Laboratory research methods. Treatment

Forecast.

The prognosis of pertussis largely depends on the age of the child, the severity of the course and the presence of complications. Whooping cough is not very dangerous for older children.

The prognosis remains serious in young children with the addition of complications (pneumonia, asphyxia, encephalopathy).

Mortality among children under one year old reaches 0.1-0.9%.

Basic principles of treatment.

Children of early age with a severe form of whooping cough, with complications or with concomitant diseases are subject to hospitalization.

It is necessary to create a protective regime, to exclude as much as possible all irritants (mental, physical, painful, etc.).

The main task of pathogenetic therapy in severe forms is to combat hypoxia, oxygen therapy is carried out in oxygen tents, while the oxygen concentration should not be higher than 40%, in mild and moderate forms, aerotherapy is indicated (prolonged exposure to fresh air), when breathing stops - mechanical ventilation.

To improve bronchial patency, eufillin is prescribed orally or parenterally (especially in case of signs of cerebrovascular accident, with obstructive syndrome, pulmonary edema).

To thin viscous sputum: mukaltin, mucopront, potassium iodide solution; antitussive drugs for children after 2 years - glaucine hydrochloride, glauvent, etc.

Inhalations with a solution of sodium bicarbonate, aminophylline, novocaine, ascorbic acid.

Carrying out postural drainages, suction of mucus.

Diet food.

Sedatives: seduxen, phenobarbital (reduce the frequency of seizures).

Immunomodulators.

Antibacterial therapy: erythromycin, rulid, vilprafen, sumamed (prevent the colonization of pertussis bacteria, but their effectiveness is limited by the early stages of the disease, in addition, they are indicated when a secondary bacterial infection is attached) course of treatment - 8-10 days.

Pertussis immunoglobulin (children under 2 years).

Vitamin therapy.

Preventive and anti-epidemic measures for whooping cough:

In conditions of incomplete and late diagnosis, the patient is isolated for 30 days from the onset of the disease at home, and in severe forms and according to epidemic indications, hospitalization is carried out.

The focus is quarantined for 14 days from the moment of separation from the sick person, contacts are identified, they are registered and monitored daily (coughing detection) with a 2-fold bacteriological examination, with an interval of 7-17 days (until 2- x negative tests).

Only children of 7 years old are subject to separation.

Carrying out current disinfection during quarantine.

Specific prophylaxis: routine active immunization of children under one year of age with DTP (associated pertussis-diphtheria-tetanus vaccine).

DTP vaccination: from 3 months three times with an interval of 30 days.

I revaccination of DTP - 1.5-2 years after vaccination.

Vaccinations against whooping cough are not available for children older than 3 years.

Children under one year of age who have not been vaccinated against whooping cough are given immunoglobulin according to indications.

Nursing process in whooping cough.

Timely identify real and potential problems, violated needs of the patient and his family members.

Possible patient problems:

sleep disturbance;

loss of appetite;

persistent, obsessive cough;

respiratory failure;

violation of physiological functions (loose stools);
violation of motor activity;
change in appearance;
the inability of the child to independently cope with the difficulties that arose as a result of the disease;
psycho-emotional stress;
complication of the disease.

Possible problems for parents:

maladaptation of the family due to the illness of the child;

fear for the child;

uncertainty about the successful outcome of the disease;

lack of knowledge about illness and care;

inadequate assessment of the child's condition;

chronic fatigue syndrome.

Nursing intervention.

Inform parents about the causes of development, the course of whooping cough, the principles of treatment and care, preventive measures, and prognosis.

Limit the contact of a sick child with other children as much as possible.

Provide isolation of the patient at home until 2 negative results of bacteriological examination are obtained, and in severe cases, provide assistance in organizing hospitalization.

Ensure adequate aeration of the room where the sick child is located. Optimally, if the windows are constantly open, this is necessary for the child, especially at night, when the most severe coughing attacks occur (in the fresh air they settle down, are less pronounced and complications occur much less frequently).

