Medical Health Information

Treatment:

• Notifiable disease to the health authorities.
• It need to isolate the sick child.
• Close supervision of children, especially infants primarily during coughing.
• Antibiotic and cough in children over seven years.
• Antibiotic (in case of infection erythromycin). Chemoprophylaxis is sometimes recommended in 40 to 50 mg per kilogram per day of erythromycin. This dose should not exceed 1 g jour.Après the contagion which is in contact with a person with pertussis; incubation occurs silently and lasts about seven days.
• Hospitalization is necessary in infants less than six months and children with cyanosis (blue purplish skin mucous membranes).
• Specific immunoglobulins administered after counting not prevent the occurrence of pertussis and are likely to reduce the symptoms, especially in children less than one year.

Prevention:

Pertussis vaccine is a vaccine consisting of inactivated bacteria and are administered subcutaneously or intramuscularly. The most common is this vaccine in combination with C DT vaccine (diphtheria tetanus pertussis) and DTCP (diphtheria pertussis tetanus polio). The modern variety of pertussis vaccine has improved tolerance compared to the old one. These new vaccines are based on acellular are antigenic. They are not mandatory vaccination. It is possible from three months. It includes a booster shot every five years during childhood. This vaccination does not generally is safe and effective.

The pertussis vaccine is usually associated with diphtheria and tetanus.
It is administered from the second month in three subcutaneous injections deep in a less interval, followed by a booster at 18 months and a late booster performed between 11 and 13 years.

The vaccine is not recommended against when the patient has a history of seizures or encephalopathy.

It has been described neurological complications after vaccination for a patient of 10 000 to 180 000. This figure is at the center of a controversy.
The pertussis vaccine must be a whole-cell vaccine containing. It is indicated for primary vaccination in infants.

The acellular pertussis vaccine is indicated for the reminder of the eighteenth month and late booster between 12 and 13 years.

Complications of pertussis are rare since the use of vaccination.

The most common complications are otitis media. Nervous complications in type convulsions and encephalitis are rare. However, it is possible to describe mechanical accidents related to coughing. It is primarily incontinence, vomiting, bleeding in conjunctival and nasal bleeding (nosebleed epistaxis). Another bleeding is also possible (cerebral meningitis) but much rarer. Sometimes patients have umbilical hernias, prolapse, emphysema (air in the tissues) or interstitial pneumothorax.

Pulmonary complications are suffering from respiratory infant who sometimes accompanied with a hydro-alveolate difficulty breathing and increase breathing rate, which may progress to asphyxiation. Bronchopneumonia by superinfection is also possible but uncommon. The aftermath of bronchiectasis and emphysema residuals are also rare the bronchus atelectasis as well.

Infant's phlegm could cause breathing difficulties sometimes serious; this is why pertussis is especially dangerous under six months and in the elderly. In contrast in children over two years and adult disease is less severe.

Deaths from pertussis are rare in industrialized countries.
Infectious nature of this disease should not be confused with adenovirus infections, Haemophilu's influenza, chlamydia.


Evolution of the disease

Pertussis lasts 8 to 10 weeks and usually precedes a period during which the patient has a cough and sometimes isolated tic pertussis.

Sometimes infants, pertussis is complicated by exhaustion or not associated with dehydration (fluid loss from the body) of a secondary infection of the lungs by bacteria other than pertussis accompanied by asphyxia.

Finally, in the most serious cases have been observed encephalitis (inflammation of the brain).

The increase in the number of white cells in the blood can, with the symptoms, the diagnosis of pertussis.

Culture of the bacillus Bordet-Gengou which the best results are obtained after sampling probe nasal mucus, which should be promptly brought to the laboratory. It is also possible to draw, using a syringe, mucus from the pharynx and then proceed to seed on a Bordet and I Gengou. Cultures are positive in 20-50% of cases during the invasion phase and the beginning of coughing. These tests are being phased out in favor of the polymerization reaction chain.

The polymerase chain reaction called PCR also permits identification of Bordetella pertussis DNA samples taken through the nasopharynx. It is an analysis that is getting faster and requires one to two days. On the other hand, it is much more specific than the crops that can take between three to seven days.

