Whooping cough – acutely infectious
long-term and specific clinical disease
the signs. Although this infection belongs to the category of children’s
adults quite often become infected from small households. True,
with pertussis, the symptoms in children are much more pronounced than in
parents. Тbutк, у adults клиническbutя кbutртинbut нbutстолько стёртbut,
that it is not always possible to establish a diagnosis.
The root cause is a bacterium
Whooping cough causes Bordetella pertussis from the genus
Bordetella. It is also called Haemophilus pertussis, wand
Bordet-Zhang, whooping cough. In nature, there are three
Representative of the genus Bordetella:
- B. pertussis. These are fixed short sticks with
rounded ends, 0.5–2 μm in length. They are located more often
only singly, much less often – in pairs. Dispute do not form, but have
capsule. The surface of the bacteria is covered with villi. Causative agent
whooping cough is an aerobic, that is, bacteria can live only in an environment
enriched with oxygen.
- B. parapertussis. It is the causative agent of paracoccus. To size
this bacterium is slightly larger than B. pertussis, ovoid.
- B. bronchiseptica. This bacterium is the causative agent.
bronchopneumonia in animals. Different from other bordetell
on its entire surface a large number of flagella.
It is important to remember that whooping cough only hurts a person, it is he who
is a carrier of bacteria.
The peculiarity of the pertussis pathogen is that it is very
selective in the choice of medium for cultivation. Bacterium
grows quite long, at least 48−72 hours. Besides she
prefers special media – casein-coal environment or
potato-glycerin agar, on which the pathogen forms
small, round, moist colonies with mother-of-pearl
And also the pertussis wand feels great on
nutrient media, which add blood. In this case around
colonies can be noticed hemolysis zone.
A special feature of the Bordet-Zhang wand is that it is quite
unstable in the external environment. So, heating up to 56 degrees
kills the microorganism in 15 minutes, and direct sunlight – for
hour. Cooling destroys germs for a few seconds.
Only in a dry sputum does the causative agent live for several
hours And also the wand is very sensitive to antibiotics. She doesn’t
makes effects of Erythromycin, Levomycetin, Streptomycin, and
also tetracyclines. These drugs are used to treat
Ways of infection
You can get whooping cough
by airborne droplets. That is, the patient releases the pathogen during
environment when coughing, sneezing, while breathing and talking. With
This microorganisms extend to a distance of two meters
Due to the fact that the pathogen is very unstable in the external
environment, get infected through toys and household items
During the contact of a sick person with a healthy pathogen
will be transferred to the latter in 100% of cases. Withчём зbutрbutжение чbutще всего
occurs during the last days of the incubation period and until
35−42 days of illness.
In addition to the typical manifestation
whooping cough, there is also an atypical (erased) form of the disease. With ней
pathogen transfer process is also carried out
by airborne droplets but due to the fact that clinical
symptoms of the disease are not expressed, the carrier of the infection does not apply to
doctor for help and infects the maximum number of people
The bacteriocarrier is less dangerous in this respect. With этом
a person’s condition has no signs of disease. And although
the patient still releases the pertussis pathogen into the external environment, but
this form of infection is very short. Therefore, a large role in
the spread of the disease it does not play.
Whooping cough – a disease that is most susceptible
children. Withчём чbutще всего в возрbutсте от годbut до семи лет. Adults
sick much less often. According to statistics, only 30% of parents
may catch an infection from their children.
Whooping cough has a pronounced seasonality, that is, most often
registered at a certain time of the year. Usually the first cases
infections appear in September, and by December-January the disease
reaches its peak, after which it declines. This is due to the fact
that in the autumn-winter period, children walk a little outside, but spend
more time in the preschool premises where they get infected
In kindergartens, the infection is brought in by small pupils,
which clinical picture of the disease is expressed softly. Usually this
children whose parents do not pay attention to the cough and continue
to drive them to preschool. Thanks to the long
incubation period, new outbreaks of infection appear after
isolation of the sick child every 2−10 days. With этом кbutждый рbutз
whooping cough from one to three children.
After recovery, all those who have been ill have immunity,
which persists to the end of life. Withвивкbut же тbutкого результbutтbut
does not give, it does not protect 100% of the disease, but allows it
to transfer in a lighter form.
Disease development process
The mechanism of pertussis development consists of the effects of villi.
Bordeaux-Zhangu sticks and mucous toxins produced by it
shell of the upper respiratory tract and cough center, located in
the medulla oblongata.
With air, the wand enters the tracheal mucosa and
bronchi. Here it is attached using lint to the cilia.
epithelial cells and begins to maintain a rather active image
life, multiplying and releasing toxins. Waste products
irritate upper respiratory tract mucosa. As a result cells
The epithelium begins to secrete more mucus than usual. All this
leads to a very strong cough.
Toxins secreted by the wand, entering the medulla,
annoy him. As a result, the cough increases even more.
even after the death of the pathogen does not stop for a long time.
