. I don’t know why. Recently, many friends and colleagues around me have coughed. They said that my baby coughed many times in a row and was diagnosed with whooping cough by the doctor. Of course, most of them are due to various discomfort caused by turning on the air conditioner too low. This triggered me to integrate the content about baby whooping cough in order to make the first-time parents feel relieved, so this article was born.
Before The World Health Organization (WHO) reported that in 2012, there were about 200,868 patients with pertussis worldwide, of which 95% were from developing countries. The hospitalization rate and mortality rate of infants and young children who were not vaccinated or incompletely vaccinated were high, with a mortality rate of up to 3%. Due to the atypical clinical manifestations, the limitations of pathogen detection methods and the lack of understanding of the disease by medical workers, the early misdiagnosis and misdiagnosis rate is high, which leads to some children with serious complications and high mortality rate, which seriously threatens the life and health of children with whooping cough. Those who suffer from repeated apnea, hypoxemia, whooping cough encephalopathy, and cardiovascular dysfunction are considered severe pertussis, otherwise it is an ordinary case ( ordinary cases are not serious, the harm of severe pertussis will be displayed in the later part of the article, and you can directly pull it to the bottom to view ). In this season of high temperatures and rainy water, it is worthwhile to learn more about this type of disease!
review
pertussis, caused by the bacillus B. pertussis, is an acute infectious childhood disease. Because the disease infects the respiratory tract, the typical symptoms are paroxysmal cough, and it can only stop after prolonging inhalation. It can be delayed for 2 to 3 months without treatment, so this disease is named. Before the 20th century, the general spelling of the epidemic name did not contain the initial letter "w" and was not widely used until the end of the 18th century. The most common disease name in the early 19th century was chincough. Whooping cough was first used in the second half of the 17th century by Thomas Sydenham. In recent years, adults may also suffer from whooping cough, mainly manifested as dry cough and lack of paroxysmal spastic cough.
Pertussis distribution and incidence
Pertussis distribution is now global. Generally speaking, it is an endemic disease that occurs in a sporadic form. However, in most developed countries the disease has been controlled through immunization programs. Among clinical cases, 80% occur in children under the age of 10. Unlike most other infectious diseases, whooping cough is often more patients with women than men.
etiology of pertussis and epidemiology
Although pertussis is a more important childhood disease, it is relatively ignored by people and all aspects of epidemiology have not been fully understood. Air appears to be the main transmission route, apparently through droplets. Humans are the only storage host for the disease, and Bodhidrosis 100% does not survive for a long time outside the host (it will soon die of dryness, ultraviolet rays and 49-54 degrees Celsius). The disease is transmitted primarily through contact between home and school classrooms, however, some mild subclinical cases (perhaps occur in young and adults) play a further (unpresented) role in transmission. Lifelong immunity is obtained once the disease occurs, and a rare second infection can be explained by the milder and less common infection of Boduterella parapertussis.
clinical manifestations of pertussis
7~10 days incubation period followed by the initial catha period, which lasts for 1 to 2 weeks. During this period, the disease is highly contagious, but the symptoms are non-specific, similar to many other infectious diseases and mild respiratory diseases. The persistent cough becomes increasingly serious, becomes more severe in the third stage and becomes spastic, and eventually develops into a characteristic cough.
Acute cases will experience 40 to 50 paroxysmal coughs within 24 hours, and vomiting will often occur after frequent asthma coughs. Children have constant asthma and are difficult to recover quickly and effectively breathe. They have developed fever after paroxysmal cough. The acute phase lasts for 4 weeks, but paroxysmal cough lasts for up to 3 months or more. When vomiting stops, the patient gradually recovers and the degree of paroxysmal cough is reduced. Complications include lung collapse, hypoxic convulsions and failure; secondary leucorrhea infection can cause otitis media or pneumonia.Bronchodilation has been rare since the advent of antibiotics.
Regarding pertussis vaccine and its side effects
Diphtheria, pertussis, tetanus three-in-one vaccine is referred to as diphtheria, tetanus . The current immunization procedure in my country stipulates that the first dose of diphtheria, tetanus vaccine should be started at full term 3 after birth, and 3 consecutive shots should be given, and the interval between each shot must be at least 28 days. At the age of 1 and a half to 2 years old, I would like to strengthen the immunity with diphtheria vaccine. At the age of 7, I would like to strengthen the immunity with refined diphtheria vaccine or refined tetanus and rupture vaccine.
diphtheria and tetanus vaccine has been proven by many years of practice at home and abroad that it has good preventive effects on pertussis, diphtheria and tetanus. At present, it is generally believed that the immunization effect of tetanus and diphtheria is more satisfactory. After my country implemented the planned immunization and popularization of children's lemonad vaccination in 1978, the incidence of pertussis decreased significantly, from 100,000 to 200,000 before the use of vaccines to below 100,000 after the 1990s; in the past decade, although the incidence rate of pertussis has remained at a low level, some areas have rebounded, and there are outbreaks and epidemics in some areas, with an incidence rate exceeding 1/100,000.
