This week, the infection ward suspended its preparations for Ebola hemorrhagic fever and reintroduced patients. Today, a 40-day-old infant with pertussis was admitted, and I wanted to re-edit my thoughts on the gradual increase of pertussis written six months ago to remind everyone of it.
1. Etiology: Pertussis is a serious potentially fatal disease caused by the bacterium Bacillus pertussis. The symptoms appeared 20 days after birth and were most severe a week ago, with generalized bruising and other signs of asphyxia.
Complications of pertussis include encephalopathy, pneumonia and apnea, convulsions, and death, especially in small infants who are prone to life-threatening asphyxia due to spasmodic coughing.
3. Pertussis fever is not high, often low, and many children do not even have a fever at all (perhaps with a low fever that parents do not notice), and coughing symptoms worsen after the fever subsides, especially at night when the cough is intense.
4. Antibiotics can reduce the symptoms of spasmodic cough in the early stage, but most patients have already entered the spasmodic cough stage when they are diagnosed.
5. Vaccination is recommended for all children, and vaccination for older children and adults is recommended for booster immunization. We often neglect to vaccinate adolescents and adults against pertussis, especially pregnant women, families caring for babies, baby-sitters, etc. The mother of the child with today’s income had a violent cough a week before delivery, and it is considered that the mother-to-be infected with pertussis infected her newborn, so it is recommended that pregnant women be vaccinated against pertussis, and other family members who are prepared to care for the baby, such as dads, grandparents, and grandma and grandpa should be vaccinated against pertussis (a bit difficult).
6, laboratory tests: routine blood white blood cells will be significantly higher, mainly lymphocytes, the proportion of lymphocytes up to 60% or more.
7, again: pregnant women over 20 weeks gestation are recommended to be vaccinated again if they are not sure that they have been vaccinated against pertussis in the last 10 years, and family members who may come into contact with the newborn are also recommended to be vaccinated, otherwise it is easy to transmit pertussis to the newborn through family members.
8. Clarithromycin (for infants ≥1 month, 7.5mg/kg BID, maximum dose 1g/day, 7 days) or azithromycin (for infants <6 months, 10mg/kg, once daily, 5 days. 6 months, day 1: 10mg/kg, days 2-5, 5mg/kg. maximum dose 250mg daily) is preferred for treatment. 9.Sedation with Valium, Phenobarbital, etc., hormones and immunoglobulins can be used to relieve symptoms if the cough is severe, ventilator assisted ventilation can be considered if there is a risk of asphyxia, and extracorporeal membrane lung therapy (ECMO) can be considered if there is respiratory failure. 10. Infected patients should be isolated until 40 days after the disease, and close contacts should be observed for 3 weeks.