Signs, symptoms and treatment of whooping cough in adults. Not just a cough in an adult, but a serious whooping cough

Whooping cough is classified as an acute infectious disease characterized by severe paroxysmal cough. The causative agent of the disease is whooping cough (bordetella bacterium). The disease can be treated with both medicines and folk remedies, but hospitalization is only for patients in serious condition.

Whooping cough forms

In medicine, there are three forms of the considered infectious disease:

• typical- the process of development of the disease goes according to the classical scheme;
• atypical- there are no pronounced symptoms of whooping cough, the patient is only worried about paroxysmal cough with periodic periods of disappearance;
• bacteriocarrier- the patient is a carrier of the whooping cough virus, but he himself does not get sick with this infection (no symptoms).

Ways of infection

Infection with whooping cough occurs only from a sick person, or from a bacteriocarrier (when the virus is present in the body, but the person himself does not have whooping cough) - the virus is transmitted by airborne droplets. At the same time, a person is considered infectious not only directly at the peak of the disease, but also within 30 days after undergoing full treatment. The incubation period for whooping cough is 5 to 14 days.

whooping cough symptoms

For the infectious disease under consideration, the distinguishing feature is the gradual increase / addition of symptoms. The entire period of the disease is divided into several stages:

1. Incubation period- the period from the moment of infection to the appearance of the first signs of the disease.
2. The period of precursors of the disease- prodromal period:

• a cough appears - dry, unobtrusive, but intensifying in the evening and at night;
• body temperature rises to subfebrile indicators (37-38 degrees);
• general well-being does not deteriorate.

note: the duration of the period of the precursor of the disease is 1-2 weeks.

Note:the spasmodic period is characterized by apnea - a short-term cessation of breathing (30-60 seconds).

1. Permission period(reverse development). Symptoms begin to disappear - first, attacks with apnea and convulsive movements of the body stop, body temperature stabilizes.

Even after a complete cure for whooping cough, the patient may be bothered by coughing, but it is characterized by the absence of seizures and spasms. If a similar symptom is present within 3 weeks after the diagnosis of whooping cough is removed, then there is nothing to worry about - this is the norm.

How is whooping cough diagnosed?

In order to make a diagnosis, the doctor uses several diagnostic methods:

Treatment methods for whooping cough in children and adults

Important:whooping cough is treated at home, hospitalization is indicated only in case of a severe course of the infectious disease in question, when the patient has disturbances in the functioning of the respiratory system and in the blood circulation of the brain.

Medical therapy

Since the patient during the development of whooping cough experiences real torment from each coughing fit, doctors try to alleviate his condition as much as possible. The treatment regimen for the infectious disease in question consists in prescribing the following drugs:

• bronchodilator drugs- they expand the lumen of the bronchi and counteract the development of spasm;
• mucolytic drugs- most often they are used in the form of inhalations, the essence of the action: dilute sputum, ensure its free outflow;
• antitussive drugs- doctors rarely prescribe them, because the effectiveness of such drugs for whooping cough is minimal;
• sedatives and vasodilators- they are able to improve blood circulation in the brain, work "ahead of the curve" preventing the development of oxygen starvation.

Treatment of whooping cough is carried out on an individual basis, because the course of the disease is different for each patient. For example, with a severe course of the disease or infection with the whooping cough virus in early childhood, the risk of developing hypoxia (oxygen starvation of the brain) increases. Therefore, it is advisable to:

• oxygen therapy- through a special mask or tent (for newborns and infants), air with a high content of pure oxygen is supplied to the body of children;
• nootropic drug therapy- they contribute to the improvement of metabolic processes taking place in the brain;
• two-day treatment with glucocorticosteroid hormones- they quickly and effectively reduce the intensity of convulsive cough attacks, relieve apnea (short-term cessation of breathing).

If a patient has hypersensitivity or individual intolerance to any drugs, psycho-emotional arousal is noted, then doctors can prescribe and. During the period of recovery and rehabilitation, patients should undergo vitamin therapy - vitamins of groups B, C and A will help to quickly restore the body and increase the level of immunity. Note:it is appropriate to prescribe antibacterial drugs (antibiotics) only in the first 10 days of the disease, or in case of complications in the form of inflammation of the upper respiratory tract () and.

ethnoscience

In folk medicine, there are several recipes that will help cure whooping cough faster. They are approved by official medicine, but should only be used as additional procedures - medicines are indispensable. So, when diagnosing whooping cough in both children and adults, the following recipes should be used:

1. Take 5 cloves (they should be medium in size), grind and boil in a glass of unpasteurized milk. You need to boil the drug for 5-7 minutes, and take it every 3 hours for 3 days in a row.
2. Pour two tablespoons of finely chopped garlic with melted butter in an amount of 100 grams. Let the mixture harden a little - it must be rubbed into the soles of the feet at night, the legs should be warmed with something on top (wear woolen socks).
3. Mix camphor and fir oil, table vinegar in equal amounts. Moisten any rag in the resulting mixture, squeeze it out and apply it to the upper part of the chest of a sick person. Such a compress is done at night, on top you need to cover the patient with something warm. This recipe is suitable for adults and children over 13 years old.
4. Take ordinary sunflower seeds, dry them in the oven or in a pan (do not fry!), grind and pour water with honey (proportions: 3 tablespoons of seeds, a tablespoon of honey, 300 ml of water). The resulting product must be brought to a boil and boiled until exactly half of the broth remains. Here it needs to be cooled, filtered and taken during the day in small sips.

