Notes on clinical findings, mode of transmission and prevention of Whooping Cough

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Definition:

It is an acute infectious disease of a very distressing nature, caused by a micro-organism. It is a disease of respiratory tract followed by severe attacks of coughing frequently ending in a whoop.

Mode of Transmission:

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It is a disease of the child­hood and mostly occurs between the ages of 2 to 10 and highest below the 5 years. Adults and old persons rarely suffer from it. It is prevalent in all the countries of the world but is less severe and fatal in tropical countries.

The infection is spread in fine droplets produced during cough­ing, sneezing or speaking and by direct contact with the patient.

Incubation Period:

Incubation period is from 5 to 15 days but not more than 3 weeks.

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Clinical Features:

The course of the disease can be divided in to three stages. In the Preliminary stage the Paroxysmal stage and the Convalescent stage. The preliminary stage begins like an attack of cold with some fever, running from the nose and cough. This lasts for a week or 10 days.

During the next stage the cough becomes mere violent, more frequent and longer in duration and during which period no air enters in to the lungs. The chief feature of this stage is a series of short spasmodic coughs followed by a crowning noise or “whoop.”

The child looks distressed, the face becomes blue, eyes prominent and the face is covered with perspiration. This is often followed by vomiting, especially, if occurs after food. Ordinarily, this stage lasts for 2 to 3 weeks but may be prolonged to as many months. During the third stage the cough becomes less frequent and milder in character.

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In severe attacks vomit­ing is very frequent and the patient does not want to take food and becomes physically weak. Sometimes bleeding takes place from the nose, mouth or under the conjunctiva. One attack gives immunity for life and second attack is very rare.

Protections:

An effective vaccine is now available for protection against whooping cough. The vaccine is given intramuscularly in 3 doses of 1 ml. each, about the third, fourth and fifth months of life, followed by booster dose of 1 ml. at the age of 2 and 5 years. Now a day’s ‘Triple vaccine’ is introduced which gives simultaneous protection against Whooping cough, Diphtheria and Tetanus.

Prevention:

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The patient should be kept in a well ventilated room, but should not be confined to bed unless there is fever. He should be protected against cold by adequate clothing. , physical exertion and mental excitement should be avoided. Vapor preventing its spread in one’s own home, the patient should be treated in the hospital or in an isolated room. The discharges from nose and throat should be disinfected properly.

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