How to treat parawhooping cough in children

Whooping cough is a bacterial disease transmitted by airborne droplets from a sick person to a healthy person. During a cough, bacteria fly out of the respiratory tract of an infected person and penetrate through the nasal cavity onto the bronchial mucosa of a person nearby. There they irritate the receptors and cause uncontrollable coughing, which literally turns into vomiting.

Vaccinations against whooping cough begin at 3 months of age along with vaccinations against diphtheria and tetanus - usually the DTP vaccine is used. Of the three components of the vaccine, pertussis is the most difficult to tolerate. And it often happens that weakened children or children who have previously had severe reactions to vaccination are vaccinated with an ADS drug that does not contain a pertussis component.

Timely vaccination can reduce the risk of disease by 80 percent, and if infection does occur, the disease progresses more easily.

CAUSE OF WHOOPING COUGH

Why does whooping cough occur and what is it? This is the name of an infectious, highly contagious disease that affects the respiratory system and nervous system, and is accompanied by characteristic attacks of convulsive cough. The causative agent of whooping cough is Bordet-Gengou (whooping cough bacillus), which is transmitted from sick to healthy people through airborne droplets when coughing.

Pertussis sticks can be of three main subtypes - the aggressive and severe first type of infection, and the more favorable and moderately severe ones - the second and third types of sticks. However, the age and previous state of health of the child also play an important role in the development of whooping cough.

Periods of illness:

• incubation period – 2-14 days,
• initial or catarrhal period – 2-14 days,
• period of convulsive cough – from 1 month or more,
• recovery – 1-2 months.

Whooping cough is transmitted by airborne droplets, spreading from its owner 2.5 meters to the sides. The bacillus is not transmitted through care items, and susceptibility to whooping cough ranges from 70 to 100%, depending on the degree of group density and the length of stay in the group. You can get whooping cough at any age from the neonatal period, children are especially often sick during the cold season - from November to March, when they practically do not go for walks and sit at home or in kindergarten. Increases in incidence occur approximately once every three to five years; surviving whooping cough provides lifelong lasting immunity.

Before the age of one year, whooping cough is very severe, with a high mortality rate (death) - 50-60% of cases among unvaccinated children. After vaccination against whooping cough, if the disease develops, it is not as pronounced, without characteristic attacks.

Whooping cough is an insidious infection, especially in children

Whooping cough is a disease with 100% susceptibility. This means that if a person (and especially a child) has not been vaccinated against whooping cough, and has never had it before, then if he encounters the whooping cough bacillus in nature, which is transmitted by airborne droplets and causes whooping cough infection, this person will definitely get sick. And the younger the child, the more severe the disease will be.

More than half of whooping cough cases (including fatal cases) occur in children under 2 years of age.

Alas, even if a child has been vaccinated against whooping cough, there is no guarantee against infection - it is still possible to get sick. However, timely vaccination provides a huge advantage - firstly, the chances of getting sick are greatly reduced. And secondly, even if a child gets whooping cough, the infection will not be able to acquire severe and deadly forms.

Neither vaccination nor previous illness provides lifelong protection against whooping cough. Immunity lasts for a maximum of 5 years. Then it begins to sharply decrease, and 12 years after the last vaccination or after the disease itself, the person is again completely defenseless against whooping cough. Therefore, most often: if one of the household members falls ill with whooping cough in the house, the whole family immediately falls ill.

As a rule, whooping cough in children lasts about 3 months, almost regardless of how actively the child is treated or not treated.

SYMPTOMS OF WHOOPING COUGH

The incubation period for whooping cough is 6-20 days (usually 7 days). If whooping cough occurs in a child, the main symptom is attacks of severe spasmodic coughing, repeated over a long period of time (see photo).

However, the first signs of whooping cough in children resemble a common acute respiratory infection: malaise, loss of appetite, slight runny nose, rare dry cough, fever (most often up to 37-37.5 degrees, in some cases up to 39 degrees).

Day after day, the cough intensifies; on days 12-14 of the disease it becomes spasmodic and paroxysmal in nature. At night, coughing attacks tend to become more frequent, preventing the baby from sleeping peacefully. Depending on the course of the disease, attacks can last 4-5 minutes and repeat up to 20 times a day. After the coughing attack ends, the child may complain of pain in the chest and abdomen. In some cases, the disease is accompanied by vomiting.

The disease occurs in three stages (catarrhal, paroxysmal and convalescent stage). In general, the illness lasts 6-8 weeks.

