Whooping cough in children: symptoms and treatment, prevention and photos, Komorowski
How to treat whooping cough in children?
Many pediatricians and infectious disease specialists alarming progression of pertussis infection in children. The incidence of light and atypical forms has increased significantly in recent years, not only in infants but also children from 7 to 14 years. Who data says that each year worldwide recorded cases of the disease in 60 million population, with millions of deaths in children up to one year.
Reduced epidemic wariness among pediatricians leading to late detection of the disease. How to treat whooping cough in children to a favorable prognosis and avoid the development of pathologic complications? How to facilitate the course of infection and whether prevention measures?
The etiology of the disease
Whooping cough is an acute disease anthroponomy cyclic flow, distinctive manifestations of which are convulsive paroxysmal attacks of cough, catarrhal phenomena in the upper respiratory tract and the development of complications in the respiratory and Central nervous system.
The causative agent of whooping cough belongs to the genus Bordetella, his representative B. Pertussis is the main parasite causing the infection. Inductor paroxysmal phase, responsible for the clinical specificity of the disease is pertussis toxin (heat stable).
The effect of the toxin provokes bronchoconstriction, increased peripheral vascular tone the skin, irritates the receptors of the afferent fibers of the vagus nerve, increases intravascular pressure due to generalized vascular spasm. In these actions the body reacts cough syndrome, which, at the initial stage of the disease can be confused with the tracheobronchial cough. Tonic convulsions of the respiratory muscles cause whooping cough paroxysmal character.
Mild pertussis infection affects the upper respiratory tract, with severe there is a loss of the entire bronchial tract down to the bronchioles.
Important! According to the practical observations of pertussis infection is a seasonal disease, with an eight-month duration of the development. The rise of infection to patients occurs in September and falls in April. The peak incidence is in December. Depending on the year the decline or rise of the disease (the interval of the periodicity of 3-4 years), there may be a change in the spread of seasonal increase of morbidity.
In order to understand how is whooping cough should define the mechanism and route of transmission. The source of infection is the patient at the end of the incubation period, the maximum danger is people since the development of the clinical picture.
Patients with spastic cough in the first week of the disease there are of the order of 90-100% of the pathogen over the next weeks figures are significantly reduced by 4 weeks do not exceed 10%.
Infection is by inhalation of air together with the pathogen through close contact with the patient. The source of the infection is contagious at a distance of 2 meters. A contact mechanism of transmission through objects belonging does not occur, due to the low resistance of the pathogen to environmental conditions.
The clinical picture of infection
Most infectious diseases in children is accompanied by the primary toxicity with an increase in subfebrile temperature of body, with a pronounced primary symptomatic picture.
Pertussis infection in turn manifests itself cyclically, with the slow development of the clinical picture. The culmination of the development occurs in 14 to 21 days after the occurrence of primary symptoms.
Whooping cough is manifested depending on the type of disease – typical or atypical. In turn, the atypical form of the disease is divided into abortive and erased forms that are mainly found in children, vaccinated.
Paroxysmal attacks of cough ending with reprisal, no. Among the main symptoms – cough reflex unproductive nature, is not amenable to effects of antitussive drugs. The child may cough for a long time (several months), the patient’s condition does not deteriorate, complications occur rarely.
Important! Among children vaccinated, incidence occurs at 4 to 6 times smaller and has mild than not vaccinated. There are no cases of death, Reprise and retching are observed rarely.
The abortive form peculiar to the unexpected resolution of the disease after the passage of the catarrhal stage (for 7 days after appearance of paroxysmal cough).
The typical appearance is characterized by the occurrence of defined periods, each of which has its own peculiar symptomatic picture:
- Incubation. The average duration of 7-8 days, are asymptomatic;
- Predatorily. He is characterized by a gradual and slow progression of the disease. Indicators of body temperature are normal, the child’s condition is stable, with no change in behavior. Appears dry obsessive cough, worse in the first few hours after falling asleep or right before sleeping. Perhaps blanching of the skin due to spazmirovannah peripheral vessels. Duration predadores period depends on the age of the child and the availability of vaccines against infection. In vaccinated patients lasts 10 to 13 days, in neonates and infants – from 3 to 5 days.
- Spasmodic. In this period, the clinical manifestations develop as possible. Dominated by paroxysmal cough with short jolts, one after one during one exhalation. Ends attack reprisal (whistling sound during intense and sudden inspiration), the discharge of viscous mucus thick consistency, retching. Secondary signs – red or bluish face, watery, bloodshot eyes. In spasmodic period there are pronounced changes in the lungs (see photo).