Teach parents to provide first aid in case of vomiting and convulsions. Follow all doctor's orders in a timely manner.

Create a calm, comfortable environment around the child, protect him from unnecessary unrest and painful manipulations. Involve parents in the process of caring for a child, teach them how to properly sanitize the airways, carry out inhalations with a 2% solution of sodium bicarbonate, vibration massage.

Provide the child with nutrition adequate to his condition and age, it should be complete, enriched with vitamins (especially vitamin C, which contributes to better absorption of oxygen). Easily digestible liquid and semi-liquid foods are recommended: dairy cereals or vegetable mashed vegetarian soups, rice, semolina, mashed potatoes, fat-free cottage cheese, you should limit the consumption of bread, animal fats, cabbage, extractive and spicy foods. In severe forms of the disease, give liquid and semi-liquid food (not containing crumbs, lumps), often and in small portions. With frequent vomiting, it is necessary to supplement the child after an attack and vomiting.

The amount of fluid consumed should be increased to 1.5-2 liters, a rosehip broth, tea with lemon, fruit drinks, warm degassed mineral alkaline waters (Borjomi, Narzan, Smirnovskaya) or a 2% solution of soda mixed in half with warm milk should be introduced.

Advise parents to organize an interesting leisure time for the child: diversify it with new toys, books, decals and other calm games according to age (since whooping cough attacks increase with excitement and increased physical activity).

Protect the patient from communicating with patients with acute respiratory viral infections, since the addition of secondary viral and bacterial infections creates a threat of developing pneumonia and an increase in the severity of whooping cough.

Organize current disinfection at home (disinfect dishes, toys, care items, furnishings, carry out wet cleaning twice a day with a soap and soda solution).

In the period of convalescence, it is recommended that the child be given non-specific disease prevention (complete nutrition enriched with vitamins, sleeping in the fresh air, hardening, dosed physical activity, exercise therapy, physiotherapy, massage).

Map the Nursing Process

whooping cough

Questions for self-study:

Define whooping cough.

What are the properties of the whooping cough pathogen?

What are the sources of infection?

What is the mechanism and ways of transmission of infection?

What is the development mechanism of whooping cough?

What are the main clinical manifestations of whooping cough in the catarrhal period?

What are the main clinical manifestations of whooping cough in the spasmodic period?

What are the features of the course of whooping cough in children under one year old?

What are the basic principles of whooping cough treatment?

What preventive and anti-epidemic measures are taken for whooping cough?

What complications can develop with whooping cough?

NURSING PROCESS MAP

NURSING PROCESS MAP

(the result of the dynamics of the disease)

date

Stage 1

Collection of information

Stage 2

Patient problems

Stage 3

care plan

Stage 4

Implementation of the care plan

Stage 5

Evaluation of the effectiveness of care

Used but not reflected in daily monitoring

The examination is subjective (questioning)

Objective (examination, anthropometry,

percussion, auscultation, etc.)

Study of medical records (history of development,

survey data)

real

Primary (priority) and secondary

Priority

Potential

Short term goals (less than a week)

Long term goals (more than a week)

Independent interventions (do not require doctor's orders)

Dependent interventions (based on doctor's orders or instructions)

Mutually dependent interventions (carried out together with another health worker)

Effect achieved:

fully

not completely

partially

not achieved

NURSING PROCESS IN TUBERCULOSIS

At all times, when treating patients with whooping cough, doctors paid great attention to general hygiene rules - regimen, care and nutrition.

In the treatment of whooping cough, antihistamines are used (diphenhydramine, suprastin, tavegil), vitamins, inhalation aerosols of proteolytic enzymes (chymopsin, chymotrypsin), which facilitate the discharge of viscous sputum, mukaltin.

Mostly children of the first half of the year with a pronounced severity of the disease are subject to hospitalization due to the risk of developing apnea and serious complications. Hospitalization of older children is carried out in accordance with the severity of the disease and for epidemic reasons. In the presence of complications, indications for hospitalization are determined by their severity, regardless of age. It is necessary to protect patients from infection.

