pertussis
Release time : 06/15/2025 09:30:01
My baby coughs and runny nose after taking cold medicine for 2 days, but there is still no improvement? Will it still be accompanied by a low-grade fever? Then take your baby to the hospital as soon as possible. The baby may have been infected with whooping cough.
Some netizens on Mum.com will also ask if the baby must have whooping cough when it cries like a rooster crows. How should my baby be treated for whooping cough? Does whooping cough really cause death? Questions such as these are also troubling new mothers, so let's learn about whooping cough with our mother's website editor and have more confidence in your baby's health and safety! What is pertussis? Pertussis is commonly known as chicken cough and cormorant cough. It is a common acute respiratory infectious disease in children. It is an acute respiratory infectious disease caused by Bacillus pertussis, which is the causative agent of the disease.
Its clinical characteristics are paroxysmal spastic cough, which is accompanied by a deep "rooster crowing"-like inspiratory roar at the end of the cough. If it is not treated promptly and effectively, the course of the disease may be delayed for about several months, so it is called "whooping cough".
The disease is highly contagious and often causes epidemics.
The younger the child is, the more severe the condition is. He may die due to concurrent pneumonia and encephalopathy. 40% of the deaths are infants and toddlers within 5 months old.
In the past three decades, due to widespread vaccination of vaccines, the prevalence of pertussis in my country has been greatly reduced, and the incidence and fatality rates have also been significantly reduced.
Pertussis is endemic worldwide and is generally sporadic with outbreaks occurring in child care institutions.
The disease can occur throughout the year, with an increased incidence in winter and spring seasons extending into the end of spring and early summer, and peaks may even occur in June, July, and August.
The only source of infection is the patient with pertussis, including both typical cases and mild ones.
Bordetella pertussis is difficult to survive in the environment and can only grow and reproduce in the upper respiratory tract mucosa, spreading through cough droplets. Therefore, the transmission of Bordetella pertussis primarily occurs through coughing, with the possibility of inhaling the bacteria within about 2 meters around the patient.
The bacillus is rapidly killed in vitro.
Hence, it is seldom transmitted through indirect means such as clothing and utensils.
Additionally, the population is generally susceptible to whooping cough and infants and young children are particularly vulnerable during their first year of life. Approximately two-thirds of cases occur in children under the age of seven, as it is during pregnancy that the mother does not have antibodies to whooping cough bacteria and these antibodies are transferred to the fetus via the placenta, thus rendering newborns susceptible to the disease upon birth.
The younger the age, the higher the mortality rate. After getting pertussis once in life, a person can get immunity for life.
Causes of Pertussis: Following the invasion of Bordetella pertussis into the respiratory tract, the bacteria attach to the cilia on the epithelial cells and multiply, producing endotoxin. This leads to impaired ciliary movement and destruction of cilia cells.
Bronchial mucosal inflammation, increased mucus secretion, and damage to cilia: the accumulation of irritative mucus continually stimulates the respiratory nerve endings, which in turn stimulate a reflex contraction of the diaphragm and cough. A focus of excitation is formed in the brain's cerebellar cortex.
Therefore, during the recovery period or a few months after the onset of illness, due to factors such as crying, recurrent coughing pneumonia can still be induced.
**Spring Baby Care: Beware of Pertussis in Babies** 1. Many babies have not been vaccinated on time or have not completed the full series of vaccinations (DTP vaccine), which can lead to serious side effects, deterring some parents from getting their children vaccinated.
2. The Bacillus Pertussis "adapts" to the Pertussis vaccine, developing an "immune resistance," rendering the original vaccine ineffective.
3. The causative agent of pertussis is becoming more complex, with not only the Bordetella pertussis but also the paratyphoid bacillus capable of causing symptoms similar to those of pertussis.
What are the symptoms of pertussis? Bacillus pertussis invades from the respiratory tract of susceptible people. Symptoms appear after an incubation period of about 1 to 3 weeks (usually 7 to 10 days). The course of disease is divided into 3 stages, but there is no obvious boundary.
