Whooping cough making a comeback<\/p>\n
S. Quarles van Ufford-Thomson, Contributor, Jakarta<\/p>\n
Considered a disease of the past, whooping cough is staging a
\ncomeback, posing a threat to babies in communities throughout the
\nworld, including Jakarta.<\/p>\n
Spread by bacteria through the air, whooping cough causes mild
\ncold symptoms or a nagging cough in adults, but can be fatal for
\ninfants, especially those under one year of age.<\/p>\n
Once infecting millions of people each year, whooping cough
\nwas greatly curbed by a vaccine developed in the 1940s and
\nsubsequent global immunization programs. Six decades later, the
\nincidence of whooping cough is again on the rise.<\/p>\n
The Center for Disease Control in the U.S. reported a 51
\npercent increase in reported cases during the 1990s from the
\n1980s with 7,867 persons diagnosed in 2000. In 1997, Australia
\nregistered 10,699 cases of the disease. Epidemiologists estimate
\nthat the actual number of cases could be ten times higher than
\nthe reported cases due to the difficulty in diagnosing the
\ndisease among adults.<\/p>\n
Although the disease has textbook symptoms in infants, some
\ndoctors fail to recognize them, leading to critical situations.
\nI experienced this very situation in Jakarta a few months ago.<\/p>\n
At that time, our four-month-old baby suffered from repeated
\ncoughing fits, which progressively worsened, leaving her gasping
\nfor air and blue in the face. I consulted four different doctors
\nin the space of a week and a half at the private clinics of
\nMedikaloka and SOS.<\/p>\n
After I described my child's symptoms to each doctor with the
\ngreat detail of a concerned mother, all four physicians diagnosed
\nthe common cold, prescribing various remedies from cough syrups
\nto nose drops.<\/p>\n
My daughter turned purple on the observation table of the
\nfourth doctor, a foreign doctor at SOS, who reacted in this way:
\n\"Your baby just has a bad cold and every child coughs
\ndifferently. I recommend that you go home and not give her any
\nmedicine at all. Is this your first child?\"<\/p>\n
Instinctively, I felt she had no cold. She had no cold
\nsymptoms apart from her coughing spasms, which often left her
\nstruggling to breathe.<\/p>\n
Exasperated, I visited a fifth doctor the next day at the
\nAustralian clinic, after another torturous night. A stand-in
\ndoctor observed my daughter's cough and deemed her condition
\nserious. A medical evacuation was ordered with still no
\ndiagnosis.<\/p>\n
Within 24 hours, our baby was admitted to a hospital in
\nBangkok, with an immediate prognosis of whooping cough, later
\nconfirmed through observation and a nasal culture. She remained
\nin hospital for a week, receiving antibiotics and oxygen during
\nher coughing spasms.<\/p>\n
Whooping cough begins as a mild upper respiratory infection
\nwith symptoms that may include a mild cough, runny nose, sneezing
\nor a low-grade fever for a period of a week.<\/p>\n
During the next stage of the disease, coughing is
\ncharacterized by five to 15 rapid coughs followed by a
\ncharacteristic high-pitched whoop, in which the face may turn
\nblue or purple due to a lack of sufficient oxygen. Mucus is often
\nthick and sticky and vomiting often follows the fit.<\/p>\n
Coughing fits initially occur at nighttime but then also
\nbecome increasingly frequent during the day with minimal or no
\nfever. Symptoms in adults and immunized children are much less
\nsevere than those in infants.<\/p>\n
The most serious complications of whooping cough include
\nseizures, mental retardation and death.<\/p>\n
The most effective way to control the spread of the disease is
\nto maintain high levels of immunization in the community.
\nInfected persons and all those people living in close proximity
\nto the infected person should be treated with the antibiotic
\nerythromycin, to prevent further spread of the disease.<\/p>\n
Another preventative measure is through the vaccination of
\nadults, especially those who are in close contact with infants,
\nsuch as parents, infant care givers and health care workers. Ten
\nyears after receiving the last booster, adults are no longer
\nprotected against the disease and can unknowingly transmit it to
\ninfants.<\/p>\n
At the very least, heightened awareness among doctors and
\nparents of whooping cough and its ever presence in our community
\nmay help to save precious young lives.<\/p>\n
The writer is an international development consultant and
\nfreelance writer with areas of specialization, which include
\npublic health issues.<\/p>",
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