Severely ill infants are advised to be placed in a darkened, quiet room and disturbed as little as possible, since exposure to external stimuli can cause severe paroxysm with anoxia. For older children with mild forms of the disease, bed rest is not required.

Severe manifestations of pertussis infection (profound respiratory rhythm disorders and encephalic syndrome) require resuscitation, as they can be life-threatening.

Erased forms of whooping cough do not require treatment. It is enough to eliminate external stimuli to ensure peace and longer sleep for patients with whooping cough. In mild forms, prolonged exposure to fresh air and a small number of symptomatic measures at home can be limited. Walks should be daily and long. The room in which the patient is located should be systematically ventilated and its temperature should not exceed 20 degrees. During an attack of coughing, you should take the child in your arms, slightly lowering his head.

With the accumulation of mucus in the oral cavity, it is necessary to free the child's mouth with a finger wrapped in clean gauze ...

Diet. Serious attention should be paid to nutrition, since pre-existing or developed nutritional deficiencies can significantly increase the likelihood of an adverse outcome. Food is recommended to give fractional portions.

The appointment of antibiotics is indicated in young children, with severe and complicated forms of whooping cough, in the presence of concomitant diseases in therapeutic doses for 7-10 days. The best effect is provided by ampicillin, gentamicin, erythromycin. Antibacterial therapy is effective only in the early stages of uncomplicated whooping cough, in catarrhal and no later than 2-3 days of the convulsive period of the disease.

The appointment of antibiotics in the spasmodic period of whooping cough is indicated for the combination of whooping cough with acute respiratory viral diseases, bronchitis, bronchiolitis, in the presence of chronic pneumonia. One of the main tasks is the fight against respiratory failure.

The most responsible therapy for severe whooping cough in children of the first year of life. Oxygen therapy is necessary with the help of a systematic supply of oxygen, cleaning the airways from mucus and saliva. When breathing stops - suction of mucus from the respiratory tract, artificial ventilation of the lungs. With signs of brain disorders (tremor, short-term convulsions, increasing anxiety), seduxen is prescribed and, for the purpose of dehydration, lasix or magnesium sulfate. From 10 to 40 ml of a 20% glucose solution with 1-4 ml of a 10% calcium gluconate solution is injected intravenously, to reduce pressure in the pulmonary circulation and to improve bronchial patency - eufillin, for children with neurotic disorders - bromine preparations, luminal, valerian. With frequent severe vomiting, parenteral fluid administration is necessary.

Antitussives and sedatives. The efficacy of expectorant mixtures, cough suppressants, and mild sedatives is questionable; they should be used sparingly or not at all. Cough-provoking influences (mustard plasters, jars) should be avoided.

For the treatment of patients with severe forms of the disease - glucocorticosteroids and / or theophylline, salbutamol. With apnea attacks, chest massage, artificial respiration, oxygen.

Prevention in contact with the sick

In unvaccinated children, human normal immunoglobulin is used. The drug is administered twice with an interval of 24 hours as soon as possible after contact.

Chemoprophylaxis with erythromycin at an age dosage for 2 weeks can also be carried out.

whooping cough vaccine

Timely identify real and potential problems, violated needs of the patient and his family members.

Possible patient problems:

sleep disturbance;
loss of appetite;
persistent, obsessive cough;
respiratory failure;
apnea;
violation of physiological functions (loose stools);
violation of motor activity;
change in appearance;
the inability of the child to independently cope with the difficulties that arose as a result of the disease;
psycho-emotional stress;
complication of the disease.

Possible problems for parents:

maladaptation of the family due to the illness of the child;
fear for the child;
uncertainty about the successful outcome of the disease;
lack of knowledge about illness and care;
inadequate assessment of the child's condition;
chronic fatigue syndrome.

Nursing intervention.

Inform parents about the causes of development, the course of whooping cough, the principles of treatment and care, preventive measures, and prognosis.

Limit the contact of a sick child with other children as much as possible.

Provide isolation of the patient at home until 2 negative results of bacteriological examination are obtained, and in severe cases, provide assistance in organizing hospitalization.

