Abstract □ 71

Children's suscebtibility to whooping cough reaches 90-100 per cent but vaccination prevents from this disease. Meanwhile this infection is very dangervus for babies of the first three months who aren't vaccinated still. The disease in them can be manifested not only by attacks of cough, but by life-threatening episodes of breath arrest (apnea), grave pneumonia, atelectasis. Brain hipoxia, haemorrhages occurring during attacks of cough, may condition encephalopathia resulting in camps or ever in cerebral coma.

Infants are usually infected with this disease by elder family members. Literature data indicate that vaccination from whooping cough ensure immunity up to 15 years. Later on cases of this disease are possible even among vaccinated persons, but they are mild. Only a certain contingent of not vaccinated children remains epidemiologically dangerous.

In 1998 10 infants of age from 25 days to 4 month, still not vaccinated from whooping cough, were treated at Kaunas District Infectional Hospital. 9 babies had contact with persistently coughing family members. They were parents in 5 cases and older brothers or sisters - in 4 cases. In a single case only no contact was found. In 9 infants the disease started with subfebrile fever and cold, cough was becoming more and more intense. One baby was in a fever up to 39 degrees Celsium at the beginning of his disease. Catarrhal stage of the disease lasted for 6 to 14 days. Acute viral respiratory infection was diagnosed for all infants. The idea of whooping cough was caught only after occurrence of cough attacks characteristic of this disease. Thus all the infants were hospitalized in a convulsive stadium of the disease. 4 of them were admitted to the intensive care department 3 infants were ill with grave form of the disease there used to be more then 10 cough attacks with reprises and apnea episodes per twenty-four hours. In 6 infants the disease took a moderate course: Hure used to be less than 10 cough attacks with reprises per twenty-four hours. There was one case of mild illness: cough attacks were rare, without reprises. Pneumonia developed in 3 patients. Leucocytosis (16,3- 47,2- 109/l) and lymphocytosis was established in blood of all the patients. Patients were treated with erytromycin, ampicillin, gentamicin, cephazolin, mandol, antispasmotics, oxyden through a mask during an attack of apnea. Artificial lung ventilation was performed in one case. We present the date of this patient.

Patient R.K., 25 days of age, had been coughing at home for seven days. He had been treated with ospamox, penicillin. After admission to Kaunas District Infectional Hospital cough attacks were rare. Leucocytosis (20,6.109l) and lymphocytosis (84%) were established. It was found out that both parents of the infant had been coughing for a long time. Whooping cough was diagnosed the patient was treated with ampicillin, prednisolon. A week later the patients mother took him back home. On the next day an attack of apnea occurred at home and the infant in a serious condition was admitted to the intensive care department of another hospital. Attacks of apnea were taking place repeatedly with bradycardia developing developing during them. As soon as clinical death occurred, artificial lung ventilation was performed and continued for 5 days. The infant was treated wit zinacef, mandol, cephazolin, mucolytics and infusion therapy.

The described case is instructive in the fact that whooping cough in infants is dangerous of apnea episodes capable of cousing clinical death. Informs ought to be treated in a hospital up to their full recovery.