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Whooping cough is an acute illness of infectious character at which in an organism moderate intoxication, acute Qatar of respiratory tracts is shown, and also periodically there are attacks of convulsive cough. Diseases cause specific bacteria of Bordetella pertussis (a so-called pertussoid stick, Borde-Zhangu's stick). The activator has the form of a short stick at which the ends are rounded off. In external environment of a bacterium are unstable, very quickly the causative agent of whooping cough perishes in the course of drying, at ultra-violet radiation, when using means for disinfection. Also bacteria are very sensitive to levomycetinum, erythromycin, streptomycin, antibiotics of tetracycline group.
Today whooping cough is widespread in the world very widely. So, every year about sixty million people get sick with this illness. Besides whooping cough is often diagnosed also for residents of those countries where many years are spent vaccination against this illness. Specialists assume that whooping cough meets among adult population more often, however not always reveal it as the illness proceeds without convulsive fits of coughing. A source of an infection of a disease is only the person: it can be patients, both with typical, and with an atypical form of whooping cough, healthy people – carriers of bacteria. The greatest danger to people around from the point of view of infection is constituted by patients at an initial stage of a disease. Whooping cough is transmitted in the airborne way. Most often whooping cough at children is shown at preschool age. So wide circulation of a disease in this age group occurs in view of lack of sufficient level of maternal immunity. If the number of the children who received inoculations makes less than 30%, then in such countries incidence of whooping cough is compared to a situation during the dovaktsinalny period. Seasonality is not characteristic of this disease, but nevertheless during the autumn and winter period a certain increase of number of the diseased is observed.
Features of whooping cough
The infection gets to an organism through a mucous membrane of a respiratory path. Microbes of whooping cough fasten to cells of a ciliary epithelium, and begin to breed on a mucous membrane later, at the same time, without getting into a blood stream. On that place where the activator was implemented, the inflammation begins, secretion of slime becomes more expressed, functioning of the ciliary device of cells of an epithelium is oppressed. Further on an epithelium of respiratory tracts there is an ulceration and the focal necrosis is shown.
Most considerably pathological processes are shown in bronchial tubes and bronchioles. Owing to obstruction of a gleam of small bronchial tubes mucopurulent pro-barrels the patient has an emphysema, a focal atelectasis. In view of irritation of receptors of respiratory tracts of the patient cough constantly disturbs. After treatment of whooping cough lifelong immunity does not develop therefore the person can repeatedly get sick. The similar situation is observed also with antipertussoid inoculations.
Considering that cough develops not right after infection, and before display of characteristic cough it is very difficult to distinguish whooping cough from other infectious diseases, for the first days carriers of an infection can infect people around.
Whooping cough symptoms
At infection with whooping cough the incubation interval can last from 2 to 14 days, but most often it proceeds about seven days. In the catarral period with which whooping cough begins symptoms are shown at once by the general condition of an indisposition. The patient complains of cold, cough, subfebrile temperature. In development of an illness the pertussoid stick emits toxins which affect a nervous system, irritating nervous receptors mucous respiratory tracts. Therefore, the tussive reflex works, and the person suffers from attacks of characteristic convulsive cough. Sometimes process affects also nerve centers, nearby. Then the vomiting arising mainly after a fit of coughing, disorder of vascular character, nervous breakdowns which are shown by spasms can be reaction to such irritation.
If at the child whooping cough develops, disease symptoms gradually become more various. So, the sick child shows irritability, becomes whimsical. Spasmodic cough develops at the end of the second week of a disease. The sharp, sudden beginning is characteristic of convulsive cough. At first there is a series of pushes of cough, further the child inhales air with the whistling sound then convulsive tussive pushes are again shown. During an attack of such cycles can be from two to fifteen. When the attack comes to an end, there is an allocation of a vitreous viscous phlegm, and in certain cases it is continued by a vomiting attack. In the course of an attack the sick child is very excited, his face becomes cyanotic, on a neck veins extend, eyes can be poured by blood, will put out from a mouth tongue. Sometimes in the course of cough asthma develops and there comes the apnoea. Similar attacks proceed about four minutes and repeat sometimes from five to fifty times a day, depending on that, how hard there passes whooping cough. Symptoms of a disease are observed about three-four weeks, then the quantity of everyday attacks declines, and cough becomes usual. Whooping cough at children proceeds some more weeks, however attacks of convulsive cough are not observed any more.
At the same time at adults at whooping cough convulsive cough is not shown. Whooping cough passes as bronchitis at which persistent constant cough takes place. At the same time body temperature does not change, the person feels well. Whooping cough at children to whom inoculations were carried out is usually shown in the latent form.