1. Catarrh stage: Generally 1 to 2 weeks. In the early stages of the disease, children have symptoms such as tearing, runny nose, coughing and low fever, which are indistinguishable from the common cold.
About 3 days later, the symptoms eased, except for the worsening of the cough, which gradually transformed into paroxysmal spastic cough, which gradually developed into paroxysmal spastic period, which was highly contagious in this period.
2. Spastic cough period: Generally 2 to 6 weeks, paroxysmal spastic cough is the characteristic of this period.
When spasmodic cough occurs, there are more than ten or even dozens of frequent, short coughs. The patient is in a state of exhalation, followed by a deep inhalation. However, the throat is still in a spasmodic state, and the air flows through the tight and narrow glottis. A high-profile roar, like the crowing of a rooster or a barking of a dog.
This attacks occur several times a day or even 30 to 40 times, especially at night. The younger the age, the more severe the condition.
Repeat the above coughing process until the sticky phlegm accumulated in the respiratory tract is coughed out.
Due to severe cough, it can cause vomiting, incontinence, redness, cyanosis of the lips, and opening the mouth and stretching the tongue.
Severe cough can cause obstruction of the return of the superior vena cava, edema of the face and eyelids, severe cases of nasal mucosa and ocular conjunctiva bleeding, hemoptysis, and even intracranial hemorrhage.
Spastic cough attacks without warning and can be induced by any stimulus.
In the absence of secondary infection, the patient's temperature is normal, there are no positive signs in the lungs, and there may be a variable wheezing in children with pertussis.
Infants and infants under 6 months old often exhibit no coughing or peculiar vocalizations, instead presenting with paroxysmal apnea, cyanosis, prone to seizures, and succumb to asphyxiation.
Adult patients often have typical symptoms, but may only have a few weeks of dry cough, most still insist on work and as the source of infection, this should be given attention.
The duration of the convulsive cough stage is related to the timing of treatment and the severity of the condition, with short periods lasting only a few days and longer ones up to 2 months, generally lasting between 2 and 6 weeks.
3. Recovery Phase: Coughing diminishes, ceases, and the sound of barking inspiration disappears. Mental and appetite functions return to normal. If no complications arise, recovery typically takes 2 to 3 weeks.
Upon encountering smoke, odors, or upper respiratory tract infections, spasmodic coughing may recur but is less severe.
Upon recovery from an upper respiratory tract infection and bronchitis, the spasmodic cough subsides.
Bronchopneumonia is a common complication, occurring mostly during the coughing phase.
Concurrent pertussis meningoencephalitis can occur, presenting with consciousness disturbances and seizures. However, there is no change in cerebrospinal fluid.
The treatment of pertussis should include general supportive care in addition to the following measures: maintaining a quiet environment and fresh air to reduce the predisposing factors for coughing spasms.
Attention should be paid to suctioning phlegm in infants and young children to prevent asphyxiation.
Early application of antibiotics is generally indicated with erythromycin, chloramphenicol, ampicillin, kanamycin, and compound sulfamethoxazole (compound neomycin).
Patients with severe conditions should be administered short-term corticosteroids.
In the event of complications, appropriate treatment should be administered.
1. General Treatment: Maintain isolation for respiratory infectious diseases, ensure indoor quietness, fresh air, and appropriate temperature. Avoid factors that may induce coughing in the child, eat nutritious and easily digestible food, and pay attention to supplementing various vitamins and calcium.
Sedatives can reduce the convulsive coughing induced by fear, anxiety, and irritability in children, while ensuring sleep. Sedatives such as Ipramin (Promethazine) at a dose of 1 mg/kg per child and Phenobarbital can be administered.
For severe coughing, antitussives can be used. If the phlegm is thick, nebulized inhalation can be administered.
When convulsions occur, medications such as diazepam, chlorpromazine, and pentobarbital may be used to control the seizure.
When a very young infant exhibits severe convulsive coughing, it should be attended to by a designated person.
