Whooping Cough Vaccine Required of 7th- to 12th-Graders

A new state law requires public school students in grades seven to 12 to get a vaccine for whooping cough.
A new state law gives schools the option of granting parents a couple more weeks to get their children the whooping cough vaccine in accordance with a new state law.

Whooping cough, also known as pertussis, is a highly contagious condition that produces violent coughing and may interfere with breathing.

Students entering grades seven and above are required to have received a whooping cough shot (Tdap) after their 10th birthday. The schools can conditionally allow students to attend class for up to a month after the first day of class before being excluded from campus.

Oceanside schools opened on Aug. 25.

It is unclear how many students in the Oceanside Unified School District are not in compliance. The websites of OUSD schools are running reminder bulletins such as this:

"A new state law, which takes effect for the beginning of the 2011-12 school year, now requires ALL students who will be in grades 7-12, to be immunized against Whooping Cough. Proof of this Tdap vaccination must be submitted prior to the start of the new school year, which begins Thursday, August 25, 2011.

"Students will NOT be allowed to register or attend class until showing proof of having received this vaccine. Students who have been given a Tdap shot on or after a 7thbirthday will meet the school immunization requirement by providing proof of immunization.

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Whooping cough

Introduction

Whooping cough, sometimes referred to as pertussis, is an infection of the lining of the airways. It mainly affects the windpipe (trachea) and the two airways that branch off from it to the lungs (the bronchi).

Whooping cough is highly infectious. The condition is caused by a bacterium called Bordetella pertussis, which can be passed from person to person through droplets in the air from coughing and sneezing.

The condition is known as whooping cough because the main symptom is a hacking cough, which is often followed by a sharp intake of breath that sounds like a 'whoop'.
Who is at risk?

Whooping cough usually affects infants and young children, although adults can sometimes develop the condition. Whooping cough tends to be most severe in young infants. In rare cases, it can be fatal.

How common is it?

The introduction of a vaccination programme during the 1950s and the introduction of a pre-school booster jab in 2001 means the annual number of cases of whooping cough in the UK is now very low.

Just under 600 cases of whooping cough were recorded in England and Wales in 2005. Before the introduction of the whooping cough vaccine, the average annual number of cases exceeded 120,000.

Despite the number of cases falling, it is still important that all children have the whooping cough vaccine to prevent future outbreaks of the infection.

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What is the treatment for whooping cough?

Antibiotics directed against Bordetella pertussis can be effective in reducing the severity of whooping cough when administered early in the course of the disease.

Antibiotic therapy can also help reduce the risk of transmission of the bacterium to other household members as well as to others who may come into contact with an infected person. Unfortunately, most people with whooping cough are diagnosed later with the condition in the second (paroxysmal) stage of the disease. Treatment with antibiotics is recommended for anyone who has had the disease for less than three to four weeks. Azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin (E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone), and trimethoprim and sulfamethoxazole (Bactrim, Septra) are antibiotics which have been shown to be effective in treating whooping cough. It is unclear whether antibiotics have any benefit for people who have been ill with whooping cough for longer than three to four weeks, although antibiotic therapy still is often considered for this group. There is no proven effective treatment for the paroxysms of coughing that accompany whooping cough.

Antibiotics also are routinely administered to people who have had close contact with an infected person, regardless of their vaccination status.

What are possible complications of whooping cough?

The most common complication and the cause of most whooping cough-related deaths is secondary bacterial pneumonia. (Secondary bacterial pneumonia is bacterial pneumonia that follows another infection of the lung, be it viral or bacterial. Secondary pneumonia is caused by a different virus or bacterium than the original infection.) Young infants are at highest risk for whooping cough and also for its associated complications, including secondary pneumonia. Other possible complications of whooping cough, particularly in infants less than 6 months of age, include seizures, encephalopathy (abnormal function of the brain due to decreased oxygen delivery to the brain caused by the episodes of coughing), reactive airway disease (asthma), dehydration, hearing loss, and malnutrition.

Data indicate that secondary pneumonia occurs in about one out of every 20 infants with whooping cough, and one out of 100 affected infants develop convulsions.