Teach parents to provide first aid in case of vomiting and convulsions. Follow all doctor's orders in a timely manner.

Organize current disinfection at home (disinfect dishes, toys, care items, furnishings, carry out wet cleaning twice a day with a soap and soda solution).

Whooping cough can affect both adults and children. Immunity from this respiratory infection is developed only after a person has been ill once. In children, the manifestations are more severe, and complications can be very serious, even fatal. Vaccination is done in the first months of life. It does not guarantee complete protection against infection, but in vaccinated children, the disease occurs in a much milder form. Doctors recommend that parents, when caring for children with whooping cough, protect them as much as possible from any factors that provoke the appearance of a suffocating cough.

The causative agent of this disease is whooping cough (a bacterium called Bordetella). The infection affects the trachea and bronchi.

The respiratory tract is covered with the so-called ciliated epithelium, the cells of which have "cilia" that ensure the movement of sputum and its removal to the outside. When irritated by their toxic substances secreted by whooping cough pathogens, the nerve endings transmit a signal from the epithelium to the brain (to the area responsible for coughing). The response is a reflex cough, which should push out the source of irritation. Bacteria are firmly held on the epithelium due to the fact that they have special villi.

Characteristically, the cough reflex is so fixed in the brain that even after the death of all bacteria, strong urges to cough continue to persist for several more weeks. Waste products of pertussis bacteria cause general intoxication of the body.

Warning: Humans have no innate immunity to this disease. Even a baby can get sick. Therefore, it is so important to protect him from contact with adults who have a strong persistent cough. It may well be a sign of whooping cough, which in an adult, as a rule, does not have other characteristic manifestations.

The susceptibility of a person is so great that if a baby gets sick, then the rest of the family will definitely get infected from it. Whooping cough lasts 3 months as long as the cough reflex exists. In this case, for about 2 weeks, the disease has practically no symptoms. If somehow it is possible to establish in the very first days that pertussis bacteria are present in the body, then the disease can be quickly suppressed, since the dangerous cough reflex has not yet had time to gain a foothold. Usually, the symptoms of whooping cough in children are detected already at a severe stage. Then the disease continues until the cough gradually disappears on its own.

Video: How to prevent coughing fits

How infection occurs

Most often, whooping cough infects children under the age of 6-7 years. Moreover, in babies younger than 2 years, the probability of infection is 2 times higher than in older children.

The incubation period for whooping cough is 1-2 weeks. Within 30 days, the child should not attend a childcare facility, contact with other children, since whooping cough is very contagious. Infection is possible only by airborne droplets in close contact with a sick person or a carrier when he sneezes or coughs.

Outbreaks of the disease occur more often in the autumn-winter period. This is due to the fact that whooping cough bacteria quickly die under the rays of the sun, and the duration of daylight hours in winter and autumn is minimal.

Whooping cough forms

When infected with whooping cough, the course of the disease is possible in one of the following forms:

Typical - the disease consistently develops with all its inherent signs.
Atypical (erased) - the patient only coughs slightly, but there are no strong attacks. For some time, the cough may disappear altogether.
In the form of a bacteriocarrier, when there are no signs of the disease, but the child is a carrier of bacteria.

This form is dangerous because other people can be infected, while the parents are sure that the baby is healthy. Most often, this form of whooping cough occurs in older children (after 7 years), if they have been vaccinated. The baby remains a carrier also after recovery from a typical whooping cough up to 30 days from the moment the infection enters his body. Often in such a latent form, whooping cough manifests itself in adults (for example, workers in child care facilities).

The first signs of whooping cough

At the initial stage, the disease does not cause much concern for parents, since the first signs of whooping cough resemble the common cold. The baby has severe chills due to rising temperature, headache, weakness. Snot appears, and then an intensifying dry cough. And the usual cough medicines do not help. And only after a few days, symptoms of a typical whooping cough may appear, which gradually increase.