When suffocation occurs, timely suction or artificial respiration and oxygen supply should be performed. If cerebral edema occurs, timely dehydration treatment should be carried out to prevent the occurrence of cerebral herniation.
2. Antibacterial treatment: Antibiotics applied during the kattarrh period can reduce or even prevent spasmodic cough. If applied after entering the spasmodic cough period, it cannot shorten the clinical process of pertussis.
However, it can shorten the bacterial excretion period and prevent secondary infections. Erythromycin is the first choice. Bacillus pertussis is sensitive to erythromycin and can penetrate into respiratory secretions to reach an effective concentration. Dose: 30 - 50mg/kg daily, orally or intravenously.
7 - 14 is a course of treatment.
In recent years, some new macrolide antibiotics such as roxithromycin are administered orally at 5 - 10mg/kg twice a day, with a course of 7 - 10 days.
Azithromycin is taken at 10mg/kg per day once, and a course of 3 days is a course of treatment.
The latter two have the advantages of strong antibacterial effect and less gastrointestinal reactions, so they can be selected as appropriate.
Ampicillin has poor clinical efficacy. Although chloramphenicol has good efficacy, it can occasionally cause granulocytopenia.
3. Complication Treatment: When concurrent with bronchitis or pneumonia, administer antibiotics; for isolated atelectasis, employ postural drainage, suction, and pulmonary physiotherapy. If necessary, use a bronchoscope to remove the localized obstructions of secretions.
In cases of coma, the treatment may involve the use of compound chlorpromazine or phenoperidine sulfate for anticonvulsant therapy.
When cerebral edema occurs, mannitol at a dosage of 1g/kg per time should be given by intravenous injection; when necessary, dexamethasone can be given by intravenous drip.
Immune globulin can be used in the treatment of encephalopathy and cough in children. The contents contain high-priced antitoxin and unique immunoglobulin. The dosage is 15ml/kg, intravenous injection, and it will take effect within 72 hours.
Traditional Chinese medicine refers to whooping cough as "tun chu" (a term derived from the sound made by the patient's barking cough), "lu chu le" (a term derived from the bird's name, which is a reference to the characteristic cough of the disease), and "yi chu".
The principle of syndrome differentiation and treatment: (1) In the initial stage of coughing (due to external wind-heat): it is appropriate to clear wind, cool heat, transform phlegm, and reduce qi.
Commonly used in Sangju Yin (San Jiao Yin) formula: Mulberry leaf, Chrysanthemum flower, Moutan, Almond, Platycodon, Forsythia, Reed Rhizome, Licorice, etc.
For high fever, add gypsum, scutellaria, and gardenia; for phlegm, add tianzhuhuang and clematis.
(2) Spasmodic Cough Phase (Phlegm-Heat Obstructing the Lung): It is advisable to clear heat, transform phlegm, and purge the lung to reduce reversal.
Commonly used formulas include Ma Xing Shi Gan Tang and Xie Bai San Compounded with Wen Dan Tang Modification: Ephedra, gypsum, almond kernel, licorice root, bamboo rhizome, Pinellia, Amomum villosum fruit, Pinellia, Poria cocos, Mulberry bark, and Cornus officinalis.
For individuals who experience excessive sweating due to heat, it is essential to increase the usage of substances like raw gypsum, scutellaria baicalensis, and anemarrhena asphodeloides.
In cases of bleeding from the eyes, add Qingdai, Baimaogen, and Xuanshen.
For patients with thick sputum, add Tianzhu Huang and Haifushi.
(3)Recovery period (deficiency of both lungs and spleen): It is advisable to replenish qi and nourish yin, replenish lungs and spleen.
Use Ginseng Wumaizi Decoction to reduce: ginseng, atractylodes rhizome, tuckahoe, licorice, dwarf lilyturf, schisandra chinensis, etc.
If qi deficiency is the main factor, add astragalus membranaceus and raw oysters. If the cough is still severe, add winter Farnsfoot flower, aster, wolfberry bark, Sichuan fritillary bulb, etc.
