cough. Typically, the diagnosis of whooping cough is made when there is reliable evidence of contact with someone who has whooping cough.

In the paroxysmal period, it is easier to suspect whooping cough, but in its classic course. So with erased and abortive forms of less pronounced attacks. It should be remembered that for some infectious diseases of the respiratory tract caused by other microorganisms, attacks of whooping cough may occur.

This is typical for adenovirus infection and viral pneumonia. Such a cough can also occur when the bronchi or other airways are compressed from the outside, for example, by a tumor.

The causative agent of whooping cough is isolated using a swab from the oropharynx and subsequent inoculation of the material on a nutrient medium in the laboratory. The microorganism can also be isolated using the “cough patch” method, when a child coughs directly onto a Petri dish with a nutrient medium. The first method is more effective.

If the results of the bacteriological method are negative(the microorganism was not detected in smears from the oropharynx) and if whooping cough is suspected, serological research methods can be used. To do this, the titer of antibodies to the causative agent of whooping cough and its toxins is examined in venous blood. The diagnosis of whooping cough is valid when the antibody titer increases 4 times and the antibody titer ratio is 1:80 or more.

Differential diagnosis is carried out with various respiratory infections during the catarrhal period. During the paroxysmal period, it is advisable to distinguish whooping cough from bronchial asthma, cystic fibrosis, bronchoadenitis against the background of a tumor or tuberculosis, or foreign body entering the respiratory tract.

Treatment of whooping cough

Older children with mild whooping cough can be treated at home.

Indications for hospitalization:

1. Children under one year of age;
2. Moderate and severe form of the disease;
3. According to epidemiological indications (children from boarding schools, orphanages);
4. If complications or concomitant diseases arise, especially if they aggravate the course of whooping cough;
5. In unfavorable living conditions and the lack of adequate child care.

Main methods of treatment:

• Routine and child care
  Necessary Provide your child with a calm environment at home, exclude watching TV, violent emotions, outdoor games. If the body temperature is not elevated, it is better to walk the child outside more often (preferably near water sources: pond, river, lake), but avoid contact with other children. In the fresh air, coughing bothers the child less.
  room where the child is, it is necessary to ventilate as often as possible. The air must be humidified; if it is not possible to use a humidifier, you can install containers of water in the room and hang wet towels, this is especially necessary during the heating season.

• Diet
  A sick child's nutrition should be complete; it is better to reduce the portion size and increase the frequency of feedings. It is important not to interrupt breastfeeding in infants. Older children should not eat dry food, as solid food particles irritate the back of the throat and provoke a cough. During illness, the child should drink plenty of fluids (tea, fruit drinks, juices, mineral water). It must be remembered that chewing can also cause a coughing attack, so it is better if the food is in puree form (exclude chewing gum!).

• Antibacterial treatment and specific therapy.
  The use of broad-spectrum antibiotics is effective in the early stages of the disease (at this time the pathogen is in the body). Antibacterial drugs are prescribed during the catarrhal period and the first days of the paroxysmal period. For this purpose, macrolides (clarithromycin, tetracycline) are used. Duration of use is 5-7 days.
  It is allowed to use anti-pertussis specific immunoglobulin intramuscularly.

• Symptomatic treatment.
  Antitussive drugs are used to reduce the cough reflex. The most effective drugs in this case are Stoptussin and Sinecode.

• Vitamin therapy.

Prevention

Isolation of the patient and contact persons

A child with whooping cough is isolated from other children for 25 days from the onset of the disease until two negative results are obtained from a bacteriological examination. In a children's group, children under 7 years of age who have been in contact with a patient with whooping cough are quarantined for 2 weeks from the date of isolation of the sick child.

Administration of anti-pertussis gamma globulin (hyperimmune)

Indications:

• All children under one year old;
• Unvaccinated children over one year old or with an unfinished vaccination schedule against whooping cough; Weak children over one year old, with infectious and chronic diseases

Vaccination

The most effective method of preventing whooping cough is vaccination with whole-cell and acellular vaccines.

Currently, the DPT vaccine (whooping cough, diphtheria, tetanus), Infanrix (analogue of DPT), Pentaxim (whooping cough, diphtheria, tetanus, infection from Haemophilus influenzae, polio), Tetraxim, Hexavak (whooping cough, diphtheria, tetanus, infection from Haemophilus influenzae) is used coli, polio, viral hepatitis B) and others.

Despite the obvious advances in medicine, which have defeated many diseases over the last hundred years, whooping cough still remains one of the most dangerous infections today, and extremely common in children. Usually, when it comes to diagnosing and treating whooping cough in a child, parents rely entirely on doctors, while it is the mothers and fathers themselves who can radically influence the course of the disease...

If a child does not have a whooping cough vaccination, sooner or a little later he will definitely get it. Moreover, it is in this case that whooping cough will be the most severe and painful.