Video: Whooping cough infection, symptoms, the importance of vaccination

Periods of illness and characteristic symptoms of whooping cough

There are the following periods of development in a child of whooping cough symptoms:

Incubation. The infection has already occurred, but there are no first signs of the disease. They appear only on the 6-14th day from the moment the bacteria enters the body.
Premonitory. This is a period associated with the appearance of whooping cough harbingers: a dry, gradually increasing (especially at night) cough, a slight increase in temperature. At the same time, the child feels well. But this state lasts 1-2 weeks without change.
Spasmodic. There are bouts of convulsive coughing associated with an attempt to push out something that irritates the respiratory tract, it is difficult to inhale air. After several coughing exhalations, a deep breath follows with a characteristic whistling sound (reprise) arising from a spasm of the larynx in the vocal cords. After that, the baby convulsively shudders several times. The attack ends with the release of mucus or vomiting. Coughing fits with whooping cough can be repeated from 5 to 40 times a day. The frequency of their occurrence is a characteristic of the severity of the disease. During an attack, the child's tongue sticks out, the face has a red-blue color. The eyes turn red, as blood vessels burst due to tension. It is possible to stop breathing for 30-60 seconds. This period of illness lasts approximately 2 weeks.
Reverse development (resolution). The cough gradually weakens, attacks appear for another 10 days, the pauses between them increase. Then severe symptoms disappear. The child coughs a little for another 2-3 weeks, but the cough is normal.

Note: In infants, the excruciating attacks do not last so long, but after a few coughing movements, respiratory arrest may occur. Oxygen starvation of the brain causes diseases of the nervous system, developmental delays. Even death is possible.

Video: How to recognize whooping cough

Possible Complications

Complications of whooping cough can be inflammation of the respiratory system: lungs (pneumonia), bronchi (bronchitis), larynx (laryngitis), trachea (tracheitis). As a result of the narrowing of the lumen of the respiratory passages, as well as spasms and swelling of the tissues, death can occur. Especially quickly bronchopneumonia develops in children under the age of 1 year.

Complications such as emphysema (bloating), pneumothorax (damage to the lung wall and air leakage into the surrounding cavity) are possible. Strong tension during an attack can cause an umbilical and inguinal hernia, nosebleeds.

After whooping cough, due to cerebral hypoxia, tissue damage to individual centers sometimes occurs, as a result of which the child's hearing is impaired or epileptic seizures occur. Seizures are very dangerous, which also occur due to disruption of the brain and can lead to death.

Due to tension when coughing, damage to the eardrums, hemorrhage in the brain occurs.

Diagnosis of whooping cough in children

If whooping cough in a child occurs in a mild and atypical form, the diagnosis is very difficult. The doctor may assume that the malaise is caused by this particular disease, in the following cases:

the child does not cough for a long time, the symptom only intensifies, while the runny nose and fever stopped after 3 days;
expectorants do not have any effect, on the contrary, the state of health worsens after taking them;
Between coughing fits, the baby seems healthy and has a normal appetite.

In this case, to make sure that the patient has whooping cough, a bacteriological culture of a throat swab is done. The difficulty lies in the fact that the bacterium is sufficiently firmly held by the ciliated epithelium and is not brought out. The likelihood that even in the presence of pertussis pathogens they can be detected in this way is reduced to zero if the child has eaten or brushed his teeth before the procedure. They will be completely absent in the sample if the baby was given even an insignificant dose of antibiotic.

A general blood test is also done, which allows you to detect a characteristic increase in the content of leukocytes and lymphocytes.

Methods for diagnosing whooping cough are used by a blood test for antibodies (ELISA, PCR, RA).

There is a method of express diagnostics. The smear is processed with a special composition and studied under a microscope, which uses the effect of the glow of antibodies when illuminated.

Warning: If there are characteristic symptoms of whooping cough, the child must be isolated to avoid infecting other people. In addition, his situation may worsen after communicating with patients with a cold or flu. Even after recovery, the body is weakened, the slightest hypothermia or infection causes severe complications of whooping cough.

