A week ago, the baby was sick. He was tormented by periodic fever, runny nose, cough. Today he has become much better, but his mother continues to worry about one “but.” Why did the cough, instead of passing, on the contrary, intensify? That is how pertussis begins in a child.
A dangerous infectious disease that can be fatal. Let's talk about the signs of pertussis in a child, methods of treating the disease and preventive measures that will help protect both the baby and yourself.
Causative agent of the disease
The disease "pertussis" in children causes pertussis. This is a motionless gram-negative microbe that produces agglutinins.
Pertussis is very unstable in environmental conditions. That is why during the collection of analyzes, its sowing should be carried out immediately after the collection of material. The microbe is sensitive to the effects of almost all disinfectant solutions, ultraviolet radiation, many groups of antibiotics (chloramphenicol, tetracyclines, streptomycin).
Whooping cough is not geographically attached to any particular country. It is widely distributed around the world. At the same time, the incidence is much higher in those countries where children are not vaccinated. Whooping cough can cause a baby to die. This occurs in approximately 0.6% of cases of the total number of cases. Most at risk are children under the age of 2 years.
Development mechanism
The microbe enters the body through the mucous membranes and transmits impulses through the nervous system to the brain. As a result of irritation, there are attacks of spasmodic, convulsive, asphyxiating cough.
Unlike many other infectious diseases, pertussis immunity is not transmitted in utero or through breast milk from mother to baby. Therefore, the risk of contracting even exists in a newborn baby.
After the disease, a stable immunity is developed to the pathogen, which will be completely lost after 12 years.
Clinical manifestations
The signs of pertussis in a child will depend on various factors, ranging from the activity of the pathogen to the age or condition of the baby’s immune system. The most vulnerable to the disease are children who are less than 3 months old, because until this age they cannot start vaccination against whooping cough.
From the moment a microbe enters the body and until the first symptoms appear, it usually takes about a week. Although in some cases, the incubation period can stretch to 20 days.
There are three stages of the disease: catarrhal, paroxysmal and recovery. It is worth paying special attention to each of them.
Catarrhal stage
Its duration is about 1-2 weeks. At this stage, it is impossible to say that the child has whooping cough. All signs of the disease during the catarrhal stage are similar to a common cold:
- a slight increase in temperature;
- runny nose;
- tearing;
- weak cough.
Suspension of pertussis is suspected only if the child's parents report his contact with the patient in the last 2-3 weeks.
Paroxysmal stage
The average duration of this stage is within 2-4 weeks. The exception is only unvaccinated and children up to a year in whom it can stretch up to 2-3 months.
By the end of the previous stage, the main symptom of pertussis in children (cough) began to decline. Now it is intensifying again, seizures are becoming more frequent and intense. Any experienced pediatrician will determine whooping cough in a child, just by hearing a characteristic cough. It can be described as follows:
- During one exhale, a series of 5-10 strong coughing tremors is repeated.
- A sudden and intense breath, which is accompanied by a whistling sound (reprise).
During the next attack of coughing, the child's face acquires a red or even bluish tint. Veins swell around his neck, his eyes roll out, his tongue dangles. Attacks can follow one after another until the baby coughs up a small lump of viscous mucus that blocked the airways. Vomiting occurs on the background of a strong cough.
Such attacks are very dangerous for children under 1 year old. In such crumbs, they can even lead to respiratory arrest (apnea).
Pertussis in children (a sick baby is shown in the photo above) is also accompanied by poor sleep, loss of appetite, and weight loss. The reason for this is the same debilitating cough, which not only torments, but also very scares the baby.
It is important to remember! The maximum possible temperature for whooping cough in a child is 38 degrees. If the indicator on the thermometer exceeds this mark, then the baby has a completely different disease.
It often happens that during whooping cough, pneumonia also develops. At the same time, it is very difficult to diagnose, and even experienced doctors do it too late. In medicine, there is even a special term “dumb lung”, which refers to this condition.
It is during the paroxysmal stage that the greatest risk of developing various complications is.
Stage of recovery
This is the final stage when the disease finally begins to go away. On average, the stage of recovery lasts about 1-2 weeks. During this time, body temperature normalizes, coughing attacks occur less and less and become not so strong. Vomiting and relapses also come to naught.
The only thing that will soon remain from whooping cough in children up to a year or older is coughing, which can persist even for several months. But they are no longer dangerous for the baby and are not paroxysmal in nature. Against the background of upper respiratory tract infections, coughing may intensify.
Diagnosis of the disease
The first thing that the doctor will do is to reveal what symptoms the patient is worried about. But the final diagnosis can be established only after several laboratory serological studies. It can be:
- Bacteriological culture from the nasopharynx. At the catarrhal stage, this method is most informative. Its minus is that the results will have to be expected 5-7 days. In the case of whooping cough, this is a fairly long period of time.
- General blood analysis. If you have a disease, ESR will be within normal limits, but the levels of lymphocytes and white blood cells will be elevated. But it is worth noting that such signs only indicate the presence of an inflammatory process in the body, and not directly about whooping cough.
- PCR (polymerase chain reaction). The analysis is performed over several days and helps to identify the causative agent of the disease.
- RNGA (indirect hemagglutination reaction) and RPHA (direct hemagglutination reaction). The study helps to identify antibodies to the causative agent of the disease. A negative result indicates the absence of whooping cough. Positive - confirms the diagnosis.
- ELISA (enzyme immunoassay). Detects specific antibodies and their number. As in the previous version, a positive test result indicates the presence of the disease.
