Introduction: The intersection of autumn and winter is very likely to cause a series of diseases for children; how to effectively prevent and care for common diseases of children is common knowledge that every parent and friend should master. Whooping cough is a common disease that children experience, so what is whooping cough? How should a child treat whooping cough?
What is whooping cough? Pertussis is an acute respiratory infectious disease caused by Bacillus pertussis. More common in infants and young children. Clinically, it is characterized by paroxysmal spastic cough and chicken crowing inhalation and roar. The course of the disease can last up to 2 to 3 months, hence the name pertussis.
Causes of pertussis
1. Source of infection: patients are the only source of infection of this disease. It is contagious from the end of the incubation period to 6 weeks after the disease, and the Catastrophe period is the most contagious in the first week of the onset of the disease.2. Transmission pathway: is mainly transmitted through droplets.
3. Susceptible people: people are generally susceptible, but the incidence rate of young children is the highest. The mother does not have enough protective antibodies to pass to the fetus, so infants and young children under 6 months old have more diseases. Long-lasting immunity can be obtained after the disease, which is rare for the second time.
Symptoms of pertussis
Incubation period is 2 to 20 days, generally 7 to 10 days. Typical passages are divided into three phases:1, Catalogue period (prodromal period): starts from onset to spasm and cough, about 7 to 10 days. The symptoms of general upper respiratory tract infection at first occur, including low fever, cough, runny nose, sneezing, etc. After 3 to 4 days, other symptoms will improve and the cough will worsen. This period is the most contagious and has the best treatment effect.
2. Spasmodic period: cough changes from mono cough to scheming cough, more than ten consecutive times to dozens of short coughs, followed by a deep and long inhalation. Because the glottis is still in a state of contraction, it makes a roar like a chicken crow. Then there is a series of coughs, repeating this way until the viscous sputum is coughed or the contents of the stomach are spit out. Each episode of cough can last for several minutes, ranging from dozens to dozens of times a day, day and night. When coughing, the children often have red faces, tears, cyanosis of their faces and lips, and incontinence. A few patients may experience frequent spasms and coughs, edema of eyelids, bleeding from the conjunctiva and nasal mucosa, and the tongue extension is damaged by the lower incisors, resulting in ulcers. Adults and older children may not have typical spasms. Due to the small glottic stenosis, infants may have apnea during spasm and cough, and may twitch and even die due to cerebral hypoxia. This period is 1 to 2 weeks shorter. Elders can reach 2 months.
3. Recovery period: paroxysmal cough gradually decreases to stop, and the roar like a chicken crow disappears. This period is generally 2 to 3 weeks. If there are complications, it can last up to several months.
check for pertussis
1. Blood signs: white blood cell count and lymphocyte classification have increased since the first weekend of the disease, and the increase in the spasm period is the most obvious. The total number of white blood cells can reach 20~40×109/L or higher. Due to the effect of lymphocyte promoter factors, lymphocyte classification is generally 60~95%.2. Bacteriological examination.
1) Coughing and sneezing method, use B-G (Bdet--Gegou) medium flat plate, place it 5 to 10 cm in front of the patient's mouth, and incubate for several consecutive sounds for 3 to 4 days. The positive rate in the first week can reach 59-98%, and the spasm period is often lower than 50%, and it is only 2% after the fourth week.
2) Nasopharyngeal culture method. After coughing, mucus was taken from the posterior wall of the nasopharynx with a metal tester, and the positive rate was better than that of the coughing method.
3. Serological examination .
(1) Complement binding test, agglutination test, etc. are mainly used for retrospective diagnosis.
(2) ELISA test. Specific IgM antibodies for this disease can be determined, which are helpful for early diagnosis.
4. Fluorescent antibody examination. Use nasopharyngeal secretions smear, add fluorescently labeled antiserum, and examine under a fluorescence microscope. 75-80% of early patients were positive. But there are false positives.
Treatment of pertussis
1, general and symptomatic treatment. isolate it 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.2. 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.
3. Traditional Chinese medicine treatment. bile preparations have a significant inhibitory effect on Bacillus pertussis.
