Doctor Komarovsky: symptoms and treatment of whooping cough

Coughing in young children most often indicates a cold. But this symptom is also the main manifestation of whooping cough - an acute respiratory infection. The disease is characterized by paroxysmal coughing, which can last up to several months. The diagnosis of whooping cough is rarely made at the initial stage of the disease, which is due to the similarity of the infection with acute respiratory viral infections and acute respiratory infections.

Causes of whooping cough in children

Whooping cough is a highly contagious disease that develops after the penetration of a bacterium called Bordet-Gengou or otherwise Bordetella into the respiratory system. The causative agent of the disease is often referred to as pertussis bacillus.

The route of transmission of the microorganism is air. The bacterium is found in large quantities in the secretions of a patient with whooping cough or a carrier of the infection - saliva, mucus. When coughing and sneezing, Bordetella spreads over a distance of one and a half to two meters in the surrounding space.

Bordetella is very unstable in the environment; it quickly dies at low temperatures, under the influence of sunlight and disinfectants. Due to this feature, the anaerobic (air) route of transmission is of particular importance in the spread of infection. No contact cases of infection have been recorded, since the bacterium on personal items, toys, and dishes quickly loses its activity and ability to move.

In children, whooping cough predominantly develops before the age of 10 years, and children in the first 2-3 years of life are considered the most vulnerable to whooping cough bacillus.

Children who are not vaccinated against whooping cough become infected in 90-100 percent of cases if they come into close contact with a sick person. After recovery from whooping cough, long-term immunity remains.

Treatment of whooping cough with medicinal methods

Therapy for an infectious disease should be selected by the attending physician. This is a mandatory condition, since when choosing the wrong medications, parents can aggravate the baby’s health condition and provoke side effects or complications.

Whooping cough is treated with several groups of drugs:

• Antibiotics;

Levomycetin, Erythromycin or Ampicillin are most often prescribed. They are taken orally, but in severe cases of whooping cough can be administered intravenously or intramuscularly. If complications of the pathological process occur, such as pneumonia or bronchitis with the formation of purulent exudate, then use Cefazolin, Ceftriaxone, Suprax, or the like.

For infants 2-4 months old, Macropen is selected in suspension. For children over four years of age, Rulid or Roxithromycin is recommended.

• Mucolytic agents;

For dry cough, expectorants are prescribed to separate sputum, such as Lazolvan, Bromhexine, Herbion, etc. They help improve mucus drainage and expand the tracts of the bronchial tree. Thus, mucolytics prevent the development of complications in the respiratory system.

In case of prolonged whooping cough, the drugs are replaced with analogues every 10 days so as not to cause addiction to the body and to prevent the occurrence of side effects.

• Neuroleptics;

Since Bordetella bacillus toxins affect the nervous system, Atropine, Propazine, and Aminazine can be prescribed during periods of spasmodic cough. They reduce the frequency of paroxysms and alleviate spasms.

• Sedatives;

If a child often cries or is frightened by the symptoms of the disease, it is advisable to calm him down with simple folk tinctures or tablets. Motherwort and valerian are mainly used.

• Antihistamines;

If allergic reactions develop during whooping cough, antiallergic medications are prescribed - Zyrtec, Diprazine, Claritin. They relieve the inflammatory process.

Additionally, it is recommended to give children Ascorbic acid. Oxygen therapy is sometimes given with oxygen masks to prevent whooping cough from pathologically altering the lung and heart tissues.

Dr. Komarovsky reminds that the child’s treatment cannot be interrupted independently or changed without the doctor’s recommendation. If parents see that medications do not relieve a cough, this does not mean that the medications do not help. The medications are aimed at relieving the inflammatory process and thinning the mucus. Unfortunately, they are not able to eliminate cough, but they perform the main task - they prevent complications and alleviate symptoms in general.

