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Body & Spirit

Bali Advertiser

09 February - 23 February, 2011


Whooping Cough again! If you thought Whooping Cough (Pertussis) was one of those diseases from the deep dark ages that we don’t see anymore, think again. I have heard of several cases of whooping cough this week. Whooping cough is alive and thriving. Even in the UK, a recent study showed that nearly 40% of school aged children who had a cough lasting for more than 2 weeks had whooping cough, even when most of them had been immunised against whooping cough. Immunisation against whooping cough works well in protecting babies and young children (it is part of the routine baby vaccine schedule), but the effect wears off over the years. Preschool children and teenagers still need to receive booster vaccines against this disease. Whooping cough is an infection of the nose and throat and lungs which causes long bursts of coughing. In young children the coughing spell often ends in a ‘whooping’ noise when the child can finally take a breath in. Children can have several coughing spells each hour, including while they are sleeping. They can also go on having coughing spells for many weeks (up to about 3 months for some). Very young babies, older children and adults can have whooping cough without the ‘whooping’ sound. What is whooping cough? • Whooping cough is an infection caused by a bacterium, Bordetella pertussis. Outbreaks of whooping cough were first described in the 16th Century. • The coughing spells seem to be caused by thick mucous, which is difficult to cough up. • Pertussis kills about 250,000 children worldwide each year. Nine Australian babies died from this in 1996-97. In Australia, epidemics of whooping cough occur about every 3 to 5 years. • Babies are at most risk of having severe health problems from whooping cough. About 1 in 200 babies who get whooping cough before they are 6 months old will die from the infection. How does it spread? • The infection spreads by droplets that are coughed or sneezed out. These droplets can be breathed in or they can be carried to the nose by hands which come in contact with the droplets (eg through handling used tissues or by touching surfaces which have the drop lets on them). • Whooping cough is very easy to catch. 70% to 100% of people living in the same house as someone with whooping cough will get the infection unless they have been immunized or have had the infection. How long is it infectious? • A child or adult who catches whooping cough will usually start to be unwell about 7 to 10 days after being exposed to the infection (this is called the “incubation period”). • A person with whooping cough is highly infectious in the first few days (when they seem to only have a ‘cold’). • Without treatment with an effective antibiotic, a person will go on being infectious for about 3 weeks. If the illness is treated with an effective antibiotic, a person will usually stop being infectious within 5 days. Signs and symptoms of whooping cough • The illness usually starts like a ‘cold’ with runny nose and a cough which is not like the spells of coughing later in the illness. • After several days the long spells of coughing start, causing difficulty breathing during the spells. The child will have many quick coughs in one spell. There can be several spells of coughing each hour (with an average of 25 coughing spells per day). • Young children often have a whoop after the coughing spell (when they can finally breathe in). They might vomit any food or drink that they have recently swal lowed, during the cough or soon afterwards. • Very young babies may not cough, but they may just stop breathing for a minute or longer many times per day. If they cough there might not be the whoop. • Adults and older children may not whoop, but they will have coughing spells and they may feel tired

(the coughing can interfere with sleeping), and generally unwell. It can be many weeks before it is recognized that the older child or adult has whooping cough. Finally, after several weeks or more, the coughing spells start happening less often and they stop happening about 2 to 3 weeks later. If the person gets a cold soon after having whooping cough, the coughing can start again for a while (much shorter than the original illness).

Treatment • If your child has been exposed to whooping cough, see your doctor, as your child might need an antibiotic to protect him from becoming infected. This will kill the bacteria but it does not stop the coughing which may go on for many weeks, unless the antibiotic is given very early in the illness. • Young babies with whooping cough are often so ill that they need hospital treatment. Feeding can be a problem because they often vomit after coughing. A baby may need tube feeding. • Cough suppressing medicines may be helpful for adults but should never be used for young children with whooping cough. Part of the reason for coughing is that there is sticky mucous in the airways which needs to be coughed up. What you can do • It is important to check often that the child is eating and drinking enough. • It seems that feeding a young child immediately after a coughing spell may mean the food and drink stays down. Feeding seems to trigger a coughing spell if the child has not coughed recently, but soon after a coughing spell, food and drink usually does not trigger another coughing spell. • Children who are coughing often will be tired and uncomfortable (coughing can cause tummy pain from overused muscles). Some paracetamol may help with aching muscles. Immunization • Immunization of babies against whooping cough protects most children completely, although a small number of immunized children may have a milder illness with whooping cough. • The immunization is given at the same time as immuniz ing them against tetanus, diphtheria and polio (at 2, 4 and 6 months and 4 years) • Immunization is also recommended for o adults before planning a pregnancy o parents of newborn babies o adults working with young children o adults at age 50 years (when combined tetanus, diphtheria and pertussis [whooping cough] vaccine can be used instead of diphtheriatetanus). You can make an appointment for immunization by calling either myself (08123660000), or Dr Ristie (08123818570) Preventing the spread of whooping cough • Any person with whooping cough should be excluded from child care, kindergarten and school until 5 days after starting treatment, or if not treated, for 3 weeks from the start of symptoms. • Children who are unwell should not be at child care, kindergarten or school even if they are no longer infectious. The teachers are not able to provide the care that sick children need. Kim Patra is a qualified registered nurse and midwife who has been living and working in Bali for almost 20 years. She now runs her own private practice and medical referral service from her Kuta office. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at or Hp. 081 2366 0000.

Copyright © 2011 Kim Patra You can read all past articles of Sickness & in Health at

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