Side effects of the pertussis vaccine (mainly diphtheria and dysfunction, of course, this does not mean that this vaccine cannot be taken out of context. The vaccine that should be given must be administered)
1. Neuritis: It usually occurs 5-7 days or two weeks after vaccination, or even longer, manifested as limb numbness and pain, weakening or disappearing tendon reflexes. In severe cases, symptoms such as muscle atrophy and paralysis may occur, often occur with facial nerve paralysis and crooked mouth corners.
2. Encyclopedia: It usually occurs within 3 days after vaccination, with symptoms such as convulsions, spasms, convulsions, lethargy or abnormal howling, but most of them can recover. A few patients may leave permanent damage, such as limb muscle atrophy and paralysis, mental retardation or epilepsy-like seizures.
3. Allergic encephalomyelitis: It usually occurs 1-4 weeks after vaccination, with an average of about 10 days. It is manifested as sudden onset of the disease, soreness in the limbs, numbness in the hands and feet, and may be accompanied by fever, irritability, drowsiness, vomiting, and convulsions. Later, reflex changes, hemiplegia, and cerebral nerve paralysis. If the spinal cord is damaged, limb paralysis will occur, and some may have symptoms of meningeal irritation such as coma. Most patients develop rapidly, and can gradually relieve after the acute phase, and some people will have sequelae.
routine treatment of pertussis
general and symptomatic treatment. Isolate by respiratory tract. Keep the air fresh, pay attention to nutrition and good care. Avoid irritation, crying and causing spasms. When infants and young children have coughs, they can take a low head and pat their backs lightly. For those with severe cough, you can take Hibernation Spirit or Fenagen before going to bed, which is beneficial to sleep and reduces coughing. You can also use 3-5 mg/kg/time to add 30-50ml of glucose to drop in silence, 1-2 times/day, and use it for 3-5 days, which has antispasmodic effects. Vitamin K1 can also relieve spasms. When the child suffers from asphyxiation, artificial respiration, sputum suction and oxygen supply should be performed in time. In severe cases, sedatives such as phenobarbital or diarrhea can be appropriately added. If the phlegm is thick, expectorant or atomized inhalation can be given. Severely ill babies can be given adrenal corticosteroids to reduce inflammation.
antibiotic treatment. The use of antibiotics within 4 days of cathar can shorten the cough time or block the occurrence of spasm. After 4 days or during the spasmodic period, it can shorten the bacterial discharge period and prevent secondary infections, but it cannot shorten the course of the disease. The first choice is erythromycin 30-50mg/kg/day, and it is used for 7-10 days. Chloramphenicol (dose the same as above), or compound Xinnuomine, ampicillin, etc.
Traditional medicine treatment. Bile preparations have a significant inhibitory effect on Bacillus pertussis.
search and paper trends of pertussis and the latest trends
search trends of pertussis. Although the incidence of pertussis has dropped significantly due to vaccines in recent years, the search trend is increasing. In addition to the traffic of some websites doing pertussis, it also reflects the signs of resuscitation of pertussis among the public.