In addition, it is very important to give babies as much attention and affection as possible. They especially need parental warmth when faced with frequent paroxysms. Also, you should not force your child to eat, as he may be afraid to make swallowing movements due to the possible appearance of a gag reflex. While eating, the patient should be distracted from negative thoughts, then the irritated subcortical center will not give a signal to cough or vomit.

Features of the development of whooping cough in children

Once in the respiratory tract, the pertussis bacillus attaches to the surface of the mucous membrane of the throat, bronchioles and bronchi, after which it begins to release toxins that cause initial changes and an inflammatory reaction. Pathological changes are not very pronounced, since bacteria do not enter the cells.

The mechanism of the appearance of specific whooping cough includes several stages of development. Initially, the bacteria release toxins that irritate the receptors of the mucous membrane, which leads to coughing. Then biologically active substances are released, causing an inflammatory reaction in the throat. Constant irritation of nerve endings leads to the formation of a focus of excitation in the respiratory center of the brain. At this stage, the cough becomes paroxysmal.

Cough shocks occur under the influence of strong and moderate irritants affecting the nervous system, such as a sharp sound, bright light, laughter, emotional stress.

In addition to the respiratory center, the focus of excitation can spread to the emetic, vasomotor and a number of other subcortical structures during whooping cough. That is why whooping cough, in addition to coughing at the time of an attack, can be accompanied by severe vomiting, convulsions, fluctuations in blood pressure, and tachycardia. In young children, breathing may be impaired, up to a short-term stop (attack of apnea).

The infectiousness of a child with whooping cough depends on the period of the disease:

• In the first week, the highest possible number of pathogenic microorganisms is released into the surrounding space;
• In the second week, no more than 60% of sick people transmit the infection;
• By the end of the third week, about 30% of children with whooping cough may be infectious;
• In the fourth week, the pathogen is released in only 10%.

However, theoretically, the patient is considered infectious until the 6th week of the disease.

What is whooping cough?

Whooping cough itself is an infectious disease that has a severe and acute etiology. Often the disease affects the respiratory system of those children who have a very negative clinical picture. The peculiarities of such symptoms lie in the disruption of the functioning of certain systems and organs, because the disease affects the mucous membrane.

The name of the disease comes from the French word “coqueluche”; some experts compare this word to the crowing of a rooster. This is justified by the fact that a child’s cough with this type of illness is completely similar to the crow of a rooster. Unfortunately, we end here with the fun, because in the Middle Ages such a phenomenon took people’s lives.

Today, the danger of such a disease also knows no bounds. Statistics from last year say that about 300 thousand people die from a disease called whooping cough. Complications of this type mostly affect children under two years of age. But this does not mean that after two years of life the child has nothing to fear; a complication can overcome the child’s immune system at any time. For this reason, every person should know all the nuances and features of the course of the disease in order to protect their own child in the future.

Symptoms of whooping cough in a child depend on the stage of the disease

What kind of cough a child will have with whooping cough depends on the severity of the disease:

• In mild forms of infection, attacks occur from 10 to 15 times a day, and the number of cough impulses is no more than 5;
• With a moderate form of whooping cough, attacks can occur up to 25 times a day, the number of cough impulses is up to 10. At the end of the attack, vomiting usually occurs. Characterized by asthenic syndrome - lethargy, apathy, nervousness, loss of appetite, pale skin and swelling of the face;
• Whooping cough is said to be severe when attacks occur up to 50 times a day. They are characterized by increased duration, the occurrence of cyanosis (blue discoloration of the nasolabial triangle), convulsions, and severe respiratory distress.

In infants, an attack of spasmodic cough does not last long, but often leads to temporary cessation of breathing and convulsions. Hypoxia leads to brain damage and pneumonia, which can be fatal.

The most likely complications of whooping cough in children include bronchitis, laryngitis, pneumothorax (damage to the walls of the lung), and otitis media. It is possible to develop inguinal and umbilical hernias due to strong tension in the abdominal wall during coughing. Lack of oxygen often causes encephalopathy.