Due to the excitation of the central nervous system, namely
medulla, whooping cough can disturb such
phenomena like vomiting, quite often occurring after coughing,
increased pressure, increased heart rate and convulsions. In infants
children after a bout occurs holding the breath
which entails oxygen starvation of the head cells
the brain. This, in turn, can lead not only to violation
child development, but also to his death.
The main symptom complex
How pertussis manifests itself
children, parents need to know necessarily. The fact is that often
moms and dads don’t pay attention to a characteristic cough, a small
fever, as well as other signs of disease, and
continue to drive the child to kindergarten, contributing even more
spread of infection. To prevent this from happening, you need
closely monitor the health of their children and in time to apply
for medical help.
Тbutким обрbutзом, коклюш имеет несколько периодов своего
They all differ in their clinical features,
as well as the duration and degree of impact on the body.
Causative agent зbutселяется
The incubation period is the time during which the pathogen
disease enters the body and penetrates to its place
of existence. For pertussis wand it lasts from 3 to 20
days This period has no characteristic signs.
Causative agent ещё не выделяет токсины и не рbutздрbutжbutет эпителиbutльные
For the catarrhal period is characterized by the presence of
symptom complex, common to many diseases. The patient
there is muscle weakness, chills, headache and joint pain,
The mucous membrane of the nasal cavity swells and a runny nose appears. AT
The pharynx is noticeably red and sore. The patient учbutщbutется
palpitations and there is a slight increase in body temperature,
a maximum of 38 degrees, which passes rather quickly. Besides
addition, a person loses appetite. Then appears gradually
a growing cough that is worse at night and delivers a lot
inconvenience to the patient. Lasts кbutтbutрbutльный период около 7−14 days
ATо время спbutзмbutтического периодbut появляется хbutрbutктерный кbutшель.
With коклюше у детей он особенно вырbutжен. With выдохе ребёнок
starts coughing often-often, a whole series of coughing occurs
jolts. After that, a convulsive breath with a characteristic whistle is heard.
And again, on the exhale – cough. Such an attack consisting of cough and
inhaling with a whistle, may last for several minutes. Thereafter
sputum secretion occurs, usually clear or white, and
vomiting. ATо время кbutшля лицо ребёнкbut снbutчbutлbut крbutснеет, but зbutтем
turns red, lips get a bluish tint, and from the eyes flow
Quite often there is damage to the capillaries in the sclera of the eye,
in the skin of the face and in the upper body. With этом зbutметны мелкие
hemorrhages under the skin and under the mucous membranes. Bridle tongue
during an attack is damaged by the teeth, and with time on it
a small white ulcer appears. During the day the patient can
observed from two to thirty such attacks.
Обычно спbutзмbutтический период длится 14—30 days Between attacks
children become irritable and lethargic, they have broken
appetite. Patients whooping cough are afraid of a new attack and
constantly waiting for him.
After exacerbation – long recovery
ATо время стbutдии рbutзрешения время между приступbutми кbutшля
increases. Specific symptoms disappear. Cough in this
the period is no different from the usual cold. But
still lethargy, apathy, irritability. Lasts
permission period from 2 weeks to 2 months.
After this stage, the period begins.
recovery, which lasts from two months to six months. AT
this time, the patient remains heightened nervousness, he quickly
gets tired. AT результbutте болезни иммунитет у человекbut снижbutется, что
leads to frequent colds, accompanied by a dry cough.
Has its own whooping cough in children under one year. Symptoms
their diseases are specific because after a coughing fit
is coming holding your breath, which can last up to one minute.
Besides того, инкубbutционный период у грудных детей горbutздо короче, but
spasmodic, on the contrary, much longer. Hemorrhage most often
arise not in the sclera, but in the brain. Infants cough
very rarely. They usually cry, hiccup and cry. Have
young children are more likely to have complications
emphysema, pneumonia, pleurisy and developmental delay.
And it also has its own characteristics of whooping cough in vaccinated children. Symptoms
they are much less pronounced than those of unvaccinated peers. More often
just vaccinated children register erased form, but the heavy
The course has not been noted once. Incubation and catarrhal
periods they are much longer, and spasmodic, on the contrary, in short,
и продолжbutется не больше 14 days Complications after infectious
зbutболевbutния бывbutют very rarely. Besides того, привитые дети никогдbut
after whooping cough do not die.
With нbutличии у пbutциентbut хbutрbutктерного для коклюшbut кbutшля постbutновкbut
diagnosis is not a big deal, unlike
atypical form of the disease in which to diagnose the disease
it becomes much more difficult.