1. Catarrhal. The general condition of the child remains without significant changes. Body temperature may rise to subfebrile levels (37.5°C). A dry cough appears, worsening in the evening and at night. The cough gradually becomes obsessive and gradually becomes paroxysmal. There may be a runny nose, decreased appetite, restlessness and irritability. The symptoms resemble those of pharyngitis, laryngitis, and tracheitis. The more severe the disease, the shorter the catarrhal stage. So, in children in the first year of life, the duration of the catarrhal period is 3-5 days, in older children – up to 14 days.
2. Paroxysmal. There are no signs of acute respiratory infections at all, and the cough becomes obsessive and spasmodic. This occurs in the second or third week of illness. It is at this stage that it is possible to recognize whooping cough in a child by its characteristic cough. An experienced pediatrician will immediately determine by the type of cough whether it is whooping cough or not. And this does not require any diagnostics or laboratory tests. The signs of whooping cough in a vaccinated child at this stage appear much milder. It often happens that whooping cough is tolerated without a diagnosis: you cough and it goes away without any treatment.
3. Resolution period (2 to 4 weeks). During this period, the body’s immunity mobilizes its strength and, with the help of antibiotics, defeats the aggressor. The cough subsides, attacks become less frequent. The “rooster” character of the cough disappears. The composition of sputum changes - it becomes mucopurulent and gradually stops being released. Over time, all the symptoms of the disease gradually disappear and the baby recovers.

Severe whooping cough in children can lead to serious consequences and complications, in particular, hypoxia develops, as a result of which the blood supply to the brain and heart muscle is disrupted. If the treatment method for whooping cough is incorrect, children may have complications in the functioning of the respiratory system, developing pleurisy, emphysema, and pneumonia. Other bacteria can also develop in stagnant lung tissue.

Parawhooping cough: symptoms in children, treatment and prevention, Komarovsky’s opinion

There are many diseases that mainly affect children. Parapertussis refers specifically to such acute infectious pathologies. A characteristic feature of the disease is attacks of dry cough, which makes it similar to whooping cough. However, these are two different ailments with their own characteristics and therapy.

What is parawhooping cough, how is it different from whooping cough?

Parawhooping cough affects the central nervous system and respiratory organs of the child. Its causative agent is the bacillus Bordetella parapertussis, which is not resistant to environmental conditions. The disease is characterized by a cyclical course. The disease is transmitted by airborne droplets. Stages of pathology:

• catarrhal;
• spasmodic cough;
• recovery.

Despite the fact that parawhooping cough in children and whooping cough have similar symptoms, not to mention the similarity in names, the first disease is not a type of the second. There are many differences between these pathological processes. The difference between whooping cough and parawhooping cough can be seen in the table.

Causes of disease in children

The source of infection with parawhooping cough is a sick child or a carrier of the bacterium who has no clinical signs of the disease. Children who attend kindergartens and schools are at risk. Factors provoking the development of pathology:

• crowd of people in one room;
• poor ventilation of rooms;
• dry and warm air, due to which the mucous membrane dries out, which as a result loses its protective properties;
• neurological pathologies;
• chronic diseases of the nasopharynx, leading to weakened immunity.

Types and symptoms of childhood parawhooping cough

Symptoms and treatment options for parapertussis in children may vary depending on the type of disease. There is a classification of varieties of the disease according to:

• severity of the current;
• clinical picture;
• the presence of complications.

In the first case, the disease occurs in a mild or moderate form. As for the clinical picture, there are 4 types of the disease: typical, atypical, whooping cough and asymptomatic.

Diagnostic methods

Stages of diagnosing parawhooping cough:

• visual examination by a doctor, collecting anamnesis, studying the patient’s symptoms and complaints;
• laboratory research.

Instrumental diagnostics include:

1. Bacteriological research. The patient is tested for parawhooping cough. To do this, mucus is taken from the back wall of the nasopharynx on an empty stomach or 2 hours after a meal.
2. Serology. This is a blood test for the presence of antibodies to pathogens.
3. Immunological research.
4. Hemogram. Analysis shows moderate leukocytosis and lymphocytosis.
5. X-ray. The photographs show thickening of the walls of the bronchi and an enhanced pattern of the lungs. Rarely done.

Features of the treatment of parawhooping cough in a child

In the presence of parapertussis, treatment is recommended on an outpatient basis. Hospitalization is carried out only in cases where:

• the patient is less than 3 years old;
• the child attends kindergarten or other indoor group activities;
• the disease is severe;
• serious complications develop.