Whooping cough is an insidious infection, especially in children

Whooping cough is a disease with 100% susceptibility. This means that if a person (and especially a child) has not been vaccinated against whooping cough, and has never had it before, then if he encounters the whooping cough bacillus in nature, which is transmitted by airborne droplets and causes whooping cough infection, this person will definitely get sick. And the younger the child, the more severe the disease will be.

More than half of whooping cough cases (including fatal cases) occur in children under 2 years of age.

Alas, even if a child has been vaccinated against whooping cough, there is no guarantee against infection - it is still possible to get sick. However, timely vaccination provides a huge advantage - firstly, the chances of getting sick are greatly reduced. And secondly, even if a child gets whooping cough, the infection will not be able to acquire severe and deadly forms.

Neither vaccination nor previous illness provides lifelong protection against whooping cough. Immunity lasts for a maximum of 5 years. Then it begins to sharply decrease, and 12 years after the last vaccination or after the disease itself, the person is again completely defenseless against whooping cough. Therefore, most often: if one of the household members falls ill with whooping cough in the house, the whole family immediately falls ill.

As a rule, whooping cough in children lasts about 3 months, almost regardless of how actively the child is treated or not treated.

Whooping cough: symptoms in children

One of the main insidious properties of whooping cough in children is that in the first stages of the disease it perfectly passes itself off as a banal acute respiratory infection - the symptoms are the same. But it is in the first 10-12 days of the disease that whooping cough is especially contagious and is transmitted instantly from a sick person to healthy people. After the 20th day of illness, despite the fact that the child is still sick and will continue to be sick for about 2 months, he no longer poses a threat to others, his whooping cough is no longer contagious.

Primary symptoms of whooping cough in children:

• mild sore throat;
• moderate increase in temperature (never rises above 38 ° C).

If, with all other signs, the baby’s temperature exceeds 38 ° C, then with almost one hundred percent probability we can assume that this disease is not related to whooping cough.

After 10-14 days, these symptoms disappear, and the cough comes first, the attacks of which become stronger and stronger each time. After about another 10 days, the cough becomes paroxysmal. Young children endure such attacks extremely hard - they suffocate, not being able to breathe fully. Vomiting often occurs during attacks. But between coughing attacks, the child usually feels well.

It is this symptom—a paroxysmal, severe, “barking” cough” in the absence of other signs of poor health—that is the main reason for diagnosing whooping cough in children.

“Hundred-day cough” is a distinctive feature of whooping cough in a child

The occurrence of such a characteristic cough during whooping cough in children has its own specific reasons. Namely:

In the bronchi and on the inner surface of the respiratory tract there are special thin growths called “cilia” (the inner surface of the trachea and bronchi is called ciliated epithelium). They vibrate as they move, and thus move mucus through the respiratory tract, thereby providing protection and hydration in the respiratory system.

It is these “cilia” that are the most attractive place in the body for the whooping cough bacillus - there is its favorite habitat and reproduction. Constant irritation (caused by the active reproduction of the whooping cough bacillus) forces the “cilia” to constantly send signals to the so-called cough center in the brain - in response, the body receives the command “Cough!” This is where this episodic, terrible, non-stop “barking” cough appears, which is the most striking and most severe symptom of whooping cough.

This also explains the duration of treatment for whooping cough - the disease usually does not go away after 3 months. And the point is not that it is difficult to kill the bacterium itself, which has “proliferated” on the “cilia” (approximately on the 20th day of illness, the number of whooping cough bacillus in the body itself is greatly reduced and gradually disappears), but that in The process of bacterial activity affects the nerve center (the same part of the brain that is responsible for coughing) - this is why the cough lasts so long. In the medical lexicon there is even a special term - “hundred-day cough”, which can be considered as a synonym for whooping cough.

This is the main paradox and the main feature of whooping cough in children - having severely “disturbed” the part of the brain that is responsible for coughing, the whooping cough bacillus gradually dies on its own. But “by inertia” the child still continues to cough even after there is not a single harmful bacteria left in his body. And it is almost impossible to cure this cough - it goes away on its own over time.

How to relieve a child's whooping cough cough

It is impossible to cure whooping cough, but parental power can significantly alleviate the attacks themselves. On the one hand, by improving the atmosphere around a sick child, on the other hand, by actively distracting the child from the illness.

The air a child breathes dramatically affects how he coughs. It turns out that if the atmosphere in which a child with whooping cough is located is damp and cool, then coughing attacks are much easier than under normal “room” conditions, when the room is warm and dry. So:

• 1 Provide so-called “church” air in the room where the child is sick: turn off the heating completely, bringing the temperature to +15-16 ° C and humidity to 50%;
• 2 Walk with your child in the fresh air as often and as long as possible;
• 3 If a child is lying down and starts coughing, immediately sit him down;
• 4 And do not scare the baby during an attack! Since cough during whooping cough is, strictly speaking, not of a physiological nature, but rather of a psycho-somatic nature, any stress (including your reaction to a child’s cough) will only intensify the attack. On the contrary, be calm and try to distract the child.
• 5 Finally - pamper and entertain your child! Try it even as an experiment: bring your baby a new toy or turn on new cartoons for him, and you will notice that while he is enthusiastically looking at the screen or playing, there will most likely be no coughing attacks at all.