Treatment basics
Treatment of pertussis in children younger than 2 years old is carried out only in a hospital setting. Their hospitalization is mandatory even in cases where there is a suspicion of whooping cough, but the diagnosis has not yet been confirmed. This is necessary because the disease in young children develops much faster than in adults. And with the beginning of the second stage, the first attacks of suffocation and even respiratory arrest may occur.
In all other cases, placement in a hospital is necessary only with an average and severe form of the disease, or in the presence of special indications.
If hospitalization is not necessary, the doctor will tell you how to treat whooping cough in children at home. First of all, it is important to provide the child with maximum peace. Treatment of pertussis in children involves constant hydration and ventilation of the room. It is best if there is no bright light or loud sharp sounds in the room.
With an easy stage of the disease, there is no need to comply with bed rest. Rather, on the contrary, it will be useful for the child to spend more time in the fresh air. As a rule, on the street coughing attacks begin much less frequently than indoors. Moderately-mobile games are not prohibited. It is only important to ensure that the child does not overwork.
No need to try to force-feed the baby. Let him eat as much as he wants. Food should be easily digestible, but at the same time - nutritious and rich in vitamins. If coughing attacks are accompanied by vomiting, then it is better to forget about the feeding regimen for a while and give it to eat after the baby coughs.
Switching a child’s attention to something interesting will help reduce a coughing fit. This may be a new toy, coloring, board game, cartoon, and so on. The main goal of parents is to provide the baby with positive emotions. It is even possible to allow what was previously banned (within reason, of course).
Drug treatment
It is immediately worth noting that there is no point in using various antitussive drugs. The use of cans, mustard plasters and thermal procedures, which will only intensify the attack, is also contraindicated!
How to treat pertussis in children in this case? The exact answer to this question will be given only by the doctor.
If the disease was detected at the catarrhal stage, the specialist will prescribe antibiotics from the macrolide or ampicillin groups. Tetracyclines can also be used to treat older children. At the same time, the shortest course and average doses are chosen.
If pertussis has managed to move to the paroxysmal stage, there will no longer be any effect from the use of antibiotics. Explaining this phenomenon is very simple. The fact is that at this moment there are no bacteria in the body, and coughing attacks occur due to irritation of the cough center in the brain.
In this case, psychotropic drugs - antipsychotics can be prescribed. For treatment of children usually use "Droperidolum" or "Aminazinum". It is best to take them before bedtime, since such remedies have a calming effect. In more severe cases, it is possible to use the “Relanium” tranquilizer (orally or intramuscularly).
With a mild form of whooping cough, the use of antiallergic drugs is effective. It can be Pipolfen or Suprastin. In severe form, they are replaced by stronger glucocorticoids. Therapy with these drugs lasts up to 7-10 days.
Additionally, physiotherapeutic procedures are prescribed:
- inhalations with drugs that improve blood circulation in the brain and prevent the occurrence of central nervous system hypoxia (Vinpocetine, Pentoxifylline);
- inhalation for liquefaction of sputum ("Chymotrypsin", "Himopsin");
- vitamin therapy;
- general strengthening physiotherapy;
- breathing exercises;
- massage.
Treatment of severe pertussis in stationary conditions also includes oxygen therapy (oxygen saturation). If there is a suspicion of complications from the central nervous system, drugs are prescribed that improve blood circulation in the brain.
Possible complications
In the absence of proper treatment, the likelihood of developing various complications increases. It can be:
- laryngeal stenosis;
- asphyxia;
- hernia formation;
- microbial pneumonia;
- cramps
- encephalopathy;
- epileptic seizures.
That is why it is important to consult a doctor in a timely manner, follow his recommendations and not refuse hospitalization if the situation requires it!
Disease prevention
Prevention of pertussis in children consists of vaccination and timely revaccination. In 80% of cases, this guarantees complete protection against the disease. In the remaining 20%, the likelihood of getting sick remains, but in this case the ailment will pass in a mild and harmless form for the baby's life.
The pertussis vaccine is part of the DTP vaccine. Its contents also include components from tetanus and diphtheria. As a rule, children are vaccinated according to the schedule approved by the Ministry of Health. In the presence of any medical indications, the local pediatrician will draw up an individual schedule for the child.
Pertussis vaccination for children is done in 3 stages with a break of 1.5 months. It is equally important to carry out a booster vaccination in a year, which will “consolidate” the achieved result. But that is not all! DTP does not apply to those vaccines that provide protection against the disease throughout life. Therefore, further revaccination will need to be repeated every 10 years. And this applies not only to children, but also to adults.
Special attention should also be paid to another, not so common method of prevention - the use of antibiotics. For this purpose, "Erythromycin" is used. It is necessary to take it in cases where there is a high risk of infection of the baby. For example, if he was in contact with a person with whooping cough.
This method is also supported by the famous Dr. Komarovsky in the CIS countries. Despite the fact that usually Yevgeny Olegovich is categorically against the prophylactic use of antibiotics, in this case he makes an exception. The doctor is confident that taking "Erythromycin" even before the onset of the first symptoms of the disease can prevent the development of seizures. In addition, this drug is considered safe for the health of crumbs, since it does not have a significant effect on the liver, intestines and other organs.
In conclusion, I would like to remind once again that the responsibility for the health of children lies entirely with their parents. It is the latter who decide whether the child needs to be vaccinated. Before you abandon them, it is worth considering one point. Until 1960 (it was then when the DTP vaccine was invented) whooping cough was in first place among the diseases that became the cause of child mortality. Since that time, much has changed, the probability of death has decreased by 45 times. Does anyone want everything to go backwards?