Whooping cough is classified as a childhood disease, but people of any age can get sick with it. Another thing is how the disease will proceed and how dangerous the consequences can be in case of complications. In this sense, children under two years of age are most at risk. This article will provide information about what this infectious disease is and how to treat whooping cough in adults and especially in children.
Case history
It is very likely that this disease was known in antiquity. So, there is evidence that in the writings of Hippocrates, and then Avicenna, the symptoms of a disease very similar to whooping cough were described. But this is a moot point, but the description of whooping cough by Guillain de Bayo in 1578, who observed an epidemic of the disease in Paris, which then claimed many lives, is known for certain. Somewhat later, there were reports of outbreaks of a similar disease in England and Holland. How whooping cough is treated was not yet known, since nothing was known about what exactly causes this dangerous disease.
Pertussis causative agent
The causative agent of the disease was isolated from the sputum of a sick child only in 1906 by scientists J. Bordet and O. Zhangu. It is a rod-shaped microorganism with rounded edges, immobile and non-spore forming, transmitted by airborne droplets and affecting the epithelium of the bronchi. The entry gate for this infection is the upper respiratory tract. At the genetic level, the bacterium is similar to parapertussis bacillus, which causes a whooping cough-like but milder disease.
Pertussis is very demanding on environmental conditions, and therefore is extremely unstable outside the human body and quickly dies under the influence of ultraviolet radiation, disinfectants, elevated (more than +55 ºС) temperature. Therefore, household items, as a rule, are not contagious, and only a sick person is the source of infection, regardless of how this pathology proceeds.
At the same time, a sufficiently close contact is necessary for the transmission of the disease, since, not differing in volatility, the whooping cough bacterium does not spread even from one room to another, dispersing around the patient no further than 2 meters. Whooping cough (bordetella), entering the human body, produces toxins that cause symptoms characteristic of the disease.
Symptoms
Before you figure out how whooping cough is treated, you need to familiarize yourself with the signs and characteristics of this disease. Its main symptom is a specific cough, but it does not appear immediately. As is the case with anyinfection, the course of this disease occurs in several stages. The incubation period for whooping cough averages a week, but can be shorter or longer. The prodromal (catarrhal) period has the same symptoms as acute respiratory infections. The temperature may not be at all, the cough is dry, moderate; possible runny nose, laryngitis. Manifestations of intoxication of the body are absent. During this period, which lasts about two weeks, the patient is most contagious, he, unaware of whooping cough, is able to infect his entire environment. The nature of the cough gradually changes, it is not affected by any traditional symptomatic drugs, and when the spasmodic period of the disease begins, it is so characteristic that there are no problems with the diagnosis.
Bouts of convulsive coughing are characterized by short coughing shocks. They follow on exhalation one after another, not giving the patient the opportunity to inhale for a sufficiently long time. When this is finally succeeded, air breaks through the narrowed glottis with a whistling sound typical of the disease, which is called a reprise. Further, the cycle of "cough shocks - reprise" is repeated from 2 to 15 times, the attack can last 1-5 minutes and ends with the separation of a large amount of viscous sputum, and often with vomiting. The number of attacks, depending on the severity of the disease, can be from 10 to 25 per day, most often at night and in the morning. The doctor, having heard such a cough, no longer doubts that the disease is whooping cough. How to treat - depends on many nuances, but more on that later.
Beforeattacks, which may differ in the severity of the course, a person may feel discomfort and anxiety, sore throat. In severe cases, during a convulsive cough, the face of the patient turns red, the veins swell, tears flow from the eyes, and the tongue protrudes so far forward that this can lead to a rupture of the frenulum. Hemorrhages on the face, conjunctiva of the eyes are possible. Between attacks, the patient usually feels completely normal.
The most dangerous thing in such attacks, especially for young children, is oxygen starvation, up to holding and stopping breathing, when you have to literally resuscitate the child: suck the mucus from the nose and throat, do artificial respiration. Parents who are in a panic are unlikely to be able to do this, and for the most part they do not know how to treat whooping cough in children at home, so young children are necessarily hospitalized if this disease is suspected.
The spasmodic period of the disease can last from 2 to 8 weeks. Gradually, the frequency and severity of attacks weaken, but with the accumulation of other infections, coughing may resume. The period of residual effects continues for another 2-3 weeks, and sometimes longer. It is not for nothing that in some countries whooping cough is called the "hundred-day cough" - this disease really proceeds very slowly.
