Nursing care for patients with whooping cough. Whooping cough is an acute infectious disease

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 stress. 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.

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.

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).

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. Ampicillin, gentamicin, erythromycin have the best effect. 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

With whooping cough, the actions of a nurse will depend on her profile (district nurse, hospital nurse, kindergarten nurse, etc.).

Actions of the hospital nurse:

Creation of a protective regime in the ward, department;

Providing physical assistance to the child during a coughing fit (support the child, soothe);

Organization of walks in the fresh air;

Control over the feeding regimen (frequent, small portions);

Prevention of nosocomial infection (control of the isolation of the child);

Providing emergency care for fainting, apnea, convulsions.

Actions of the site nurse:

Monitor compliance of the child's parents with the isolation regime within 30 days from the moment of illness;

Inform parents of other children about whooping cough;

Identify possible contacts of the child (especially in the first days of illness) with healthy children and ensure observation of them within 14 days from the moment of contact;

Be able to provide emergency care for apnea, convulsions, fainting;

Timely inform the doctor about the deterioration of the child's condition.

The leading action of the kindergarten nurse in case of whooping cough, quarantine measures will be carried out within 14 days from the moment of isolation of a sick child (early isolation of all children suspected of whooping cough; not to allow transfers of children to other groups, etc.).

The most common problem in all children with whooping cough is the risk of developing pneumonia.

The purpose of the nurse (district, hospital): prevent or reduce the risk of pneumonia.

Nurse actions:

Careful monitoring of the child's condition (timely notice changes in behavior, changes in skin color, the appearance of shortness of breath);

Counting the number of breaths, pulse per minute;

Body temperature control;

Strict adherence to medical prescriptions.

The most common laboratory confirmations of whooping cough are leukocytosis up to 30x10 9 /l with severe lymphocytosis and bacteriological examination of pharyngeal mucus.

Children in the first year of life and children with severe disease are usually hospitalized in DIB.

The period of isolation of patients with whooping cough is long - at least 30 days from the moment of illness.

With the advent of spasmodic cough, antibiotic therapy is indicated for 7-10 days (ampicillin, erythromycin, chloramphenicol, chloramphenicol, methicillin, gentomycin, etc.), oxygen therapy (the child's stay in an oxygen tent). Also apply hyposensitizing agents(diphenhydramine, suprastin, diazolin, etc.), mukaltin and bronchodilators (mukaltin, bromhexine, eufillin, etc.), inhalation of aerosols with sputum thinning enzymes (trypsin, chymopsin).

Since the problem of all children is the risk of whooping cough, and the main goal of the nurse is to prevent the disease, her actions should be aimed at developing specific immunity in children.

For this purpose, it can be applied DTP vaccine(adsorbed pertussis-diphtheria-tetanus vaccine).

Timing of vaccination and revaccination:

vaccination is carried out from 3 months three times with an interval of 30-45 days (0.5 ml IM) to healthy children who have not had whooping cough;

revaccination - at 18 months (0.5 ml / m, once).

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

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 whooping cough patients. 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 need to 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.

Features of whooping cough in children of the first year of life.

1. Shortening of the catarrhal period and even its absence.

2. The absence of reprises and the appearance of their analogues - temporary stops in breathing (apnea) with the development of cyanosis, the possible development of seizures and death.

3. Longer period of spasmodic cough (sometimes up to 3 months).

If any problems arise in a sick child purpose of the nurse is their elimination (reduction).

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 is injected intravenously with 1-4 ml of a 10% solution of calcium gluconate, 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.

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.

What is this disease?

Whooping cough is an extremely contagious respiratory tract infection. The disease is characterized by sudden attacks of spasmodic coughing, which usually end in wheezing. The peak incidence occurs in early spring and late winter. Half of the cases are unvaccinated children under the age of two.

As a result of mass immunization and timely recognition of the disease, the number of deaths from whooping cough has decreased dramatically. Children under one year old die from pneumonia and other complications; whooping cough is also dangerous for the very elderly, but it tends to be less severe in older children and adults.

What are the causes of the disease?

The causative agent of whooping cough is coccobacteria. The infection is usually transmitted by airborne droplets from a patient in the acute phase of the disease; much less often through bedding and other items contaminated with secretions from the nasopharynx.

What are the symptoms of the disease?

7-10 days after infection, coccobacilli enter the respiratory tract, where they cause the formation of viscous mucus. Classic whooping cough lasts 6 weeks; in its course, 3 periods are distinguished; the duration of each is 2 weeks.

The catarrhal period is characterized by an irritating cough, nocturnal cough, loss of appetite, sneezing, restlessness, and sometimes a slight fever. During this period, whooping cough is especially contagious.

The spasmodic period begins 7-14 days after the onset of the disease. It is characterized by paroxysmal convulsive cough with the release of viscous mucus. Each bout of coughing usually ends in a noisy, convulsive breath, and choking on mucus can lead to vomiting. (Very young children may not have this typical gasping breath.)

In between breaths during a convulsive cough, complications such as increased pressure in the veins, nosebleeds, swelling around the eyes, hemorrhages under the conjunctiva, retinal detachment (and blindness), rectal prolapse, hernia, convulsions and pneumonia are possible. In children, convulsive coughing can cause intermittent respiratory arrest, oxygen deficiency, and metabolic disorders.

During this period, patients are very vulnerable to the addition of secondary bacterial or viral infections, which can be deadly. With the appearance of temperature, a secondary infection can be assumed.

Recovery period. At this time, coughing fits and vomiting gradually subside. However, even after a mild respiratory tract infection, a whooping cough may return within a few months.

How is whooping cough diagnosed?

Classical symptoms - especially in the convulsive period of the disease - make it possible to suspect whooping cough and prescribe laboratory tests to confirm the diagnosis. Isolation of a bacillus carrier using a throat swab is possible only in the early stages of the disease. Usually at the beginning of the convulsive period, leukocytosis increases, especially in children older than 6 months.

How is the disease treated?

Patients with severe attacks of convulsive cough should be hospitalized; in the hospital they will receive fluids and electrolytes. Treatment consists of proper nutrition, codeine and mild sedatives are prescribed to reduce cough; if the patient has periodic respiratory arrests, oxygen therapy is necessary; antibiotics are used to prevent secondary infections.

A patient with a spasmodic cough needs to be isolated. Wear a mask when caring for whooping cough. Care should be taken to create a calm environment so as not to provoke coughing fits. It is better to feed patients in small portions, but more often.

Whooping cough vaccines

Since infants are especially susceptible to whooping cough, immunization (pertussis-diphtheria-tetanus vaccine) is usually given at 2, 4 and 6 months. At 18 months and at 4-6 years, additional vaccinations are given.

The vaccine can damage the nervous system and cause other complications, but the risk of getting whooping cough is greater than the risk of complications.