Whooping cough is a disease that occurs due to the penetration of a bacterial infection into the body by an airborne droplet.
What can pertussis analysis show? In children with whooping cough, the level of leukocytes in the blood rises (2-7x10 9 / l), and mainly lymphocytes are present in the leukocyte formula . As the disease complicates, the white blood cell count increases. In children with weakened immunity, vaccinated and those who have unexpressed forms of whooping cough, fluctuations in the analysis are not observed. The erythrocyte sedimentation rate has average or slightly underestimated indicators. Deviations in the blood picture are observed only in the catarrhal stage of the disease.
Symptoms of pertussis in children
What are the symptoms of whooping cough? How is this disease? At the initial stage, the disease in children develops without any specific manifestations. Body temperature can rise to 38 degrees, a runny nose, a rare and dry cough is observed. During this period of the disease, whooping cough is most dangerous for people around. In general, the symptoms are similar to acute respiratory illness. Pertussis at this time multiplies as actively as possible, while it secretes toxin.
At the next stage of the disease, which occurs after 2 weeks, the condition of the child becomes much worse. A special spasmodic cough appears. Each such push of cough is accompanied by a whistle and a deep breath. With this cough, the child can stick out his tongue, damaging it. The face and neck area may turn blue, respiratory arrest is sometimes observed. At the end of the attack, sputum, and sometimes vomit, is released. Based on the complexity of the disease, the number of seizures can reach up to 50 per day.
After 20-30 days, the disease transforms into the next stage. A spasmodic cough is replaced by a regular cough. The child's well-being becomes much better, the temperature drops and the appetite returns. This stage lasts up to 3 weeks.
How is pertussis in adults? How is this unpleasant disease? Symptoms in adults are similar to those in children, with the only difference being that there are no boundaries between the stages of the disease. In this case, the cough is very pronounced, fading, increasing by night.
Characteristics of pertussis in young children
Incubation and preconvulsive time is reduced to 1-2 days, and the time of convulsive cough increases to 6-8 weeks.
In newborns, instead of the usual coughing fits, equivalent symptoms are observed: sneezing, unreasonable crying, screaming. Hemorrhagic disorders are diagnosed: bleeding in the central nervous system, sometimes in the outer dense shell of the eye and skin. The condition of patients during between periods is worsened: in children there is a loss of strength, the skills that were developed before the disease process are lost. Often there are special exacerbations, which can sometimes be life-threatening in nature, among them: apnea, deviations from normal blood flow to the brain. Interruptions in breathing, up to a temporary stop, can occur without coughing attacks, for example, during sleep, or after eating. Among non-specific exacerbations, pneumonia is most often diagnosed. Fatalities are noted.
Characteristics of pertussis in vaccinated children
Children who are vaccinated against whooping cough have a chance to get sick due to weak immunity or worsening of their tension. In most cases, simple and moderate forms of the disease are diagnosed, severe are not peculiar. Special complications arise very rarely, and at the same time they do not pose a threat to life, so fatal cases do not occur. For the most part, atypical types of whooping cough are found. Up to 2 weeks, the incubation and pre-convulsive periods increase, and the spasmodic cough cycle decreases to 2 weeks.
Diagnosis of the disease
What type of pertussis test should I take? In order to detect possible exacerbations, a general urine test and a biochemical blood test are done. In the case of a normal course of the disease, they do not change.
A general sputum analysis makes it possible to exclude bronchial asthma, tuberculosis and flu. With whooping cough, sputum is mucous, with the appearance of concomitant pneumonia, it turns into mucopurulent or purulent.
The bacteriological method of analysis — the cultivation of microorganisms on nutrient media — gives the doctor a great deal of help in determining the diagnosis, especially in the initial stages of the disease. For a long time to determine the pertussis bacteria practiced the method of "cough plates" recommended by Mauritsen. At the time of the next coughing attack, an open Petri dish with a nutrient medium is placed at a distance of 5-8 cm from the child. Microscopic drops of mucus, in which the pertussis bacterium is located, flying out of the mouth, settle on it. After 2-4 days, based on the grown culture, a diagnosis is made. There is one flaw in this type of diagnosis - it is practically not effective in young children who do not cough well, and also who have no cough.
There is a relatively recent method for finding the cause of whooping cough - sowing bacteria from the nasopharynx and from under the tongue. This method of diagnosis is considered the most effective, but after 4-5 weeks after the onset of the disease, it makes no sense to implement it, because the pathogen cannot be isolated. Premature use of antibiotics also reduces the chances of isolating pertussis bordetella.
