Battling pertussis Fast facts

A family’s experience in fighting whooping cough, and how their lives have been changed by it.

SHEILA Prasannan and her family’s determined fight against pertussis (also known as whooping cough) is an experience to be shared with all.

This contagious respiratory disease caused by the bacteria Bordetella pertussis, infected the entire family in a matter of days through the inadvertent transmission from mother to baby, and eventually, to the rest of the family.

Pertussis can be difficult to diagnose as the early symptoms of this disease resembles that of the common cold or bronchitis.

In addition, pertussis occurs more commonly in children because its symptoms are hardly diagnosed in adults. As a result, the disease often goes undetected, misdiagnosed or undertreated in both adults and children.

This was precisely what Sheila and her baby experienced when they contracted the disease and were initially misdiagnosed.

A normal cough?

On July 12, Sheila gave birth to her second son, Krishen, at a hospital in Kuala Lumpur.

Two weeks after discharge, she developed a mild cough and sneezing, which gradually became more frequent. Worried that she might pass on the cough to her baby while breastfeeding him, she went to a clinic for a check-up.

“I was informed by the clinic’s doctor that it might be my asthma recurring, although I had not had asthma symptoms for 15 years. The doctor also assured me that it was safe to go on breastfeeding my son, though my doubts on this persisted,” she said.

She was then treated for asthma and given a course of antibiotics.

However, her cough became progressively worse over the next few days, and was accompanied by bouts of vomiting. Sometimes, a “whoop” sound could be heard while she gasped for breath at the end of a coughing spell.

Various clinics that she once again visited informed her that it was just a mild cough and would go away. Some even concluded that it was food poisoning!

Sheila’s worst fears were confirmed when her infant son started coughing and vomiting as well. His cough increased with frequency over the next week until he was coughing every few minutes and gasping for breath.

“I took my son to a paediatrician, who told me that it was just a normal cough and that I should not overly worry about it.

“My son was also given a course of antibiotics. Unfortunately, his cough failed to get better.

“My own cough by then had become really bad and I was vomiting almost every five minutes. Breathing also became very difficult for me as my asthma had now recurred,” she added.

It’s pertussis!

As Sheila and baby Krishen’s health continued to worsen, they were both taken to a nearby hospital and admitted for observation.

The doctor attending her case was quick to suspect that both mother and child had contracted whooping cough and administered them a course of antibiotics used to treat pertussis.

“The doctor explained to me that whooping cough is a very serious childhood illness and is less common in adults.

“In addition to fever, sneezing, vomiting, and runny nose, the severity of the cough can cause a child to turn blue or experience bleeding within the whites of the eyes during severe coughing spells.

“Life-threatening complications such as fits, broken ribs, brain and lung damage, pneumonia, and even death, can occur in very severe cases.

“He also explained that because my son had not been vaccinated against pertussis, it was easier for him to contract it. I was also very surprised that pertussis could affect adults too,” she shared.

While in the hospital, Sheila’s elder son, 1½-year-old Naga, her husband and mother also contracted the cough, although in a milder form. All three of them however, are recovering as they were immediately put on the same course of antibiotics as Sheila and Krishen.

How life has changed

After both mother and baby were discharged from hospital, Sheila proceeded to find out more about whooping cough from various resources and online websites, and came across a Positive Parenting (PP) article on ‘Pertussis in Adults’ in The Star Online.

“I am very grateful to PP for having published this article as not many Malaysian resources online give such detailed information on whooping cough.

“Through this article, I also managed to get in contact with the author of the article, Datuk Dr Zulkifli, to get a second opinion, and learn more about this disease.

“Because pertussis is highly contagious, Dr Zulkifli advised us to quarantine ourselves for about 100 days to observe if this disease progresses. He has been guiding us ever since,” Sheila added.

She describes this contagious illness as “a living nightmare”, and has yet to fully recover from the symptoms of pertussis.

She recalls feeling the utmost frustration that many medical practitioners lacked knowledge on pertussis, and this added to her own sense of helplessness as she herself had never heard of whooping cough before.

Had there been more widespread information on whooping cough, the doctors may have been able to detect the disease as pertussis much earlier, and given them the right tests, medications and vaccination needed to fight the infection.

“I strongly advise other parents to get the pertussis booster shots for themselves and for their children as soon as possible, as it is better to pay a little more now than to bear the consequences later on.

“Also, read up online to get more information, even though you or your children have (only) a slight cough or cold. Get different opinions from different medical professionals so that you know your options to make an informed decision,” Sheila advised.

Both her children have now been vaccinated with DTaP vaccine (Diptheria-Tetanus-acellular Pertussis), a recommended childhood immunisation, and are now in the stages of recovery.

The adults need to be vaccinated with the adult Tdap vaccine, which has lower pertussis and diphteria antigens, compared with the childhood vaccine.

Get vaccinated

“There are vaccinations for both children and adults to protect against pertussis.

“In Malaysia, infants are given the DTaP vaccine at two, three, and five months, plus a booster dose at 18 months of age. Children at age 7 receive Diphtheria and Tetanus (DT) vaccinations (but not the pertussis component).

“However, because the protective effects of the vaccine wear off after four to 12 years, children, adolescents and adults have to be re-vaccinated against the disease. It is advisable that they are vaccinated with the Tdap vaccine, which is used as a booster shot to reinforce immunity,” advises Dr Zulkifli.

If you are pregnant and want to be vaccinated against whooping cough, it is advisable to wait until the second or third trimester before getting the vaccination.

For those of you who intend to travel overseas, it is advised that you get the pertussis booster shots to reduce your risk of contracting the disease while abroad.

In any event, do consult a doctor or paediatrician for the optimum time to get vaccinated.

This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting Programme that is supported by an educational grant from GlaxoSmithKline. For further information, please visit www.mypositiveparenting.org

Fast facts

? Pertussis can cause serious illness in infants, children, and adults, and can even be life-threatening, especially in infants.

? Worldwide, there are 30-50 million cases of pertussis, and about 300,000 deaths per year.

? More than half of infants less than one year of age who get pertussis must be hospitalised.

? Vaccination of pre-teens, teens and adults with Tdap is especially important for families with new infants.

Source: The star online 21 Dec 2011