It can be seen that the number of research papers on pertussis is quite small (and to a certain extent, Japan has far more public literature on the distribution data about pertussis than in China. I hope that the country can go further in sharing medical-related data)
Clinical characteristics and pathogenic bacteria resistance analysis of neonatal pertussis - Luo Jie Wang Huixin Yuan Lin Gu Song Jiang Min Ding Yijun Guo Dan Yao Kaihu Wang Yajuan - "Chinese Journal of Contemporary Pediatrics" - 2014, (10)
Comparison of clinical characteristics of severe pertussis and pertussis-like syndrome in children - Cui Yun Zhang Yucai Rong Qunfang Xu Liang Zhu Yan - "Chinese Journal of Practical Pediatrics" - 2014, 29(4)
Epidemiological characteristics of cases reported in Guizhou Province from 2004 to 2013 - Jiang Feng Mu Qiuyue Zhang Dayong Feng Jun Zhu Qing - Modern Preventive Medicine - 2015, 42(11)
Clinical analysis of the pathogens of pertussis-like syndrome in children - Cheng Yan Chen Hui - Jilin Traditional Chinese Medicine - 2014, 34(5)
Survey on the level of pertussis and diphtheria antibodies in healthy people in Wenzhou - Wang Zhigang Lin Xiandan Yang Xiaoxia Ni Chengjian Xu Yizhun Lin Xiaoyi - Zhejiang Preventive Medicine - 2016, 28(6)
Clinical characteristics and risk factors for severe pertussis in 247 cases of children with pertussis and analysis of risk factors for severe pertussis - Hu Yunge Liu Quanbo - Chinese Journal of Pediatrics - 2015, 53(9)
Based on the theory of "three-year epidemic", we explore the correlation between pertussis and early meteorological factors and establish a predictive model - Zhang Xuan He Juan - Western Traditional Chinese Medicine - 2015, 28(11)
Primate model research shows that acellular pertussis vaccine cannot effectively prevent pertussis infection and block the spread of bacteria - Shao Zhujun - Chinese Journal of Preventive Medicine - 2014, (12)
Monitoring and analysis of antibody levels of pertussis and diphtheria toxins in healthy people in Quzhou City - Lan Yueyun Jiang Xianchen Yin Zhiying Li Feiyong - "Zhejiang Preventive Medicine" - 2016, 28(4)
Analysis of pertussis infection status and molecular epidemiological characteristics in Tianjin in 2013 - Liu Yong Huang Haitao Liu Peng Su Xu Gao Zhigang Guo Liru Zhang Ying - "Chinese Journal of Epidemiology" - 2014, 35(12)
About the harm of severe pertussis
Foreign research reports that early hyperleukemia is prone to severe pertussis, which leads to pulmonary hypertension and threatens life. Under normal circumstances, white blood cells need to deform when passing through relatively narrow alveolar capillary beds. The time required for red blood cells is 10 to 15 times longer. The time required for red blood cells is extended, and the number of them is higher, causing severe pulmonary hypertension, resulting in cardiac insufficiency and even death. In the
study, the leukocyte count in the severe group was significantly higher than that in the ordinary group; the leukocyte count in the three dead children was (58.1~114.9)×109/L, of which 1 of them had heart color ultrasound and indicated mild pulmonary hypertension, which was consistent with literature reports. This suggests that in clinical work, children with obvious leukocyte elevation should be wary of the possibility of pulmonary hypertension and should undergo routine cardiac color ultrasound examination.
study also found that those with imaging combined with lung consolidation and (or) atelectasis are prone to severe cases. At the same time, it was found that the lung consolidation and (or) atelectasis in the group infected with other respiratory pathogens was significantly higher than those in the group whooping cough. Considering that the combined infection is prone to complications of lung consolidation and (or) atelectasis affects lung function, which can lead to dyspnea or even respiratory failure, and is more prone to severe pertussis.
Diet for pertussis
It is advisable to eat:
It is advisable to choose semi-liquid or soft food that is fine, soft, rotten, easy to digest and absorb, and should be swallowed. Due to the long course of the disease, please pay attention to choosing foods with high heat energy, high-quality protein and rich in nutrients.
It is not suitable to eat:
1. Spicy and greasy foods: Spicy foods such as ginger, garlic, chili, pepper, etc. have a stimulating effect on the tracheal mucosa and can aggravate inflammatory changes; greasy foods such as fatty meat and fried foods can easily damage the spleen and stomach, causing their dysfunction of receiving, transport and transforming, which can aggravate the condition. Therefore, children with this disease should eat light and nutritious foods.
2. Seafood hair products: Baikou cough is particularly sensitive to foods such as sea fishy and river food. Eating fishy fishy foods during the cough will lead to aggravation of coughing. This type of food includes shrimp, hairtail, crab, etc. 3. Raw and cold food: Raw and cold foods often damage the spleen and stomach, leading to disordered spleen and stomach movements, weakening the body's recovery function and increasing the amount of phlegm. Children with whooping cough often have aggravated cough after eating raw and cold foods, especially frozen soda and ice cream. These foods are cold and sweet, and it is common for them to intensify cough after eating them. Furthermore, the food must be cooked and cooked so that it is easy to digest. Children with whooping cough have a long course of illness, so the food should be cooked, rotten and easy to digest. When the disease occurs in winter. You should avoid eating hot pot.
4. Hormones: If effective antibiotics are not used during treatment of this disease, use hormones to treat it, which can spread inflammation and is not conducive to the recovery of the child.
5. Warm and tonic drugs: Do not use warm and tonic drugs during the inflammatory and spasm periods of this disease to avoid helping yang and causing the condition to worsen. Even during the recovery period, it should depend on the condition. It is generally better not to use it if it is not extremely weak.
Note:
Some data in this article are excerpted from:
247 cases of children whooping cough clinical characteristics and severe cases Analysis of risk factors for pertussis -- Paper
Pertussis enters the high incidence period to be wary of infants and young children being infected -- Sina Domestic News 2014 part of data
World Health Organization -- Public welfare organization