For whooping cough in children, cough medicines do not help at all! But walks in the fresh air, new dolls and stuffed hares, fascinating picture books, a railway “that no one else has” and other entertainments help effectively. And this is not a joke, but the most fact!

Even things that are not allowed for a child in normal life are definitely possible during an illness with whooping cough. Allow your baby everything that distracts him from his illness! And you will see for yourself - this will really save him from a “killer” cough. While the child’s brain is engrossed in something, it literally “forgets” to give signals to cough.

Treatment of whooping cough in children

There are virtually no medications to treat typical forms of whooping cough and its symptoms. And the point is not that medicine has not come up with suitable remedies, but that the best time to use them, as a rule, is always “missed.”

Let us remind you that Bordet Zhangou bacteria (this is the pertussis bacillus) are extremely active in the first 10-12 days after infection. If you start giving the child antibiotics during this period, then the stick, of course, can be safely killed. And even - to some extent prevent the occurrence of severe coughing attacks. Another thing is that, given the symptomatic diagnosis of whooping cough, few people manage to diagnose it during this period - the first 10-12 days, since at this time there is no cough yet, and all other symptoms are very reminiscent of an ordinary mild acute respiratory infection.

The peculiarity of the bobbin bacillus is that it does not develop resistance to antibiotics. And this is great luck for us. That is, if you recognize whooping cough at a very early stage (which, alas, is almost impossible) and give the child the simplest, most accessible and non-toxic antibiotic, such as erythromycin, it will cope perfectly with the proliferation of bacteria and prevent the onset of a more severe phase of the disease.

When these 10-12 days pass from the onset of the disease and, finally, the “hundred-day cough” sets in, the use of antibiotics is practically pointless - since the pertussis bacillus itself gradually loses in number and activity.

So it turns out that in theory, of course, there is a cure for whooping cough - these are effective antibiotics. But it is almost never possible to give them to the child on time.

Antibiotics are not for treatment, but for prevention

Indeed, it is rarely possible to cure a child with whooping cough using antibiotics. Just like an adult, actually. Meanwhile, antibiotics are very effective in preventing whooping cough in children. Most often, a drug such as erythromycin is used for these purposes.

Well-known pediatrician, Dr. E. O. Komarovsky: “Preventing the spread of whooping cough among the population is one of those rare cases in medicine when the use of antibiotics for preventive purposes is justified and advisable. Moreover, erythromycin in this sense is drug No. 1, since it is effective, safe, and not expensive. Erythromycin does not affect the liver, the intestines, or anything at all, so it is actively recommended by pediatricians all over the world as a means of protection and prevention against the spread of pertussis infection.”

Antibiotics against whooping cough in children should be used as prescribed by a doctor and in cases where still healthy children and adults have close contact with someone who is already clearly sick with whooping cough. For example: one child in the family gets sick, which means that it is definitely useful for all other family members to take preventive measures. Let us remember that whooping cough is a disease with 100% susceptibility. Therefore, if your vaccination period has long expired, and your child has come down with whooping cough, then you will probably get sick too. To avoid this, it makes sense to take a course of safe antibiotics that effectively kill whooping cough.

Vaccination against whooping cough as prevention: does it make sense?

Let us repeat - the most dangerous (it would even be appropriate to say - deadly) age for whooping cough in children is infancy up to 2 years. While children have not yet developed their respiratory muscles, it is extremely difficult for them to withstand the prolonged paroxysmal cough characteristic of this disease. That is why children are usually given a preventive vaccination against whooping cough at the “young” age possible - from 3 months.

If a newborn or an infant under 3 months falls ill with whooping cough (and there is no innate immunity against this disease), he must be admitted to a hospital. Because at this age the risk of dying from whooping cough is highest.

Usually the vaccine against whooping cough is part of a well-known one (where diphtheria and tetanus are also vaccinated “in one fell swoop” along with whooping cough).

But since the whooping cough vaccine does not protect a person for life, but gives a more or less strong immunity to the disease for only 3-5 years, the question reasonably arises - is it necessary to vaccinate the child again?

Most pediatricians will immediately answer - yes, it is necessary. And the main reason for this is the extreme severity of the disease, which is usually experienced by children. The younger the child, the more dangerous and severe form of whooping cough usually overcomes him. If an adult just coughs for several months and becomes infected with whooping cough, the baby is really in danger of dying.

Therefore, it is very important to vaccinate your child at an early age to protect him from whooping cough during the most vulnerable period of his life.

Before the invention of the whooping cough vaccine, this disease was in first place in terms of mortality among children. And once the vaccine became widely used (in the early 1960s), infant mortality from whooping cough decreased by more than 45 times. Meanwhile, today children continue to die from this infection. But as statistics say, the overwhelming majority are children who were not vaccinated on time.

