Posts for tag: Cough
Whooping Cough, Claimed the Life of a San Bernardino County Infant
The California Department of Public Health (CDPH) announced [Tue 17 Jul 2018] pertussis, better known as whooping cough, claimed the life of a San Bernardino county infant. This is the 1st confirmed infant death from the disease since 2016, when 2 deaths occurred.
"This baby's death is a tragedy for the family and for California as a community, as this is a preventable disease," said Dr Karen Smith, CDPH director and state public health officer. "This serves as a grim reminder that whooping cough is always present in our communities, and immunizations are the 1st line of defense."
What whooping Cough looks and sounds like: https://www.youtube.com/watch?v=TIV460AQUWk
Akron's Children's Hospital Video about Pertussis: https://www.youtube.com/watch?v=8QWdEwjBEBw
Each year, 50-200 California infants are hospitalized with pertussis. CDPH and the Centers for Disease Control and Prevention (CDC) recommend that expectant mothers receive the whooping cough booster shot (also called Tdap, or tetanus, diphtheria and acellular pertussis vaccine) at the earliest opportunity between 27 and 36 weeks of every pregnancy, even if previously immunized. Getting immunized during pregnancy boosts a mother's immunity and passes on protective antibodies directly to their babies before birth. This helps protect newborns until they are old enough to begin receiving their own whooping cough immunizations at 6 to 8 weeks of age.
"No baby should have to be hospitalized due to a vaccine-preventable disease, and certainly no baby should die," said Dr Smith. "To give babies the best protection, I urge all pregnant women to get vaccinated against whooping cough as early as possible during the 3rd trimester of every pregnancy."
To avoid the spread of whooping cough, CDPH also recommends that:
- parents immunize their babies against whooping cough as soon as possible. The 1st dose is recommended at 2 months of age, but can be given as early as 6 weeks of age;
- California 7th grade students [should] receive the whooping cough booster, Tdap;
- adults should receive a whooping cough booster once in their lives.
Source: Hoy Digital [in Spanish, machine trans, edited
Two children under 2 [years of age] died in the last week at the Robert Reid Cabral Children's Hospital because of whooping cough, a contagious and vaccine-preventable disease. The dead are a girl aged 15 months from the community of Cambita, San Cristóbal and another one of 3 months, who lived in La Romana.
Also, another 28 children have been admitted with this disease, which calls the attention of the pediatricians of the hospital, since the vaccine that immunizes is included in the Expanded Program of Immunizations (PAI).
The official website of the Ministry of Health, in the epidemiology component, defines pertussis as an endemic respiratory disease that commonly affects children under the age of 5, with infants under 6 months of age at the highest risk of complications, but also it can affect teenagers and adults. The use of the vaccination scheme with DPT [diphtheria, pertussis, tetanus] or pentavalent [diphtheria, tetanus, pertussis, hepatitis B, and _Haemophilus influenzae_ type b (Hib)] is the main prevention measure, while pertussis outbreaks tend to occur every 3 to 4 years, according to official information.
So far this year , 29 probable cases of whooping cough have been reported, 7 in the last 4 epidemiological weeks. As many as 9 out of 10 cases correspond to children under 1 year of age. Santo Domingo Norte and Santiago are the demarcations that register the highest number of cases.
Faced with this situation, the Ministry of Health instructed the provincial directorates and corresponding health areas to ensure adequate research and response to preventable diseases.
Dr. T comments:
For every case of reported Whooping Cough, 100 cases go unreported and unrecognized. Teens and adults are usually not as sick as children under age one year, but they are highly contagious. Whooping Cough is called the 100 day cough. Sometimes the cough is so bad, that one can break a rib or two. Women who are pregnant are antibody factories. That is why pregnant women are encouraged to have the Tdap vaccine shot every pregnancy in their last trimester even if they have had it before. The antibodies against Pertussis that they produce because of the Tdap vaccine passes through the placenta to their babies offering them some protection until their babies are old enough to receive immunizations to stimulate their own immune systems to produce their own protective antibodies.
The same reasoning applies to pregnant women getting the influenza shot in their last trimester as well. Babies can not get a flu shot until they are six months old. So in addition to the gift of life, mothers who get the flu shot (in season) and a Tdap also give the gifts of antibody protection to their newborn infants. Not a bad way to start a healthy life!
The Wrong way to Cover Your Mouth when coughing!
