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Saturday, January 22, 2011

A Family Doctor's Tale - WHOOPING COUGH

DOC I HAVE WHOOPING COUGH

Whooping cough or pertussis is rare now a day since the introduction of the vaccine to all children.

However the vaccine may have some side effect such as seizures in some children.

However a recent acellular vaccine for pertussis has reduced this risk considerably.


Whooping cough is an acute infectious childhood disease of the respiratory tract caused by the bacillus Bordetella pertussis.



Whooping Cough is transmitted by droplets from coughing spells.

It is highly infectious.

The early stage when it appears to be a cold is the most infectious period.

Most infections occur in children under six years of age.

One attack usually confers immunity



The incubation period is usually 10 - 12 days after contact with an infected child.

Symptoms start off with:

1.an ordinary cold (runny nose, sneezing, cough, fever) for 1-2 weeks followed by:

2.uncontrolled coughing that can last 1 - 2 months.

Cough persists and become paroxysmal ending in a noisy inspiration "whoop" sound causing the child to go blue and vomit.

Between the spasms of coughing the child seems relatively well



The worst affected are children below the 1 year old.

Some serious complications are:

1.pneumonia,

2.seizures,

3.brain damage

4.nose bleeds

5.death can occur during the severe coughing stage.

Serious complications are less with older children or adults.

Adults rarely get whooping cough because their immunity from vaccination usually last 10 years after the last dose.

When adults get whooping cough, a prolonged, irritating cough may be present instead of whooping type of cough.

Treatment of Whooping Cough:


Antibiotics (erythromycin) are used in the treatment of Whooping cough.

Once severe coughing has begun, antibiotics are less effective. They can reduce the duration of the illness and stop the spread to others.

Family members should be treated once there is an infected person.

Tetracycline is used if the patient is allergic to erythromycin but should avoided in children because of the staining of the teeth.

Besides antibiotics, the following will help:

1.Steam inhalation

2.cough mixtures

3.oxygen therapy

4.avoid smokes,  dust,  dry air, sudden temperature change



Vaccination against whooping cough is the best prevention .

Since vaccination began, the worldwide incidence of whooping cough has declined.

Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.

There is a booster vaccination at 18 months.

In very rare cases (1 in 100,000 cases), there has been serious reactions such as seizures to the whooping cough part of the vaccination.

Recently, an improved acellular pertussis vaccine is now available. There are fewer side effects such as high fever and seizures with this new vaccine.

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