Whooping cough is an airborne infection that affects the respiratory tract. It is caused by a bacterium from the genus Bordetella, the second name of which is the bacterium Bordet-Gangou. Immunization of children with the DTP vaccine protects against infection (according to the vaccination calendar, it is carried out from the age of 3 months). But whooping cough can also develop in vaccinated children. Why is this possible and is it worth vaccinating a child? The characteristics of whooping cough in vaccinated and unvaccinated children will be discussed in this article.

Why do vaccinated children get sick?

As a result of DTP vaccinations, protective specific antibodies are produced in the body, which prevent the pertussis bacterium from causing disease when it enters the body. But, unfortunately, the effectiveness of vaccination is only 80-85%. In addition, post-vaccination immunity protects against the development of infection only for 5-12 years.

Does your child get sick often?

your child constantly sick?
A week in kindergarten (school), two weeks at home on sick leave?

Many factors are to blame for this. From bad ecology to weakening the immune system with ANTI-VIRAL DRUGS!
Yes, yes, you heard right! By feeding your child powerful synthetic drugs, you sometimes cause more harm to the little organism.

In order to radically change the situation, it is necessary not to destroy the immune system, but to HELP IT...

Therefore, for future protection, revaccination should be carried out.. Ideally, the child’s immunity against whooping cough should be checked and, if the antibody titer is low, revaccinated. But in the Russian Federation such examination and revaccination of adolescents is not carried out.

Many parents, having read this, will doubt the advisability of DPT, and many, even without such knowledge, refuse to vaccinate their child, succumbing to a wave of information articles in the media (not always professional!) about the dangers of vaccination. Some parents don’t even bother to get the facts in favor of and against vaccination: a friend or neighbor refused to vaccinate her child, and so will I.

The feasibility or even necessity of vaccination against whooping cough is that the disease poses a danger to the life of a child under one year of age due to possible respiratory arrest. And vaccination will precisely protect against the disease during this most dangerous period.

In addition, even if a vaccinated child gets sick, whooping cough will occur in a milder form than in unvaccinated children and will not cause complications. The duration of cough due to whooping cough in vaccinated children is significantly less. The mortality rate of children from whooping cough decreased with the introduction of vaccination by 45 times.

Susceptibility to the whooping cough bacillus is very high, it is practically impossible to avoid meeting with a sick person or a bacteria carrier (sources of infection), which is why a vaccinated child can get whooping cough.

Whooping cough symptoms

The latent period can last 1-3 weeks, depending on the infecting dose and the condition of the child. During this period, infected children are not infectious to others.

The course of pertussis infection can be divided into 3 periods:

• catarrhal (1-2 weeks);
• paroxysmal period (2-4 weeks);
• recovery (1-2 months on average).

Catarrhal period

Why is my child's immune system weakened?

Many people are familiar with these situations:

• As soon as the cold season begins - your child is bound to get sick, and then the whole family...
• It seems that you buy expensive drugs, but they only work while you drink them, and after a week or two baby gets sick again...
• Are you worried that your child's immune system is weak, very often illnesses take precedence over health...
• You are afraid of every sneeze or cough...

  It is necessary to strengthen YOUR CHILD'S IMMUNITY!

Signs of the disease in the initial period, as a rule, are more reminiscent of acute respiratory infections; it is almost impossible to diagnose whooping cough in children in this period. As the temperature rises to 38 0 C, a runny nose, dry cough, sore or sore throat, and malaise appear. That is why this period is called “catarrhal”.

A lack of effect from the treatment could indicate the onset of whooping cough, but worsening cough is more often explained by the development of bronchitis or tracheitis against the background of acute respiratory infections, and they continue to treat with other antitussive drugs, also unsuccessfully.

It is possible to make a correct diagnosis in the catarrhal period using laboratory tests, but they are usually prescribed to unvaccinated children and more often only by the bacteriological method, the diagnostic efficiency of which is only about 30%. In terms of the spread of whooping cough, this period is the most contagious, but children are not isolated and continue to visit the children's clinic.

Period of convulsive cough

During the paroxysmal period, unvaccinated children develop typical signs of whooping cough - bouts of painful coughing with a characteristic wheezing inhalation (reprise) between repeated coughing impulses. Attacks are more likely to occur indoors and at night, especially if there is no ventilation and dry air.

The appearance of attacks is associated with the irritating effect of the pertussis toxin on the mucous membrane of the trachea and bronchi, impulses from which enter the brain into the cough center. Excitation of this center is also supported by the direct action of the bacterial toxin on nerve receptors.

During an attack, the child’s face turns red, tears flow, veins in the neck may swell, and in severe cases, small children may experience involuntary urination and impaired consciousness.

Depending on the severity of the disease, attacks are repeated with a frequency ranging from several per day to very frequent (40 or more). It is impossible to stop the attack. It prevents children from sleeping, the child becomes irritable and capricious. A coughing attack may result in vomiting. The cough can continue for up to 3 minutes until thick sputum (vitreous mucus) is released.

