Infectious diseases. Whooping cough (most important)

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Infectious diseases. Whooping cough (most important)

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28. Whooping cough

Whooping cough is an acute respiratory disease that can develop at any age, but it occurs and becomes most severe in young children.

Etiology. The causative agent of whooping cough is Bordetella pertussis and, less commonly, B. parertussis.

B. pertussis is a short immobile gram-negative rod, has a capsule, a strict aerobe.

Epidemiology. The causative agents of whooping cough are extremely rarely isolated from healthy individuals, the transmission of infection occurs only through direct contact with the patient.

Pathomorphology. The respiratory tract is the site of the primary localization of the pathological process, where a mild inflammation such as serous catarrh occurs. In the larynx and vocal folds, the greatest lesions are observed: proliferation of epithelial cells.

Pathogenesis. In the body of a person infected with whooping cough, agglutinins, hemagglutinin-inhibiting, bactericidal, complement-binding and immunofluorescent antibodies begin to be produced, but resistance to whooping cough does not correlate with them. The existence of a protective antigen in the cell wall of the pathogen suggests that antibodies that act on this antigen are capable of conferring immunity.

Clinical manifestations. The incubation period of whooping cough is 6-20 days, more often - 7 days. In general, the disease proceeds within 6-8 weeks.

There are 3 stages of the disease:

1) catarrhal stage. Lasts 1-2 weeks, characteristic signs are rhinorrhea, injection of vessels of the conjunctival membrane, lacrimation, weak cough;

2) paroxysmal stage. Lasts 2-4 weeks or more. There are characteristic repeated series of 5-10 strong cough shocks during one exhalation, followed by an intense and sudden breath;

3) the stage of recovery. Passes within 1-2 weeks. During this period of time, attacks of coughing, reprises and vomiting are easier and occur less frequently. The cough may continue for several months.

Diagnosis. An accurate diagnosis is made when:

1) bacteriological examination of the material;

2) study of material from the nasopharynx using the method of fluorescent antibodies;

3) obtaining positive results of serological diagnostics;

4) bronchological X-ray examination. Treatment. Antibiotics do not shorten the duration of the paroxysmal stage of whooping cough. Immune antipertussis globulin is used to treat children under 2 years of age.

Prevention. Active immunity is created using the pertussis vaccine. It is part of the complex preparation of DPT vaccine and is given to all children aged 3 months to 3 years.

Author: Pavlova N.V.

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