Practice the diagnosis and treatment of pertussis

2021-03-25 12:00 AM

The spread of the disease to others is difficult to prevent, due to the high possibility of spread during the incubation period of the patient, when the symptoms of the disease are not detected.

Pertussis is an acute respiratory infection that is especially dangerous in children. Infants under 6 months of age can be very severely affected by this disease. The disease causes inflammation of the entire respiratory tract. About 50% of cases of this disease occur in children under 2 years of age. However, sometimes the disease also occurs in adults. The vaccine has helped reverse the disease worldwide, with the number of cases plummeting in vaccinated areas.

Reason

It is caused by a rod-shaped bacterium called Bordetella pertussis.

The disease is transmitted through the respiratory tract, the infected person is caused by inhaling this bacterium in the air, by the infected person when coughing, coughing ... Therefore, contact with the sick person increases the risk. get sick.

The spread of the disease to others is difficult to prevent, due to the high possibility of spread during the incubation period of the patient, when the symptoms of the disease are not detected.

Diagnose

The incubation period usually lasts about 1 week, but sometimes longer.

Then the disease develops into two stages. The first stage lasts about 7 to 10 days with the following symptoms:

A short, dry cough is usually only present at night.

Runny nose.

Eyesore.

Low-grade fever.

The next stage can last from 8 to 12 weeks, with the following symptoms:

Dry coughs every 10 to 20 hours, occurring day and night.

Long, intense coughs end with a characteristic strong inhalation, because the patient is unable to breathe during the cough. For infants, this breath noise cannot be discerned.

Vomiting, caused by a cough.

Intermittent apnea, which can take longer than 10 seconds.

Convulsions.

If you cough a lot, it can cause nosebleeds, bleeding blood vessels in the outer surface of your eyes.

If the patient vomits a lot, it can cause dehydration and malnutrition.

In some cases, pneumonia, pneumothorax, bronchiectasis may appear.

A confirmed diagnosis may sometimes require a culture of pathogenic bacteria. Get a specimen for diagnosis by swabbing the back of the nose with a swab in the early stages of the disease.

Chest X-rays may be needed when trying to check the condition of the lungs.

Treatment

There is no cure. Antibiotics are of little help during the coughing phase. Treatment is therefore primarily about monitoring and controlling symptoms.

If the disease is detected early, using erythromycin continuously for 10 days can help to limit the possibility of infection and at the same time shorten the duration of the disease.

Protect the airway for sick children by staying warm at all times. Avoid things that can trigger a cough, such as a cigarette smoke. When a child coughs a lot, rubbing or patting his back with his hands can make him feel better.

Feed your child into many small meals a day, not overeating in one meal.

Give your child plenty of water to drink.

Pertussis can last for many months, and there is a very high risk of recurrence in later years. Therefore, the care and monitoring of the disease need to be paid attention.

Immediately refer patients to hospital treatment when there are serious signs such as:

Cyanosis after a cough.

Convulsions.

Very weak, debilitating.

The cough is heavy and doesn't go away after 6 weeks.

Immunizations

The pertussis vaccine for babies is usually done as early as 2 - 3 months of age. Currently, the vaccine is combined with all 3 types in one dose of DTP, including the vaccine for diphtheria (diphtheria), tetanus (tetanus) and pertussis (pertussis). Children must get all 3 shots. The second shot is given at 3-4 months of age and the third at 4-5 months of age. Then, need another injection at about 4-5 years old. The time between injections may vary, but should not be shorter than 1 month.

The pertussis vaccine does not provide complete protection, meaning that the child can still get the disease. However, the severity is greatly reduced and the duration of the illness is shortened compared to the unvaccinated child. For example, in the United States today, there are still about 7,800 cases of whooping cough reported each year, but the average number of deaths from the disease each year is less than 5 cases.

On the other hand, the protective ability of the drug decreases over time, so repeated injections are required. If not, the adult could become sick. Whooping cough in adults is usually just a mild illness, but the main danger is the infection to children.

The pertussis vaccine can have some undesirable side effects, and a very low rate of serious complications. Therefore, considering the severity of the disease when it is acquired in children, the risk ratio of the vaccine is completely acceptable. Possible reactions after the vaccine are:

Low-grade fever for 1-2 days. This is the most common reaction and is completely free of concern.

Children are strongly stimulated, convulsive. This reaction is rare, occurring in approximately 1 in 100,000 cases.

Brain damage. This is a very rare case, occurring about once in about 300,000 vaccinations.

To further reduce the risk of serious complications, care should be taken not to use the vaccine in the following cases:

Children with a history of epilepsy.

Children have a high fever.

Your child has had a reaction to previous vaccines.

Children with unstable neurological signs.