During a severe, prolonged cough, a sudden stop in breathing may occur - apnea (also a typical sign of whooping cough). This complication is very dangerous and requires resuscitation measures. Apnea occurs more often in infants.

It is still possible to become infected from a sick child at the beginning of a period of convulsive cough, but its contagiousness is significantly reduced: after 25 days. from the onset of the disease the patient is no longer dangerous. Whooping cough bacteria die on their own. If treatment with an antibiotic is carried out in the initial period, then after 5 days the patient is not infectious, although the cough continues due to excitement in the center of the cough.

Recovery period

The recovery period lasts 1-2 months, but sometimes up to 6 months. Symptoms of whooping cough fade: attacks become shorter, occur less frequently and disappear. The cough continues in the form of isolated cough impulses. But the disease exhausts the body so much that the addition of another disease (viral or bacterial) easily occurs. And this can provoke a return of coughing attacks.

Features of whooping cough in vaccinated people

When whooping cough occurs in vaccinated children, the symptoms are not so pronounced. The temperature may remain normal or rise slightly. General health does not suffer, appetite is good. Most often, the disease is never diagnosed and occurs under the guise of an acute respiratory infection.

Whooping cough in previously vaccinated children can occur in an erased form, when the manifestation of the disease is a prolonged cough without attacks.

Even if coughing attacks appear, they are not long-lasting, occurring up to 7-10 times a day. During a coughing attack, no repetitions appear, which makes it difficult to diagnose whooping cough. The duration of cough during the recovery period is also shorter in vaccinated people.

Diagnosis of whooping cough in vaccinated children

When typical coughing attacks occur, the doctor makes a clinical diagnosis. Diagnosis of erased forms of whooping cough in a vaccinated child can be difficult.

The diagnosis can be confirmed by laboratory methods:

1. A bacteriological method (smear culture or the use of “cough plates”) can help isolate whooping cough bacteria only in the initial period of the disease, when they are actively multiplying. And then, the average seeding rate is 30%. The material should be collected before treatment with antibiotics and on an empty stomach or 2 hours after a meal. The method can be used in case of repeated cases of morbidity in the outbreak, when whooping cough is suspected at the stage of catarrhal manifestations.
2. Serological method: the ELISA method determines the presence of antibodies in the blood serum. Class M immunoglobulins (early antibodies) and their increase in titer when examining paired sera taken at intervals of 5-7 days will confirm the presence of whooping cough at the time of the study, since their appearance is typical in the first 3 weeks. diseases. And the detection of class G antibodies does not confirm current whooping cough: they may be a consequence of vaccination or previous whooping cough.
3. PCR can help detect pathogen DNA in the nasopharyngeal mucus, which is present in the body even in small quantities. But only if whooping cough is suspected and PCR is prescribed in the first 2-3 weeks. diseases. After all, the bacterium dies on its own by day 20-25.

Treatment of whooping cough in vaccinated children

Whooping cough in a vaccinated child is usually treated at home, as it is mild. There are no effective medications that can quickly relieve whooping cough. If the diagnosis is made in the catarrhal period, antibiotics (most often low-toxic Erythromycin) are prescribed in an age-appropriate dosage.

When diagnosed after 2 weeks, the use of antibiotics does not make sense, since the toxin has already accumulated, the disease mechanism has started, and the bacterium itself dies.

It is best to ensure that children stay in the fresh air near a body of water (coughing is less likely to occur in cold, damp air). Fresh, moist air must also be provided in the child’s room. To do this, wet cleaning of the room and airing is carried out several times a day, using special devices for humidification or placing containers with water and hanging wet sheets. The optimal temperature will be 16-20 0 C with a humidity of 50%. Getting the baby interested in an interesting activity (construction set, new doll, cartoons, etc.) can help reduce stimulation of the cough center.

Vaccinated children can actually get whooping cough. But the value of vaccination is that it provides protection during the most dangerous period - in children under one year of age. There is no innate immunity. If a vaccinated child gets sick, the disease will be mild and will not cause dangerous complications that could cause the baby’s death. Parents should think carefully before writing a refusal to vaccinate their child.

This might be interesting:

If a child is constantly sick, his immune system DOES NOT WORK!

Whooping cough is an acute infectious disease transmitted by airborne droplets and characterized by a long course with the presence of specific stages.

The name of the pathology comes from the French word coqueluche, which means a severe paroxysmal cough. Indeed, the main symptom of the disease is painful coughing attacks (so-called relapses), which occur against the background of a relatively satisfactory general condition of the patient.

Some statistics
Whooping cough is widespread, but in cities this diagnosis is made more often than in rural areas. This is due to a number of reasons: greater population density in large cities, environmentally unfavorable urban air and more scrupulous diagnosis (in towns and villages, erased forms are often not diagnosed due to less epidemiological alertness).

Like other respiratory infections, whooping cough is characterized by seasonal incidence with an increase in the frequency of recorded cases of infection during transition periods (autumn-winter and spring-summer).