Whooping cough can cause serious illness and even death in young children; 10 children died from the infection in 2007. From 2004-2005, 66 deaths due to whooping cough were reported to the CDC, and 56 of these were children under 3 months of age. In 2008, 18 deaths due to whooping cough were reported in the U.S. Most deaths from whooping cough have occurred in children who have not been vaccinated or who are too young to have received the vaccine.

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Vomiting With Cough a Symptom of Asthma in Children

A team at Walter Reed Army Medical Center in Washington, DC, believes that posttussive emesis is a probable sign of asthma in children.

If that is the case, then treatment should be directed more toward airway management than toward suppression of cough, principal investigator Joseph Turbyville, MD, from the Department of Allergy and Immunology at Walter Reed Army Medical Center, told Medscape Allergy & Clinical Immunology during poster sessions here at the American Academy of Asthma, Allergy and Immunology (AAAAI) 2009 Annual Meeting.

The investigators distributed 780 questionnaires during a 2-week period to parents of children aged 2 to 17 years attending the pediatric and allergy clinics at Walter Reed. Questions pertained to age, sex, previous diagnosis of pertussis, frequency of respiratory infections, gastroesophageal reflux (GERD), and a prior diagnosis of asthma.

Five hundred questionnaires were returned and evaluations of 144 children were completed.

The prevalence of physician-diagnosed asthma was 23%, occurring in 33 children. Of those, 48% reported a history of posttussive emesis.

There were 37 children who had "surrogate markers suggestive of asthma," but had not been given a formal diagnosis. Surrogate markers included wheeze, chest tightness, recurrent respiratory infections and sinusitis, and nighttime cough. Posttussive emesis was reported in 49% of this group.

No evidence of asthma was seen in 74 children, of whom 11% reported a history of posttussive emesis.

Posttussive emesis, either with asthma or a suspicion of asthma, was significantly more prevalent than in children without asthma (P < .0005), Dr. Turbyville reported.

"We think it's a simple, mechanical thing," he explained. "There is a flattening of the diaphragm, which compromises the stomach and puts pressure on it, causing it to empty.

"Another possibility is that the airway obstruction pushes air into the esophagus. There is a significant obstruction at the tracheal-esophageal junction in these kids," he said.

"The mechanical explanation would also explain the link with GERD and obstructive sleep apnea," Dr. Turbyville added.

"Our finding, if it is confirmed, would lead us toward treatment with a long-acting beta-agonist and anti-inflammatory agents rather than an antitussive agent," Dr. Turbyville concluded. "The cough may signal asthma rather than a respiratory infection if the child is vomiting with it."

"These findings give us one more clue to think about when considering a diagnosis of asthma," Andy Nish, MD, an allergist with Allergy and Asthma Care Center in Gainesville, Georgia, commented in an interview with Medscape Allergy & Clinical Immunology after Dr. Turbyville's presentation.

"It can be hard to sort out a cough and whether it has segued into bronchospasm," Dr. Nish observed. "We have to look at the whole ball of wax...whether there is wheezing, chest tightness, if it increases on exercise or with stress, whether there is smoke exposure, and so on.

"We need to do a complete physical examination, with pulmonary function testing...listening to the lungs for wheezing or decreased airflow, checking changes in the inspiration/expiration ratio, peak flow changes, possibly a chest x-ray, and so on," he said.

"The presence of posttussive emesis should raise your level of suspicion, and you should conduct follow-up testing, specifically pulmonary function tests, sooner rather than later, if posttussive emesis is present," Dr. Nish advised.

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Causes of Coughs

The list of possible causes of cough is long and highly varied. Doctors classify coughs into 2 categories, acute and chronic. Many doctors define an acute cough as one that been present for less than 3 weeks. Chronic coughs are those present for more than 3 weeks.

Acute coughs can be divided into infectious (caused by an infection) and noninfectious causes.

Infectious causes of acute cough include viral upper respiratory infections (the common cold), sinus infections, pneumonia, and whooping cough.

Noninfectious causes of cough include flare-ups of the following chronic conditions: chronic bronchitis, emphysema, asthma, and environmental allergies.

The easiest way to simplify the causes of chronic cough is to divide them into their locations with respect to the lungs. The categories are environmental irritants, conditions within the lungs, conditions along the passages that transmit air from the lungs to the environment, conditions within the chest cavity but outside of the lungs, and digestive causes.

