Recently, there has been a lot of news about children's whooping cough, and some serious ones may lead to serious illness or even death, which is worthy of parents' understanding and attention, otherwise their babies will be at a loss if they really have whooping cough.
Children's whooping cough, the average incubation period is 7-14 days, the first stage of whooping cough is the catarrhal stage, the peak amount of bacteria, strong contagiousness, the time is usually 1-2 weeks, this time and the time of the common cold is more consistent, so it is easy to be regarded as a common cold by parents, but it is easy to infect the family, and this period is not vigilant and identified, in the cramp period, even if antibiotics are used, the course of cough can not be shortened.
One
These measures are not effective for whooping cough in children
The cough characteristics of pertussis in children are different from other respiratory tract infections, after the pertussis bacillus invades the respiratory tract of children, adheres to the cilia of respiratory epithelial cells, multiplies locally and produces toxins such as whooping cough, after the inflammation of the respiratory tract, the discharge of respiratory secretions is blocked, stimulates the cough center, and reflexively causes continuous spasmodic cough until the secretions are discharged. It can last anywhere from a few seconds to a few minutes. Persistent coughing can lead to manifestations such as hypoxia, and infants become cyanotic due to their inability to cough.
The persistent spasmodic cough is exhaled, and before the cough is over, the spasmodic glottis suddenly inhales a large amount of air, and some children produce short, high-pitched echoes like rooster crows.
The cough of whooping cough is most likely due to pertussis toxin destroying the ciliated cells of the upper respiratory tract, causing nasopharyngeal secretions to flow into the larynx, inducing the cough reflex. The cough subsides only when the cells of the mucous membranes of the respiratory tract slowly recover, which usually takes several weeks.
Parents are also very anxious and uneasy when they hear their children's cough, but coughing may be a protective mechanism, and unscientific methods should not be abused to control coughing.
For infants, no strong central cough suppressant drugs are recommended, as they will not control cough and will lead to the risk of respiratory depression and suffocation.
If you are a toddler or a school-age child, dextromethorphan is generally chosen because it has a good cough suppressant effect and fewer adverse effects.
There is no strong evidence recommendation for pertussis in children, and infants often cry when they are nebulized, and parents cough when they are emotional, so nebulized inhalation is not routinely recommended for the treatment of pertussis in children.
There is also a lack of strong evidence for the effect of hormone therapy on the cough of children with whooping cough, and hormones are effective for allergies, asthma, and other allergic inflammatory reactions, but generally not for whooping cough.
Whooping cough is usually dry and usually does not require conventional suction, otherwise it will be irritated and extremely induce cramps.
During the illness, keep enough water, use a humidifier to avoid a clean environment, avoid cough triggers (secondhand smoke, oil smoke, allergens), try to eat small meals to reduce reflux, soothe emotions and avoid crying.
Two
These are the keys to the prevention and treatment of whooping cough
Early identification of whooping cough in children, especially in the catarrhal stage, children who have been exposed to a pertussis patient or whose cough does not improve for a week, it is necessary to timely pertussis nucleic acid testing to confirm the diagnosis. If you are interested, you can learn about it through the column: how to identify children with whooping cough early, why it has been high recently, what are the risk factors, and what to do?
Prompt antibiotic therapy:
Cough less than 3 weeks :
Antibiotics are recommended because the risk of transmission is highest at this stage, and antibiotic therapy given later in the catarrhal phase may not affect the course of symptoms, but may be effective in eradicating pertussis bacilli in infected individuals, thereby reducing transmission.
Cough for more than 3 weeks:
Antibiotics are not routinely used for more than 3 weeks after the onset of cough (except for pregnant women, especially those near-term mothers, who can be given for up to 6 weeks of cough onset to avoid transmission of whooping cough to newborns). Antibiotics are not needed in adolescents or adults who have had a cough attack more than 6 weeks ago, as most patients clear their pertussis infection within 6 weeks.
We suggest that empiric antibiotic therapy can be initiated without waiting for the results of diagnostic tests, as long as the clinical suspicion of pertussis is sufficiently high.
Azithromycin was treated orally for 5 days, clarithromycin for 7 days, and compound sulfamethoxazole tablets for 14 days, but azithromycin was preferred for pregnant patients.
Effective vaccination: Proactive vaccination with diphtheria toxoid + acellular pertussis vaccine + tetanus toxoid (DTaP) before the pertussis epidemic season. Infants are vaccinated at 3 months, 4 months, and 5 months of age, with a booster dose at 18 months of age. The level of protective antibodies decreases after 3~5 years of vaccination, and the antibodies almost disappear after 12 years, and it is recommended to be vaccinated again.
Children's whooping cough is a highly contagious, with certain complications, individual and even life-threatening diseases, I hope that everyone will improve the awareness of early identification of children's whooping cough, timely medication, and kill the germs of the disease in the bud.
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Dr. Ke is the chief physician of pediatrics from a tertiary hospital, a father of two children, a member of the Health Communication Committee of the Chinese Medical Doctor Association, and a member of the Pediatric Gastroenterology Group of the Pediatric Branch of the Zhejiang Medical Association and the Medical Doctor Association. Use your spare time to share reliable parenting and disease prevention knowledge with you, I hope it will help you, the baby is not anxious, and the parenting is not confused.
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