Complications of whooping cough
Most often as complication of whooping cough at children and adults pneumonia develops. This disease provokes influence of a pertussoid stick or it becomes a consecutive bacterial infection. Besides, laryngitis with a throat stenosis (a so-called false croup), bleedings from a nose, bronchiolites, trouble breathing, inguinal, umbilical hernia become complications of this disease. Besides, owing to a disease of whooping cough encephalopathy can be shown. It changes in a brain of noninflammatory character. In development of encephalopathy there can be spasms. As a result, the lethal outcome or serious damages is possible: the patient can periodically have epileptic attacks or be shown constant deafness. All complications are mainly shown at children, at adult patients they are fixed less often.
Diagnosis of whooping cough
To establish the correct diagnosis in the catarral period of whooping cough, it is necessary to conduct bacteriological researches. Similar researches are, as a rule, appointed after studying by the specialist of epidemiological data. So, recent contact of the patient with sick whooping cough, lack of the necessary inoculations, etc. can be the basis for purpose of such analyses. At the same time if at the patient spasmodic cough is already shown, then diagnosis of whooping cough happens much more simply. But at statement of the diagnosis the doctor surely pays attention that similar fits of coughing in certain cases arise at the patient and owing to other reasons which are not connected with whooping cough. So, similar cough is sometimes shown at an adenoviral infection, pneumonia, an infectious mononucleosis, in the presence of malignant tumors which squeeze respiratory tracts. It happens also that whooping cough passes atypically, that is characteristic fits of coughing are not shown in general. Such disease is characteristic of adult patients, and also of children who were imparted.
There is the main method of definition of the diagnosis in this case - it is laboratory allocation of the causative agent of whooping cough. At the same time, the material for researches is taken from the patient earlier, the high probability of receiving positive takes. Material for research undertakes from a nasopharynx. Also for capture of material for researches at the child before the coughing patient Petri's cup with a medium is established. After catching of several pushes of cough the cup is brought to laboratory in the thermostat.
Today the immunoenzyme method which allows to find antibodies in serum and in nasopharyngeal slime is also often applied. It is important to differentiate whooping cough in the catarral period from ORZ and when spasmodic cough, from diseases of which persistent cough, lack of the increased temperature and symptoms of intoxication is also characteristic is shown.
Treatment of whooping cough
It is important that treatment of whooping cough which proceeds in a severe form was carried out only in the conditions of a hospital. Hospitalize without fail children till one year, during fits of coughing they often have an apnoea. For full therapy it is necessary to provide special conditions in chamber: good ventilation, air moistening is necessary. Treatment of whooping cough at children of chest age provides the room them in the darkened quiet room. You should not disturb the child often, any irritants can provoke very severe cough. If the disease at children of advanced age passes benign, then it is possible to do without observance of a bed rest. Therefore, in this case it is possible to treat an illness without hospitalization. It is necessary to take care that the child as long as possible was in the fresh air, there fits of coughing are practically not shown.
Food needs to be organized so that the child received food often and small portions. If attacks of vomiting disturb the patient constantly, then the doctor appoints intravenous administration of liquid. It is very important that at babies suction from a slime throat was made. Also to children of early age on condition of the expressed hypoxia oxygen therapy is appointed. For this purpose the patient is supported in special oxygen tent.
To children of early age at the heavy course of whooping cough, and also in case of complications of a disease the course of antibiotics is often appointed. At a catarral stage erythromycin is often applied to treatment of whooping cough.
Specific antipertussoid gamma globulin is also shown a whooping cough course of treatment. It needs to be entered intramusculary for three days.
The means having antibechic, and also sedative action should not be applied in general or it is necessary to treat their use carefully. Means which provoke cough, for example, banks, mustard plasters, it is not necessary to apply at all.
If the patient had an apnoea, it is necessary to clear very quickly respiratory tracts, having sucked away from them slime and to carry out artificial ventilation of the lungs.
Recovery process even at reception of antibiotics occupies rather long span. The patient with whooping cough has to stay in isolation of 25 days from the beginning of an illness if two results of bacteriological research were negative. If such research is not conducted, isolation has to last not less than thirty days.
There are also folk remedies which are used for simplification of a condition of patients with whooping cough. These are compresses from garlic and honey which put on a breast, broths of herbs (a thyme grass, roots of a primrose spring, elder flowers, fruits of an anise, a bud of a pine, a leaf of coltsfoot, a marjoram grass, etc.).
Prevention of whooping cough
As a reliable prophylactic against whooping cough vaccination is applied. Today several types of vaccines are applied, vaccination begins with three-months age. After a thrice course of vaccination (intervals between inoculations make one and a half months) about two years later the revaccination is carried out. According to specialists vaccination allows to warn a disease approximately in 70-80% of cases. And at the children who received a vaccine and caught an illness, whooping cough proceeds benign.
It is important to inspect immediately children who were in contact with patients.
Section: Diseases of a respiratory organs
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