Whooping cough

Whooping cough, acute infectious disease characterized by episodes of spasmodic cough.
The causative agent of whooping cough - Вact. pertussis is a stick with rounded ends. In the external environment microbe unstable, dies quickly under the influence of disinfectants, sunlight; with temperature of 56 degrees dies within 10-15 minutes
The source of infection in whooping cough is a sick man, representing the greatest danger to others in catarrhal and in the first weeks spasmodic period. The infection is transmitted by airborne droplets during coughing, crying, because of instability sticks pertussis such transmission is possible only at close range. A person ceases to be contagious to others after 6 weeks of onset. Kids get sick more often at the age from a few months to 5-8 years. After suffering pertussis remains persistent post-infectious immunity. Epidemics of whooping cough appear when the immune stratum among the smallest children. The spread of pertussis contribute to some of the social factors: poor living conditions, overcrowding of the population.
Infection in the case of whooping cough is localized in the mucous membrane of the upper respiratory tract, causing catarrhal inflammation and specific irritation of nerve endings.
Frequent bouts of coughing cause cerebral and pulmonary circulation (insufficient oxygen saturation, the shift of the acid-alkaline balance in the direction of acidosis). Anxiety respiratory centre persist long after recovery.
Autopsy picture emerges from nonspecific changes in the lung (bronchitis, peribronchial, emphysema, areas pneumonic infiltration), as well as in the brain (the expansion of the blood vessels, congestive plethora, small hemorrhages) In the clinical course of pertussis distinguish the following periods: incubation (2-21 day, usually 10 to 14 days); catarrhal (10-14 days); spasmodic, or seizure (3-4 weeks), and the recovery period. The disease develops gradually. During the catarrhal period there are only catarrhal manifestations on the part of the upper respiratory tract; the nature of cough normal; blood - leukocytosis with limfotsitoz.
The major clinical manifestation of spasmodic period pertussis is paroxysmal whooping cough. A coughing spell begins with a few deep cough tremors, which on the background of inspiratory convulsions , a number of short expiratory tremors, accompanied by whistling breath - reprisal. Repetition cough aftershocks after Reprise can reach up to 20. A coughing spell ends of the Department of viscous sputum or vomiting. In severe pertussis the number of attacks can reach up to 60 per day, followed by an oxygen deficiency symptoms: cyanosis persons and mucous membranes, the excitation of the child, swelling of the veins of the neck and head, subcutaneous and conjunctival hemorrhage. Due to congestion at frequent coughing person becomes bloated. During coughing language of the child pressed by the bridle to the incisors of the lower jawthat, with frequent repetition of attacks causes ulceration of the bridle.
Maximum development of clinical manifestations reach the 2nd week spasmodic period. When erased form of whooping cough can be short and not take paroxysmal and convulsive character.
In children of the first year incubation period pertussis is usually reduced to 3-5 days, catarrhal - till 6 days. Coughing without reprisal, often accompanied by cessation of breathing, and convulsions.
The most common complication of whooping cough, especially in children under 1 year is interstitial pneumonia. Observed lesions of blood and lymphatic vessels of the lungs, peribronchial. Often develop atelectasis, acute swelling of the lungs. Symptoms of cardiovascular system: spasm of peripheral vessels, increase blood pressure, hemorrhagic manifestations, tachycardia. The defeat of the nervous system primarily due to hypoxia (oxygen deficiency) and vascular disorders, and is manifested by loss of consciousness, the defeat of the cranial nerves, transient paresis and paralysis.
Diagnosis of pertussis put on the basis of clinical and epidemiological data. Specific bacteriological diagnosis is selection of the pathogen from the droplets of mucus. To identify disease whooping cough epidemic foci use of serological reactions.
The prognosis of the disease is determined by the child's age and the severity of disease. In the application of modern methods of treatment and mortality in whooping cough decreased, however, among young children remains high. Death from asphyxia if laryngospasm and bleeding in the brain.
Treatment. To eliminate the primary and secondary infectious foci apply tetracycline antibiotics (tetracycline, oleandomitin, and others), penicillin, streptomycin and other age dosage, courses of up to two weeks. With frequent bouts of coughing can be recommended drugs that reduce the excitability of the Central nervous system: chlorpromazine in the dose of 1-2 mg per 1 kg of weight per day intramuscularly, pipolfen in the dose of 1-2 mg per 1 kg of weight per day, phenobarbital 0,005-0,05 g 2-3 times a day inside. When developed appoint sudorozhnom syndrome 25% solution of magnesium sulfate 0.2 ml per 1 kg of body weight intramuscularly, chloral hydrate , depending on the age of 0.05-0.3 g enema; 10% solution glukonata calcium 0.5-1 ml of 1 year of life intravenously. Shows blood transfusion (under medical supervision), long stay in the fresh air, vitamin therapy (B1 and B2 on 0,001-0,002 g, ascorbic acid 0.1-0.2 g), oxygen therapy.
Prevention of whooping cough is isolation of patients on 40 days from the moment of disease or for 30 days from the start coughing. In contact with a patient with whooping cough are isolated on day 21. Children, the sick pertussis attending nurseries and kindergartens, can be transferred to a special country health institution or service in isolated groups.
Specific prevention: active vaccination of children pertussis vaccine or drugs, including pertussis vaccine (pertussis-diphtheria-tetanus vaccine). The vaccine is administered to children from 5 to 6 months. subcutaneously three times at intervals of 30 to 40 days.
Paracoccus is an infectious disease caused by a germ Bordetella parapertussis and clinically resembling a light or medium-gravity whooping cough. Treatment does not differ from the treatment of pertussis.