Although children have been vaccinated, sometimes whooping cough is not uncommon, especially in small babies before vaccination. **Symptoms are atypical, most of them are not timely**, and it is easy to transmit to children. Pertussis is transmitted through close contact with respiratory droplets, and if infected with whooping cough, it is contagious at the end of incubation, and is most contagious for the first 1-3 weeks, and can last for 6 weeks after the onset of symptoms.
After pertussis infection, the incubation period is 5 21 days, generally 7 14 days; The catarrhal phase can last for 1 2 weeks, and this period is the most contagious, manifested as symptoms of upper respiratory tract infection such as runny nose and sneezing, and the cough gradually worsens into the cramp phase; The spasmodic cough period can last for 2 to 6 weeks, and some can last up to more than 2 months, which is manifested as paroxysmal spasmodic cough, accompanied by a "rooster" roar at the end of the cough, and some patients can cough up mucous sputum, and the symptoms of cough at night are more obvious; Newborns and young infants often have inconspicuous cough symptoms, and can directly appear cyanotic, bruising, apnea and even heart rate drops. During the convalescent period, the intensity of persistent cough gradually decreases, the number of episodes gradually decreases, and the chirping-like symptoms gradually resolve, and paroxysmal symptoms can last for weeks to months.
Routine blood tests may show a marked increase in white blood cells, but the proportion of lymphocytes is usually predominant, which sometimes needs to be differentiated from Epstein-Barr virus infection. Bordetella pertussis culture is the diagnostic criterion, positive and infectious, the culture cycle is 5 to 7 days, and the positive rate of catarrhal phase and early culture of spasm is higher. It can also be used for specific nucleic acid detection, which has high sensitivity and specificity, and the positive rate is high within 3 weeks of onset, and the detection time is relatively short; Pertussis IgG antibody serology is suitable for retrospective diagnosis, and the convalescent antibody titer is 4-fold or more elevated than that in the acute phase.
* Macrolides are preferred; It should be noted that all kinds of stimuli may induce whooping cough cramps, try to maintain a relatively quiet environment and avoid unnecessary stimuli, such as pungent odors, laughter, strenuous activities, etc.; When small infants have a spasmodic cough, it is necessary to avoid choking and inhaling.