Epidemiological data indicate the presence of unique mini-epidemics of whooping cough that occur every three to four years.

In general, the incidence of whooping cough in the world is quite high: up to 10 million people fall ill every year, while for 600 thousand patients the infection ends tragically. In the pre-vaccination period, about 600,000 people fell ill annually in the USSR, and about 5,000 died (the mortality rate was on average more than 8%). The highest mortality rate from whooping cough was among children in their first year of life (every second child died).

Today, thanks to widespread long-term vaccination, the incidence of whooping cough in civilized countries has sharply declined. However, it should be noted that the whooping cough vaccine does not provide immunity to parapertussis infection, which is transmitted in a similar way and clinically occurs as a mild form of whooping cough.

In recent years, the incidence of whooping cough among adolescents has increased; doctors attribute these figures to a general decrease in immunity, violations of the rules of vaccination of children, as well as an increase in the number of cases of parents refusing vaccinations.

The causative agent of whooping cough and routes of transmission

Bordetella are unstable in the external environment and quickly die under the influence of high and low temperatures, ultraviolet radiation, and drying. So, for example, open sunlight destroys bacteria in one hour, and cooling - in a matter of seconds.

Therefore, handkerchiefs, household items, children's toys, etc. do not pose an epidemic danger as transmission factors. Special sanitary treatment of the premises in which the patient stayed is also not carried out.

Transmission of infection, as a rule, occurs through direct contact with the patient (staying at a distance closer than 1.5 - 2 m from the patient). Most often, inhalation of mucus particles released into the air occurs when coughing, but the pathogen can also be released into the environment when sneezing, talking, etc.

The maximum danger in epidemiological terms is posed by the patient in the first week of spasmodic cough (during this period, the causative agent of whooping cough is isolated from 90 to 100% of patients). Subsequently, the danger decreases (in the second week, about 60% of patients secrete bordetella, in the third - 30%, in the fourth - 10%). In general, infection is possible through contact with a patient with whooping cough, starting from the last days of the incubation period until the 5-6th week of the disease.

With whooping cough, bacterial carriage also occurs, that is, a condition in which a person releases dangerous bacteria into the environment, but does not feel any signs of the disease. But bacterial carriage in whooping cough is short-lived and has no particular significance for the spread of the disease. The greatest danger is posed by mild and erased forms of whooping cough, when a periodically coughing child or adult remains in a group.

Whooping cough is a disease that is usually classified as a so-called childhood infection. The proportion of children among those diagnosed with whooping cough is about 95-97%. The greatest susceptibility to infection is observed between the ages of 1 and 7 years.

However, adults are also not immune to developing whooping cough. According to some data, the probability of infection among adults in a family with a sick child can reach 30%.

In adults, the disease often occurs in an erased form. Often such patients are mistakenly diagnosed with “chronic bronchitis” and unsuccessfully treated for a non-existent disease. Therefore, doctors advise that if you have a prolonged cough, especially in cases where it occurs with painful attacks, you should pay attention to the epidemiological situation - whether there has been contact with a child who has been coughing for a long time.

Patients who have recovered from whooping cough develop lifelong immunity. However, as with vaccination, immunity to whooping cough does not exclude the disease from parapertussis, which is clinically indistinguishable from a mild form of whooping cough.

Mechanism of whooping cough development

The functional immaturity of the mucous membranes of the upper respiratory tract in young children leads to the fact that whooping cough predominantly affects this age group of the population. The infection is especially severe in children in the first two years of life.

Having attached to the epithelium, bacteria begin to secrete special substances - toxins that cause an inflammatory reaction. The small bronchi and bronchioles are most affected. The pathogen does not penetrate inside the cells, so pathological changes are minimally expressed - plethora and swelling of the surface layers of the epithelium are observed, sometimes desquamation and death of individual cells. When a secondary infection occurs, erosions may develop.

After the death and destruction of bacteria, pertussis toxin reaches the surface of the mucous membrane, which leads to the development of spasmodic cough.

The mechanism of occurrence of a specific cough during whooping cough is quite complex. First, cough shocks are associated with direct irritation of epithelial receptors by toxins of the pertussis bacillus, then an allergic component is added, associated with the release of specific substances - inflammatory mediators. A spasm of the bronchi and bronchioles occurs, so that the cough begins to resemble the clinical picture of asthmatic bronchitis.
Subsequently, due to constant irritation of the vagus nerve, a focus of congestive excitation develops in the central nervous system in the area of ​​the respiratory center, and the cough takes on a specific paroxysmal character.

It is the presence of a central mechanism that leads to the fact that coughing attacks occur when exposed to a wide variety of irritants of the nervous system (bright light, loud sound, strong emotional stress, etc.).

Nervous excitation from a stagnant focus can spread to neighboring centers in the medulla oblongata - emetic (in such cases, attacks of convulsive coughing result in painful vomiting), vasomotor (a coughing attack leads to fluctuations in blood pressure, increased heart rate, etc.), as well as to other subcortical structures with the development of seizures resembling epilepsy.