Signs of pneumonia

Inflammation of the lungs is one of the most common complications. Since parents know that whooping cough does not go away quickly, they do not always go to the doctor if the baby's condition changes. However, in some cases, delay is dangerous, so it is imperative to show the child to a specialist. Warning signs that require urgent treatment include:

Temperature increase. If this happens 2-3 weeks after the onset of whooping cough attacks, the baby does not have a runny nose.

Increased cough after the condition of the child has already begun to improve. Sudden increase in the duration and frequency of seizures.

Rapid breathing between attacks. General weakness.

Treatment of whooping cough in children

Whooping cough is mostly treated at home, unless it occurs in babies under the age of 1 year. Their complications develop rapidly, the baby can simply not have time to save. A child of any age is hospitalized if complications arise or respiratory arrest occurs during attacks.

First aid at home for whooping cough

During a coughing fit, the baby should not lie down. He must be planted immediately. The temperature in the room should be no more than 16 degrees. Turn off the heating completely and use a sprinkler to humidify the air.

It is important to calm and distract the baby with the help of toys, cartoons. Since the cause of coughing is the excitation of the nerve center of the brain, fear and excitement provoke increased coughing and spasm in the respiratory tract. At the slightest deterioration in the condition, it is urgent to call an ambulance.

Note: As doctors emphasize, any means are good to stop and prevent an attack, as long as they evoke positive emotions in the baby. Watching children's TV shows, buying a dog or new toys, going to the zoo force the brain to switch to the perception of new experiences, reduce sensitivity to irritation of the cough center.

How to alleviate the condition and speed up recovery

A sick baby needs to walk every day to prevent brain hypoxia and improve breathing. At the same time, one must remember that it can infect other children. Especially useful are walks along the banks of a river or lake, where the air is cooler and more humid. It is not recommended to walk a lot, it is better to sit on a bench.

The patient should not be nervous.

An attack can provoke improperly organized nutrition. It is necessary to feed the baby often and little by little, mainly liquid food, since the chewing movement also causes coughing and vomiting. As Dr. E. Komarovsky explains, in a baby frightened by a previous attack while eating, even an invitation to the table often reflexively causes a whooping cough.

Warning: In no case is it recommended to self-medicate, use "grandmother's remedies" to get rid of a cough. The nature of the cough in this case is such that heating and infusions do not get rid of it, and an allergic reaction to plants can lead to a state of shock.

In some cases, after consulting with your doctor first, you can use folk tips to alleviate the condition when you cough. For example, traditional healers recommend for children over 13 years of age to prepare a compress from a mixture of equal amounts of camphor and eucalyptus oils, as well as vinegar. He is advised to lay on the chest of the patient for the whole night. This helps make breathing easier.

Antibiotic treatment

Whooping cough is usually detected at a stage when the cough reflex, which is the main danger, has already developed. In this case, antibiotics do not help.

At the stage of the appearance of harbingers of the disease, the baby is given only antipyretic medicine if there is a slight rise in temperature. It is impossible to give him expectorants when a dry paroxysmal cough appears on his own, since the movement of sputum will cause increased irritation of the respiratory tract.

Antibiotics (namely erythromycin, which has no harmful effect on the liver, intestines and kidneys) are used to treat children for whooping cough at a very early stage, while severe coughing fits have not yet appeared.

They are taken more often for preventive purposes. If someone in the family has whooping cough, then taking an antibiotic will protect children from the action of the bacterium. It kills the microbe before a cough develops. The antibiotic will also help not to get sick to adult family members caring for a sick baby.

Treatment in the hospital

In conditions of increased severity, the patient with whooping cough is hospitalized. The hospital uses funds to eliminate respiratory failure and oxygen starvation of the brain.

If a child is admitted to the hospital at the first stage of the disease, then the task is to destroy microbes, stop apnea attacks (stop breathing), relieve convulsions, and eliminate spasms in the bronchi and lungs.

To enhance the body's resistance to whooping cough infection, gamma globulin is introduced at an early stage. Vitamins C, A, group B are prescribed. Calming agents are used (infusions of valerian, motherwort). To relieve spasms and convulsions, treatment with antispasmodics is used: calcium gluconate, belladonna extract.

