• Wednesday July 15,2020

whooping cough

Whooping cough (pertussis) is a bacterial infectious disease of the bronchi and respiratory tract. It is triggered by the Bordetella pertussis Balterium. Although whooping cough is commonly known as a childhood disease but also increasingly adolescents and adults. There is a vaccine against whooping cough.

What is whooping cough?

The bacterium Bordetella pertussis as the causative agent and cause of whooping cough finds spread by means of droplet infection. When talking, coughing or sneezing, the pathogens get into the air and are inhaled by people in the area.
© Henrie - stock.adobe.com

Whooping cough or medical pertussis is a highly contagious infectious disease caused by bacteria that affect the patient's nose, throat, trachea and lungs. As the name implies, the whooping cough manifests itself in spasmodic coughing fits, followed by a wheezing breath (shortness of breath, morbid breathing sounds)).

The illness is very lengthy (several weeks to months) and ends fatally in one in every thousand patients. Infants are particularly at risk in their first half year, as they may experience sudden respiratory arrest.

Whooping cough is by no means a pure childhood disease. People of all ages may be affected. After having passed through, immunity exists for about four to twelve years. Following a further infection is not excluded. Similarly, the immunity after vaccination against whooping cough.

causes

The bacterium Bordetella pertussis as the causative agent and cause of whooping cough finds spread by means of droplet infection. When talking, coughing or sneezing, the pathogens get into the air and are inhaled by people in the area. So the bacteria get into the respiratory tract, where they settle in the mucous membranes.

Here they multiply and operate their own metabolism. The bacteria produce different proteins, some of which as toxins (poisons) destroy the mucous membranes and weaken the immune system. In addition, they damage surrounding tissue and thus cause the typical disease symptoms.

The exciters of whooping cough have a particularly high infectivity. More than three quarters of the people who come in contact with them fall ill. In addition to Bordetella pertussis, Bordetella parapertussis may also lead to the clinical picture of whooping cough, but in most cases these infections are shorter and less severe or even dumb.

Symptoms, complaints & signs

In whooping cough the symptoms and discomfort often persist for weeks or even months. The disease signs occur in three stages. In the catarrhale stage, the symptoms of a cold are similar. Those affected suffer from sneezing, runny nose, coughing and hoarseness. In addition, a slight fever sets in.

Sometimes a conjunctivitis is added, which persists like the other signs one to two weeks. In the second stage, the actual whooping cough develops. Patients suffer from severe coughing fits with wheezing on inhalation. This stage lasts for three to six weeks, with the coughing attacks only subsiding after one month. The coughing fits occur especially in children and adolescents.

They can be recognized by the fact that the patient coughs several times with his tongue outstretched and then inhales gasping. Typical is the wheezing sound, which is accompanied by a tough, glassy ejection. Many sufferers have to vomit or suffer from fever. The symptoms occur especially at night and in the morning.

Depending on the age, other symptoms may occur, such as respiratory arrest in infants and dry cough in adults. In the last stage, the symptoms slowly fade away. After six to ten weeks the whooping cough is overcome.

disease

Usually, whooping cough disease occurs in three stages that are characterized by different symptoms:

The first, cold-like stage (catarrhal stage) lasts about one to two weeks. There are symptoms that are similar to a common cold, such as sneezing, runny nose, mild cough, hoarseness or mild fever. Already in this phase, there is the greatest risk of infection.

The second stage is the seizure stage (convulsivum stage), which lasts two to six weeks. Here are the typical symptoms of whooping cough: Strong, spasmodic coughing attacks with tongue outstretched are accompanied by a gasping inhalation. The coughing fits are repeated at frequent intervals and often end in choking and vomiting. An accumulation of cough attacks occurs at night and after exercise such as exercise or stress.

Pertussis is also threatening because of severe comorbidities such as pneumonia, otitis media or brain hemorrhage. The stage decrementi is the last phase of the disease, in which the symptoms gradually become weaker and weaker. Untreated, it takes six to ten weeks.

complications

In the stage decrementi, the symptoms gradually decrease, but it is here usually too late for a causal therapy of whooping cough. Accordingly, it is still possible to treat with antibiotics, which covers the course of the disease in this last phase for up to six weeks. Left untreated, the remaining cough and spasmodic coughing attacks can last for another ten weeks.

Especially in infants a pertussis leads faster to dangerous swelling of the respiratory tract and concomitantly to respiratory misfires. The longer the body is affected by the whooping cough, the more likely to appear stronger symptoms. Secondary infections of the lungs (15 to 20 percent of cases) and the middle ear are common. Seizures that lead to a temporary oxygen deficiency of the brain affect up to four percent of sufferers. Here, any consequential damage depends on the duration of the oxygen deficiency.

