Monday, October 3, 2011

Whooping Cough - What Do You Know?

Whooping cough is caused by the bacterium Bordetella pertussis.  Sometimes other bacteria can cause an illness like whooping cough. Bacteria enter the air passages and damage the lining of the windpipe and the main air passages in the lungs. The inflamed airways produce mucus, which then causes the irritating cough. The bacteria are passed from person to person by the infected mucus during coughing or sneezing.

Whooping cough (Pertussis)  is highly infectious.  It affects people of all ages, and is most severe in children. It was first recognised after an epidemic in Paris in 1578. It was then called the ‘dog bark’, the ‘chin’ cough or ‘kin’ cough, meaning ‘convulsive’ cough.

Whooping cough can be a life threatening infection in babies. In babies it can lead to apnoea (pauses in normal breathing), pneumonia, feeding problems and weight loss, seizures, brain damage and, in some cases, death. Older children and adults can get whooping cough too and pass it on to babies.

The disease causes sudden attacks of an irritating cough that often, but not always, end in a high-pitched whooping sound as the child takes a breath. Although immunisation has reduced its severity, it is still a common infection. Regular epidemics occur every in Australia 3 to 4 years. It is particularly severe in children less than one year of age. You can hear the sound of the whooping on the following .wav file.  It is quite distinctive:

Small Child With Whooping Cough (wav file) 

If your child contracts whooping cough and has not been vaccinated, he is more likely to develop pneumonia. A severe case of whooping cough or pneumonia could result in brain damage or death. If your child has never had the disease and has not been vaccinated against it, he is likely to get whooping cough if he comes into contact with the bacteria. Whooping cough is also dangerous in elderly people, but does tend to be less severe in adolescents and adults.

Whooping cough is spread when an infectious person coughs bacteria into the air which can be inhaled by people nearby. If they are not treated early, people with whooping cough are infectious in the first three weeks of their illness.
Whooping cough spreads easily through families, childcare centres and at school.

The symptoms of whooping cough commonly develop about 7 to 10 days after exposure to the bacteria, but can occur any time from a few days to a few weeks. Whooping cough symptoms can be divided into 3 stages. The cough commonly persists for up to 3 months.

  • Whooping cough usually begins like a cold with a blocked or runny nose, tiredness, mild fever and a cough.
  • The cough gets worse and severe bouts of uncontrollable coughing can develop. Coughing bouts can be followed by vomiting, choking or taking a big gasping breath which causes a "whooping" sound. The cough can last for many weeks and can be worse at night.
  • Some newborns may not cough at all but they can stop breathing and turn blue. Some babies have difficulties feeding and can choke or gag.
  • Older children and adults may just have a cough that lasts for many weeks. They may not have the whoop.
Anyone can get whooping cough. People living in the same household as someone with whooping cough are especially at risk.  Immunisation reduces the risk of infection but immunity fades over time. You can still get whooping cough even if you've been immunised.

Whooping cough vaccines provide good protection from infection but immunity fades which means that boosters are needed.

Babies need to be immunised at 2 months, 4 months and 6 months (Australia). The first dose can be given as early as 6 weeks of age.
Getting your baby vaccinated on time gives them some protection when they are most at risk of severe illness.
If your baby's vaccines are overdue, see your GP now to catch up.
A whooping cough booster is needed at 4 years of age.
In the UK, children are vaccinated against whooping cough at two, three and four months of age, and again before starting school at about three years and four months of age.)

A booster for adults is recommended for:
Both parents when they are planning a pregnancy, or just after the baby is born
Other adult household members, grandparents and carers of infants under 12 months of age.
Adults working with young children, especially health care and child care workers. For a limited time, a free booster is available from GPs for new parents grandparents and carers of babies under 12 months.

If you are a close contact of someone with whooping cough:
If you have been exposed to someone with whooping cough early in their illness while they are infectious, watch out for symptoms and see your doctor if you get a new cough.

Some babies and some pregnant women need antibiotics to prevent whooping cough infection if they have had significant contact with an infectious person.

How is whooping cough diagnosed?
Your doctor may ask about your symptoms and whether there you've had any contact with whooping cough. If your doctor thinks you have whooping cough, a swab from the back of the nose or throat can confirm the diagnosis. (I think it is a great idea to video the cough to show the doctor.)

How is it treated?
Some babies may need treatment in hospital or in intensive care.
Antibiotics are used to treat whooping cough in the early stages and can help prevent spreading whooping cough to others. People who are not treated early with the right antibiotics can spread the infection in the first 3 weeks of their illness. After 5 days of antibiotics, you are normally no longer infectious.

The cough often continues for many weeks, despite antibiotics.
Infectious children are restricted from going to pre-school and school. Un-immunised contacts may be excluded from child care unless they take the special antibiotics.


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