Antitussive drugs do not have a sufficient effect on whooping cough, however, with excruciating attacks, under the supervision of a doctor, they are given to children to facilitate sputum discharge. Among the drugs used are ambroxol, ambrobene, lazolvan (to thin sputum), bromhexine (mucus excretion stimulant), eufillin (relieves spasms in the respiratory organs).

In the treatment of children for whooping cough, antiallergic drugs are also used, and in severe cases, tranquilizers (seduxen, relanium).

To reduce the frequency of attacks and reduce the likelihood of apnea, psychotropic drugs (chlorpromazine), which also have an antiemetic effect, are used. Respiratory arrest is prevented by the administration of hormonal drugs. At the end of the spasmodic period, massage and breathing exercises are prescribed.

In order to prevent complications, oxygen therapy is used, and sometimes artificial ventilation of the lungs.

Video: The use of erythromycin for whooping cough, the importance of vaccination, cough prevention

Prevention

Since whooping cough is highly contagious, when cases of the disease are detected in a children's institution, all children and adults who have been in contact with the patient are examined and prophylactically treated. Erythromycin, which kills pertussis bacteria, is used, as well as injections of gamma globulin, which stimulates the production of antibodies.

Especially dangerous is infection with whooping cough in infants. Therefore, it is necessary to limit the child's stay in crowded places and communication with unfamiliar children and adults. If a child is brought from the hospital, while one of the family members is sick, it is necessary to completely exclude his contact with the baby.

Vaccination is the main preventive measure. It reduces the risk of infection. In the case of whooping cough, the course is much easier.

Whooping cough – acute infectious disease with a cyclic course and characteristic bouts of convulsive cough. Etiology. Pathogen infections - bacteria in the form of short rods - was discovered by the Belgian scientist Bordet and the French scientist Zhangu in 1906. Infection occurs by airborne droplets More often, whooping cough affects children from 1 to 5 years, but sometimes children under the age of one are sick. The incubation period lasts from 2 to 15, but more often it is 5–9 days. At this time, the symptoms of the disease do not appear. Then, during the course of the disease, three periods are distinguished: catarrhal, convulsive and resolution. catarrhal period lasts up to 2 weeks. The onset of the disease is atypical. A general malaise develops, a runny nose, a cough that worsens every day, the temperature rises to subfebrile (37-38 ° C), and then drops to normal. convulsive period lasts from 1 to 5 weeks. The number of convulsive coughing attacks increases from 10 to 50 per day. Disease resolution period lasts 1-3 weeks. Gradually, the cough becomes weaker, convulsive attacks are less frequent and less prolonged, recovery begins. Total duration whooping cough can be from 5 to 12 weeks. The patient is considered contagious for 30 days from the onset of the disease. Complications: pneumonia, bronchitis (especially in children from 1 to 3 years old), respiratory arrest, nosebleeds. Care of sick children. An important place in the treatment is properly organized patient care. It should be in a separate room, in which wet cleaning and thorough ventilation are carried out 2 times a day. Bed rest is prescribed only at elevated temperature and the occurrence of complications. A sick child with a normal temperature should spend more time in the open air, but separately from healthy children. Fresh cold air has a very good effect on children with whooping cough, which improves ventilation of the lungs and increases the flow of oxygen into the body: coughing fits become less frequent and weaker. Feeding children should be frequent (up to 10 times a day), but in small portions and better after a coughing fit. Regardless of the severity of the disease, the main place in the treatment is given to antibiotics prescribed by a doctor. Prevention whooping cough in the children's team provides for isolation of the patient, which is usually organized at home. Isolation continues until the 30th day from the onset of the disease. Children under 7 years of age who have not had whooping cough and have not received vaccinations, after contact with the patient, are separated from children's groups for 14 days. Children over 7 years old, as well as adults working in childcare facilities and in contact with the patient, are subject to medical supervision for 14 days.