A patient diagnosed with whooping cough should regularly take walks in the fresh air - it is recommended to walk for at least 2 hours every day. Such walks relieve coughing attacks, serve as a prevention of oxygen starvation of the brain. In some medical clinics from traditional healers there is such a recommendation: patients with whooping cough should walk near the river every morning and inhale its vapors for 20 minutes. Healers claim that after 5 days of regular procedures, the symptoms of the infectious disease in question disappear. So, you can combine outdoor walks with the implementation of this recommendation.
The daily regimen should be as “correct” as possible, it should:

• avoid nervous shocks;
• clearly observe the alternation of periods of rest and wakefulness;
• exclude any physical activity (even if you need walking, then try to sit on a bench in the park more than “walk” kilometers).

During the treatment of whooping cough, a diet is prescribed:

• alcoholic drinks, strong and tea are excluded;
• food rich in vitamin B is introduced into the diet - chicken liver, chicken eggs, cottage cheese;
• fried and smoked dishes are excluded;
• preference should be given to pureed soups;
• the number of meals per day - at least 6, but in small portions.

Possible Complications of Whooping Cough

Despite the fact that whooping cough is not considered a life-threatening disease, complications can develop even with proper treatment. These include:

• bronchitis and pneumonia;
• encephalopathy - brain damage, accompanied by convulsive seizures;
• development of umbilical and / or inguinal hernia;
• hemorrhage in the eyes and / or brain;

Note:the development of hernias, various hemorrhages and prolapse of the rectum occur only against the background of a strong cough - there is an overstrain of the muscles and ligaments, they are weakened.

Whooping cough prevention

The only way to protect against infection with the whooping cough virus is vaccination. It is provided free of charge as part of the universal vaccination of children. It is necessary to make three vaccinations with an interval of 3 months. The first time the vaccine is administered at the age of 3 months, and the revaccination (last) is carried out already at 18 months.

Regionally it is possible to change the scheme of revaccination - for example, in the Sverdlovsk region, one more revaccination is carried out at the age of 6 years.

If infection with whooping cough has already occurred, then such a patient must be urgently isolated from the children's and adult team for a period of 30 days. In this case, a two-week quarantine is immediately established in a children's institution (preschool or school). Whooping cough is a well-known infection that is treatable and often goes away without any complications. But control by doctors during the period of therapeutic measures is mandatory - this will help prevent the development of various kinds of consequences and complications. If a person has been ill with whooping cough at least once, then he develops lifelong immunity. The pediatrician, Dr. Komarovsky, talks about the symptoms of whooping cough, the treatment of this disease and its prevention in this video review.

Diseases caused by pertussis. Respiratory complications, including asphyxia in infants, are the most common. Otitis media is common. Bronchopneumonia can be fatal at any age. Seizures are common in infants but rare in older children. Hemorrhage in the brain, eyes, skin may be the result of severe paroxysms and subsequent hypoxia. Intracerebral hemorrhage, intracerebral edema, and posthypoxic encephalopathy can lead to spastic paralysis, mental retardation, or other neurological disorders. Umbilical hernia and rectal prolapse sometimes also occur.

Epidemiology of Whooping Cough in Adults

The causative agent is fixed in the walls of the bronchial tree (up to small bronchioles) and causes inflammation due to irritation of the mucous membrane by the released toxin. Initially, there is a slight cough, runny nose, redness and sore throat. After 2 weeks, more severe signs of the disease are found - a severe spastic cough, bronchospasm; in young children, tonic-clonic convulsions of skeletal muscles are sometimes possible. In severe forms, hypoxia develops - a lack of oxygen due to suffocation.

The morbidity cycle in the USA is every 3-4 years. In the territory where the unvaccinated population lives, the disease becomes epidemic every 2-4 years. Occurs in all ages, but 71% of cases occur in children<5 лет, а 38% случаев, включая почти все смертельные случаи, фиксируют у младенцев <6 мес. Большинство смертельных случаев вызваны бронхопневмонией и осложнениями на мозг. Заболевание также тяжело протекает у пожилых людей. Однократно перенесенное заболевание не дает пожизненного иммунитета, но при повторном инфицировании болезнь протекает легко или бессимптомно.

Causes of whooping cough in adults

The spread of the microorganism B. pertussis (small, immobile gram-negative coccobacillus) occurs by airborne droplets. Transmission through contact with contaminated objects is rare. Patients are usually non-infectious after the 3rd week of the paroxysmal phase.

Parapertussis. This disease, caused by 6. parapertussis, may be clinically indistinguishable from whooping cough, but is usually milder and often less fatal.

Symptoms and signs of whooping cough in adults

The initial period of whooping cough does not have a strict specificity and, as a rule, is expressed as a common acute respiratory disease: the child has a slight rise in temperature, slight malaise, dry cough appear. During this period, the child is most contagious, and upon contact with him, the infection affects up to 90% of persons susceptible to this disease.

Difficulties in recognizing the disease occur in erased forms, for example, in patients who have previously received vaccine prophylaxis. The diagnosis is confirmed by the detection of whooping cough from the tracheobronchial discharge.

Symptoms - initially the same as in non-specific acute respiratory infections, accompanied by a convulsive or spasmodic cough, which usually ends with a prolonged, high-pitched breath with a characteristic sound (reprise). The diagnosis is confirmed by culture from the nasopharynx, PCR and serological analysis. Treatment - macrolides.