Any environmental substance that irritates the air passages or the lungs is capable of producing a chronic cough with continued exposure. Cigarette smoke is the most common cause of chronic cough. Other cough-producing irritants include dusts, pollens, pet dander, particulate matter, industrial chemicals and pollution, cigar and pipe smoke, and low environmental humidity.

Within the lungs both common and uncommon conditions cause chronic cough. Common causes include asthma, emphysema, and chronic bronchitis. Less common causes of lung-induced chronic cough include cancer, sarcoidosis, diseases of the lung tissue, and congestive heart failure with chronic fluid build-up in the lungs.

The passages that connect the lungs to the external environment are known as the upper respiratory tract. Chronic sinus infections, chronic postnasal drip, diseases of the external ear, infections of the throat, and use of ACE inhibitors for high blood pressure have all been implicated in chronic cough.

In addition to disease processes within the lung and air passages, diseases elsewhere within the chest cavity may also be responsible for chronic cough. Conditions within the chest known to cause chronic cough include cancer, unusual growth of a lymph node, and an abnormal enlargement of the aorta, which is the main blood vessel leaving the heart.

An often-overlooked cause of the chronic cough is gastroesophageal reflux (GERD). GERD occurs when acid from the stomach travels up the esophagus. This abnormal condition can cause irritation of the esophagus and larynx resulting in the reflex production of a cough.

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Coughs

Coughing is the body's way of removing foreign material or mucus from the lungs and upper airway passages camera or of reacting to an irritated airway. Coughs have distinctive traits you can learn to recognize. A cough is only a symptom, not a disease, and often the importance of your cough can be determined only when other symptoms are evaluated. For information about coughs in children, see the topic Coughs, Age 11 and Younger.

Productive coughs

A productive cough produces phlegm or mucus (sputum). The mucus may have drained down the back of the throat from the nose or sinuses or may have come up from the lungs. A productive cough generally should not be suppressed-it clears mucus from the lungs. There are many causes of a productive cough, such as:

Viral illnesses. It is normal to have a productive cough when you have a common cold. Coughing is often triggered by mucus that drains down the back of the throat.

Infections. An infection of the lungs or upper airway passages can cause a cough. A productive cough may be a symptom of pneumonia, bronchitis, sinusitis, or tuberculosis.

Chronic lung disease. A productive cough could be a sign that a disease such as chronic obstructive pulmonary disease (COPD) is getting worse or that you have an infection.

Stomach acid backing up into the esophagus camera. This type of coughing may be a symptom of gastroesophageal reflux disease (GERD) and may awaken you from sleep.

Nasal discharge (postnasal drip) draining down the back of the throat. This can cause a productive cough or the feeling that you constantly need to clear your throat. Experts disagree about whether a postnasal drip or the viral illness that caused it is responsible for the cough.

Smoking or other tobacco use. Productive coughs in a person who smokes or uses other forms of tobacco is often a sign of lung damage or irritation of the throat or esophagus.

Nonproductive coughs

A nonproductive cough is dry and does not produce sputum. A dry, hacking cough may develop toward the end of a cold or after exposure to an irritant, such as dust or smoke. There are many causes of a nonproductive cough, such as:

Viral illnesses. After a common cold, a dry cough may last several weeks longer than other symptoms and often gets worse at night.

Bronchospasm. A nonproductive cough, particularly at night, may mean spasms in the bronchial tubes (bronchospasm) caused by irritation.

Allergies. Frequent sneezing is also a common symptom of allergic rhinitis.

Medicines called ACE inhibitors that are used to control high blood pressure. Examples of ACE inhibitors include captopril (Capoten), enalapril maleate (Vasotec), and lisinopril (Prinivil, Zestril, or Zestoretic).

Exposure to dust, fumes, and chemicals in the work environment.

Asthma. A chronic dry cough may be a sign of mild asthma. Other symptoms may include wheezing, shortness of breath, or a feeling of tightness in the chest. For more information, see the topic Asthma in Teens and Adults.

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Effectiveness of Honey As A Cough Suppressant

One οf thе mοѕt well Ɩονеԁ flavors οf cough drops іѕ honey. It іѕ nο bolt frοm thе blue bесаυѕе thе cough suppressing powers οf honey аrе quite impressive.