In very young children, excitement can spread to the respiratory center with the development of various breathing rhythm disturbances, up to apnea (stopping breathing).

Severe, prolonged, frequently repeated coughing attacks lead to increased pressure in the vessels of the head and neck. As a result, swelling and cyanosis of the face and hemorrhages in the conjunctiva of the eyes develop. In severe cases, hemorrhages in the brain tissue may occur.

Whooping cough symptoms

Clinical periods of whooping cough

• incubation;
• catarrhal cough;
• spasmodic cough;
• permissions;
• convalescence (restorative).

Catarrhal period begins gradually, so that the first day of the disease, as a rule, cannot be established. A dry cough or coughing appears, a runny nose with a thin viscous mucous discharge is possible. In young children, catarrhal symptoms are more pronounced, so the onset of the disease may resemble ARVI with profuse nasal discharge.

Gradually, the cough intensifies, patients become irritable and restless, but the general condition remains quite satisfactory.

Period of spasmodic cough begins in the second week from the appearance of the first symptoms of infection and lasts, as a rule, 3–4 weeks. This period is characterized by paroxysmal cough. Older children may report warning signs of an attack, such as a scratchy throat, tightness in the chest, or feelings of fear or anxiety.

Characteristic cough
Attacks can occur at any time of the day, but most often occur at night. Each such attack consists of short but strong coughing shocks, interspersed with convulsive breaths - reprises. Inhalation is accompanied by a whistling sound as air forcefully passes through the spastically narrowed glottis.

The attack ends with coughing up characteristic viscous transparent sputum. The appearance of vomiting, impaired breathing and heartbeat, and the development of seizures indicate the severity of the disease.

During an attack, the child's face swells, in severe cases acquiring a bluish tint, the veins of the neck swell, the eyes become bloodshot, and lacrimation and drooling appear. A characteristic sign: the tongue protrudes outward to the limit, so that its tip bends upward, and, as a rule, the frenulum of the tongue is injured by the incisors of the lower jaw. In a severe attack, involuntary urination and loss of feces may occur.

Complications of persistent cough
In the absence of complications, the child’s condition between attacks is satisfactory - children play actively, do not complain of appetite, body temperature remains normal. However, over time, puffiness of the face develops, and on the frenulum of the tongue damaged by teeth, an ulcer covered with a whitish coating appears - a specific sign of whooping cough.

In addition, hemorrhages under the conjunctiva are possible, and there is often a tendency to nosebleeds.

Resolution stage
Gradually the disease passes in the resolution stage. Coughing attacks occur less frequently and gradually lose their specificity. However, weakness, coughing, and irritability persist for quite a long time (the resolution period ranges from two weeks to two months).

Convalescence period can last up to six months. This period is characterized by increased fatigue and emotional disturbances (moody, excitability, nervousness). A significant decrease in immunity leads to increased susceptibility to acute respiratory infections, against the background of which an unexpected resumption of a painful dry cough is possible.

Criteria for the severity of whooping cough

In mild forms, coughing attacks occur no more than 10-15 times a day, while the number of cough impulses is small (3-5). Vomiting after coughing, as a rule, does not occur, the general condition of the child is quite satisfactory.

With moderate whooping cough, the number of attacks can reach 20-25 per day. The attacks have an average duration (up to 10 coughing impulses). Each attack ends with vomiting. In such cases, asthenic syndrome (general weakness, irritability, decreased appetite) develops quite quickly.

In severe cases, the number of coughing attacks reaches 40-50 or more per day. The attacks last a long time, occur with general cyanosis (the skin acquires a bluish tint) and severe breathing problems, and convulsions often develop.

In severe cases of whooping cough, complications often develop.

Complications of whooping cough

• associated with the underlying disease;
• development of an autoimmune process;
• addition of a secondary infection.

During severe, prolonged coughing attacks, the supply of oxygen to the brain is significantly disrupted - this is associated both with bronchospasm and breathing rhythm disturbances, as well as with impaired blood flow in the vessels of the head and neck. The result of hypoxia can be brain damage such as encephalopathy, manifested by convulsive syndrome and signs of irritation of the meninges. In severe cases, hemorrhages occur in the brain.

In addition, a severe cough against the background of spasm of the bronchi and bronchioles can lead to disruption of the filling of the lungs with air, so that emphysema (bloating) occurs in some areas, and atelectasis (collapse of lung tissue) in others. In severe cases, pneumothorax develops (accumulation of gas in the pleural cavity due to rupture of lung tissue) and subcutaneous emphysema (penetration of air from the pleural cavity into the subcutaneous tissue of the neck and upper half of the body).

Coughing attacks are accompanied by an increase in intra-abdominal pressure, so in severe cases of whooping cough, umbilical or inguinal hernia and rectal prolapse may occur.

Among secondary infections, the most common are pneumonia and purulent otitis media (inflammation of the middle ear).
Sometimes autoimmune processes develop, which arise as a result of long-term inflammation with a pronounced allergic component. Cases of whooping cough progressing to asthmatic bronchitis and bronchial asthma have been reported.

