Whooping cough in a child: signs, treatment and prevention

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

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? This is how whooping cough starts in a child.

A dangerous infectious disease that can be fatal. Let's talk about the signs of whooping cough in a child, ways to treat the disease and preventive measures that will help protect both the baby and yourself.

Pathogen

Whooping cough in children is caused by whooping cough. It is an immobile 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 done immediately after the material is taken. The microbe is sensitive to the effects of almost all disinfectant solutions, ultraviolet radiation, and many groups of antibiotics (levomycetin, tetracyclines, streptomycin).

Whooping cough is not geographically tied to any particular country. It is widely distributed throughout the world. At the same time, the incidence is much higher in those countries where vaccination of children is not carried out. Whooping cough can cause the death of a baby. This happens in about 0.6% of cases of the total number of cases. Children under 2 years of age are most at risk.

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, attacks of spasmodic, convulsive, suffocating cough occur.

Unlike many other infectious diseases, immunity to whooping cough is not transmitted in utero or through breast milk from mother to child. Therefore, the risk of infection exists even in a newborn baby.

After a disease, a persistent immunity is developed to the pathogen, which will be completely lost in 12 years.

Clinical manifestations

Signs of whooping cough in a child will depend on various factors, ranging from the activity of the pathogen to the age or state of the immune system of the crumbs. The most vulnerable to the disease are children who are less than 3 months old, since before this age they cannot begin vaccination against whooping cough.

It usually takes about a week from the moment the microbe enters the body until the first symptoms appear. Although in some cases the incubation period can be extended up 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 the common cold:

• slight increase in temperature;
• runny nose;
• teary;
• weak cough.

Suspicion of pertussis infection is possible only if the child's parents report contact with the sick person in the last 2-3 weeks.

Paroxysmal stage

The average duration of this stage is within 2-4 weeks. The only exceptions are unvaccinated and children under one year old, in whom it can stretch up to 2-3 months.

By the end of the previous stage, the main symptom of whooping cough in children (cough) began to decline. Now it is getting stronger again, the attacks are becoming more frequent and intense. Any experienced pediatrician will identify whooping cough in a child as soon as they hear a characteristic cough. It can be described as follows:

1. During one exhalation, a series of 5-10 strong coughing shocks is repeated.
2. Sudden and intense inhalation accompanied by a whistling sound (reprise).

During another bout of coughing, the child's face turns red or even bluish. On hisveins swell in the neck, the eyes protrude, the tongue hangs down. Attacks can follow one after another until the baby coughs up a small lump of viscous mucus that blocked the airways. There are frequent cases of vomiting 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).

Whooping cough 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 scares the baby very much.

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 pneumonia also develops during whooping cough. 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 "silent lung", which refers to this condition.

It is during the paroxysmal stage that the greatest risk of developing various complications.

Recovery stage

This is the final stage when the disease finally starts to go away. On average, the recovery phase lasts about 1-2 weeks. During this time, body temperature normalizes, coughing attacks occur less and less often and become less severe. Vomiting and reprisals are also fading away.

The only thing that will soon be left ofwhooping cough in children up to a year and older - 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 infections of the upper respiratory tract, the cough may increase.

Diagnosis of disease

The first thing the doctor will do is to identify what symptoms are bothering the patient. But the final diagnosis can be established only after several laboratory serological studies. These could be:

1. Bacteriological culture from the nasopharynx. At the catarrhal stage, this method is the most informative. Its disadvantage is that the results will have to be expected in 5-7 days. In the case of whooping cough, this is a fairly long period of time.
2. Complete blood count. In the presence of the disease, the ESR will be within the normal range, but the levels of lymphocytes and leukocytes 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.
3. PCR (polymerase chain reaction). The analysis is performed within a few days and helps to identify the causative agent of the disease.
4. 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.
5. ELISA (ELISA). Detects specific antibodies and their number. As in the previous version, a positive test result indicates the presence of the disease.