The disease without complications lasts approximately 6-10 weeks and consists of 3 stages:

• Catarrhal.
• Paroxysmal.
• Recovery.

The catarrhal stage begins abruptly, usually with sneezing, lacrimation, or other symptoms of coryza; anorexia; lethargy; and a compulsive, barking cough at night. Hoarseness may also appear. Fever is rare.

After 10-14 days, the paroxysmal stage begins with an increase in the severity and frequency of coughing. Repeated bouts of >5 rapid consecutive coughs in one breath occur during one expiration and are accompanied by a reprise - a quick, deep breath. Copious viscous mucus may ooze or blister from the nose during or after paroxysms. Vomiting is characteristic.

Symptoms subside as the convalescent stage begins, usually 4 weeks after the onset of illness. Whooping cough lasts approximately 7 weeks (range 3 weeks to 3 months). Whooping cough may recur over many months, usually triggered by irritation of the still sensitive airways in acute respiratory infections.

Diagnosis of whooping cough in adults

It is carried out on the basis of anamnesis, the results of an objective examination, laboratory data. In order to obtain the latter, the following methods are used: RPGA, radioimmunoassay (RIA), ELISA, PCR, LMA.

Adenovirus infections and tuberculosis should also be taken into account.

Since special media and lengthy incubation are required, the laboratory should be informed that whooping cough is suspected. Specific fluorescence analysis of antibodies in a nasopharyngeal swab accurately diagnoses whooping cough, but is not as sensitive as culture. PCR may also be used. The white blood cell count is usually between 15,000 and 20,000/mL, but may be normal and, conversely, as high as 60,000/mL, usually with 60-80% lymphocytes.

Parapertussis is differentiated by culture or fluorescent antibody testing.

Differential Diagnosis

Pertussis should be differentiated from parapertussis, ARVI with obstructive syndrome, measles, bronchopulmonary cystic fibrosis, tuberculous bronchoadenitis, mediastinal tumor, foreign body aspiration, etc.

"Whooping cough" means "cock crow". This is due to the fact that children suffering from this disease, during the moments of attacks, make a similar sound and are frightened of it, jump out of bed, trying to clear their throats. At such moments, you need to try to calm the child, as nervous strain increases the attacks. For example, you can take the child to the bathroom and turn on hot water so that he breathes in warm, moist air, or hang wet towels all night in the room where the patient is.

Complications of whooping cough in adults

Whooping cough is most often complicated by pneumonia. Due to straining during coughing, umbilical or inguinal hernias can form, and rectal prolapse occurs. Less commonly, whooping cough is complicated by atelectasis, emphysema of the mediastinum and subcutaneous tissue, encephalopathies, and obstruction of the respiratory gap (croup).

Whooping cough prognosis

With adequate treatment, the prognosis is favorable.

Treatment of whooping cough in adults

• pathogenic treatment.
• Erythromycin or azithromycin.

Children of the first year of life, as well as all children with severe course and complications of whooping cough, should be hospitalized. It is necessary to exclude possible irritants that can provoke an attack of spasmodic cough, which can even start from an unexpected fright of a child, with screaming and loud conversation of adults, sudden movements.

Hospitalization with respiratory isolation is recommended for critically ill infants.

For infants, suctioning of mucus from the upper respiratory tract may be vital. Expectorants, cough suppressants, and mild sedatives have little effect. Because any disturbance can provoke a severe, convulsive, oxygen-starved cough, severely ill infants should be kept in a darkened, quiet room and disturbed as little as possible. Patients treated at home should be isolated, especially from susceptible infants, for at least 4 weeks from onset and until symptoms resolve.

Antibiotics that are taken during the catarrhal stage can alleviate the course of the disease. Once paroxysms have appeared, antibiotics usually have no clinical effect, but are recommended to limit spread. The drugs of choice are erythromycin or azithromycin.

Whooping cough prevention in adults

Active immunization is part of the standard childhood vaccination. The schedule includes five doses of the vaccine (usually in combination with diphtheria and tetanus) at 2.4 and 6 months; booster dose - at 15-18 months and 4-6 years. Within 7 days, encephalopathy may appear as a significant negative effect of the components of the pertussis vaccine; seizure or shock within 48 hours; fever >40.5°C within 48 hours; as well as an immediate type of anaphylactic reaction. These reactions are a contraindication for further use of pertussis vaccine; a combined diphtheria-tetanus vaccine is available without the pertussis component. The cell-free vaccine (DTaP) is better tolerated.

Vaccination should be given to close contacts< 7 лет и тем у кого <4 доз вакцины.

Whooping cough is considered a dangerous infectious disease. Symptoms and treatment in adult patients is carried out under the supervision of a physician. A strong bronchospasm proceeds with a characteristic sound. A person experiences discomfort, cannot work normally and sleep.

General characteristics of the disease

Whooping cough is an infectious cough caused by the bacterium bordatella pertussis. Upon contact with an infected patient, infection occurs in 100% of cases. A few years ago, the disease was found only in people under 18 years of age. The childhood disease has been modified over the years, today whooping cough is also observed at an older age. This disease is severe.

