Pertusis was once dismissed as a child’s disease called ”Whooping Cough” after the whoop sound in the coughing spasms. Whooping cough had virtually been eliminated in the U.S. because of a DTaP vaccine, but it is returning to epidemic proportions.
Nurses See It All
The medical professionals that don their scrubs and survey all potential cases are the first to recognize the sometimes-fatal disease that would have otherwise appear as a common cold. A runny nose, low grade fever, and dry cough are only an incubation period leading to a respiratory problem that can last for months and cause considerable distress.
This is followed by a “whooping” sound on inspiration that lasts for weeks until the symptoms gradually disappear. Among infants, this can lead to seizures, apnea, encephalopathy, and death. According to the Centers for Disease Control (CDC), pertussis can be deadly “for 1 or 2 in 100 babies who are hospitalized.” Older children and adults are less vulnerable unless they already have respiratory weaknesses.
A highly contagious condition resulting in 300,000 deaths per year worldwide, it is airborne and spreads quickly among those close to the patient and communities in need of clean air and circulation. The administration of antibiotics can reduce the spread in early stages, but there is no immediate cure for the disease. At its most serious among the youngest patients, a regimen of antibiotics can reduce related infections and conditions, such as pneumonia. Over-the-counter cough remedies provide little comfort, but a cool-mist vaporizer may help in sleeping.
Nurses Can Do It All
Frontline nurses are the best advocates for patient care. They have seen it all and know the facts about this aggressive disease.
- As with so many other health problems, you have to consider personal hygiene and the need for sanitized hands, glassware, dishware, and shared implements.
- Covering the mouth during coughing and sneezing is a must.
- Pregnant women have additional concerns with pertusis infection.
- Nurses are required by law to report cases of pertussis to minimize potential outbreaks.
- And, all this can be avoided with an early age vaccination and subsequent booster shots.
DTaP* is a proven success story, a combination of diphtheria, tetanus, and acellular pertussis viruses without the side effects of injections reported prior to 1977. Doctors and nurses recommend administration of the vaccine starting at 2 months of age. Additional injections are given at 4, 6, and 15 to 18 months and 4 to 6 years. Booster shots are given at 11 to 12 years and every 10 years thereafter.
*(The revised Tdap does not contain thiomersal, the mercury-containing preservative used in the production of some whole cell vaccines. Contraindications are the standard concerns evident in anaphylactic reactions. And, vaccinations should be postponed for children with systemic upset, febrile illness, or neurological illnesses until the conditions improve.)
Nursing professional are immune once Tdap immunized and current on boosters. People cannot spread whooping cough to patients, family, or associates. Nurses without immunity need to disclose their situation and comply as directed as soon as possible.
- Check the vaccination status of all patients against available immunization registries.
- Summon patients with out-of-date immunizations.
- Continue to treat all suspect cases as if they were pertusis-probable.
When case trends increase, epidemics may be in the offing. Nurses, as always, remain our first line of defense.