Symptoms and treatment of baby whooping cough: 5. First aid measures: Use drugs such as diazepam, compound chlorpromazine or phenobarbital to relieve convulsions during convulsions. Immediately aspirate phlegm or artificially assisted breathing when coughing or sticky phlegm causes phlegm obstruction.
1. Timely isolation for 4-6 weeks is required.
It is best to let your child live alone in a room or corner at home; prevent adverse stimulation such as wind, smoke, fatigue, mental stress, etc.
2. The air in the sick child's room should be kept fresh, but it should be prevented from feeling the cold. The clothes should be washed and dried frequently to keep them clean.
After the onset of the disease, sick children should pay attention to rest and ensure sleep. For children whose frequent coughing at night affects their sleep, sedatives can be given as appropriate.
3. Pay attention to diet regulation and ensure the daily supply of calories, fluid volume, vitamins and other nutrients.
Especially for sick children whose cough and vomiting affect their food intake, the food needs to be dry, soft and easy to digest.
Make small and multiple meals and replenish them at any time.
Avoid eating raw, spicy, and greasy foods.
Select semi-liquid food or soft food that is fine, soft, nutritious, easy to digest and absorb, and should be swallowed.
And pay attention to supplementing various vitamins and calcium.
For the elderly with the disease, you can choose foods with high calories, high-quality protein and rich nutrients.
Eat less and more meals.
It is not advisable to eat foods that produce phlegm and get angry, such as: a variety of processed desserts, snacks, candies, drinks and dairy products, meat dishes, meat soups and greasy food.
>>What should my baby pay attention to for for whooping cough? 4. Discharge phlegm in time to prevent apnea.
You can give some drugs that can dilute sputum so that it can be coughed out. However, it is not suitable for severe coughing reactions and small infants. In case of severe sputum obstruction, a sputum aspirator should be used to suck out the secretions.
When apnea, cyanosis, hypoxia, and convulsions occur, artificial respiration (ventilators can be used if conditions permit), oxygen inhalation, and sputum aspiration should be given; when convulsions occur, anticonvulsants should be used.
How should pertussis be prevented? It is necessary to promptly identify and isolate patients, generally isolating for 40 days after the onset of symptoms or 30 days after the start of spasmodic coughing; patients' sputum, mouth and nose secretions need to be disinfected. It is also important to protect susceptible individuals through vaccination, including inoculation with diphtheria-pertussis-tetanus (DTP) trivalent vaccine, which has been included in routine vaccination schedules.
For infants and those with weakened immune systems, Pertussis poly-valent immunoglobulin can be administered as passive immunity, and erythromycin can be used for drug prophylaxis.
Early diagnosis, timely isolation, isolation period from onset of disease for 7 weeks and from convulsion for 4 weeks.
For children with close contact, quarantine for 3 weeks.
For individuals with a history of minor exposure or physical weakness, passive immunization may be considered. High-titer specific immunoglobulins can be administered, and antibiotics or traditional Chinese medicine may also be used.
Currently, China uses the trivalent vaccine consisting of pertussis vaccine, diphtheria tetanus toxoid and acellular pertussis (DTaP) vaccine.
The basic immunization can be administered at birth, with a single dose every month for three months.
Moving forward, we will strengthen it regularly as per regulations.
Avoid use in people with brain diseases and convulsive diseases, and pertussis vaccine is not administered during the epidemic season of Japanese encephalitis.
>>The most effective measure to prevent pertussis is vaccination. 1. Control the source of infection: Isolate children for 3 to 4 weeks.
Close contacts were observed for 21 days.
2. Protect susceptible populations: ① Automatic immunization: Vaccinate triple vaccines (pertussis vaccine, diphtheria toxoid, tetanus toxoid) on time, which is one of my country's planned immunization.
2. Drug prophylaxis: Family members who are in close contact with patients, especially children, should receive erythromycin at a dose of 50 mg/kg per day, administered orally in divided doses for a continuous period of 10 to 14 days.
*The medical information in this article is for reference only.
If you feel unwell, it is recommended to seek medical attention immediately, and the medical diagnosis and treatment will be subject to offline diagnosis.