Weird Medicine Healthcare for the Rest of Us

May 11, 2012

Pertussis! Pertussis! Pertussis!

Filed under: Steve's Blog — dr steve @ 8:29 am

Anyone who heard Anthony on O&A today may have questions about Pertussis (Whooping Cough) and their risk of contracting it. Here’s some information:

Pertussis is caused by the bacterium Bordetella Pertussis and it is highly contagious. Children are vaccinated against it (the famous “DPT” or Diphtheria, Pertussis, Tetanus vaccine) but a lot of doctors forget to vaccinate their adult patients, assuming this is a childhood disease.

From the CDC: “Since the 1980s, there’s been an increase in the number of cases of pertussis, especially among preteens and teens (10–19 years of age) and babies younger than 6 months of age. In 2010, there were 27,550 reported cases of pertussis nationally. Preliminary data for 2010 show that 26 deaths from pertussis were reported. In 2010, several states reported an increase in cases and/or localized outbreaks of pertussis, including a state-wide epidemic in California.”

In adults, pertussis causes a “Bi-Modal” syndrome: a week of cold-like symptoms followed by up to six weeks of an intractable cough. People with pertussis syndrome cough when they talk, cough when they laugh, cough all night long, and sometimes cough so violently that they puke.

Pertussis can be treated with antibiotics, but if you wait until the coughing syndrome starts it’s too late to do anything about it. It is detectable early, but a doctor would have to be thinking pertussis to actually order a “Pertussis Direct Fluorescent Antibody” (DFA)  test on someone who seems to simply have a “cold.”

Therefore, treatment of the condition is a problem; my recommendation is that ALL adults over 20 have a pertussis vaccine  done every 10 years along with their Tetanus shot (TDaP).  From the CDC again: “Any adult 19 through 64 years of age who has not received a dose of Tdap should get one as soon as feasible. This Tdap can replace one of the 10-year Td booster doses. Tdap can be administered regardless of interval since the previous Td dose. Shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity but may be appropriate if your patient is at high risk for contracting pertussis, such as during an outbreak, or has close contact with infants.”  Note that the TDaP also has a vaccine against diphtheria which is another awful disease that you do NOT want to get.

I’m including some articles on recent outbreaks not too far from you, and the CDC site.

Pennsylvania outbreak:
http://www.post-gazette.com/stories/local/region/whooping-cough-cases-on-the-rise-in-allegheny-county-634954/

well this one is in Washington state, but it’s coming East…
http://www.foxnews.com/us/2012/05/10/whooping-cough-epidemic-declared-in-wash-state/

from the CDC
http://www.cdc.gov/pertussis/about/index.html

Have a great weekend! Hope this helps.   There are a few people who should NOT be vaccinated against Pertussis but they’re a rarity.  More on this here: http://www.cdc.gov/vaccines/recs/vac-admin/contraindications-vacc.htm

 

yr obt svt

 

Steve

 

PS: We talk about Pertussis on the May 12 “Weird Medicine” on XM105, Sirius 206 at 9pm Eastern Daylight.

 

PPS: Buy my stupid crap!

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