Preparatory phase before the study
The main symptom of whooping cough is considered to be acute attacks of suffocating cough, which is sometimes accompanied by vomiting, in especially severe cases, such an attack is quite easy to cause, for example, at the time of taking a sample for examination. At such moments, mothers need to be prepared that, perhaps, the child will need help.
The preparatory process consists in the fact that taking a smear for analysis is most effective in the early days, because during the night large volumes of mucus are formed, in which there is a huge concentration of microorganisms. It is best to take a test for whooping cough before breakfast and do not brush your teeth. Otherwise, a large proportion of sputum will be lost.
Decoding analysis for pertussis
The analysis is carried out in conjunction with the results of the establishment of antibodies of other classes (IgM, IgA)
Bordetella pertussis (Bordet-Zhangu bacterium) |
IgG | IgM | IgA | Deciphering the results |
Negatively | Negatively | Negatively | The causative agent is absent |
Negative or positive | Negatively | Negative or positive | Speaks of infection |
Negative or positive | Negatively | Positively | Talks about the recent presence of infection. |
Positively | Negatively | Negatively | Speaks of recent or past infection, or previous immunization |
Where can I get a test for whooping cough?
Where to take pertussis tests? This type of research is carried out in clinical laboratories and diagnostic centers. Usually they exist at the place of residence. The necessary study and the venue is determined by the doctor.
The type of tests for pertussis is determined based on the symptoms, course of the disease and age categories of patients.
Doctors ask for blood tests for pertussis in the first place, since this type of analysis carries a lot of information.
Possible complications
Special ones include:
- pulmonary emphysema;
- emphysema of the mediastinum and subcutaneous cells;
- atelectasis;
- whooping cough pneumonia;
- interruptions in the respiratory rate (respiratory arrest - apnea up to 30 seconds, stop - apnea over 30 seconds);
- impaired blood flow in the brain;
- hemorrhages (from the nose, back region of the pharynx, bronchi, external auditory canal; into the skin and mucous membranes, sclera and retina, brain and spinal cord);
- the occurrence of an umbilical or inguinal hernia;
- prolapse of the rectal mucosa;
- damage to the eardrum and diaphragm.
The simplest most common complications arising from the accumulation of secondary bacterial flora include:
- pneumonia;
- bronchitis;
- angina;
- lymphadenitis;
- otitis.
Pertussis treatment
The treatment process is carried out only stationary. They try to place newborn children in a quiet, dimly lit room to minimize irritation factors, since they can provoke an exacerbation in the form of a coughing fit. Older children with simple forms of the disease have no bed rest.
Particular attention is paid to nutrition, feeding in frequent small portions. Newborn children need to pump mucus out of their throats in a timely manner. For older children, the oxygen method of treatment is widely practiced.
Antibiotics are used for young children with various severe forms of the disease. At the catarrhal stage, the use of Erythromycin is preferred.
Specific gamma globulin from pertussis is often used, injected intramuscularly in 3 ml every day for 3 days.
Sedative cough remedies are rarely used, they are approached with extreme caution, since the effectiveness of such drugs is considered questionable. It is necessary to prevent the use of such means as mustard plasters and banks, which can provoke coughing attacks.
Pertussis vaccine
The vaccination schedule is set by the state vaccination calendar. Activation of immunity from whooping cough with the help of DTP (Tetracock, Infanrix) is carried out at 3, 4 and 5 months. After this, a repeated vaccination against pertussis is carried out at 18 months.
DTP is injected into the muscle, children under 1.5 years of age - into the front outer thigh, and children older than this age - into the deltoid muscle. Following the introduction of such drugs, more often, due to injections of whole-cell vaccines, during the first 3 days, the child may manifest a protective reaction to the vaccine, both local and general. In 8-9 cases out of 10, such a process can be observed already several hours after the injection. Such reactions are considered a normal natural manifestation, and are not considered complications.
Preventive and therapeutic measures
Those who have pertussis should always be isolated for 25 days from the moment of infection, while treatment should be rational and aimed strictly at eliminating the causes of the disease.
Both vaccinated and unvaccinated contact children are quarantined for 2 weeks from the start of patient isolation. The time for visiting children is strictly limited; the schedule of classes and walks is changing.
To identify whooping cough at an early stage, daily medical examinations of children and adults and a one-time bacterial examination are performed in the area of whooping cough.
How to avoid a disease like whooping cough? The immunity must be strong, it must be constantly strengthened, then many diseases, not only whooping cough, can be avoided. Well, of course, do not forget about vaccination.
In order to find and eliminate the site of pertussis, for all contact children and adults they recommend taking Erythromycin, Rulida or Sumamed for one week at the right age dosage.
Contact newborn children up to 1 year old and unvaccinated (up to 2 years old) are invited to administer donor immunoglobulin - 2-4 doses (1-2 doses every other day).