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Quieting the cough

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One of the hardest things to do as a parent is take care of a sick child. If there was a chance that you were the one that made them sick, it would be even worse.

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This year the diagnosed cases of whooping cough, or pertussis, could reach numbers unseen since the 1940s. Of the cases where the source was traced as many as 30-40 percent of children diagnosed may have contracted the disease from a parent. Eighty percent contracted it from others they came in close contact with.

For the average person a bout of whooping cough is as annoying as the common cold with a stuffed-up or runny nose, sneezing and fatigue. In fact, a person with pertussis may even seem completely fine, until they experience a sudden, violent coughing jag. But in infants and children, the disease, named for the high-pitched sound made as young victims try to catch their breath between coughs, can be deadly.

>> Staggering numbers

Nearly 18,000 cases of the disease have been reported across the nation already this year according to the U.S. Department of Health and Human Services Center for Disease Control and Prevention. Minnesota’s numbers are projected to reach as high as 3,400 cases. Reports by the CDC show 27,550 cases of pertussis were reported across the U.S. in 2010 and 3,350 of those were infants younger than 6 months old. About half of the youngest sufferers ended up hospitalized with pertussis and 25 children died. The CDC says up to two in 100 adolescents and five in 100 adults with pertussis are hospitalized or end up with other complications.

Essentia Health-St. Joseph’s Medical Center and Clinics have diagnosed a total of 48 cases of whooping cough from April through August.

The cough that characterizes the disease can be so harsh in small children that they can become bruised and vomit and if the coughing is violent enough it’s possible to break ribs. In extreme cases, a patient may be put on a ventilator to help them breathe.

For this reason, members of the medical community are working hard this year to spread the word that those needing the vaccination should get it to help protect those around them that are most vulnerable to pertussis.

>> Protecting our children

Stephanie Kubas, public health nurse at Crow Wing County Community Services Health Division, said the medical community is using a measure called “cocooning.” Even though pertussis isn’t as hard on adults, those that come in contact with infants and children such as parents, grandparents, daycare providers and others are encouraged to get the vaccination. Pregnant women also should be vaccinated. If they are given the shot around 20 weeks of gestation the timing offers optimal antibody transfer to the baby. Vaccinating a baby cannot be done for pertussis until they’re two months of age which would leave them unprotected from birth until then.

Pertussis is spread by the coughs and sneezes from an infected person and it is contagious for three weeks after contracting the disease.

After three weeks, or five days on the antibiotics, they can no longer pass on the disease. It is sometimes called the “100-day cough” and it can last that long. Testing for pertussis is easily done. The nasal passages of the patient are swabbed and sent to a lab for testing.

Current guidelines from the Minnesota Department of Health recommend that children get five doses of the vaccine DTaP. They are given at two, four, six and 18 months of age and again a final dose is administered as they enter school. But there is speculation now it might not be 100 percent effective as time goes on. There is a rise in reported cases in preteens which lead to recommendations for another booster which may be called for around 11 or 12 years of age. Kubas said this may account for the rise in numbers this year along with increased recognition by physicians, better diagnostic testing and more accurate reporting of diagnosed cases.

>> Who needs the vaccine?

“Routine recommendation is for any adult or adolescent who has never had Tdap that contains the pertussis, to get it,” says Kubas. “It doesn’t matter when you had your last dose of tetanus.”

The vaccine is available at local health care facilities. The Crow Wing County Services Health Division also offers clinics for underinsured children, uninsured and underinsured adults on the second and fourth Tuesdays of each month from 8:15 a.m. to 4:15 p.m. by appointment. Call 218-824-1098 or 877-724-1080.

■ SHEILA HELMBERGER is a freelance writer. She lives in Baxter and contributes to several publications.

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