Whooping

Whooping Cough

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Whooping cough (or, Pertussis) is an acute infectious,communicable disease affecting the respiratory tract, characterized by
spasmodic attacks of coughing & accompanied by an inspiratory whoop.

CAUSES


Causative organism – Haemophilus Pertussis (or Ordetella Pertussis)

  • AGE- mostly less than 05 years.
  • mostly females.
  • Season -usually colder months.. Spread -by droplet infection

PATHOLOGY‣ The whole respiratory tract from nasopharynx down to bronchi is involved in a narcotizing inflammation along with inflammation of the peri-bronchial and tracheobronchial lymphoid tissue. The stickiness of exudate is responsible for obstruction of bronchioles leading to atelectasis.

SYMPTOMS

  • Incubation period 01 to 03 weeks.
  • CLINICALs Catarrhal stage: Duration – one week withgradual onset.
  • Dry cough, vomiting occasionally following a severe bout of cough.
  • Anorexia and insomnia.
  • Sneezing, coryza and lacrymation (sometimes conjunctivitis).
  • Moderate fevers.
  • Paroxysmal Stage: Duration – 2 to 4 weeks.
  • Cough(paroxysmal) 30 to 50 times a day. thick mucoid sputum and vomiting maybccur at the end of bouts.
  • ‘Glottis may have ulcer, spasm and oedema.
  • Tetany due to severe vomiting.
  • Bleeding tendency i.e. haemoptysis, epistaxis, purpura,Whoop immediately following the intestinal haemorrhage may occur.
  • Convalescent Stage: Usually begins within 4 weeks after the acute onset.
  • Cough becomes less frequent and sputum is less tenacious.
  • Vomiting may rarely occur as a matter of habit.
  • Improving appetite.
  • Immunity after illness lasts long.

INVESTIGATION

  • CBC
  • ESR
  • SPUTUM CULTURE
  • X-Ray Chest

PROGNOSIS

Better in older children and in the aged but comparatively worse below 03 years.

PROPHYLAXIS

Triple antigen should be given in a dose of 1-cc subcutaneously after every month for three doses. Booster doses after one year and once again before going to school.

COMPLICATIONS

  • Pneumonia
  • Emphysema
  • Dyspnea
  • Toxic Encephalitis
  • Pneumothorax
  • Umbilical hernia
  • Convulsions
  • Meningitis
  • Cerebral hemorrhage
  • Enteritis
  • Otitis media
  • Fulminant Tuberculosis

MANAGEMENT & TREATMENT

  • Bed rest in a well ventilated calm and quiet room during catarrhal stage and for a time during paroxysmal stage.
  • Diet liquids and semi solid diet, feeds should be given immediately after vomiting or paroxysms and should be small & frequent.
  • Cough suppressants may also be used, e.g. phensedyl (promethazinecodeine, ephedrine) .
  • Sedativeday Satriclofos (Tricloryl) syrup 250-mg.
  • Antibiotics tetracycline 50-mg- per kg of body weight daily in divided doses (or Ampicillin 150-mgm. per kg of body wenght.Erythromycin 50-mg. or Hyper-immune convalescent serum 20-ml. intravenously at 2-3 days intervals.

All treatment should be given on the instructions of your Physician.