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Thursday, July 21, 2011

Whooping Cough-Complication And Immunization


The most severe, although rare, complication is a convulsion. This may occur when the baby or child goes blue at the end of a spasm. In general, these first are harmless but sometimes they are a sign of encephalitis (brain inflammation) which can be fatal or leave behind permanent brain damage. Hospital treatment is essential in this case. It is possible that pneumonia may occur when the whoop disappears. This can be detected if the child develops rapid, shallow breathing and a rise in temperature. In other patients, thick mucus may block one or more of the bronchi (air tubes) causing parts of the lung to lose their air and collapse. Most of these children recover with the use of antibiotics and physiotherapy but some may be left with permanent lung weakness. Other complications are related to the force of coughing: the eyes may become very bloodshot, a hernia (rupture) may appear as a swelling at the groin or or navel, or there may be rectal prolapse (the lining of the lower bowel is forced out through the back passage). Drugs have virtually no effect on the illness. An antibiotics is often advised during the first two weeks but this is to prevent the bacteria from spreading to other children rather than to cure the sick child. Numerous remedies have been tried, including cough mixture, antispasmodics and drops which are supposed to paralyze the nerves involved in coughing. There is no firm evidence that any are effective but your doctor may think one or two of them are worth trying. Children who are fearful and anxious may be calmed by small doses of a sedative. Many parents find the illness too alarming to cope with in small infants so hospital admission may have to arranged through the family doctor. In hospital, oxygen and an electrically-driven suction device that removes mucus during a spasm are the mainstays of treatment. Those few children who have convulsions or collapsed lung can be treated with physiotherapy. Quarantine of contacts is not always possible but babies should be kept away from brothers or sisters with the illness. Nearly all children recover completely without any complications, and lifelong immunity is achieved from a single attack. Patients are no longer infectious after three weeks and can then return to school as soon as they feel up to it.


There is a vaccine for whooping cough which can be given in three doses, usually combined with diphtheria and tetanus, at six-weekly intervals from the age of three months. The vaccine is highly, but not totally, protective. However, those who develop whooping cough despite being immunized tend to have it very mildly, often without the distressing whoop. In recent years, controversy has arisen over the use of whooping cough vaccine. It has been linked with brain damage and even death in your children. At present, there is no way of proving conclusively that the vaccine is responsible for these effects since idetical conditions can occur without the child ever having been vaccinated. Studies and medical statistics have shown that the risk of brain damage and death from complications of whooping cough is much greater than the apparent risks of vaccination. Children who are known to have a pre-existing brain disease, who have had fits or who have a parent, brother or sister who has epilepsy, not due to head injury, should not be immunized. So far as other children are concerned, parents must make a decision based on their feelings and the advice they receive from the family doctor.

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