Whooping cough is of two types:

1. Atypical - the disease proceeds without an increase in body temperature, bronchospasm does not bring unbearable pain and discomfort. Therapy lasts 10-14 days.
2. Abortive - the disease can proceed sharply in a severe form. Body temperature rises to 39 degrees Celsius. Coughing attacks are strong, cause a feeling of lack of air.

The incubation period of the disease does not exceed fourteen days. Transmission occurs by airborne droplets, so coughing with whooping cough is treated in a hospital setting. The entire period of the disease lasts 1.5-2 months. If you do not take action, then pneumonia can develop with a fatal outcome.

Vaccination does not fully protect adults from whooping cough. This disease can recur if preventive measures are not taken.

Whooping cough stages

Complications of whooping cough infection occur with improper therapy. To avoid this, you need to understand what spasm overcomes the patient. With whooping cough, the cough develops gradually, therapists distinguish 3 main stages of the course of this main symptom:

1. The first - bronchospasm resembles the symptoms of a typical cold. A person begins to take a remedy for a cold, pills and other medicines. It is during this period that the patient is contagious, he actively spreads bacteria, people who do not have immunity to these microorganisms are affected. The period lasts about 14 days. The patient should be alerted by the fact that cold medicines do not give positive dynamics.
2. The second - bronchospasm is paroxysmal in nature. Coughing with whooping cough makes it difficult to lead a normal life. The stage of the disease is determined from the number of attacks:

• no more than 15 attacks per day - a mild form, therapy will give a result in 3-4 weeks;
• no more than 25 attacks per day (medium form) - this symptom may be accompanied by vomiting. The patient refuses food, it is difficult for him to work. Treatment will last 20-40 days;
• about 40 attacks - a dangerous form of whooping cough that can provoke memory loss or respiratory arrest. The therapy is carried out in a hospital setting.

1. Third - during this period, doctors discharge the patient. Bronchial spasm decreases, there are no threats to life. Residual therapy and prophylaxis are carried out to strengthen immunity.

Cough after whooping cough can last about a week. Residual spasm should not cause panic, but the recommendations of doctors should not be ignored.

Whooping cough symptoms in adults

The disease brings a lot of discomfort to patients. Sometimes people are unaware that they are suffering from whooping cough. Illiterate therapy only exacerbates the situation. That is why you need to understand what signs of whooping cough in an adult occur:

• the temperature is kept within 38.5 degrees Celsius;
• a runny nose appears - because of it, an incorrect diagnosis is made;
• dry cough, which after 7-10 days becomes productive. The mucus is transparent, there is no presence of pus or bloody formations in it;
• vomiting during bronchospasm;
• nosebleeds if the patient has weak blood vessels.

Dangerous, but such a symptom may appear when whooping cough becomes advanced. Often such formations indicate severe lung damage. You need to call an ambulance immediately.

Stages of the disease

Treatment of whooping cough in adults begins immediately after the stage of the disease is established:

1. The incubation period - the symptoms are not expressed. For three weeks, the patient is considered to be a carrier of bacteria. Recognizing diseases during this period is difficult even for specialists. The therapist incorrectly diagnoses, treatment does not work.
2. Catarrhal period or initial - the patient complains of dry bronchospasm. The condition lasts for about three weeks. The high temperature develops into a fever, the drugs do not alleviate the condition. Independently sick put themselves SARS or other colds. Cough may be accompanied by vomiting, there is no appetite.
3. The paroxysmal period is the most severe stage of the disease. It is during this period that people call an ambulance. The patient begins to choke during attacks. There is reddening of the face and an increase in lymph nodes due to lack of oxygen. If the condition is ignored, complications can occur - meningitis, fainting, cerebral hemorrhage, or seizures. Requires hospitalization and taking potent drugs in the complex. The period lasts about 3-4 weeks.
4. Stage of resolution - the disease begins to gradually go away. The patient begins to feel better.

Cough during pregnancy in the 1st, 2nd, 3rd trimester

Only a specialist can recognize whooping cough. Although in some cases even therapists are mistaken, since children suffer from this disease in 95% of cases.

Diagnostics

It is difficult to identify the disease, since the symptoms in the early stages are similar to colds. Diagnostics is carried out as follows:

• blood and urine analysis;
• a detailed study of the mucus secreted during bronchospasm;
• molecular research;
• carrying out tests of RA, RNGA and RPGA.

Whooping cough is an independent disease. The disease does not occur against the background of complications of acute respiratory viral infections or acute respiratory infections. This is an infection caused by a certain type of bacteria entering the body.

How to treat whooping cough in adults

Strong bouts of coughing cause discomfort. Therapy is prescribed taking into account the stage of the disease. Unfortunately, there is no pill for whooping cough, therapy is carried out in a complex with a combination of fractional nutrition. Treatment consists of the following medications:

• antibacterial agents;
• syrups or tablets that thin sputum;
• antitussive drugs;
• antiallergic medicines - if the patient has swelling.

Therapy continues taking into account the patient's condition. The main thing is to adhere to the dosages prescribed by the therapist.

Antibiotics for whooping cough in adults

Antibacterial drugs are necessarily present in the treatment. Before the appointment, a sowing of mucus obtained from the pharynx is done. This procedure will help identify the pathogen. In laboratory conditions, it is established which medicines will instantly cope with bacteria and prevent the spread of the disease.

The most commonly used antibiotics are:

• Azithromycin;
• Erythromycin;
• Clarithromycin.