The serological reaction is to look for antibodies directed against different classes of at least two distinctive antigens of Bordetella pertussis. The purpose of urological reactions also highlighted a rise in antibody titre on two successive samples. The antibody is made by fluorescence methods. The serological reaction can also distinguish the pertussis and pertussis itself. The examination of the sample by direct immunofluorescence gives results in minutes.

Pertussis symptoms

The symptoms are due to infection with bacillus Bordet-Gengou varied according to individuals.
Pertussis in infants is very severe and atypical.

A child whose age is between four and eight years and who is not vaccinated, the symptoms of pertussis are.

The incubation period is silent corresponding development in the body of organisms causing a disease that manifests itself by symptoms yet. This period between contamination (contact with the germ: contagion) and the appearance of the first symptoms of this disease.

The period of invasion lasts eight days; it is characterized by a cough accompanied by nasopharyngitis. Then appear runny nose, mild fever and cough sometimes cause vomiting. The invasion is the period leading up to the first-period symptoms characterizing the disease state itself. This period is characterized by the invasion of the body by a pathogen (causing illness).

It then will intensify nasopharyngitis, cough became dry. This period corresponds to the maximum of pertussis infection.

State the period corresponds to the period of coughing. This is symptomatic of pertussis: five expiratory shaking followed by a long inspiration (the patient draws air) called wheezing "whoop."

In some cases, there is an apnea (stopping breathing) or vomiting at the end of the straight. In young children, these apneas are sometimes accompanied by cyanosis (blue or purple skin and mucous membranes) corresponding to a decrease of the arrival of oxygen to the tissues.

In contrast, the older child and adult sometimes present sole as cough, only manifestation of the disease.

The number of fifth day is variable, with a maximum at night and this for three weeks.

The disappearance of coughing occurs around the sixth week.

Pertussis
In recent years, there has been an upsurge in the number of pertussis cases reported.
However, you should know that whooping cough is a cyclical disease with a frequency of 3-4 years, the last epidemic of pertussis had been responsible for the death of France 9 children in 2000.

Given this increase, the Institute for Public Health Surveillance attracts the attention of physicians and their demand the utmost vigilance. Because we know that it is a highly contagious disease, which can infect all ages and be very severe and even fatal for infants not yet immunized.

In the world and according to WHO sources about 300 000 deaths are attributed to him (according to the OS), making whooping a major public health.

The pertussis?
Pertussis is a highly contagious disease; the causative agent is. Contamination occurs between individuals by air: they are water droplets expelled (sneezing, coughing) which spread bacteria from the mouth, nose or throat of an infected person.

Symptoms appear between six and 21 days (average 7-10) after exposure to the bacteria.

At any age!
In non-vaccinated contamination occurs from child to child while in the country vaccinated, it is adult to infant.

Pertussis can occur at any age, but it is among young children whom the consequences will be more serious (especially young children who are not immunized or during immunization) .

Recent studies have shown that adolescents and older children may be carriers of the disease, it is difficult to recognize from the beginning.
What are the symptoms?

Pertussis often begins so little evocative unnoticed because of signs minor colds, mild fever, dry cough, predominantly nocturnal. These symptoms can last up to two weeks and the appearance of a persistent cough (sometimes for more than three weeks) manifested by severe coughing associated with difficulty breathing during and after coughing, causing cyanosis (redness face, swollen eyes) and characteristic whistling during inspiration, called "whooping cough" ( e.g. cough).

There are also coughing, vomiting (cough usually produces a thick mucus). Fever, if present, is not very important.

The complications:
In infants, respiratory problems (sometimes the lips and nails turning blue due to lack of oxygen) can cause pulmonary complications (pneumonia) and neurological (seizure, encephalitis), which can be fatal.

Other possible complications: otitis media, anorexia and dehydration.
After 3 weeks, the cough decreased but some symptoms may persist for a few months.

The treatment:
It relies on taking cough suppressants and antibiotics. It can combine their antispasmodic and sedative and antipyretic needed.

The Prevention:
By vaccination: from two months, the baby can be vaccinated three injections one month apart are performed, followed by a return to the first 16-18 months and a second at 11-13 years.

There is no definitive protection against pertussis immunization is the best preventive measure for your child, but like the protection gained unfortunately it only lasts a few years, and the majority of adults is no longer protected against the disease. This is why it is recommended for parents to get vaccinated.