Pertussis: What's All the Whoop-La?
oral polio vaccine. My first cousin contracted polio about that same time. His mother did not get him vaccinated.
About 1976, we were at a historic low of only 1,010 cases, but the number of cases of pertussis began to rise again. People were either not vaccinating their children again, the original vaccination was wearing off, or we were getting better at diagnosing it. The number of cases usually teetered around 8,000 reported cases for the entire country, but in 2004, we had nearly 26,000 reported cases. In a country as large and populous as the United States, this may not sound like a large number, but when hundreds of cases show up at once at a college campus or school, people take notice.
Keep in mind that 26,000 are only the reported cases. Since pertussis is so variable in its clinical presentation and notoriously difficult to diagnose, some experts estimate that the actual number may be as high as a million cases! That's a lot of missed diagnoses. Since medical providers do not see very many cases, they fail to consider it when you have a patient that has been coughing their heads off.
There are hundreds of medical illnesses and conditions that can cause a cough. You may be coughing and hacking right now, but that does not mean you have whooping cough. Whooping cough got its name from the very loud and forceful "whoop" sound that it causes in SOME people. However, it is really NOT common for adults or infants younger than three months to have this classic whoop sound. (Hence, one of the reasons for the missed diagnosis).
Other than the characteristic whoop, that may or may not be present, the initial symptoms are medically indistinguishable from a simple cold (runny nose, sneezing, mild fever, and a mild cough). A few days to a week or so later, the person enters the coughing stage. The entire disease can last 6-10 weeks. The harsh cough is often accompanied by sweating, exhaustion, or coughing so hard that the person vomits. Many adults experience headaches, sore throat, and shortness of breath. The most common complication is pneumonia, especially in infants.
The diagnosis can be made by culturing the nasal/lung secretions, or by special testing (polymerase chain reactions or serology). The culture is consider the gold standard, but labs must be specially set up to do this procedure, and obtaining the painful, deep nasal swab is challenging to say the least, both for the provider and the patient. The other tests are easier, but not as accurate.
Unlike the high death rates in the pre-vaccination era, pertussis can be effectively treated with antibiotics, like erythromycin or Zithromax. Like many illnesses, it is much better to prevent it in the first place.
This is the Whoop-la. Pertussis can be a killer. Although modern antibiotics will most likely keep it from becoming the number one killer of kids again, it is not a disease we should ignore.
Be Wise...Immunize
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6 Comments:
I'm starting to think I have had Whooping Cough.
I vaguely remember when I was in 6th grade, having a whopper of a cold. I lived with my father who was a drug addict and never home, so I never did see a doctor.
I don't really remember running a fever much or feeling "sick" after the first week or two, but for well over a month I remember the extreme coughing and how embarrassing it was in class. I tried to stop, but couldn't. I'd have coughing spells lasting for 15 minutes or more, where I'd cough so hard that I threw up or couldn't catch my breath.
Maybe it was, maybe not. Dunno. When I look back on it, it still amazes me that my father never even thought to take me to the doctor or that the teachers at school never said anything when it was obvious I was very ill when it went on for about a month in a half.
Has anyone done any research into whether or not our "illegal alien" friends are a major source of the return of pertussis--along with various-and-sundry other diseases we in the developed world had "wiped out"?
Unimmunized vistors or immigrants can cause the spread of diseases, but the main underlying culprit is that our population is still under-immunized, and the old pertussis vaccine is wearing off sooner than anticipated. Children should be re-immunized again against pertussis at age 10-11.
I'm going to have to agree with Jeff H on this one. I think our "non-immunized" foreign friends are the culprit in a lot of these strange bugs coming back to haunt us. I've been just diagnosed with Whooping cough, and I'm miserable. I can't imagine how I picked this up rather than to say the local children at school need to be properly immunized---if not just for the protection of the children but for the protection of our nation.
Part of the issue of not getting the vaccine has to do with reactions to it. Every parent who takes their child in for this vaccine has to sign a disclaimer that says something like "one in every 300,000 people getting this vaccine has a severe reaction, like seizures, death etc etc, there are other reactions which can include crankiness, fever, swelling at site, etc. The disclaimers have changed over the years. The disclaimers I was shown for my 16 yr old in 1991 were different than the ones I saw for my 2 yr old in 2005. I realize one in every 300,000 is a small amount but my brother was one of those. He had an immediate reaction to the vaccine at 7 weeks and the doctor said it was normal. He started to run a fever and stopped breathing later on that evening. He is now paralyzed on one side, brain damaged and only progressed to about the age of 12. He is over 40 yrs old now, still lives at home and needs an aide to help him do every thing from dress, clean himself, eat etc and never will be able to live alone. I also had a first cousin who had a reaction. Several years after he got the vaccine the government came out with a fund for children who had reactions from this vaccine. Since this came out much later than he had his reaction and the doctor didn't have those records any more my parents couldn't apply for this assistance. None of my 4 children or my sister's 2 children get the vaccine. It isn't required by the school districts in any state that we have lived in. I do inform the school nurse at every school they attend that if someone comes down with whooping cough I need to be informed. I got all the vaccines and still got whooping cough in my late teens about 25 yrs ago. Also my children get every other vaccine the doctor recommends. It isn't worth the chance. My brother was born completely healthy and strong and in the matter of a second that was all taken away from him. What could he have been, what could he have done with his life, could he have been the one who found the cure for a major disease or solved world hunger or found the answer to world peace. What a heart sorrow my parents have lived with for a temporary vaccine. I think I'll take the chance and not give it to my children.
My child had Grand Mall seisures for almost two years because of this vaccine.She was kept on anti-seizure medication for almost all of that time.Her infancy was spent in a haze because of the medication.Seroius vaccine reactions do occur-BEWARE!!
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