Self-medication is prohibited. The doctor must accurately calculate the dosage and set the course of treatment.

Folk recipes

Alternative therapy can be used in combination with pharmaceutical preparations. Here are the recipes recommended by doctors:

1. Garlic mix. It is prepared from crushed garlic cloves, which are poured with one hundred grams of melted butter. The resulting mixture should cool, it is used as an ointment. The drug is rubbed into the patient's heels and then warm socks are put on.
2. Vegetable oil with garlic. Five cloves of minced garlic are stirred in a glass of oil. The tincture must be boiled and cooled. The remedy is taken every 3 hours, one teaspoon. The course of therapy is 3 days.
3. Seed medicine. It is necessary to dry 3 tablespoons of sunflower in the oven, chop in a blender and pour in three glasses of water, in which a spoonful of honey has been previously dissolved. The mixture is brought to a boil, it is necessary that the water is reduced by half. The broth is filtered and taken within 24 hours in small sips.

Whooping cough is an acute infectious disease transmitted by airborne droplets and is characterized by a long course with the presence of specific stages.

The name of the pathology comes from the French word coqueluche, which means a strong paroxysmal cough. Indeed, the main symptom of the disease is painful coughing attacks (the so-called reprises), which occur against the background of a relatively satisfactory general condition of the patient.

Some statistics
Whooping cough is ubiquitous, but is diagnosed more frequently in urban areas than in rural areas. This is due to a number of reasons: a large crowding of the population in large metropolitan areas, environmentally unfavorable urban air and more scrupulous diagnostics (in towns and villages, often erased forms are not diagnosed due to less epidemiological alertness).

Like other respiratory infections, whooping cough is characterized by a seasonal incidence with an increase in the frequency of recorded cases of infection during transitional periods (autumn-winter and spring-summer).

Epidemiological data indicate the presence of a kind of mini-epidemics of whooping cough that occur every three to four years.

In general, the incidence of whooping cough in the world is quite high: up to 10 million people fall ill every year, while for 600 thousand patients the infection ends tragically. In the pre-vaccination period in the USSR, about 600,000 people fell ill every year, and about 5,000 died (mortality averaged more than 8%). The highest was the mortality from whooping cough among children of the first year of life (every second child died).

Today, thanks to widespread long-term vaccination, the incidence of whooping cough in civilized countries has declined sharply. However, it should be noted that the whooping cough vaccine does not provide immunity to parapertussis infection, which is transmitted similarly and clinically as a mild form of whooping cough.

In recent years, the incidence of whooping cough among adolescents has increased, doctors explain these figures by a general decrease in immunity, violations of the rules for vaccinating children, as well as an increase in the number of cases of parents refusing to be vaccinated.

Pertussis causative agent and transmission routes

Bordetella are unstable in the external environment and quickly die under the influence of high and low temperatures, ultraviolet radiation, and drying. So, for example, open sunlight destroys bacteria in one hour, and cooling - in a matter of seconds.

Therefore, handkerchiefs, household items, children's toys, etc. do not pose an epidemic danger as transmission factors. Special sanitary treatment of the premises in which the patient stayed is also not carried out.

The transmission of infection usually occurs through direct contact with the patient (staying at a distance closer than 1.5 - 2 m from the patient). Most often, inhalation of mucus particles that enter the air when coughing takes place, however, the pathogen can also be released into the environment when sneezing, talking, etc.

The maximum danger in epidemiological terms is the patient in the first week of spasmodic cough (during this period, the causative agent of whooping cough is isolated from 90 to 100% of patients). In the future, the danger decreases (in the second week, bordetella is isolated by about 60% of patients, in the third - 30%, in the fourth - 10%). In general, infection is possible through contact with whooping cough patients from the last days of the incubation period to the 5-6th week of the disease.

With whooping cough, there is also a bacteriocarrier, that is, a condition in which a person releases dangerous bacteria into the environment, but he himself does not feel any signs of the disease. But the bacteriocarrier in whooping cough is short-lived and has no special significance for the spread of the disease. A great danger is the mild and erased forms of whooping cough, when a periodically coughing child or adult remains in the team.

Whooping cough is a disease that is commonly referred to as the so-called childhood infections. The proportion of children among whooping cough cases is about 95-97%. The greatest susceptibility to infection occurs between the ages of 1 and 7 years.

However, adults are also not immune from the development of whooping cough. According to some reports, the probability of infection of adults in a family with a sick child can reach 30%.

At the same time, in adults, the disease often occurs in an erased form. Often such patients are mistakenly diagnosed with chronic bronchitis and unsuccessfully treated for a non-existent disease. Therefore, doctors advise with a prolonged cough, especially in cases where it occurs with painful attacks, to pay attention to the epidemiological situation - whether there was any contact with a child who coughed for a long time.

Patients who recover from whooping cough have lifelong immunity. However, as with vaccination, immunity to whooping cough does not exclude parapertussis, which is clinically indistinguishable from mild whooping cough.

Whooping cough development mechanism

The functional immaturity of the mucous membranes of the upper respiratory tract in young children results in pertussis predominantly affecting this age group. The infection is especially severe in children of the first two years of life.

Attached to the epithelium, bacteria begin to secrete special substances - toxins that cause an inflammatory reaction. The small bronchi and bronchioles are most affected. The pathogen does not penetrate inside the cells, so pathological changes are minimally expressed - there is plethora and swelling of the surface layers of the epithelium, sometimes desquamation and death of individual cells. At accession of a secondary infection development of erosions is possible.

