the epidemiology clinical features and treatment of whooping cough ?  Epidemiology of whooping cough

. 38. Write down the epidemiology clinical features and treatment of whooping cough ? 
 Epidemiology of whooping cough :-
A. Occurrence :- Pertussis occurs worldwide. It usually occurs in endemic form. Occasionally epidemics may occur.
B. Ecological traid.
1. Agent :- Bordetella Pertussis.
2. Host :- (a) age: whooping cough occurs at all age but about 90% of cases are children under 5 years of age.
(b) Sex : Female children are more affected than mal children.
3. Environment : Whooping cough may occur throught the year, but more cases occur during winter.
C. Natural history:-
1. Reservoir (Source):- Human cases
2. Infectious material :- Nasopharyngeal and bronchi secretion.
3. Infectious period: 7 days after exposure to 21days after onset of prodromal symptoms.
4. Mode of transmission:-
-Droplet infection (mainly)
- Direct contact
- Contaminated fomites.
5. Incubation period :- 1-2 weeks.

 Clinical features :-
A. Catarrhal stage about 1 weeks :-
1. Fever
2. Watery eye.
3. Redness of eye.
4. Running hose.
5. Repeated coughing.
6. Unproductive cough.

B. Paroxysmal stage (1 to 4 weeks):-
1. Repeated distressing. spasmodic unproducted cough which  is end with an inspiratory “Whoop”.
2. Vomiting.
3. Swelling of the eyelids and may causes subconjunctival haemorrhage.
4. During cough the child may be cyanose.
5. Stress defication  and mixurition.
C. Convalsent stage (1-2 weeks) :-
1. Cough become less frequent and no distressing and short period.
2. Sputum become to productive cough.
 Treatment :-
1. Antibiotic :- Erythromycin 125-250 mg 6 hourly may reduce the severity of the infection if given during the initial stage.
2. Cough suppressant :- Methadone it may be helpful in controlling the severity of paroxysms.
3. Supportive care :-
(i) Adequate hydration and nutrition must be maintained.
(ii) Ventilation may be required.