"Cough should last for a hundred days?" "Isn't it a child's disease?" "Pertussis sounds terrible." Recently, pertussis related topics have been frequently searched, and many netizens are full of worry in their messages. How is whooping cough diagnosed? What are the typical symptoms? How to treat its "comeback" scientifically? In response to these hot issues, the Beijing News reporter invited Li Dongzeng, chief physician of the Department of Respiratory and Infectious Diseases of Beijing You'an Hospital affiliated to Capital Medical University, Wang Tiancheng, deputy chief physician of the Department of Neonatology of Beijing Shijitan Hospital affiliated to Capital Medical University, and Ding Mingming, chief physician of the Department of Pediatrics of Peking University People's Hospital, to answer them.
How to diagnose clinically?
Li Dongzeng: Nucleic acid diagnosis is the first choice for the diagnosis of whooping cough, but at present most hospitals have not carried out this test. Many hospitals make clinical diagnosis, and doctors will make diagnosis based on clinical symptoms and blood routine tests of patients. The blood routine examination of the patient is characterized by the increase of white blood cells and lymphocytes. If the diagnosis is to be confirmed, pathogen detection is required. If the nucleic acid or antibody of pertussis is positive, the diagnosis of pertussis can be confirmed.
What are the main symptoms?
Wang Tiancheng: At the initial stage of infection, whooping cough may show symptoms similar to common cold, such as runny nose, fever, sore throat, etc. These symptoms usually last for one to two weeks before typical cough symptoms appear. The typical cough symptoms are severe cough, sometimes continuous cough for several minutes, cough attack may lead to dyspnea and vomiting; The cough of whooping cough is usually described as having the sound of "inspiratory cock crowing" or "dog barking", which is caused by the spasm of trachea and bronchus; Cough attacks may cause dyspnea, especially in infants and young children; Coughing is usually more frequent at night and may disturb sleep.
Must cough for 100 days?
Ding Mingming: whooping cough is just a concept, not necessarily cough for 100 days. The average onset time of the disease is two months or even 100 days, but it varies from person to person. Some patients recover in one month. Pertussis often needs to go through three stages of "catarrhal stage - spasmodic cough stage - recovery stage" before it can be relieved. In catarrhal stage, symptoms of upper respiratory tract infection such as runny nose, sneezing, paroxysmal cough, fever, etc. can last for 1-2 weeks; The spasmodic cough stage is characterized by paroxysmal spasmodic cough, with inspiratory roar at the end of the cough, repeated for many times until mucus sputum is coughed up, which generally lasts for 2-6 weeks. During the recovery period, the spasmodic cough continued, but gradually tended to ease, the cough intensity weakened, and the number of attacks decreased, lasting about 2-3 weeks.
How should parents deal with children with serious complications?
Ding Mingming: If the child has serious complications, such as hypoxia, convulsion, lethargy, pulmonary hypertension, pneumonia, vomiting, etc., the parents should try to keep calm. If there is an oxygen inhaler at home, they should help the child inhale oxygen as soon as possible, and call 120 at the same time. If vomiting occurs, keep the child's head side to side to avoid aspiration again after vomiting.
Why is it still infected after DPT vaccination?
Wang Tiancheng: DPT vaccine cannot completely prevent whooping cough. DPT vaccine is mainly used to prevent diphtheria, tetanus and pertussis, but its protective effect on pertussis is limited and may gradually weaken over time. Therefore, even after vaccination, infection can not be avoided 100%, but vaccination can reduce the disease condition and mortality.
Why does it change from young children to older children and adults?
Li Dongzeng: At present, the protection period of pertussis vaccine is relatively short. Previously, the whole cell vaccine had a long protection period, but the side effects were large. Later, most countries changed to cell-free vaccine, which has high safety and few side effects, but the protection period is short. Generally, the protection of the vaccine will decline after three to five years. Therefore, teenagers become susceptible groups. In addition, in the past, whooping cough mainly depended on clinical diagnosis. Infants' cough was a typical spastic cough, which was easy to make clinical diagnosis. However, many children and adults with whooping cough had no typical spastic cough and were often missed diagnosis. In recent years, with the increasing awareness of doctors and the public about whooping cough and the development of detection technology, nucleic acid detection and antibody detection have emerged, so the proportion of older children and adults diagnosed has increased.
How to treat pertussis "comeback" scientifically?
Li Dongzeng: The rising infection rate of pertussis is a common problem facing the world. People should think about how to better prevent diseases and develop vaccines with high safety and good effect. In fact, the case fatality rate of whooping cough is very low, which is the most harmful to infants. Family members should improve their awareness of prevention. Once a family member has a cough, they should take good precautions and keep away from children.
Beijing News reporter Zhang Zhaohui
Checked by Jia Ning
Original title: Why can you still be infected with pertussis after vaccination? How to treat its "comeback" scientifically?
