Tuesday, December 14, 2010

Whooping Cough

"We are eager to tunnel under the Atlantic and bring the Old World some weeks nearer to the New; but perchance the first news that will leak through into the broad, flapping American ear will be that the Princess Adelaide has the whooping cough." - Henry David Thoreau
Many years ago my sister lived in Watertown, NY, on the north-western edge of the state near the Canadian border. I'm glad she's not living there now since this region is experiencing an epidemic of Whooping Cough with some 300 cases to date.

Whooping cough, formally called Pertussis, is a highly contagious bacterial disease that causes uncontrollable, violent coughing. It is spread through the air by tiny droplets when a patient coughs or sneezes. The coughing is extreme and can make it hard to breathe; often a deep "whooping" sound is heard when trying to take a breath. It is a serious disease and the infection usually lasts 6 weeks.

Pertussis used to kill 5,000 to 10,000 people (usually children & infants) in the United States each year. Now, a vaccine has reduced the annual number of deaths to less than 30. But today parents are skipping the vaccine and the disease is returning. In 2004 the number of whooping cough cases spiked past 25,000, the highest level it's been since the 1950s.

Whooping cough begins like the common cold about a week after exposure. But 10 to 12 days later the coughing fits begin, they can last for more than a minute, and the patient may turn red or purple from lack of air (the "whoop" is a desperate gasp to breath!) Vomiting may also result from a coughing fit. Fits usually occur in groups, with multiple episodes every hour around the clock.

These extreme symptoms can be fatal with infants who rarely "whoop". Instead they gasp for air with a reddened face and may actually stop breathing for a few seconds during particularly bad spells or they may choke on vomit.

Treatment - antibiotics such as erythromycin are effective if Whooping cough is caught early BEFORE the coughing begins, but when diagnosed too late, the antibiotics will reduce infectiousness but not the symptoms. Infants younger than 18 months need to be monitored to ensure breathing and may need to be hospitalized. Curiously, cough mixtures, expectorants, and suppressants are usually not helpful and should NOT be used. Most cough mixtures loosen the mucus in the lungs to encourage coughing - with whooping cough the patient is already coughing too much and too frequently so the last thing you want is more coughing.

During recovery, let your child rest in bed and use a cool-mist vaporizer to help soothe irritated lungs and breathing passages. Be sure to follow directions for keeping it clean and mold-free. In addition, keep your home free of irritants that can trigger coughing spells, such as aerosol sprays, tobacco smoke, and smoke from cooking, fireplaces, and wood-burning stoves.

Kids with whooping cough may vomit or not eat or drink much because of frequent coughing. So offer smaller, more frequent meals and encourage your child to drink lots of fluids. Watch for signs of dehydration, too, including thirst, irritability, restlessness, lethargy, sunken eyes, a dry mouth and tongue, dry skin, crying without tears, and fewer trips to the bathroom to urinate (or in infants, fewer wet diapers)

Bottom Line

During a pertussis outbreak, unimmunized children under age 7 should not attend school or public gatherings, and should be isolated from anyone known or suspected to be infected. This should last until 14 days after the last reported case. Remember that the first symptoms do not appear for a week to 10 days and two weeks for the severe coughing. In rare cases it can be 21 days from infection to symptoms. So people may be infected and not know it.

All children should be immunized before the sixth birthday and given a booster shot between ages 11-12.


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Blogger swedemom said...

Outbreaks of whooping cough are precisely the reason I choose to vaccinate my children. I find the small risks of vaccines to be so small in comparison to the real problems of the diseases themselves.

December 15, 2010 at 7:44 PM  

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