Basics of treatment

Treatment of whooping cough in children under 2 years of age is carried out only in a hospital setting. Their hospitalization is mandatory even in cases where whooping cough is suspected, but the diagnosis has not yet been confirmed. This is necessary due to the fact that 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, hospitalization is necessary only for moderate and severe forms of the disease, or if there are 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 whooping cough in children involves constant moistening and ventilation of the room. It is best if the room does not have bright lights and loud harsh sounds.

With a mild stage of the disease, bed rest is not necessary. Rather, on the contrary, it will be useful for the child to spend more time in the fresh air. As a rule, coughing attacks begin much less frequently outdoors than indoors. Moderately active games are not prohibited either. It is only important to ensure that the child does not overwork.

Don't try to force feed your 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 for a whileforget about the feeding regimen and give food after the baby clears his throat.

Reducing a coughing fit will help switch the child's attention to something interesting. It can be a new toy, a coloring book, a board game, a cartoon, and so on. The main goal of parents is to provide crumbs with positive emotions. Perhaps even allow what was previously banned (within reason, of course).

Medicated treatment

It should be noted right away that there is no point in using various antitussive drugs. It is also contraindicated to use cans, mustard plasters and thermal procedures, which will only intensify the attack!

How to treat whooping cough in children in this case? Only a doctor will give an exact answer to this question.

If the disease was detected at the catarrhal stage, the specialist will prescribe antibiotics from the groups of macrolides or ampicillins. Tetracyclines may also be used to treat older children. In this case, the shortest course and average doses are selected.

If whooping cough has managed to go to the paroxysmal stage, there will be no effect from the use of antibiotics. It is very easy to explain this phenomenon. 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 - neuroleptics can be prescribed. For the treatment of children, Droperidol or Aminazin is usually used. It is best to take them before bed as they have a calming effect.action. In more severe cases, it is possible to use the Relanium tranquilizer (orally or intramuscularly).

In 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 prescribed physiotherapy procedures:

inhalations with drugs that improve blood circulation in the brain and prevent the occurrence of CNS hypoxia ("Vinpocetine", "Pentoxifylline");

• inhalations to thin sputum ("Chymotrypsin", "Chymopsin");
• vitamin therapy;
• general strengthening physiotherapy;
• breathing exercises;
• massage.

Treatment of severe whooping cough in a hospital also includes oxygen therapy (oxygen saturation). If there is a suspicion of the development 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. These could be:

• laryngeal stenosis;
• asphyxia;
• hernia formation;
• microbial pneumonia;
• convulsions;
• encephalopathy;
• epileptic seizures.

This is why it is important to see a doctor in a timely manner, follow itrecommendations and not refuse hospitalization if the situation requires it!

Disease prevention

Prophylaxis of whooping cough in children consists in 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 disease will pass in a mild and non-life-threatening form for the baby.

The whooping cough vaccine is contained in 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 He alth. If there are any medical indications, the district pediatrician will draw up an individual schedule for the child.

Vaccination against whooping cough for children is done in 3 stages with a break of 1.5 months. It is equally important to carry out a revaccination in a year, which will “fix” the achieved result. But that's not all! DTP is not one of those vaccines that provide lifelong protection against the disease. Therefore, in the future, 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 - taking 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.

Supports this method and well-known in the CIS countries, Dr. Komarovsky. Despite the fact that Evgeny Olegovich usually performscategorically against prophylactic antibiotics, in which case he makes an exception. The doctor is sure that taking "Erythromycin" even before the first symptoms of the disease appear can prevent the development of seizures. In addition, this drug is considered safe for the he alth of the crumbs, as it does not have a significant effect on the liver, intestines and other organs.

Finally, I would like to remind once again that the responsibility for the he alth of children lies entirely with their parents. It is the latter who decide whether the child needs to be vaccinated. Before you refuse them, it is worth considering one point. Up until 1960, when the DPT vaccine was invented, whooping cough was the number one disease that caused infant mortality. Since that time, much has changed, the probability of death has decreased by 45 times. Does anyone really want everything to go back?