In 0.5% of cases, brain involvement occurs due to the toxins produced by the pertussis pathogens. Such encephalopathy always leaves tissue damage. The sequelae range from motor impairments to permanent sensory difficulties and may also affect cognitive performance. Younger people are often more affected than older people. One in a thousand infected people dies of the disease.

When should you go to the doctor?

If the classic whooping cough symptoms persist for more than a week, a doctor should be consulted. The treatment of whooping cough is essential to avoid serious complications. For this reason, a doctor should be called in at the first sign of the illness, who can clarify the symptoms and, if necessary, treat them directly on site. If a high fever or shortness of breath sets in, it is best to consult a doctor the same day. For circulation problems, a visit to the hospital is indicated. The patient should be promptly examined and made sure that whooping cough is not a serious disease underlies.

At the latest, if the whooping cough significantly affects the well-being or other health problems result, must go with the complaints to the doctor. Neurological deficits indicate involvement of the brain and must be treated immediately in a clinic. Children, elderly and sick people as well as pregnant women should always have pertussis examined by a doctor to avoid complications. In addition to the family doctor, the ENT doctor or a pulmonologist may be consulted.

Treatment & Therapy

The course of the disease in whooping cough can only be alleviated and shortened if timely antibiotic therapy, ie during the stage catarrhale or the early stage convulsivum, is started. But even at a later date, the use of antibiotics makes sense, since it breaks the contagion chain.

Infants who are suffering from whooping cough have to go to the hospital because they often can not cough up the resulting mucus on their own. In addition to the drug therapy, simple measures to relieve the symptoms: A quiet environment, ample hydration and many small meals are important general measures. Hanging wet towels in the bedroom can reduce nocturnal coughing fits.

Outlook & Forecast

Whooping cough is usually caused by a bacterial infection. For the affected person, an existing whooping cough is often a very unpleasant matter, since a whooping cough is very difficult to cough up. It is also a very dry cough, which should usually be treated with medication. If the person concerned decides to undergo such a treatment, antibacterial drugs can be used to bring about a speedy recovery or a complete cure. After two to three days, the coughing should slowly subside and the resulting sore throat will also improve.

If the person dispensed with an existing whooping cough on a medical or drug treatment, it is to be expected considerable complications. The intensity of the whooping cough will worsen considerably, so that a medical treatment is inevitable. As soon as the first symptoms of an aggravation of the whooping cough are evident, the visit to the doctor must not be postponed. By means of an appropriate treatment, an existing whooping cough can be effectively combated, so that a complete and timely healing can take place.

If a whooping cough does not improve after a few days, treatment should be resorted to. As a result, complications can be avoided.

aftercare

Even after completed antibiotic therapy, the symptoms of a whooping cough persist for some time. This is due to the damaged mucous membranes and cilia in the bronchi as well as a persistent irritation of the lung tissue by bacterial toxins, which are only gradually degraded by the body. The focus of aftercare is therefore measures to restore the mucous membranes; also to prevent subsequent infections of the weakened airways with other pathogens.

Regular inhalations with hot water and a few teaspoons of sea salt help the damaged bronchial tubes to regenerate, and also relieve the often-existing irritant cough. The addition of dried thyme for inhalation may additionally aid in the healing of inflamed tissue in the bronchi and the removal of the toxins. Increasing the humidity to 40 to 50 percent in the sleeping area, for example by using a humidifier or boiling water, is also helpful so that the night's sleep necessary for the healing process is not interrupted by coughing fits.

Even after an infection has survived, healed patients may, after some time, become infected with the virus again unnoticed and infect other people, especially infants and toddlers. As soon as the symptoms have completely disappeared in one's own life, one should, therefore, as the last after-care measure, have their own vaccination protected and, if necessary, refreshed.

You can do that yourself

Whooping cough does not necessarily require medical treatment. Some self-help measures and household and natural resources are just as effective as pharmaceuticals from the pharmacy.

Basically, for all concerned: Drink a lot. Recommended are classic herbal teas, tap water or mild fruit juices. The diet should consist of small, light meals such as soup or baby porridge during the first few days. Accompanying this bed rest is important. The patient should sleep a lot - preferably in a warm environment (up to 21 ° C) with high humidity.

In addition, several home remedies can relieve the pertussis symptoms. For example, the inhalation of hot water with sea salt or chamomile flowers has proved its worth. An effective home remedy is a brew of sour cider with sugar and fennel, which is best swallowed. Homeopathy recommends, among others, the preparations Belladonna, Carbo vegetabilis and Ledum palustre.

If the symptoms have not subsided after a few days, a doctor's visit is recommended. With infants and toddlers in whooping cough should always go to the pediatrician. The doctor can give more tips and measures to help cure the pertussis quickly.


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