General recommendations for parents

In order to alleviate the condition and speed up the child’s recovery, parents should adhere to the following recommendations:

• maintaining high air humidity in the patient’s room;
• regular walks in the fresh air;
• the presence of soft and liquid low-fat foods on the menu;
• exclusion from the diet of acidic foods, for example, juices and citrus fruits, as well as those that can cause irritation of the mucous membranes, crackers, chips;
• enriching the menu with dishes containing protein, there should be a lot of fruits and vegetables;
• a calm lifestyle without too active games.

Drug therapy

The main goal of drug treatment is to combat symptoms. For this purpose, the following groups of drugs are used:

1. Antitussives. To suppress cough, Tussin Plus or Bronholitin, Ambroxol, Bromhexine are prescribed.
2. Antispasmodics. Eufillin is considered the most effective.
3. Antibiotics. They are used only when complications develop in children under one year of age.
4. Antihistamines (Diphenhydramine and Pipolfen).
5. Vitamin complexes.
6. Inhalations.

Folk remedies

Traditional medicine is effective in treating parawhooping cough. Decoctions, tinctures and rubbing help to cope with the disease. Most popular recipes:

1. Garlic with honey. A few cloves are grated and poured into a glass of milk. The mixture must be boiled for 10 minutes. Give the child 1 tsp. before meals three times a day.
2. Apricot kernels. They are passed through a meat grinder and filled with honey. The product is taken 3-4 times a day, 1 tbsp. spoon.
3. Herbal tincture of thyme, pine buds, dill fruits, anise, licorice root or pine buds, coltsfoot leaves, plantain. All ingredients are taken in equal proportions, poured with warm water and infused for 2.5 hours. Then the mixture should be boiled for about 5 minutes.

Possible complications

Parawhooping cough is one of the serious and dangerous diseases. Previously, this disease was often fatal. The main threat to the child is the complications that arise when a secondary infection occurs. For this reason, it is important to diagnose the disease when the first symptoms appear in order to initiate adequate treatment.

Complications of parapertussis affecting the respiratory system:

Also possible:

Preventive measures

There are no preventative measures for parawhooping cough, nor are there any vaccinations against this disease. In case of infection, the following measures are taken:

1. Quarantine. Infected persons are isolated for 25 days. This does not apply to those who have had direct contact with an infected person. The exception is children under one year old. For them, quarantine lasts 2 weeks from the moment of contact with a sick person.
2. Ventilation and wet cleaning. No other disinfection methods are necessary.
3. Strengthening the immune system (hardening, physical exercise, walking, proper nutrition, taking vitamin complexes).
4. Timely treatment of diseases - factors causing the disease (tonsillitis, caries, adenoiditis).

Komarovsky's opinion on parawhooping cough in children

Dr. Komarovsky has his own opinion about parawhooping cough and methods of combating it. He believes that both children and adults can become infected, but the former are more susceptible to the disease. The risk of infection is not reduced even if the child is vaccinated against whooping cough or has already had it.

When a specific cough appears, diagnosis is not difficult. However, to make an accurate diagnosis, the doctor advises taking a blood test. Suitable treatments include:

• rosehip decoction;
• black radish, grated with honey;
• fresh elderberry;
• decoctions of lungwort and fennel;
• milk with garlic.

Source: https://www.deti34.ru/bolezni/infekcii/parakoklyush-simptomy-u-detej-lechenie.html

COURSE OF THE DISEASE IN YOUNG CHILDREN

Whooping cough in young children is very severe and the incubation period is shorter. The short catarrhal stage turns into a long paroxysmal period.

There may not be a classic coughing attack; it is replaced by sneezing, restlessness, screaming, and the child assumes the fetal position. Reprises, if any, are not clearly defined. There may be apnea (stopping breathing) during an attack or between attacks; sleep apnea is especially dangerous. Younger children have a very high risk of developing complications.

BLOOD TEST FOR WHOOPING COUGH

At an early stage, when the symptoms of whooping cough in children are not yet expressed, a whooping cough test helps diagnose the disease. It is carried out using the bacteriological method, when a colony of bacteria is grown from mucus taken from the nasopharynx of a patient and their species is determined, or, if it is necessary to obtain a result in a short time, using the PCR method, which makes it possible to detect the presence of pertussis bacillus directly in the smear.

In addition, serological tests are used to show the presence of antibodies to whooping cough in the blood or mucus of the throat.

TREATMENT OF WHOOPING COUGH IN CHILDREN

A larger number of sick children are treated at home, but under the supervision of a doctor. However, there are cases when hospitalization in a hospital is a vital necessity. This:

• infants up to six months of age;
• complicated course of whooping cough;
• whooping cough in combination with other diseases;
• whooping cough in weakened children;
• all severe forms of whooping cough.