During the entire recovery period, children after whooping cough may be nervous and capricious, during which time there is a high probability of infection with viruses and bacteria that cause respiratory and intestinal infections.

Whooping cough

published 16/07/2013 15:42 updated 20/10/2015

1. In the Video and Audio section, watch episodes of the program School of Doctor Komarovsky:

• Whooping cough
• DTP vaccination

And other programs:

• Whooping cough and parawhooping cough

2. Read the following chapters in the book “The Health of the Child and the Common Sense of His Relatives”:

• Whooping cough
• Preventive vaccinations

3. A section of the book “ARD: A Guide for Sensible Parents” is devoted to the problem of treating cough due to whooping cough.:

• 10.22 Symptomatic therapy. Cough

4. The Smart Parent's Guide has information regarding whooping cough. We recommend reading the following chapters:

• Chapter Four. Vaccinations
• 4.5.4 Whooping cough

5. In the book “Emergency Care” - the second part of the “Handbook of Sensible Parents”, read the section:

• 11.4 Cough without stopping

6. Read the section in the book “Medicines” - the third part of the “Handbook of Sane Parents”:

• 2.4 Medicine for cough
• 2.4.1 Antitussives

7. In Blog , read:

• About the threat to the country's biological security and about whooping cough, which does not exist
• Where to inject vaccinations?
• Vaccinations: safety precautions
• Vaccination in Ukraine: looking for the right phone...
• Vaccinations: silence of the lambs...

8. Information about whooping cough in the Letters section:

• Whooping cough
• About whooping cough, which does not exist
• Cough with undisturbed general condition
• My recipe - how to get out of a dead end

9. In the Questions and Answers section about whooping cough:

• Whooping cough. Prevention.
• Whooping cough (prevention for infants)
• A persistent cough that ends in vomiting
• Contagiousness of whooping cough
• Reaction to DTP
• Vaccines, purified and unpurified. Vaccination is paid and free
• ADS and DTP: what is the difference?
• Tetracok vaccine
• Reaction to DTP (induration at the injection site)
• Coughing attacks. What to do?

10. On our Forum everything about whooping cough and vaccination against it:

• Whooping cough, suspected whooping cough
• DPT vaccination (whooping cough, diphtheria, tetanus)
• Whooping cough or obstructive bronchitis
• Do they have the right to make a diagnosis of whooping cough if the tests are negative?
• DTP or ADS? Vaccinations after whooping cough
• Blood test results for whooping cough
• Whooping cough?
• What to do about a cough?
• Repeated unknown illness after treatment with antibiotics. What if you have whooping cough?
• A child has a cough. Possible contact for whooping cough
• Nocturnal coughing attacks in a child
• Posterior rhinitis for 3 months
• Can whooping cough get worse?
• Dry cough
• The child vomits and chokes when coughing
• Cough into the garden?
• Very persistent cough
• Cough 1.5 months
• DPT revaccination
• DTP
• Antitussives (Sinekod, Glycodin, Bronholitin, etc.)

11. Read about whooping cough in our Library:

• New calendar, new vaccines
• How dangerous are vaccines?

12. In the Site Directory you can find information about whooping cough and its prevention:

• Diphtheria-pertussis-tetanus vaccines
• Measures regarding persons who communicated with infectious patients
• National calendar of preventive vaccinations
• Table of “contagiousness” of infectious diseases
• Incubation period for airborne infections
• Diagnosis of bacterial infections
• Prophylactic use of antimicrobial agents
• Centrally acting antitussives

Does the vaccine protect against whooping cough?

Can a vaccinated child get whooping cough? It is quite possible for vaccinated children to become infected with pertussis. However, in vaccinated children the disease is mild; there is usually no spasmodic cough, but a dry, obsessive cough has been bothering them for a long time. After vaccination, there are no serious complications, and the body recovers faster.

A child's first year of life is vaccinated against whooping cough three times - at 3, 4.5 and 6 months. At one and a half years, another revaccination is carried out. Full revaccination provides long-term immunity from whooping cough, however, it is not lifelong. But adults tolerate whooping cough quite easily and most often without complications.