Atypical forms of whooping cough

The abortive form is characterized by an unexpected resolution of the disease 1-2 days after the appearance of the first coughing attacks specific to whooping cough.

Whooping cough in patients from different age groups

In children of the first year of life, whooping cough is especially severe and is often complicated by the development of secondary pneumonia.

At the same time, the periods of the clinical picture have a different duration: the incubation period is reduced to 5 days, and the catarrhal period is reduced to one week. At the same time, the period of spasmodic cough lengthens significantly – up to two to three months.

In addition, during attacks of spasmodic cough in infants there are no reprises; a coughing attack often ends in temporary cessation of breathing and a convulsive seizure.

Diagnosis of whooping cough

Doctor consultations

At an appointment with a general practitioner or pediatrician.

At an appointment with an ENT doctor
The doctor will be interested in the condition of the mucous membrane of the larynx and pharynx. To do this, the doctor will examine the laryngeal mucosa using a special reflective mirror or flashlight.
Signs of whooping cough upon examination include swelling of the mucous membrane, the presence of hemorrhages, and light mucopurulent exudate.

At an appointment with an infectious disease doctor
The doctor will listen to your complaints. May inquire about possible contacts with coughing and whooping cough patients. Typically, the final diagnosis is made based on the results of laboratory tests, which an infectious disease specialist will send you for.

Laboratory diagnosis of whooping cough

General blood analysis

1. Increased level of leukocytes
2. Increased level of Lymphocytes
3. ESR is normal

The collected material is placed in a special nutrient medium. However, you will have to wait a long time for the result, 5-7 days.

Serological tests

Direct hemagglutination reaction (DRHA), indirect hemagglutination reaction (IRHA) This blood test technique allows you to identify antibodies to the causative agent of whooping cough. The result can be positive (confirmation of the diagnosis of Whooping Cough) or negative (exclusion).

ELISA (Enzyme-linked immunosorbent assay) Now there are express tests that can be used to detect whooping cough using ELISA. The result can be positive (confirmation of the diagnosis of Whooping Cough) or negative (exclusion)

PCR (Polymerase chain reaction) Allows you to identify the pathogen within a few days. The result can be positive (confirmation of the diagnosis of Whooping Cough) or negative (exclusion).

Treatment of whooping cough

Does a patient with whooping cough need bed rest?

A cough is more easily tolerated in the cold, so it is necessary to frequently ventilate the room and prevent the air from drying out and overheating (ideally, the temperature in the patient’s room should not be higher than 18-20 degrees Celsius). It is advisable to use humidifiers. To prevent your child from freezing, it is better to dress him warmly.

Toys, puzzles and other board games of a non-aggressive nature are used as a distraction.
In addition, sufficient attention should be paid to the patient’s nutrition. For breastfed infants, it is advisable to increase the number of feedings by reducing the amount of food taken at one time. Older children are recommended to drink plenty of alkaline drinks (juices, fruit drinks, tea, milk, alkaline mineral water).

When is inpatient treatment necessary?

What medications and physiotherapeutic procedures are used for whooping cough?

Therefore, antibiotics are prescribed only during the catarrhal period. Ampicillin and macrolides (erythromycin, azithromycin) are quite effective; tetracyclines can be prescribed to children over 12 years of age. These antibacterial agents are taken in medium doses in short courses.

Standard antitussive drugs are ineffective for whooping cough attacks. To reduce the activity of the focus of excitation in the brain, psychotropic drugs are prescribed - antipsychotics (aminazine or droperidol in age-appropriate dosages). Since these medications have a sedative effect, they are best taken before bedtime or nighttime sleep. For the same purpose, you can use a tranquilizer (Relanium - intramuscularly or orally in an age-specific dosage).

In mild forms of whooping cough, antihistamines - pipolfen and suprastin, which have an antiallergic and sedative effect - are prescribed to relieve coughing attacks. Diphenhydramine is not used because this drug causes dry mucous membranes and may increase coughing.
In severe forms of whooping cough with a pronounced allergic component, some clinicians note significant improvement with the use of glucocorticoids (prednisolone).

All of the above remedies are taken until the attacks of spasmodic cough disappear (usually 7-10 days).

In addition, to liquefy viscous sputum, inhalations of proteolytic enzymes - chymopsin and chymotrypsin - are used, and in case of severe coughing attacks, drugs that improve blood circulation in the brain (pentoxifylline, vinprocetin) are used to prevent hypoxia of the central nervous system.

To improve mucus discharge, massage and breathing exercises are indicated. During periods of resolution and convalescence, restorative physiotherapeutic procedures and courses of vitamin therapy are prescribed.

Traditional methods of treating whooping cough

To liquefy sputum during whooping cough, an infusion of tricolor violet is also used: 100 g of the herb is poured into 200 g of boiling water and infused for half an hour. Then filter and take 100 g twice a day.