Vaccines

WINTER WARNING ABOUT WHOOPING COUGH

By Dana Sullivan

First the good news: The vaccine against whooping cough, also called pertussis, is very effective and has dramatically decreased the overall incidence of the life-threatening illness in this country.

Now, the bad news: According to the Centers for Disease Control, the disease is on the rise. Since the 1980s, the number of people who have contracted whooping cough has risen steadily. Between 5,000 and 7,000 people in the United States still contract the disease each year (which is down from the hundreds of thousands who got it before the vaccine was created), and an average of five to 10 children die from it. The deaths tend to occur in children who are unvaccinated, either because their parents choose not to vaccinate, or because they are so young they haven't yet received their primary immunizations. Infants under one year are at the greatest risk of contracting the illness.

Whooping cough, caused by the bacteria Bordetella pertussis, is an infection of the respiratory system. The bacteria get into the lining of the breathing passages, causing inflammation and narrowing the airways. The disease starts out with symptoms like a common cold -- runny nose, sneezing, red and watery eyes, mild fever, and a dry cough -- which last for one to two weeks. If you're worried that your child's cold is something more serious, here are some signs to watch for:

• A dry cough that becomes wet, and may include coughing up stringy mucus
  
  
• Coughing spells that last for as long as a minute, with deep inhalations between coughs
  
  
• Signs of shortness of breath, including a bluish tint around the mouth and fingertips
  
  
• A cough that includes a "whooping" sound (though some infants don't make this sound)
  
  
• Teary eyes, drooling or vomiting following a coughing spell

If you notice any of these symptoms, call your pediatrician immediately. If your child is diagnosed with pertussis (to make the diagnosis, your pediatrician will take a swab from her nose and have the cells tested for the bacteria), she will most likely be given antibiotics, and may be admitted to the hospital where she will be observed, and possibly given fluids and oxygen, depending on the severity of her illness.

The disease is very contagious since it's spread through coughing and sneezing, so it's a good idea to keep your infant away from anyone who has a serious cough, just in case. The disease is rarely life-threatening for adults, and the best defense against it is immunization (although the vaccine doesn't provide 100 percent protection). Pertussis is the "P" in the DTaP vaccine and is typically given at 2 months; two more doses are given before the first birthday, and a fourth is administered at the 15-18 month check-up; a fifth dose is recommended at 4 to 6 years.

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• Pediatric Nutrition: William J. Klish
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