After the death and destruction of bacteria, pertussis toxin enters the surface of the mucous membrane, which leads to the development of a spasmodic cough.

The mechanism of occurrence of a specific cough in whooping cough is quite complicated. First, coughing shocks are associated with direct irritation of epithelial receptors by pertussis toxins, then an allergic component is added, associated with the release of specific substances - inflammatory mediators. There is a spasm of the bronchi and bronchioles, so that the cough begins to resemble the clinical picture of asthmatic bronchitis.
In the future, due to constant irritation of the vagus nerve, a focus of congestive excitation develops in the region of the respiratory center in the central nervous system, and the cough takes on a specific paroxysmal character.

It is the presence of a central mechanism that causes coughing attacks to occur when exposed to a wide variety of stimuli of the nervous system (bright light, loud sound, strong emotional stress, etc.).

Nervous excitation from a congestive focus can spread to neighboring centers in the medulla oblongata - emetic (in such cases, convulsive coughing attacks end in painful vomiting), vasomotor (coughing attack leads to fluctuations in blood pressure, increased heart rate, etc.), as well as to other subcortical structures with the development of seizures resembling epilepsy.

In very young children, excitation can spread to the respiratory center with the development of various respiratory rhythm disturbances, up to apnea (stopping breathing).

Strong prolonged often recurring bouts of coughing lead to increased pressure in the vessels of the head and neck. As a result, swelling and cyanosis of the face, hemorrhages in the conjunctiva of the eyes develop. In severe cases, hemorrhages in the brain tissue may occur.

whooping cough symptoms

Clinical periods of whooping cough

• incubation;
• catarrhal cough;
• spasmodic cough;
• permissions;
• convalescence (restorative).

catarrhal period begins gradually, so that the first day of the disease, as a rule, cannot be established. A dry cough or coughing appears, a runny nose with a slight viscous mucous discharge is possible. In young children, catarrhal phenomena are more pronounced, so that the onset of the disease may resemble SARS with copious discharge from the nose.

Gradually, the cough intensifies, irritability and anxiety appear in patients, but the general condition remains quite satisfactory.

Period of spasmodic cough begins from the second week from the onset of the first symptoms of infection and lasts, as a rule, 3-4 weeks. This period is characterized by paroxysmal cough. Older children may report warning signs of an attack, such as a scratchy throat, a feeling of pressure in the chest, and feelings of fear or anxiety.

Characteristic cough
Attacks can occur at any time of the day, but are most often disturbed at night. Each such attack consists of short but strong coughing shocks, interspersed with convulsive breaths - reprises. Inhalation is accompanied by a whistling sound as the air forcefully passes through the spasmodically constricted glottis.

The attack ends with coughing up the characteristic viscous transparent sputum. The appearance of vomiting, impaired breathing and heartbeat, the development of seizures indicate the severity of the course of the disease.

During an attack, the child's face swells, in severe cases, acquiring a bluish tint, the veins of the neck swell, the eyes become bloodshot, tear and salivation appears. A characteristic feature: the tongue protrudes to the limit, so that its tip is bent to the top, while, as a rule, the frenulum of the tongue is injured on the incisors of the lower jaw. In a severe attack, involuntary urination and fecal discharge are possible.

Complications of persistent cough
In the absence of complications, the child's condition between attacks is satisfactory - children play actively, do not complain of appetite, body temperature remains normal. However, over time, puffiness of the face develops, and a sore covered with a whitish coating appears on the frenulum of the tongue damaged by teeth - a specific sign of whooping cough.

In addition, hemorrhages under the conjunctiva are possible, and there is often a tendency to nosebleeds.

Resolution stage
Gradually the disease progresses in the resolution stage. Coughing attacks occur less frequently, and gradually lose their specificity. However, weakness, coughing, irritability persist for a long time (the resolution period is from two weeks to two months).

convalescence period may last up to six months. This period is characterized by increased fatigue and emotive disorders (capriciousness, excitability, nervousness). A significant decrease in immunity leads to increased susceptibility to acute respiratory infections, against which an unexpected resumption of a painful dry cough is possible.

Whooping cough severity criteria

With a mild form, coughing fits occur no more than 10-15 times a day, while the number of cough shocks is small (3-5). Vomiting after coughing, as a rule, does not occur, the general condition of the child is quite satisfactory.

In moderate whooping cough, the number of attacks can reach 20-25 per day. Attacks have an average duration (up to 10 cough shocks). Each attack ends with vomiting. In such cases, asthenic syndrome develops quite quickly (general weakness, irritability, loss of appetite).

In severe cases, the number of coughing attacks reaches 40-50 or more per day. The attacks last a long time, proceed with general cyanosis (the skin becomes bluish) and gross respiratory disorders, convulsions often develop.

In severe whooping cough, complications often develop.

Whooping cough complications

• associated with the underlying disease;
• development of an autoimmune process;
• accession of a secondary infection.

With strong prolonged attacks of coughing, the supply of oxygen to the brain is significantly disrupted - this is associated both with bronchospasm and respiratory rhythm disturbances, and with impaired blood flow in the vessels of the head and neck. The result of hypoxia can be such brain damage as encephalopathy, manifested by convulsive syndrome and signs of irritation of the meninges. In severe cases, hemorrhages occur in the brain.