If a person has had the disease, Whooping Cough, this disease does not convey life-long immunity as many other illnesses do. Appropriate immunizations against Whooping Cough also do not convey life-long immunity to the disease. All teens and adults should have at least one Tdap vaccine. Right now there is no recommendation for adults to have Tdap booster, however we know that Whooping Cough antibody protection from a Tdap only lasts 3-5 years. Even though we depend on a mother's Tdap antibodies passing through the placenta to protect her baby, even though it is not Public health Policy, it still seems wise to me that all adults who are going to be around a newborn in the baby's first year of life should have a current Tdap "booster" if it has been more than 3 or 4 years since the adult's last Tdap. Perhaps National Policy will eventually change to this recommendation. Don't know! But I do know that Pertussis antibodies from a Tdap only last 3-5 years and then are gone.
All forms of Whooping Cough immunizations are effective and safe and can be given with any other vaccine that is needed, e.g. influenza vaccine, etc. As a community we depend on each other for many things. This includes protection from serious disease. We expect restaurant employees to wash hands before they leave the restroom. We expect each other to not drink and drive, to not text and drive, to cover our face appropriately when we cough. Similarly, we should expect each other to get safe and effective immunizations to protect each other, our children and our families from preventable contafious disease.
Ask your doctors about your current immunizations status and that of your children. If you've not had a Tdap, get one. If you've not had a flu shot, plan to get one. The flu shot is now so purified, that even people with egg allergy can get one. September and October are perfect months for a flu shot. The flu shot is preferred this year, 2018, over the nasal spray influenza vaccine.
Some Things Old and Some Things New & Some Things Never Change
Let’s repeat the basics. Most Winter illness is viral and spreads through body fluid contact. What fluid is this, you might ask? I speak of air-borne (and hand-borne) small droplets of saliva and mucus that sprays from our mouths and noses when we sneeze or cough. This means when one has a cold and/or sore throat, no matter how young or how old we are or how sick we feel, we will ALWAYS be contagious to others.
So one of life’s lessons we want to teach our children is how NOT TO SHARE these body fluids, when they are ill. Now here’s a fact most people don’t know:
Viruses commonly live in our noses and mouths intermittently and episodically even when one is completely well__without symptoms of illness at all. This is called viral shedding and it happens frequently, and we have no clue that we are contagious! Yes, you can be infectious to others even when you are completely well. Who knew!?
So another life lesson that we should teach our kids is not to share saliva or mucus with others even when one is well. If you think we don’t do this all the time, think again. Kids and adults share gum, pizza, cookies, cupcakes, drinks, utensils, toys, etc without a second thought when they are well, and often when they are ill. This is a behavior that can be altered more easily when one is sick, but occurs unconsciously when we are well. I am not saying we should make our kids phobic, over-anxious or compulsive about germs, or ourselves, for that matter, but that good hygiene habits of behavior are in the best interest of everyone.
Since it is fairly obvious that saliva sharing is a fact of life__like frequently touching our faces with our hands unconsciously every day__teaching our kids and ourselves how to contend with this reality is another life lesson to learn. It’s called handwashing and the use of hand sanitizers safely. Sounds like a simple thing to teach our kids, but it is not. As parents we want handwashing to become an automatic behavior, not just something the kids do when we are watching and ask them to do it. We want them to do it at school, when they are out with their friends, and at home before sitting down to a meal, for example.
Believe it or not, it’s never too late to learn this behavior [https://www.youtube.com/watch?v=zxlQn7KaCNU].
Handsanitizers [https://www.livestrong.com/article/88193-hand-sanitizer-kill-bacteria/] with greater than or equal to 60% alcohol are effective hand-hygiene products but they should not be licked off the hands. So allowing young children under 5 years old to use them independently without supervision is not safe, since hands often end up in mouths. As soon as the hands are dry (after waving them in the air for a few seconds) there is no danger. Of course the sanitizing benefit of these products are short term since hands rapidly touch the world and end up in mouth not long after. But you have to start somewhere. Choosing time and place to use an alcohol-based hand sanitizer is a good idea. You can’t do it every 5 minutes through the day but certain situations, like the petting zoo, necessitate applying sanitizer frequently. After visiting a public restroom, even if you’ve washed your hands, is another good time to use sanitizer. Remember to use it when visiting the mall or taking your seat at a movie theater (or leaving the theater), and after using an escalator in the mall or airport. What these places have in common is that they are all public, meaning the world has touched all the areas you and your children are touching as you go through the day.