First of all, with whooping cough, quarantine is necessary (25 days from the first day of illness). This is necessary so that the disease does not spread further; in addition, the patient should not be exposed to other infections so as not to develop complications. In this regard, protect other children from the sick person and take all measures to prevent the spread of the disease.

Food and drink should be given to the child often, in small portions, and if vomiting occurs, re-feed. Fresh air helps relieve attacks, so the baby needs to organize walks. Treatment should take place in a calm environment, since coughing attacks are provoked by nervous tension and emotional breakdowns.

Treatment of whooping cough in children necessarily includes antibacterial therapy. The duration of the disease and the severity of the baby’s condition depend on the correct choice of drug. Also, to treat the disease, doctors prescribe anticonvulsants, antitussives and expectorants, sedatives, and homeopathic medicines.

If whooping cough is left untreated, it can develop into pneumonia within 2-3 weeks. In addition, if a child has suffered a severe form of whooping cough, then delays in the development of the nervous system may appear (speech delay, absent-minded attention).

Parawhooping cough (parawhooping cough infection): pathogen, signs, tests, therapy

Parapertussis is a disease of infectious etiology that affects the central nervous system and respiratory tract and develops mainly in children. This acute bacterial pathology is manifested by attacks of persistent, dry cough and other symptoms similar to whooping cough, but in a less pronounced form.

The causative agent of parapertussis is the parapertussis bacillus, Bordetella parapertussis, which is weakly resistant to environmental factors. The disease occurs cyclically and symptomatically resembles tracheobronchitis.

The main clinical sign of the pathology is a paroxysmal convulsive cough, which is accompanied by wheezing and noisy inhalation, and ends with the discharge of glassy sputum or vomiting. The asymptomatic period usually lasts 4-5 days.

The clinical picture of the disease consists of 3 stages:

• Catarrhal period, occurring as nasopharyngitis,
• A period of spasmodic cough lasting an average of two weeks,
• Recovery period.

Adults are less susceptible to this infection. In them, parawhooping cough is relatively mild, rarely complicated and goes away without a trace without specific antibiotic therapy. Parapertussis in adults is sporadic and rarely detected, occurring as an acute respiratory viral infection.

In children, the disease is characterized by a more severe course and pronounced clinical manifestations . Symptoms of parapertussis in children mimic the clinical signs of mild whooping cough. In this case, there are no cough recurrences, and the cough does not decrease when taking antitussives. Parapertussis does not leave behind immunity, but the risk of re-infection is low.

Until recently, parawhooping cough and whooping cough were considered one infectious pathology with a high mortality and morbidity rate among all diseases of the respiratory system. In 1937, scientists isolated the causative agent of parawhooping cough and proved that these are two different infectious diseases. Parapertussis is characterized by autumn-winter seasonality.

Children get parawhooping cough much more often than adults. The risk group includes children aged 2-6 years. Parawhooping cough is especially dangerous for children under 2 years of age. People who have had whooping cough or who have been vaccinated against it can become infected with parapertussis infection.

Parapertussis infection occurs in a typical, atypical, pertussis-like or asymptomatic form. Bacterial carriage is classified into a separate group. Based on the severity and severity of clinical manifestations, mild and moderate forms of parawhooping cough are distinguished. The disease can be complicated or uncomplicated.

Etiology and pathogenesis

The causative agent of parapertussis infection is the bacterium Bordetella parapertussis. These are small, gram-negative short rods of coccoid shape with rounded ends, located in smears in pairs, chains or singly.

Microbes have a delicate capsule, flagella and are strict aerobes. Bordetella are immobile and grow at a temperature of +35-37 ° C on synthetic and semi-synthetic media: plain agar, casein-charcoal agar, blood agar. Colonies of microbes are round, small, moist, with a pearlescent sheen, leaving a creamy trace on the medium.

The causative agent of parawhooping cough is an obligate parasite that is not resistant to environmental factors. Bordetella die when heated or under the influence of disinfectant solutions, and are resistant to many antibiotics.

The source of infection is the patient, convalescent or carrier. Microbes spread by aspiration mechanism, which is carried out by airborne droplets. This period lasts on average three weeks.

The entrance gate of infection is the nasopharyngeal mucosa.
Microbes invade epithelial cells, multiply in the epithelial tissue of the larynx, trachea, bronchi and release infectious toxins into the blood. Toxins affect the respiratory system, central nervous system, and blood vessels.
Inflammation of the respiratory tract develops and rapidly progresses, which is clinically manifested by a spasmodic cough. In the medulla oblongata, under the influence of toxins, a cough reflex is formed.

