Dr. Hagood featured on Univision; high risk of pertussis among Latino infants

Written by Shivani Singh, Sr. Web Writer

VIEW THE VIDEO (in Spanish)

Dr. James HagoodSeptember 2010: Dr. James Hagood, Division Chief of Pediatrics Respiratory Medicine at UC San Diego and Rady Children’s Hospital, was featured on Univision – the largest Spanish-speaking television station in the world.

“The purpose of the feature was to increase awareness to the Latino community regarding the symptoms and treatment of whooping cough,” remarks Dr. Hagood. “It is very contagious, with a high occurrence among Hispanic infants under 6 months old.”

Pertussis – commonly called ‘whooping cough’- is a contagious bacterial illness spread by coughing and sneezing. People who are affected with pertussis have severe coughing attacks that can last for months and often cough incessantly to the point of gasping for air, creating a ‘whooping sound.’

The disease often starts like a common cold: a runny nose and congestion. However, it can get much worse after a week or two.

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.

According to a report published by the California Department of Public Health on September 14th, 2010, there have been 4,017 cases of pertussis reported in California over the past nine months. This has been the highest number of cases reported since 1955.

To date, nine infant deaths have been reported due to pertussis; 8 (89%) were Hispanic infants.

State officials are recommending everyone age 10 and older to get a pertussis booster vaccine, known as a Tdap booster. This vaccine provides protection about 80 percent of the time and that protection begins to fade after about five years.

TREATING PERTUSSIS

Unlike treating the flu, cough mixtures, expectorants, and suppressants are usually not helpful and should NOT be used.

“Parents should talk to their primary care providers to have the child diagnosed properly,” Hagood shares. “Everyone in the family should be up to date on their pertussis vaccines.”

Infants younger than 18 months need constant supervision because their breathing may temporarily stop during coughing spells. In fact, infants should be hospitalized.

Sedatives (medicines to help one to sleep) may be prescribed for young children.

If started early enough, antibiotics prescribed by a doctor such as erythromycin could help symptoms to go away more quickly. Unfortunately, most patients are diagnosed too late, when antibiotics are not very effective. However, the medicines can help reduce the patient's ability to spread the disease to others.

If coughing spells are severe enough to prevent a child from drinking adequate fluids or breathing properly, fluids may be given through a vein, or supplemental oxygen may be given.

BEST CURE: PREVENTION

“We are recommending that everyone who is not up to date gets vaccinated for pertussis, especially pregnant and postpartum mothers, as well as those who are around newborns and infants,” Dr. Hagood urges. “Adolescents especially should be up to date on pertussis vaccination now that they’re back at school – they are at a higher risk than ever before.”

SCIENTIFIC CONTACT: Dr. James Hagood, Division Chief of Pediatrics Respiratory Medicine at UC San Diego and Rady Children’s Hospital

http://www.pediatrics.ucsd.edu/Divisions/Respiratory%20Medicine/Pages/default.aspx