The following stages is a period of development of early and late reconvalescence, in which the child’s condition becomes normal, the cough attacks subside, become less frequent.
Important! In previous years reprises considered as a mandatory manifestation of pertussis in children older than 12 months, today, this manifestation can be found in every second patient.
Features of clinical manifestations in children of small age
Children under the age of 12 months fall within the group of severe disease. The symptomatic picture may have its specific differences are:
- weak Malovodnoye cough attacks (mostly premature babies);
- in the first months of a child’s life may not be typical pertussis infection cough, the disease manifests unmotivated screaming, crying, hiccups,
- the sputum in small numbers, mainly from the nasal passages that is often confused with symptoms of the common cold;
- blue discoloration of the skin in the region of nasolabial triangle;
- loss of appetite, poor weight gain, loss of acquired speech and motor skills;
- non-specific complications occur in a shorter time (mostly pneumonia).
Learn what to do when you cough in infants
Treatment pertussis infection
Therapeutic measures the aim of relief of acute manifestations of the disease and prevent the development of adverse effects.
Comprehensive measures, including the organization of the right and power, as well as the timely appointment of causal treatment to prevent seizures, respiratory arrest, changes in respiratory system.
Compliance with this tactics allows for the treatment at home, without the hospital treatment. Hospitalization put in severe disease, patients early age (up to 12 months, not vaccinated), at high risk of complications, life-threatening.
For reference! In less severe pertussis infections a child has had up to 15 seizures a day.
Principles of the organization of the correct mode and power include:
- Often an individual walks in places with high humidity. Time spent in the fresh air – no more than half an hour. At a temperature range of -10-12 °C from the walks should refrain;
- To provide daily ration products rich in vitamins. In severe feed the baby after an attack in small numbers. Daily quantity of liquid should not exceed the physiological norm, the corresponding age of the child;
- Often ventilate the room, use a humidifier;
- To reduce the effect of external stimuli.
The effectiveness of antimicrobials and positive dynamics of the disease depends on the timely diagnosis of pertussis and the use of antibiotics in the early stages of the disease. To avoid the appearance of seizures in the child can once the antibiotic is administered in predatorily period.
The choice in favor of a particular group of antibacterial drugs is based on the form of the disease. The most often used «Erythromycin», «Azitroks», «Summed», «Augumentin», «Amoxiclav».
Antibiotic use in spasmodic period is inappropriate, as these actions can trigger complications during the pertussis. The antibiotic treatment in spasmodic period, with complications caused by secondary infection.
To eliminate bronchospasm prescribe «Efferalgan», «Tussin», «Pixelation» in the age dosage. The use of «Aminophylline» contributes to the expansion of the lumen of the bronchi. Recommended the appointment in the early stages of drugs that block the receptors of histamine with a sedative effect («Suprastin», «Pipolfen»).
In severe disease accompanied by hypoxia, method of treatment with oxygen (oxygen therapy) and glucocorticosteroids.
In order to avoid complications of pertussis infection is not recommended to treat whooping cough in children in the home folk remedies. A positive prognosis depends on timely treatment to the doctor and assign the correct therapy.
Prevention of the disease manifests in a timely DTP vaccination in the child reaching 3 months of age. The course consists of three injections administered intramuscularly at intervals of 1.5 months. Revaccination is done only once in 18 months.
Acquired vaccine-induced immunity does not protect from morbidity, but facilitates the flow of pertussis infection. Vaccinated children are diagnosed erased and mild forms of pertussis.
Known children’s doctor E. O. Komarovsky shares the opinion of his colleagues concerning tactics of treatment of pertussis infection. According to the pediatrician became widespread atypical forms of pertussis occurring in the form of light. Thanks to vaccination, typical pertussis infection is rare.
Recommendations to parents include the following items:
- Limit the child’s contact with other children.
- Strictly follow the dosage and frequency of administration of an antibiotic.
- Do not overfeed, and eat little at frequent intervals.
- Active games provoke attacks, so it is better to avoid.
- To prevent dust in the house to moisten the air, ventilate the room, daily wet cleaning.
- Mandatory daily walks in the fresh air (in the morning, near water), avoiding contact with people.
Important! Rarely every attack is accompanied by retching. In most cases, if the last attack was vomiting, the next two or three attack will be easier, without reflex eruptions.
The symptoms and treatment of pertussis in children are directly dependent on the form of the disease. Diagnosis of pertussis is always difficult, even for the most qualified doctors. Therefore, it is important not to self-medicate, do not use folk remedies, and promptly seek medical help.