Treatment

According to Komarovsky, treatment of whooping cough with antibiotics is advisable before specific symptoms of the disease develop . During the catarrhal period, antibacterial therapy can prevent the appearance of spasmodic cough. After a cough occurs, taking antibiotics does not significantly affect the course of the disease, but reduces the release of the pathogen into the environment, reducing the infectiousness of the patient. Macrolides are most often prescribed for whooping cough.

In no case should you treat a child yourself - the selection of the drug and dosage is carried out by the doctor, focusing on the patient’s age and the severity of the disease.

Antitussive medications are ineffective for whooping cough. To relieve symptoms, antispasmodics and sedatives are used: tincture of valerian, motherwort, peony .
Treatment of the patient includes organizing a daily routine, walking, sleeping, reducing physical and emotional stress.

Nutrition should be complete and age appropriate. It is recommended to give the child vitamins A, C and P. It is better to feed the patient in small portions, but more often, to ensure that he drinks enough fluid. For infants, constant weight monitoring is necessary.

The room where the patient is located must be wet cleaned and ventilated daily. Walking outside is good for your child, but you should avoid crowded places. The patient is advised to sleep longer and reduce physical activity. Parents need to learn how to perform breathing exercises and provide first aid in case of respiratory arrest.

Positive emotions are very important for a sick child. When any interest in games, books, or events arises, new foci of excitation appear in the brain, and the cough center is suppressed. Accordingly, the frequency and duration of coughing attacks decreases.

In severe forms of the disease, children are hospitalized. After recovery, it is recommended to show the child to an infectious disease specialist, pulmonologist and neurologist.

Diagnosis of whooping cough

A preliminary diagnosis is made based on complaints and examination. To confirm whooping cough, laboratory research methods are prescribed:

• A general blood test will show an increased content of leukocytes (3-4 times);
• Bacteriological culture of a smear from the back of the throat shows the presence of pertussis bacillus, but only during the catarrhal period;
• Serological tests are considered the most reliable. Antibodies to whooping cough are detected in the blood using various methods.

Complications of whooping cough

Complications of whooping cough can occur in terms of a severe form of the disease. The main disadvantage in the end is long-term hypoxia, which leads to a subsequent disruption of the blood supply to all organs, and most importantly, to the brain.

If hypoxia itself has a negative effect on the body for a long period, this will lead to structural destruction of certain organs and systems.

In most cases, such an illness develops into complications only if the therapeutic treatment tactics were prescribed incorrectly.

Principles of treatment of whooping cough in children

Children under one year old with whooping cough and babies with severe illness are hospitalized in the infectious diseases department. In other cases, treatment is carried out at home. It includes:

• Compliance with the regime. A child with whooping cough needs a constant supply of fresh air and a quiet regimen, as active games can provoke an attack. It is necessary to walk outside every day, but only alone, as a child with whooping cough can infect others;
• Diet therapy. Dishes should be such that their consumption does not irritate the mucous membrane of the throat. Therefore, spicy and salty dishes, soda, smoked foods, nuts, sour citrus fruits, crackers are excluded;
• Medications. The pertussis bacillus dies under the influence of antibiotics. However, they are effective only during the catarrhal period; in the future, their use is advisable only to reduce infectivity and with a high risk of complications. Antitussives do little to suppress whooping cough attacks; most often, doctors recommend taking expectorants - Bromhexine, Codelac, Mucaltin. Under their influence, the viscosity of sputum decreases, thereby facilitating its removal from the respiratory system. Antitussives for whooping cough should be changed every 1-2 weeks.

Additionally, children may be prescribed antihistamines and sedatives. Their use reduces irritability and improves sleep quality. The disease in a child is easier, and the body recovers faster when taking vitamin complexes. A weakened body especially needs ascorbic acid and B vitamins.

