Whooping cough making a comeback

Whooping cough making a comeback

S. Quarles van Ufford-Thomson, Contributor, Jakarta

Considered a disease of the past, whooping cough is staging a
comeback, posing a threat to babies in communities throughout the
world, including Jakarta.

Spread by bacteria through the air, whooping cough causes mild
cold symptoms or a nagging cough in adults, but can be fatal for
infants, especially those under one year of age.

Once infecting millions of people each year, whooping cough
was greatly curbed by a vaccine developed in the 1940s and
subsequent global immunization programs. Six decades later, the
incidence of whooping cough is again on the rise.

The Center for Disease Control in the U.S. reported a 51
percent increase in reported cases during the 1990s from the
1980s with 7,867 persons diagnosed in 2000. In 1997, Australia
registered 10,699 cases of the disease. Epidemiologists estimate
that the actual number of cases could be ten times higher than
the reported cases due to the difficulty in diagnosing the
disease among adults.

Although the disease has textbook symptoms in infants, some
doctors fail to recognize them, leading to critical situations.
I experienced this very situation in Jakarta a few months ago.

At that time, our four-month-old baby suffered from repeated
coughing fits, which progressively worsened, leaving her gasping
for air and blue in the face. I consulted four different doctors
in the space of a week and a half at the private clinics of
Medikaloka and SOS.

After I described my child's symptoms to each doctor with the
great detail of a concerned mother, all four physicians diagnosed
the common cold, prescribing various remedies from cough syrups
to nose drops.

My daughter turned purple on the observation table of the
fourth doctor, a foreign doctor at SOS, who reacted in this way:
"Your baby just has a bad cold and every child coughs
differently. I recommend that you go home and not give her any
medicine at all. Is this your first child?"

Instinctively, I felt she had no cold. She had no cold
symptoms apart from her coughing spasms, which often left her
struggling to breathe.

Exasperated, I visited a fifth doctor the next day at the
Australian clinic, after another torturous night. A stand-in
doctor observed my daughter's cough and deemed her condition
serious. A medical evacuation was ordered with still no
diagnosis.

Within 24 hours, our baby was admitted to a hospital in
Bangkok, with an immediate prognosis of whooping cough, later
confirmed through observation and a nasal culture. She remained
in hospital for a week, receiving antibiotics and oxygen during
her coughing spasms.

Whooping cough begins as a mild upper respiratory infection
with symptoms that may include a mild cough, runny nose, sneezing
or a low-grade fever for a period of a week.

During the next stage of the disease, coughing is
characterized by five to 15 rapid coughs followed by a
characteristic high-pitched whoop, in which the face may turn
blue or purple due to a lack of sufficient oxygen. Mucus is often
thick and sticky and vomiting often follows the fit.

Coughing fits initially occur at nighttime but then also
become increasingly frequent during the day with minimal or no
fever. Symptoms in adults and immunized children are much less
severe than those in infants.

The most serious complications of whooping cough include
seizures, mental retardation and death.

The most effective way to control the spread of the disease is
to maintain high levels of immunization in the community.
Infected persons and all those people living in close proximity
to the infected person should be treated with the antibiotic
erythromycin, to prevent further spread of the disease.

Another preventative measure is through the vaccination of
adults, especially those who are in close contact with infants,
such as parents, infant care givers and health care workers. Ten
years after receiving the last booster, adults are no longer
protected against the disease and can unknowingly transmit it to
infants.

At the very least, heightened awareness among doctors and
parents of whooping cough and its ever presence in our community
may help to save precious young lives.

The writer is an international development consultant and
freelance writer with areas of specialization, which include
public health issues.