Houston Area Pediatric Specialists

Independent pediatric specialists aim to serve our community. We want to share news and analysis regarding our specialties and our practices.

Thursday, April 19, 2012

Whooping Cough - An Under Recognized Cause of Prolonged Cough

Whooping Cough Scare In Middle School

Most kids vaccinated, but many adults are not
    Pertussis, the highly infectious bacterial disease also known as whooping cough, has made an appearance at the East Hampton Middle School, where one case was reported last week. A letter from the Suffolk County Department of Health was almost immediately put up on the East Hampton Union Free School District’s Web site, and was given to staff and parents at all the schools in the East Hampton system.
    Dr. Gail Schonfeld of East End Pediatrics said on Tuesday that she has diagnosed four cases in the last three weeks, including a 3-month-old infant who was admitted to the hospital but eventually recovered.
    Most children have been vaccinated against the illness, and the vaccine is reported to be 95 percent effective. However, when a child, particularly a baby, gets infected with pertussis, the results can be very serious and sometimes fatal.
    Pertussis is spread through the air by the cough of an infected individual. A course of antibiotics is usually helpful, while cough syrups and elixirs are not.
    According to the Suffolk County Department of Health, in a letter that is posted on the East Hampton School District’s Web site, “A person with pertussis is infectious for 21 days from the start of the cough or until he/she has been on five full days of appropriate antibiotic therapy. Children and adults may be susceptible and still develop pertussis even if they are up to date with their vaccinations, as immunity to pertussis wanes over the years.”
    Whooping cough earned its name by the distinctive whooping sound made by someone with the illness as they attempt to draw in breath. “In between coughing fits, a patient could feel pretty good,” Dr. Schonfeld said. “But when they start coughing, they can’t stop. There is really thick mucus that blocks the airways, so there is a feeling of not being able to breathe.”
    Patients with pertussis often have other cold-like symptoms: fever, nausea, a runny nose. But it is the whooping and gasping for air that are the surest signs. In other countries, it is sometimes known as the “100-day cough.”
    According to the Web site for the World Health Organization, in 2008, 16 million people were affected worldwide and 195,000 children died from the illness.
    “Pertussis has been with us a long, long time,” Dr. Schonfeld said on Tuesday. “Only 10 percent of the cases were diagnosed until recently, but now we have a test that’s fairly accurate.” The test involves a “skinny little Q-tip” being inserted way back in the throat. “It’s not a really pleasant sensation,” she said.
    Up until 2005, she continued, there was no vaccine approved for children over 7 years old. Therefore, many adults could have the disease without knowing it. “If a cough lasts for more than a month in an adult, one-third of the time it’s pertussis,” Dr. Schonfeld said. Only a small percentage of adults in the U.S. have been vaccinated, but there is currently a campaign in progress to encourage adults — particularly those who spend time around a newborn — to get immunized.
    Another unpleasant fact: Getting pertussis once does not bring immunity to the illness. “You can get it more than once,” Dr. Schonfeld said.

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