Sanitizer hand wipes are OK, but my guess is they are used less effectively than the gels which can be rubbed into tiny spaces on cuticles and between fingers by you and your children very easily. And there is no tissue to dispose of afterwards.
I don’t have anything against against hand washing. It’s great if you have the time to do it, but when you don’t hand sanitizers come to your rescue.
So that’s hand care. What about cough and sneeze hygiene? Not complicated. Most grown ups were taught to cover their mouths with their hands when they were kids. No question this is polite, but think about it..... totally ineffective in preventing the spread of body fluid (saliva and runny nose juice) between people since our hands then go on to touch other people and objects.
Today, kids in preschool and nursery school are being taught correctly, the 21st century way, the Elbow Cough-Cover. It’s quick and readily accessible and in itself NOT impolite to whip your elbow to your face and cover your mouth and nose with your elbow. Sure, no question, you will have germs on your elbow, but NOT YOUR HANDS! You can teach this to your children of all ages. You can role model it as well.
A cute story I like to tell kids this time of year (with parent permission if Santa comes to their house) goes like this: Santa doesn’t visit a home by himself. It’s a lot of work to deliver presents to good children all over the world, so he brings some of his helpers along in the sled. All the helpers want to go with him. (Remember the movie “Elf”. Good thing all the elves aren’t the size of Will Ferrell.) Some of the elves have colds, coughs and runny noses. So they have to know how to cover their face properly when they cough and sneeze. Santa doesn’t want elf germs to get on everyone’s gifts. So Santa’s helpers who can cover their faces with their elbows get to go, but the helpers who don’t know how, stay at the North Pole with Mrs. Clause practicing the Elbow-Cough-Cover so they can go with Santa next year. The punchline: Santa likes it when kids cover their faces with their elbows too when they cough and sneeze. I guess you can always add that the elves have to take and use their hand sanitizer every time before they go down the chimney with Santa to help deliver the presents.
If you like this parable, feel free to use it. No copyright on it as far as I know, since I made it up.
One more thing about our hands, we use them almost always to greet others__hand to hand shake. It’s social and appropriate and certain to transmit illness back and forth with every greeting. So why not greet one another with an elbow-bump or a fist-bump through the Winter virus season? Seems like such an easy solution, if we could only make it the social norm [https://www.youtube.com/watch?v=eYtLQc0YaMo]. If we could just get our media-TV physician personalities, like Dr. Oz and Dr. Gupta and Dr. Snyderman, to endorse the social greeting elbow-bump, this greeting could sweep the nation. Well, we do what we can, us parents and physicians. Maybe our preschool and school teachers could teach this greeting, just as they teach the elbow-cough-cover technique. Bring it up at your next PTA meeting.
One More Time About Influenza Vaccine
I can administer the appropriate influenza vaccine to your children, yourselves and close family, sitters, nannies, etc. who share time with your family. These vaccines can be offered through Winter and early Spring to enhance protection against the Flu and Pertussis among all persons over the age of 6 months. Unfortunately, there is no Flu vaccine as of yet for infants under the age of 6 months.
We should also be aware that when we immunize, we are not just protecting ourselves and our families. We are also helping those in our community who cannot get immunized because of weakened immunity from advancing age, illness disease, cancer or chemotherapy. They depend upon the rest of us to do what we can to protect them from these diseases by keeping our vaccines current. If you believe that we are our brothers’ keepers and have an obligation not to make others seriously ill through immunization apathy, please give this issue serious thought and consider staying current with your vaccines even if you have never had the flu and don’t think that Whooping Cough will make you very sick.
Please call Shelly (404-654-0426) or me or shoot us a text message and I will get back to you to schedule a house visit for the vaccine(s) you request:
Fluzone® Influenza Virus Vaccine, Contains No Preservative: Pediatric Dose Children 6-35 months of age (Single-dose, prefilled syringe, without needle, 0.25 mL) also available for over 35 months of age through adult years.
You can learn more about this and all vaccines at www.immunize.org.
If my Influenza vaccine supplies run out, you should still be able to find the vaccine at your local neighborhood pharmacies for a while longer yet.
I've come across another nasal aspirator which parents may find useful this winter, the NoseFrida. This inexpensive "snot-sucker" will be handy little item when our little ones have a congested obstructed runny nose. Check it out.