Watch out for whooping cough

How to recognize and prevent pertussis

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Winnipeg Health Region
Wave, January / February 2013

What is pertussis?  

Pertussis (whooping cough) is a highly contagious bacterial infection that spreads through coughs and sneezes or by sharing food and drink. Symptoms initially resemble a mild cold, progressing to severe bouts of coughing that can last for weeks. Pertussis most commonly affects infants and young children and can be fatal, especially in children less than one year of age. 

Anyone who has experienced mild cold symptoms that have progressed to a severe cough after seven to 14 days, along with persistent bouts of coughing that have a ‘whoop’ sound, is encouraged to see their primary health-care provider. Symptoms are often more severe in children than adults.

Can it be treated?

Pertussis is usually treated with antibiotics prescribed by your family physician.

In terms of caring for someone with pertussis, warm apple juice or tea may help break the coughing spasms and is soothing. A cool mist from a humidifier may also help. (The humidifier must be cleaned every two to three days.) For children, gentle suction with a bulb syringe and saline water may be used to get rid of thick secretions in the nose and throat.

Also, it is important for those with pertussis to drink lots of fluids to prevent the mucus in the lungs from becoming sticky and to loosen the mucous in the nose and throat. Fluids also clear secretions and make breathing easier.

All people in close contact with someone diagnosed with pertussis may need to take an antibiotic to prevent them from getting sick or passing it to other people. This includes people in your immediate household and any daycare contacts you may have. 

How can whooping cough be prevented?

Keep away from things that trigger coughing, such as tobacco smoke, perfumes, or pollutants. Proper cough and hand-washing etiquette is also an important way to prevent the spread of infection. This includes covering your mouth and nose with a tissue, or your upper sleeve, when you cough or sneeze; putting the used tissue in a wastebasket; and washing your hands with soap and water, or cleaning them with an alcohol-based hand rub.

What should I do if I suspect my child has pertussis?

Call 911 if you or your child:

  • • Is struggling to breathe
  • Passes out from coughing
  • Face, hands or feet turn blue during coughing and does not go away after  coughing (For children under the age of one)
  • Stops breathing for more than 15 seconds

Go to the Emergency Department if you or your child:

  • Experiences fast or difficult breathing
  • Becomes dehydrated
  • Has a fever higher than 40.5 ºC (104º F) after treatment with ibuprophenor acetaminophen.

Call or see your primary health-care provider immediately if you or your child:

  • Experiences coughing spasms that cause the face, hands, or feet to turn blue (symptoms disappear when coughing stops)
  • Becomes very sick
  • Has been exposed to pertussis and cough occurs 21 days or more later
  • Has a cough that lasts more than six weeks

Is there a pertussis vaccination?

In August 2012, Manitoba Health in response to a significant increase in pertussis in several Canadian provinces, recommended that adults in regular contact with children be vaccinated to prevent whooping cough infection. This is especially important for caregivers of infants less than two months of age, as those infants are not yet eligible to be vaccinated for whooping cough.

Currently, the only vaccine available is a combined vaccine for pertussis and tetanus. Free vaccination with acellular pertussis vaccine is available to primary caregivers of newborn infants, who have not previously received this vaccine. Adults who are due for a tetanus booster (given at 10-year intervals) and have not received the acellular pertussis vaccine are also eligible. For these individuals, the acellular pertussis vaccine is combined with the tetanus booster in a single vaccine, called Tdap.

If you are due for your tetanus booster then you are eligible for the combined Tdap vaccine. If you have had your tetanus booster recently, you are still eligible for the Tdap vaccine. There is no minimum time interval recommendation between tetanus (Td) and Tdap.

Tdap vaccination during pregnancy and while breastfeeding is safe. Children should follow the recommended immunization schedule. Vaccinations should be arranged through your primary health-care provider or public health nurse in those areas where they provide immunization services. You can also address any additional concerns or questions with your provider or public health nurse.

It is important to have your child immunized against all preventable illnesses, including pertussis, at their regularly scheduled health checkups.

Some parents have concerns about the neurologic side-effects of the old pertussis vaccine. It must be remembered that pertussis is a dangerous disease, especially for infants. Complications can include pneumonia, seizures and death. A newer vaccine for pertussis is now being used and the risk of a serious reaction is less than with the previous vaccine. The risk of having neurologic problems or long-term damage from the current vaccine is very low.

Common reactions to the vaccine include soreness, redness and swelling where the vaccine was given. Some children may have fever, drowsiness, fussiness, loss of appetite, or an upset stomach. These are mild reactions and usually last one to two days. Acetaminophen (Tylenol or Tempra) or ibuprohen (Advil) can be given for fever or soreness.

ASA (Aspirin) should never be given to children because it can cause a severe liver and brain disease called Reye’s Syndrome.

It is important to stay in the clinic for 15 minutes after getting any vaccine because there is a rare possibility of a severe allergic reaction. This can include hives, difficulty breathing, or swelling of the throat, tongue or lips. If this happens after you leave the clinic, call 911 or go to the nearest emergency department for immediate treatment.

Audra Kolesar is a registered nurse and manager with Health Links - Info Santé, the Winnipeg Health Region’s telephone health information service.

The information for this column is provided by Health Links - Info Santé. It is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health-care professional. You can obtain health information from a registered nurse 24 hours a day, seven days a week by calling Health Links - Info Santé. Call 204-788-8200 or toll-free 1-888-315-9257.

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