Friday, December 27, 2013

Pertussis

Contributed by  Betsey Miller, CRNP, PinnacleHealth Medical Group

I was lying awake, listening to my son cough – again. How many nights had it been?  I was trying to count them up in my head and remember when his cough had first started.  Had it been two weeks or three? My thoughts were interrupted by another coughing fit.  I went in to check on him.   He was sitting up now, gasping for air in between fits of coughing.  Tomorrow, I promised myself.  Tomorrow I would call for an appointment. 

When it comes to my kids, I’m a mother first.  But I’m also a family nurse practitioner.  And as I settled us both back to bed that night the list of possible diagnoses were running through my head.  As I thought about his coughing fits and the length of time he’d been coughing, I couldn’t help but consider pertussis as a possibility.

Pertussis, also known as whooping cough, is a highly contagious illness, characterized by severe coughing fits that can last for weeks.  It can be hard to detect initially, because its early symptoms are not unlike those of a common cold – runny nose, mild cough, low grade fever.  But as the disease progresses the coughing fits become more pronounced.  And the cough can last for up to 10 weeks!

Pertussis has made a resurgence in the last few years.  There are a number of reasons behind this, but the driving force has been a decreased immunity in our overall population.  Our children get immunized against pertussis as part of their routine immunization series as babies, but it is a series of immunizations, and they are not considered to be fully protected until they have completed the series at age 5.  Even then, no immunization is considered 100% perfect. However, studies have shown that immunization lessens the spread of the illness significantly.  Additionally, persons who become infected who were previously immunized have shorter courses of illness and do not become as sick.  

Because adults are more likely to transmit the illness, and because infants are the most susceptible, it is recommended that all caregivers of infants be updated with a Tdap vaccine.  Pregnant women are often offered this vaccine in their third trimester, or in the hospital shortly after delivery.  But other caregivers including fathers and grandparents should consider getting immunized too.  Pertussis infection in an infant can truly be a life threatening situation. 

As an adult, if you’re due for a tetanus shot, you should check to see if you need a pertussis booster.  If so, instead of getting just a plain tetanus shot (Td), you should consider getting an injection with pertussis (Tdap).  Remember, this will not only help to protect you from getting whooping cough, but it will also protect those around you. 

As for my son, I did take him to his primary care provider the following day.  He had a culture for pertussis, but thankfully it came back negative.  A chest xray showed pneumonia, but after a short course of antibiotics, he’s no longer coughing and is back to his old self!


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