What happens in the body
Getting on the mucous membrane of the upper respiratory tract, the pathogen multiplies there and irritates the ciliated epithelium of the bronchi, trachea and larynx, thereby causingspasm. In this case, bacteria do not enter the bloodstream and do not spread throughout the body. In the future, a violation at the level of the central nervous system, namely the formation of a focus of excitation in the respiratory center of the brain, joins the local irritation of the receptors. As a result, coughing fits can occur in response to any irritant: bright light, loud sound, pain syndrome. This should always be remembered if the question arose of how to treat a cough with whooping cough - sometimes an attack can be prevented.
Excitation can capture other centers of the brain: emetic, vascular, center of skeletal muscles. Therefore, after an attack of coughing, vomiting is not uncommon, there are vascular spasms, convulsions. Due to hypoxia, oxygen metabolism is disturbed in the body. In addition to all of the above, whooping cough toxin has a depressing effect on blood cells, thereby disrupting the functioning of the immune system. In such a state, the layering of a secondary infection is quite possible, and this is another insidiousness of this disease.
Diagnosis of whooping cough
Preliminary diagnosis of whooping cough can be made on the basis of the clinical picture, but it requires mandatory confirmation by laboratory tests. The matter is complicated by the fact that the bacterium is sown only in the prodromal period and when the cough has just begun. But at the very beginning of the disease, the symptoms are too general to suspect whooping cough - unless the fact of contact with the diseased is known. And in the midst of the disease, when there is no longer any doubt, the bacterium no longersown - as a rule, 4 weeks after the onset of the disease, the patient no longer poses a danger to others.
Among the symptoms, in addition to coughing, there are changes in the lungs, visible on x-rays, as well as moderate leukocytosis (due to an increase in the number of lymphocytes) in the blood, but these data are not an absolute confirmation of the diagnosis. In the later stages of the disease, serological methods are used to detect antibodies. Currently, methods have been developed for the rapid diagnosis of whooping cough, allowing you to make the correct diagnosis in the shortest possible time.
Disease forms
The typical form of whooping cough is the one whose symptoms include bouts of spasmodic coughing. But there are also atypical types of the disease, which are easier to tolerate, but, of course, dangerous in epidemiological terms, since it never occurs to anyone to isolate the sick person in time. For example, an erased form, in which the disease is accompanied by a completely “normal” cough, perhaps more intrusive, but there is no spasmodic period.
The abortive form of whooping cough begins typically, but after some time it quickly ends, and the convulsive cough lasts no longer than 1 week. There is also a completely asymptomatic type of whooping cough that occurs in vaccinated children and adults. In this case, along with the complete absence of symptoms, the pathogen is seeded.
Actually, not quite typical, but the disease is very difficult in children under the age of 1 year. As a rule, the incubation and catarrhal periodare shortened, and convulsive lasts longer. In this case, a spasmodic cough with reprisals as such may be absent. Seizures are expressed in anxiety, screaming, extremely dangerous breath holding.
Depending on the number of coughing attacks and the presence of concomitant phenomena, such as respiratory arrest, convulsions, facial cyanosis, cardiovascular disorders, respiratory failure, different forms of the disease are distinguished: from mild (no more than 15 attacks per day) to severe (over 25).
Complications
The specific complications of whooping cough include emphysema, the appearance of umbilical and inguinal hernias, rupture of the eardrum, hemorrhages, respiratory rhythm disturbances, cerebral circulation, encephalopathy. Nonspecific complications are associated with the addition of a secondary bacterial infection. It can be pneumonia, bronchitis, otitis media, tonsillitis, etc.
Treatment for whooping cough: antibiotics
Now that it is clear what causes and what threatens such an infectious disease as whooping cough, the symptoms of how to treat, or at least alleviate them, is a completely logical question. Hospitalized with a diagnosis of "whooping cough" only young children or patients with a severe form of the disease or in the presence of complications. The rest need to know how to treat whooping cough at home. However, the concept of "treat" in the sense of using medicines for whooping cough is not entirely appropriate. Of course, like any bacterial infection, whooping cough is destroyed by antibiotics. But these funds are effective only in the initial stage of this disease.
If the fact of communication of a child or an adult with an already sick person is known, then information about which antibiotics treat whooping cough at an early stage will undoubtedly be useful. The whooping cough is destroyed by erythromycin, ampicillin, tetracycline and levomycetin, while penicillin is completely powerless against this bacterium. The use of these drugs during the catarrhal period of the disease is quite capable of stopping the development of the disease, without leading to a spasmodic period.
