Whooping Cough Symptoms And Treatment

What is whooping cough?

Whooping cough or pertussis is an infectious disease of the airways which is caused by a bacterium, Bordetella pertussis (bacillus of Bordet-Gengou), which is mainly transmitted by the droplets which occur when coughing. Whooping cough is very contagious.

 Whooping cough or pertussis is an infectious disease of the airways which is caused by a  Whooping Cough Symptoms And Treatment

Whooping cough symptoms and course

The classic pertussis is divided into three successive stages:
  • The catarrhal stage. After an incubation period of 1-3 weeks the first steps, moreover, are not characteristic, phenomena. The disease starts like a cold and accompanied by sneezing, nasal and within flood-jet and unwell, and the patient has a little cough. The symptoms are therefore indistinguishable from those of a common cold. The patient develops a dry cough. The cough gradually worsens and the coughing attacks have increasingly krampachtiger character. In this catarrhal stage the child is most contagious.
  • The paroxysmal stage. This is characterized by coughing fits that empty the patient coughs to stifling and the patient with a long screeching inhalation creates more air. Often a patient vomits after such a coughing fit. All kinds of incentives can, especially at night, provoke a coughing attack. The coughing is accompanied by abandoning tough sputum. In young children, coughing may be followed by vomiting and headache and sometimes arrest. In babies the paroxismen may be missing. At this stage, the bacterial infection is already on the wane, but form the formed waste by the bacterium the problem. Antibiotics are no longer the sick themselves, but can at early stages (up to 2 to 3 weeks after infection) preventive effect against infection. This stage usually takes one to six weeks.
  • The convalescentiestadium begins approximately four weeks after the onset of the disease. The take cough in number and severity.
Going through whooping cough gives a fairly good but not complete immunity against these infections, for about 7 to 20 years.

Possible complications

The vomiting can lead to malnutrition in severe cases. The coughing, the patient can significantly deplete. The person with pertussis may have very stuffy and think to choke. The coughing can by mechanical irritation of the delicate lining of the airways sometimes accompanied by coughing up blood. This is rare. Moreover, the lungs, and by the prolonged forced cough incur permanent damage or may be a pneumonia as a complication arise. This secondary pneumonia is often caused by Streptococcus pneumoniae or Haemophilus influenzae. The coughing subside, the patient developed a fever and lymphocytosis turns into a polymorphonuclear leukocytosis. Whooping cough is sometimes accompanied by middle ear infection. The disease can be fatal, especially in young infants. If adults for more than two weeks, severe cough should take into account of whooping cough. However, the likelihood of this is still very small. An adult with an innocent cough the GP is a 50% chance that the cough after four weeks is not over yet, whether he is or is not treated with antibiotics (eg, because the bacteria already on the wane, or because the causative agent was not a bacterium, but for example, a virus, or because the respiratory tract after infection remain for a while more sensitive to non-specific stimuli). It will also almost never rely on whooping cough.

Serious brain complications (convulsions and sometimes coma) are usually ascribed to anoxia (lack of oxygen) by respiratory arrest and bleeding due to severe coughing, although bacterial toxins also play a role. The risk of these complications in children that have been admitted to a hospital because of whooping cough, is less than 1%. For very young infants up to about nine months, the disease is potentially life threatening. The mucus production can be so strong that they can not weghoesten this. This can stop breathing (apnea) occur that results in death.

Pertussis in infants is sometimes underestimated. Once there is a real suspicion of pertussis, is an urgent need to consult the pediatrician. The infant is then included as necessary, and breathing will be monitored (about 2-3 weeks). When there is too much mucus, which the infant can breathe no more, it can be easily vacuumed. The policy of the Health Department is to show up infants with whooping cough symptoms take to the hospital, both for infection, and for the life-threatening situation. For a child who in his youth had whooping cough may airway until nine years later still a weak

Whooping cough treatment

The bacterium can be treated with antibiotics, but at the time that the typical coughing start to occur such treatment does not cause shortening of the duration of illness. However, it leads to shorten the period in which they can infect others. Vulnerable people in a household where a case of whooping cough has been discovered, may be treated with preventive antibiotics. Erythromycin for two weeks is the standard treatment. However, treatment for 1 week appears equally effective. Azithromycin and clarithromycin are as effective as erythromycin, and have fewer side effects. Azithromycin is preferred because of the short course of 5 days and the fabric also gives less interactions. It mainly involves infants who are not fully vaccinated. The main point of attention in discovery of a case of pertussis is whether very young, or not fully vaccinated children may have been exposed; which must then under Dutch pertussis protocol prefer to be treated preventively and complete their vaccination series (possibly accelerated). The disease is notifiable in the Netherlands.

The cough itself is hardly to be treated. Sometimes antihistamines, corticosteroids or bronchodilators (salbutamol / Ventolin) data. However, the effectiveness is (very) low.

Whooping cough vaccine

Pertussis Netherlands makes part of the National Immunization Program. Vaccination offers approximately 4 to 12 years of protection against pertussis. Before the introduction of this kegiatan died in the Netherlands each year approximately 150 children from the disease (figure from 1940). Worldwide, the mortality rate according to the World Health Organization around 2004 still between 200000-300000 per year. It concerns children under five years who have not been vaccinated.

Because the bacterium which is vaccinated not identical to the bacterium that causes most infections, yet are relatively many cases in vaccinated persons. The disease is milder than clear. However, the side effects that may occur do not result in permanent physical or mental disability. Vaccination (in the form of the DTP vaccine) provides a protection of about 90% for a number of years. From July 1, 2001 have four-year-olds in the Netherlands vaccination with a new vaccine against whooping cough, associated with this decreased effectiveness. It concerns the so-called acellular pertussis vaccine. Vaccination initially applied for children born since 1 January 1998 and from 2005 for all vaccinations. This new type of vaccine is part of the national vaccination program, the incidence of pertussis among very young children has declined sharply. The peak age is in 2009 between 10 and 14 years. This concerns precisely the cohort of children still with the old, now less effective vaccine has been vaccinated. Also, there is now known that the immunity in vaccination, regardless of the cellular or acellular vaccine is not life long. The term of protection of the various pertussis vaccines varies and ranges from 4 to about 12 years. Obviously that varies by individual. Immunity obtained by infection with the bacterium may even be up to 20 years giving protection. In 2012, the number of infections suddenly ran back strongly.

In the recent past, an increasing number of parents do not let their children vaccinated against whooping cough vaccine because it sometimes led to quite severe febrile reactions, febrile convulsions and other symptoms. Existed among parents fear that vaccination can cause permanent epilepsy. Although cases of a first epilepsische attack after vaccination are indeed described, it is suspected that it concerned children who had already been a natural predisposition to epilepsy present. Not vaccinated has led to an increase in the number of pertussis cases, some of which were fatal. It introduced in 2001 and acellular pertussis vaccine is less associated with the side effects.

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