In addition, a strong cough against the background of spasm of the bronchi and bronchioles can lead to a violation of the filling of the lungs with air, so that emphysema (bloating) occurs in some areas, and atelectasis (collapse of lung tissue) occurs in others. In severe cases, pneumothorax develops (accumulation of gas in the pleural cavity due to rupture of the lung tissue) and subcutaneous emphysema (penetration of air from the pleural cavity into the subcutaneous tissue of the neck and upper body).

Coughing attacks are accompanied by an increase in intra-abdominal pressure, therefore, in severe whooping cough, umbilical or inguinal hernia, rectal prolapse may occur.

The most common secondary infections are pneumonia and suppurative otitis (inflammation of the middle ear).
Sometimes autoimmune processes develop, which arise as a result of a long-term inflammation with a pronounced allergic component. Cases of transition of whooping cough to asthmatic bronchitis and bronchial asthma have been registered.

Atypical forms of whooping cough

The abortive form is characterized by an unexpected resolution of the disease 1-2 days after the onset of the first whooping cough-specific coughing fits.

Whooping cough in patients from different age groups

In children of the first year of life, whooping cough is especially difficult and is often complicated by the development of secondary pneumonia.

At the same time, the periods of the clinical picture have a different duration: the incubation period is reduced to 5 days, and the catarrhal period is up to one week. At the same time, the period of spasmodic cough is significantly lengthened - up to two to three months.

In addition, during bouts of spasmodic coughing, infants do not have reprises, a coughing fit often ends with a temporary cessation of breathing and a convulsive seizure.

Diagnosis of whooping cough

Doctors' consultations

At the appointment with a general practitioner or pediatrician.

At the appointment with an ENT doctor
The doctor will be interested in the condition of the mucous membrane of the larynx and pharynx. To do this, the doctor will examine the mucous membrane of the larynx using a special reflective mirror or flashlight.
Signs of whooping cough during examination will be swelling of the mucosa, the presence of hemorrhages in them, and a slight mucopurulent exudate.

At the appointment with an infectious disease doctor
The doctor will listen to your complaints. May ask about possible contacts with coughing and whooping cough patients. Usually, the final diagnosis is made based on the results of laboratory tests, for which an infectious disease specialist will send you.

Laboratory diagnosis of whooping cough

General blood analysis

1. Increased level of leukocytes
2. Increased level of lymphocytes
3. ESR is normal

The collected material is placed in a special nutrient medium. However, the result will have to wait a long time, 5-7 days.

Serological tests

Direct hemagglutination reaction (RPHA), indirect hemagglutination reaction (RIHA) This method of blood testing allows you to detect antibodies to the causative agent of whooping cough. The result can be positive (confirmation of the diagnosis of whooping cough) or negative (exclusion).

ELISA (enzymatic immunoassay) Now there are express tests that allow to identify whooping cough by ELISA. The result can be positive (confirmation of the diagnosis of whooping cough) or negative (exclusion)

PCR (Polymerase chain reaction) Allows you to identify the pathogen within a few days. The result can be positive (confirmation of the diagnosis of whooping cough) or negative (exclusion).

Whooping cough treatment

Does a patient with whooping cough need bed rest?

Cough is more easily tolerated in the cold, so it is necessary to ventilate the room often, to prevent drying out and overheating of the air (ideally, the temperature in the patient's room should not be higher than 18-20 degrees Celsius). It is advisable to use humidifiers. So that the child does not freeze, it is better to dress him warmly.

Toys, puzzles and other non-aggressive board games are used as a distraction.
In addition, sufficient attention should be paid to the nutrition of the patient. For breastfed infants, it is desirable to increase the number of feedings by reducing the amount of food taken at one time. Older children are recommended to drink plenty of alkaline drinks (juices, fruit drinks, tea, milk, alkaline mineral water).

When is hospitalization necessary?

What medications and physiotherapy procedures are used for whooping cough?

Therefore, antibiotics are prescribed only in the catarrhal period. Ampicillin and macrolides (erythromycin, azithromycin) are quite effective, tetracyclines can be prescribed for children over 12 years old. These antibacterial agents are taken in medium doses in short courses.

Standard antitussive drugs for whooping cough attacks are ineffective. To reduce the activity of the focus of excitation in the brain, psychotropic drugs are prescribed - neuroleptics (chlorpromazine or droperidol in age dosages). Because these medications are sedative, they are best taken before bedtime or at night. For the same purpose, you can use a tranquilizer (Relanium - intramuscularly or orally at an age dosage).

In mild forms of whooping cough, antihistamines are prescribed to stop coughing attacks - pipolfen and suprastin, which have anti-allergic and sedative effects. Diphenhydramine is not used because this drug causes dryness of the mucous membranes and may contribute to an increase in cough.
In severe forms of whooping cough with a pronounced allergic component, some clinicians note a significant improvement with the use of glucocorticoids (prednisolone).

All of the above funds are taken until the spasmodic cough attacks disappear (usually 7-10 days).

In addition, inhalations of proteolytic enzymes - chymopsin and chymotrypsin are used to thin viscous sputum, and in severe coughing attacks, drugs that improve blood circulation in the brain (pentoxifylline, vinprocetine) to prevent hypoxia of the central nervous system are used.

Massage and breathing exercises are shown to improve sputum discharge. During periods of resolution and convalescence, general strengthening physiotherapy procedures and vitamin therapy courses are prescribed.