Coughing attacks intensify and become more frequent, the respiratory rhythm is disrupted, hemodynamic disorders occur, vascular permeability increases, hemorrhagic symptoms appear, bronchospasm, vascular hypertonicity, and convulsive syndrome occur.

In patients, the body's nonspecific defenses are impaired and immunity is reduced. This may result in the addition of a secondary bacterial infection and the formation of bacterial carriage. Additional infection can lead to the development of acute bronchitis, otitis media or pneumonia.

Symptoms

In the clinical course of parapertussis, there are 4 main periods: incubation, catarrhal, spasmodic, resolution.

The boundaries between these periods are smoothed out or completely absent. Usually the disease occurs as tracheitis, bronchitis, pleurisy or pneumonia.

• The incubation period lasts 5-15 days, begins from the moment a person is infected and is characterized by the absence of symptoms of pathology.
• The catarrhal period is manifested by signs of rhinitis, pain, soreness and soreness in the throat, coughing or a rare dry cough. Qatar lasts 3-5 days. In severe cases, signs of intoxication and asthenia appear in the body: persistent low-grade fever, weakness, malaise, myalgia, headache.
• Then comes a period of spasmodic cough. The nature of the cough depends on the form of the pathology. When the form is erased, it is moist, intrusive, gradually intensifying. A characteristic sign of parapertussis infection in children is long, exhausting coughing attacks against a background of normal temperature. In the whooping cough form, the cough occurs in the form of attacks that end with a reprise - a whistling deep breath, and in severe cases, vomiting. Coughing attacks are repeated 5-7 times a day. When the cough symptom intensifies, sick children become restless and capricious.
• The period of resolution is characterized by a weak cough or its absence. It lasts 2-3 days.

Parawhooping cough is very difficult to distinguish from banal tracheitis or bronchitis of bacterial or viral origin. The cough resolves on its own and does not require drug therapy.

With parapertussis infection, complications develop very rarely. In severe cases, the parapertussis form is complicated by pneumothorax, emphysema, rectal prolapse, hemorrhage in the retina or conjunctiva of the eye, and nosebleeds. Parawhooping cough ends in recovery in 100% of cases.

Diagnostics

Diagnosis and treatment of parapertussis infection is carried out by a pediatrician or infectious disease specialist. Diagnostic measures include listening to the patient’s complaints, collecting anamnesis of life and illness, and physical examination.

An epidemiological history allows you to find out whether you have had contact with a sick person. Then they move on to laboratory diagnostics and instrumental methods.

• Bacteriological examination of the patient - microbiological analysis for parawhooping cough. Mucus is taken from the back wall of the pharynx with a sterile cotton swab on an empty stomach or 2 hours after a meal and immediately cultured on nutrient media. They incubate, after which the growth pattern is studied on Petri dishes, microscopy is performed and additional tests are performed.
• Serology - determination of antibodies to parapertussis in the blood. To confirm the diagnosis, an enzyme immunoassay is performed, RA, RPGA, RSK are diagnosed.
• Immunological examination - immunofluorescence analysis and latex microagglutination reaction.
• Molecular method - polychain reaction.
• The hemogram shows moderate leukocytosis and lymphocytosis.

Prevention

There is no specific prevention for parapertussis. Patients with parapertussis infection are isolated for 25 days and quarantined for 14 days. All contact persons and carriers of the whooping cough pathogen undergo double bacteriological examination.

To improve the general condition of the body, general preventive measures are carried out: proper nutrition, hardening, active lifestyle, walking, good sleep, moderate physical labor.

: parawhooping cough and whooping cough, “Doctor Komarovsky”

Opinions, advice and discussion:

Source: https://uhonos.ru/infekcii/parakoklyush/

PREVENTION OF WHOOPING COUGH - ONLY VACCINATION

The main measure to prevent whooping cough is vaccination. No matter how much opponents of compulsory vaccination against whooping cough speak out, the fact remains: if a child is not vaccinated, the risk of getting sick is quite high, especially if the baby is in active contact with other children. And this risk is steadily increasing along with the growth of refusals and unfounded medical exemptions from vaccinations.

Today, whooping cough is often diagnosed in late stages, which makes treatment difficult and leads to complications. There is one more administrative factor. If whooping cough is discovered at a pediatrician’s office, this is an emergency that requires filling out a lot of paperwork, “sorting things out” with the sanitary and epidemiological station, etc. Therefore, they try not to advertise the diagnosis of “whooping cough.”

Vaccination performed on a healthy (or almost healthy, without contraindications) child is practically safe. The most common unpleasant effect from it is fever and pain at the injection site, but these effects can also be avoided by using modern purified vaccines (such as Infanrix or Pentaxim).