Perhaps the only time that antibiotics can be used for prophylactic purposes is the known fact of contact with an already sick person. This will allow timely destruction of the causative agent of the disease, preventing it from colonizing the epithelium of the organs of the respiratory system. Komarovsky E. O., a very popular pediatrician today, draws the attention of parents to this in his articles and interviews, outlining how to treat whooping cough in children.
But in the future, the whooping cough leaves the body, and the cause of the attacks lies in the "head", namely in the defeat of the cells of the cough center. Therefore, during the period of spasmodic cough, it is already inappropriate and even dangerous to use antibiotics, if we are not talking about emerging bronchopulmonary complications, since their influence in itself can provoke a more severe course of the disease. How whooping cough is treated in its later stages is detailed below.
Other medicines
The doctor may prescribe funds to improve bronchial patency and relieve bronchospasm, for example, the drug "Eufillin". Antitussives andmucolytic agents, due to their inefficiency, are practically not used. Hormones are prescribed if the disease is complicated by respiratory arrest, in the presence of encephalic disorders; Antihistamines are also used in the treatment. Sedatives are used for a mild form of the disease, or even psychotropic drugs for a severe course of the disease. If the disease has become severe, medications that improve cerebral circulation, immunotherapy, oxygen therapy to reduce the effects of hypoxia may be appropriate. In any case, medicines are prescribed only by a doctor, even when it comes to how to treat whooping cough at home.
Creating conditions for recovery
Unfortunately, medicine does not have methods that can cure whooping cough overnight if the disease has already passed into the phase of a spasmodic cough. How is whooping cough treated if antibiotics are powerless for the reason that there are no pathogens in the body? You can and should strive to ease the attacks and prevent complications. For this, certain conditions must be met. Explaining how to treat whooping cough, Komarovsky pays special attention to these circumstances.
So, it is extremely important that the air in the room is humid, cool, and the atmosphere is calm. As a rule, between attacks the child feels quite he althy, therefore, it is necessary to spend the maximum possible amount of time, calling on the help of all relatives, to spend on the street, if the weather permits: there is no severe frost or, conversely, dry heat. At the same time, it is worthavoid physical activity and active games.
It is interesting that you can reduce the excitation of the cough center and thus significantly speed up recovery if you create another focus in the brain, no less active, with the help of strong positive emotions. In the case of children, new toys, distractions, recreational trips will do.
Special attention will have to be paid to eating. Feed a sick child should be in small portions, pre-chopping foods. If after eating an attack with vomiting followed, after 10-15 minutes it is worth feeding him - there is a possibility that subsequent attacks will be easier.
Patients often complain that the residual dry cough after whooping cough does not go away for a very long time. How to treat it if the usual symptomatic remedies are absolutely powerless? First of all, be patient and try by all means to purify and moisten the inhaled air, visit water bodies as often as possible or just in the fresh air.
All of the above recommendations will be equally helpful if there is a need for detailed information on how to treat whooping cough in adults and children.
How to treat whooping cough with folk remedies
One of the old ways is to use garlic for whooping cough. Moreover, it is used both inside and inhaled its smell, hanging a few cloves around the neck. Traditional medicine also suggests drinking milk boiled with garlic, as well as rubbing the patient’s chest with garlic slurry with pork fat, making compresses from a garlic-honey mixture.
Of course there are manyrecipes on how to treat whooping cough in children with folk remedies using herbs. Actually, for adults, these methods are also appropriate. The most commonly mentioned plants are thyme, violet, marshmallow root, thyme grass, plantain, coltsfoot, from which infusions and decoctions are prepared. In general, for whooping cough, traditional medicine recommends almost the same remedies as for any cough. There are among the recipes a decoction of figs in milk, black radish juice with honey. It seems that it is better not to use all methods separately, but to use them together with the recommendations for treatment already outlined.
Prevention
If you suspect whooping cough, the patient must first of all be isolated, bearing in mind the exceptional contagiousness of this disease. Vaccination is believed to be the only way to prevent whooping cough. In Russia, it has been practiced since 1965 to vaccinate children under the age of 3 years. However, vaccination does not guarantee lifelong immunity. Congenital passive protection against the disease also does not exist - even a newborn can become infected. But after once suffering whooping cough, a strong immunity is already forming - it is extremely rare to get sick with this disease again.
Telling how to treat whooping cough in children, Komarovsky E. O. draws attention to the fact that vaccination provides immunity for only a few years, but thereby protects children at the age when the disease is most dangerous for them. However, in fairness, one cannot fail to mention that the most severe complications are observed for the DTP vaccine, which is whydevelopments to make the whooping cough vaccine safer for children.