Although іt іѕ nοt medically nесеѕѕаrу tο suppress a cough, thеrе mау times аѕ cough relief іѕ desired. Fοr mind, аѕ уουr cough іѕ preventing уου frοm sleeping οr іѕ becoming a distraction іn a shared setting. Thеrе аrе really nο proven effective cough treatments fοr cough due tο a respiratory infection such аѕ thе ordinary frost. WhіƖе Dextromethorphan (уου mау hаνе seen іt аѕ “DXM” οr “DM”) іѕ widely used іn over-thе-counter cough suppressants, thеrе іѕ nο hard evidence thаt іt works аnԁ mау yield feature equipment. Lеt’s curve tο ехсеƖƖеnt ancient-fashioned honey. Honey саn lower cough аѕ well аѕ Dextromethorphan.
Uniformity

Thе sweet, thick stickiness οf honey soothes mucous membranes аnԁ removes thе irritation thаt causes thе cough reflex. Thіѕ іѕ honey’s mοѕt power feature аѕ a suppressant. Thіѕ іѕ likened tο аѕ over-thе-counter cough treatments such аѕ cough medicine аnԁ cough drops look tο work immediately. It іѕ really thіѕ soothing οf thе throat аnԁ nοt thе medicine itself thаt іѕ causing thе following relief.

Antibacterial Agent

Historically, honey hаѕ bееn used tο treats wounds аnԁ insect bites. Bees add аn enzyme tο thе nectar producing hydrogen peroxide whісh acts аѕ аn antibacterial agent. Honey’s antibacterial properties mау aid іn thе healing οf thе cough.

Antioxidants

Honey’s high antioxidant ɡеt οn tο рƖеаѕеԁ сουƖԁ аƖѕο mess аbουt a role іn іtѕ effectiveness. Darker honey tends tο bе extra effective thаn іtѕ lighter counter-section bесаυѕе іt contains extra antioxidants.

Hοw Much Honey tο Uѕе

Typically, уου wіƖƖ aspire tο take thе same dosage amounts οf honey аѕ уου wουƖԁ cough medicine. Thіѕ mаkеѕ іt quite simple tο dredge up. Thеѕе amounts аrе: 1/2 teaspoon fοr 2-5 year olds; 1 teaspoon fοr 6 -11 year olds; 2 teaspoons fοr persons 12 аnԁ older.
Compensation аnԁ Disadvantages

Honey іѕ significantly less expensive thаn store bουɡht cough treatments. Thеrе аrе nο feature equipment such аѕ dimness οr sleepiness.

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Use of Cough medicines takes away the lives of 5 kids

A sad and shocking announcement made by The Belgian Pharmaceutical Group UCB SA on March 7 2008, has aroused a huge storm among people. As per them their popular cough medicine by the name of Tussionex has taken the lives of 5 kids who were suffering from rigorous cough due to off beam use.

This pharmaceutical group has also put forward an admonition among all doctors and medical practitioners to examine their patients thoroughly before prescribing this drug. Eric Miller who is the UCB SA presenter told the media that the cough medicine Tussionex Pennkinetic Extended-Release Suspension is a much stronger drug in nature. It is mainly meant to be use for the adult person and for the children of the age of 6 years or older than that. So it can well be understood why it took away the lives of those innocent kids.

Miller also stressed on the point that the company has got the Tussionex manufacturing authorization since 1987. Authoritarian experiments under all circumstances and studies have been carried out extensively before launching the drug in the market. So as per him the company from now onwards shall issue this important warning of use of the drug in prominent words. It will be furnishing a complete account to the Food and Drug Administration (FDA), USA so that further actions to be undertaken. As per Miller steps are now being put to action to request FDA to renew the label on Tussionex pack so that the doctors and even the patients are informed about the precautions.

Miller also reviewed the importance of Tussionex as a beneficial and safe cough medicine to be used for patients for the patients of ages marked on its label. The drug is also much effectual to revive patients out of pain as it contains the tranquilizer called hydrocodone. The FDA informed people to stick to the doses and usage conditions of Tussionex as instructed by the doctors. No such self usage attempts should be made to use the drug without a doctor’s authenticated prescription otherwise disasters are inevitable.

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