Whooping cough is an acute infectious disease, accompanied by inflammation in the upper respiratory tract and paroxysmal spasmodic cough.
Unvaccinated children under 5 years of age are most often infected, and whooping cough is especially dangerous for children in their first year of life. At an older age, this infection is much easier.
Whooping cough is caused by a specific bacterium called Bordetella pertussis. The microbe is transmitted by airborne droplets (by coughing, sneezing, talking) in close contact with a sick person. The disease is very contagious. However, a contact (for example, through toys) transmission of infection is impossible, since the bacterium quickly dies in the external environment.
Immunity after the disease is developed very persistent and usually lasts for life. Repeated diseases can occur in old age. However, as a rule, doctors take him for a cold – the disease is so easy.
Pertussis bacteria produce specific toxins that cause irritation to the respiratory mucosa. As a result, a spasm of the diaphragm and muscles of the bronchi (bronchospasm) develops, and a so-called spastic cough occurs. The cough reflex is gradually fixed in the respiratory center of the medulla oblongata (part of the brain), which leads to increased and more frequent coughing attacks.
The incubation period (the time from infection to the onset of the first symptoms of the disease) usually lasts from one to two weeks. The disease begins gradually. The body temperature rises slightly, a runny nose and a dry cough begin. In this phase of the illness, parents often think that he is “a little cold”, and the child continues to go to school or kindergarten, infecting others. Cough gradually increases in strength and duration and becomes spasmodic. This pertussis cough is so specific that it is enough for the doctor to hear at least once to immediately make the correct diagnosis.
In a spasmodic attack, after a whistling breath, a series of short convulsive coughing tremors follow, which non-stop follow each other for one breath. Sometimes such attacks are accompanied by vomiting, turning blue or reddening of the face, sputum discharge. Within one day of such attacks, there may be 20-30 or more, depending on the severity of the disease. The patient’s face becomes puffy, hemorrhages sometimes appear on the skin, conjunctivitis may begin, and an ulcer forms on the frenum of the tongue. Attacks of convulsive coughing can occur at any time of the day, but more often – at night and in the morning.
As a rule, out of coughing fits the condition of the child is almost the same as normal. Body temperature remains normal. An increase in body temperature during a spasmodic cough most often indicates the addition of complications.
The period of spasmodic cough lasts about 3-4 weeks or more, the number of seizures gradually decreases and they become less intense. However, a slight cough, weakness, irritability and irritability of the child persist for the next few months.
The most common complication of whooping cough is pneumonia, which is already caused by other microbes – streptococci and staphylococci. In children of the first year of life, whooping cough is dangerous for respiratory arrest during seizures, the duration of which varies from a few seconds to several minutes. Due to a lack of oxygen, they may develop skeletal muscle cramps, encephalopathy, etc.
Other complications: bronchitis, pleurisy (inflammation of the pleura covering the lungs), purulent otitis media, false croup. Occasionally, severe complications arise due to severe coughing tremors (cerebral hemorrhage, rupture of the eardrum, pneumothorax, etc.).
Diagnosis and treatment
Pertussis is diagnosed with a typical cough. To confirm this, sputum and mucus taken from the mucous membrane of the pharynx can be sown.
Treatment is usually carried out at home. It is rare to hospitalize with whooping cough, mainly young children and patients with a severe or complicated form of the disease.
Of great importance in the treatment of this disease is fresh, moistened air in the patient’s room (frequent airing of the room), fractional nutrition (frequent meals in small portions), and the reduction of external irritants that can provoke coughing (in particular, light and noise). At normal body temperature, outdoor walks are useful (at a temperature not lower than -10º C).
Of the medications, the doctor usually prescribes antibiotics, antihistamines, and antitussive drugs, and sometimes antipsychotics, to relieve spasmodic coughs.
To date, the most effective measure to combat whooping cough is the introduction of DTP vaccine, included in the mandatory vaccination schedule.
If a child with pertussis is identified, quarantine is introduced for 2 weeks for children who have not previously been vaccinated and who have not had pertussis before the age of 7 years.