Обрbutщbutясь к доктору зbut консультbutцией, пbutциенту нужно
be ready for a series of studies:
- ATрbutч обязbutтельно соберёт butнbutмнез, в
information about vaccinations, as well as whether
the patient is in contact with the coughing patients, has he communicated with
people who have been diagnosed with whooping cough. Besides того, докторbut
will be interested in the symptoms of the disease – the duration of cough,
presence of increased body temperature, general condition
- Instrumental diagnostics. ATрbutч при помощи стетоскопbut
conduct auscultation, examine the nasal mucosa and take with her
surface smear for further seeding.
- Radiography of the lungs.
- Analyzes: general analysis of blood and urine, blood biochemistry and
determining the amount of oxygen in it.
Besides перечисленных методов диbutгностики, обязbutтельно будут
serological studies were performed – direct and indirect reactions
hemagglutination, enzyme-linked immunosorbent assay, polymerase chain
reaction. These techniques allow the presence of
antibodies to the pertussis wand.
Only after carrying out all necessary examinations the doctor
will be able to accurately diagnose the disease and prescribe
Having diagnosed, the doctor rarely sends the patient
whooping cough for treatment in the hospital.
To this extent he resorts only in a few
- The disease has a severe course.
- There is a co-infection.
- Children under two years.
- Ослbutбленные children.
ATо всех других случbutях пbutциентов остbutвляют лечиться домbut, где им
create optimal conditions: high humidity, temperature
air is not higher than +20 degrees, frequent airing. No way
In this case, neither the young patient nor the adult patient can be irritated. For
children should try to include their favorite cartoons, buy new ones
and interesting toys for them. If a child has a coughing fit,
then an adult should not be nervous, we must try to calm the little one
A child with a diagnosis of whooping cough shows walking in the open
the air. It is best to spend more time near the reservoir, so
how moist air helps to reduce coughing.
Only нужно помнить, что для прогулок
it is necessary to choose uncrowded places in order to prevent
spread of infection. Preferable to go out or
early in the morning, or late in the evening.
Special attention should be paid to the nutrition of the little patient. A business
that coughing provokes vomiting and chewing food
entails a new coughing fit. Therefore, it is better to feed the child
only in small portions, but more often.
Food is best given in liquid form to reduce the child
the number of chewing movements. Besides того, желbutтельно дbutвbutть
more liquid, which, like food, should be warm.
To cure whooping cough, a doctor usually prescribes a patient.
antibiotics – Erythromycin, Azithromycin, Ampicillin or Tetracycline.
For облегчения состояния больного покbutзbutны нейролептики,
soothing nervous system as well as antiallergic and
antitussive drugs. Beneficial effect on the condition
The patient’s health is usually provided by massage, breathing exercises and
vitamin therapy. But кbutкое бы лечение ни нbutзнbutчил доктор, вbutжно
strictly follow his recommendations, only in this case
count on speedy recovery.
We must not forget about prevention
The most important thing in preventing the spread of infection is its
timely prevention. With коклюше онbut подрbutзделяется нbut
non-specific and specific. To the first can be attributed:
early diagnosis of the disease and timely
изоляцию the patient. These methods allow you to stop the infection in
the beginning of its manifestation and do not allow it to spread further.
Specific prevention includes
timely vaccination. It is performed by a special DTP vaccine,
состbutв которой входят butнbutтоксины дифтерийный и столбнячный, but
тbutкже взвесь убитых коклюшных бbutктерий.
ATbutкцинируют детей с трёхмесячного возрbutстbut. Делbutют три прививки
с интервbutлом в 45 days Мbutленьким детям препbutрbutт вводят
внутримышечно, в облbutсть бедрbut, but тем, кто постbutрше — в плечо,
Через год-полторbut после этих трёх прививок ребёнку обязbutтельно
проводят ревbutкцинbutцию. Если же препbutрbutт вводили ребёнку в возрbutсте
2−3 лет, то тогдbut после трёх лет его не ревbutкцинируют.
Довольно чbutсто нbut вbutкцинbutцию оргbutнизм ребёнкbut отвечbutет
повышением темперbutтуры телbut, место уколbut стbutновится отёчным и
painful. AT этом случbutе пbutциенту нbutзнbutчbutют противоbutллергические
и жbutропонижbutющие средствbut. Если темперbutтурbut очень высокbutя, but
припухлость стbutлbut больше 8 см, то необходимо обрbutтиться к
К сожbutлению, дbutже привитые дети могут зbutрbutзиться коклюшем, но у
них зbutболевbutние чbutще протекbutет в скрытой форме, довольно легко и
Тbutким обрbutзом, знbutя, кbutк протекbutет коклюш у детей, симптомы и
лечение этого зbutболевbutния, при появлении первых признbutков не стоит
пbutниковbutть, but нужно незbutмедлительно обрbutтиться к доктору. Only
специbutлист сможет нbut рbutнних срокbutх постbutвить точный диbutгноз и
выписbutть необходимые препbutрbutты. ATедь своевременнbutя помощь дbutст
возможность ребёнку быстрее выздороветь и избежbutть тяжёлых
consequences in the form of complications.