Symptoms

The category of people most susceptible to this disease are young children. In the vast majority of cases, having been ill once, immunity is developed after whooping cough and re-infection is impossible. However, in people with weakened immune systems, most often in old age, a relapse may occur.

• Whooping cough in children. The disease is most pronounced in the children's age group and can lead to dangerous complications. At the onset of the disease, the child develops a mild dry cough that gets worse at night. Over time, the cough intensifies, takes on a paroxysmal character, is accompanied by the discharge of sputum and often ends in vomiting. During an attack, the child’s face turns red, the veins in the neck swell, the tongue protrudes, and sometimes hemorrhage occurs in the eyeballs and skin of the upper half of the body. This condition is extremely dangerous, because due to severe coughing, overexertion occurs, intracranial pressure increases, which can lead to rupture of blood vessels in the brain.
• Whooping cough in adults. If an adult's cough lasts more than 2 weeks, according to statistics, in 21% of cases this symptom is caused by the addition of whooping cough bacillus. Most often, adults experience a milder course of the disease, the cough is not very pronounced, and sometimes there is a runny nose. This form of whooping cough is called parawhooping cough. However, severe disease also occurs. In this case, any physical activity can provoke severe coughing attacks, which tend to intensify at night, causing the patient to suffer from insomnia.

Recommendations for parents

It is impossible to completely prevent a child from becoming infected with whooping cough. But parents can reduce the body’s susceptibility to infectious agents, ease the course of whooping cough as it develops, and speed up the overall recovery of the body. Vitamin and mineral complexes help with this, one of them is the therapeutic and prophylactic product Doromarin with a completely natural composition.

A course of DoroMarine for whooping cough has several effects at once:

• Normalizes the content of vitamin C in the body, due to which vascular walls are strengthened and the functioning of the immune system is enhanced. Ascorbic acid and B vitamins are contained in one of the components of the complex - Far Eastern kelp angustata;
• Improves the drainage function of the bronchial tree due to iodine. This eases coughing attacks and promotes the removal of phlegm;
• Enhances the regeneration of damaged cells of the mucous membranes;
• Has a calming effect, which reduces irritability and nervousness in children;
• Increases appetite;
• Due to sea calcium, it enhances muscle contractility, which makes coughing more productive;
• Helps cleanse internal systems of toxins.

The use of the Doromarin vitamin complex from the very beginning of whooping cough facilitates the course of the disease, prevents the infection from progressing to more severe forms and reduces the risk of developing severe complications. With DoroMarine, the body recovers much faster, while the therapeutic and prophylactic product has a positive effect on the entire body as a whole.

You can start taking Doromarin from the age of three months. Preventive use of the product significantly reduces the likelihood of a child becoming infected with pathogenic microorganisms, prepares the child’s body for stay in children’s groups and significantly reduces the likelihood of developing acute and chronic diseases.

Recommendations of Dr. Komarovsky

Treatment of a child with whooping cough should first of all be accompanied by providing the most appropriate care. Since an acute infection can provoke the development of serious complications in the respiratory tract and cardiovascular system, it is very important to create conditions for a speedy recovery of the baby and to exclude secondary infection.

Komarovsky’s recommendations for caring for a sick child come down to several rules:

• Ventilate the room to ensure a flow of fresh air to the patient’s respiratory tract;
• Walk with your child outside at a temperature of -10-+250C, but avoid crowded places so as not to infect others;
• Humidify the air in the room to relieve the patient's symptoms;
• Avoid active movement and emotional stress, because they provoke a new coughing attack.
• Divide pureed food into small portions, it is better to feed more often, because overeating provokes vomiting.
• Provide the child with positive emotions so that the brain switches from irritation to calm.

In addition, it is important to give children dietary food that does not irritate the mucous membranes of the respiratory system. Temporarily exclude hot, spicy, salty, fatty and pickled foods from the diet. You should also not feed your child honey, chocolate, nuts and crackers, as they can negatively affect recovery. The drink is warmed to room temperature.