Alternative methods of treating whooping cough

To liquefy sputum with whooping cough, an infusion of tricolor violet is also used: 100 g of grass is poured into 200 g of boiling water and infused for half an hour. Then filter and take 100 g twice a day.

The disease has appeared for a long time and is infectious. In an adult, it is difficult. A feature is a cough, which has a paroxysmal character.

Because of it, it becomes difficult to breathe and it is not possible for the patient to lead a normal life. It is difficult to diagnose whooping cough right away, so serious complications can be observed as a result.

The whooping cough disease is caused by special bacteria, so it can be contagious and pass on to another person. All people who come into contact with the patient eventually become ill themselves.

The treatment is long, and the incubation period itself is two weeks at least. There is a special vaccine that is administered as a prophylaxis, but it does not give a 100% result and a guarantee that a person will not get infected.

Whooping cough types

Considering the disease in more detail, it is worth highlighting that there are two types of whooping cough:

1. Atypical;
2. Abortive.

In the first case, the coughing fits are not so intense and the person feels quite normal.

Abortive whooping cough is characterized by acute development, initially there is a sore throat, which gradually begins to develop into a cough. Symptoms may resolve after 5 days. You should not treat this disease negligently, as it may come, which will be fatal.

Causes of the disease

Whooping cough is caused by a bacterium that enters the human body and affects the respiratory system. The whooping cough stick is very vulnerable, it is difficult for it to get along in the external environment, therefore, in order to get infected, it is necessary to communicate with a sick person.

The initial period is the most dangerous. The disease manifests itself not only at an early age, it also often affects adults who have severely weakened immunity.

The cough of a sick person contributes to the release of rods into the environment, while those in contact also become infected.

Often the usual attack of coughing is attributed to a cold, thereby complicating your general condition.

At the first suspicions, it is worth seeking help from a qualified doctor, because complications can occur with improper treatment.

Symptoms (signs) of whooping cough in adults

Cough with whooping cough is paroxysmal, there can be 15 attacks per day. Initially, whooping cough is very similar to the common cold, for example, a runny nose appears, then a dry cough and rises.

The infection can penetrate the lungs and respiratory tract, after which sputum begins to accumulate, breathing becomes difficult, and whistling can be heard when inhaling.

Additional symptoms include the following:

• A person begins to vomit;
• Cough torments the patient for about a month;
• General health resembles a cold;
• During coughing, there may be bleeding from the nose;
• The patient's eyes turn red.

whooping cough stages

Signs of whooping cough in adults are very different, special attention should be paid at the stage of the disease:

catarrhal stage

It lasts two weeks, starting with the incubation period and the period of the disease itself. At this stage, the patient may notice a strong dry cough, the temperature rises.

It is difficult to recognize the disease, even doctors can make a wrong diagnosis, for example, SARS or bronchitis.

During this period, it is important to isolate the patient from society so that the disease does not spread further. Gradually, the cough is already turning into seizures.

Paroxysmal stage

It can last a long time, it stretches for two or even three months. The doctor can diagnose only one cough.

The patient may feel severe weakness, especially during attacks, sputum begins to stand out in large quantities, vomiting appears.

recovery stage

The last stage appears when the recovery stage comes. As a rule, this occurs after the second month of illness.

The cough ceases to be so intense, and the patient's condition improves noticeably.

Treatment

If a serious illness such as whooping cough is suspected, treatment should be immediate. Initially, it is necessary to prevent all the symptoms that are characteristic of this disease.

It is for this purpose that the patient is prescribed antibacterial drugs, it is recommended to follow a special diet so that all the nutrients that enter the body are not excreted through vomiting.

To prevent further complications, it is recommended to carry out all therapeutic measures. All drugs will be prescribed by a doctor after the diagnosis is made, and the severity of the disease is accurately established.

To cure whooping cough, the symptoms are completely removed with the help of medications.

Consider the main appointments of doctors:

1. If the disease is mild, then drugs of the macrolide group are prescribed, which help relieve spasms in the throat and alleviate cough, -;
2. If the severity is moderate, then antibacterial agents that affect the bronchial-pulmonary system should be used. It is quite possible to prescribe drugs Lazholvan, Bromhexine, Sinekod;
3. A severe form is treated only in a hospital, the patient is prescribed a whole range of drugs that must be applied unquestioningly. Means that improve blood circulation are also prescribed.

Folk methods of treatment

Additionally, you can use alternative methods of treatment, but they will be effective only with medications. For example, nettle juice perfectly softens cough, which should be drunk three times a day, 1 teaspoon.

It is also quite possible to prepare onion syrup, in this case, onion juice and honey are mixed in equal proportions.

Since ancient times, whooping cough has been treated with burnt sugar, such sugar is diluted with water and applied one spoonful four times a day.

It must be remembered that the constant ventilation of the room will help to avoid infecting others. The patient should not overcool and overwork, it is best to provide the patient with complete rest for the period of illness.

Food

Meals should be divided at least 6 times.

Conclusion

It is impossible to say with certainty that after vaccination, the risk of getting sick is equal to zero, since there are exceptions. But still, the chances of getting sick are reduced significantly. The disease itself does not pose a fatal threat.

In order not to face the disease, you need to be attentive to your health, constantly take vitamins and eat right, try to vaccinate your child in childhood or early age.

Video: Whooping cough, childhood diseases in adults