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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 02:48 PM
Original message
Anyone know anything about pertussis?
My 13 year old, 85lb son has been coughing for a month. Asthma meds are mildly helpful, pulmonary function tests were mixed, his peak flow was at 67% (the rest of the measurements I don't understand so I don't remember except that many were normal), two antibiotics have been tried (amoxcillin and minocycline) but his cough has become worse.

So today "Google Newsed" cough and Whooping Cough came up. It seems that they are closing schools in surrounding states because of it. What's worse, the symptoms fit perfectly. I've put a call into the asthma doctor but he has the day off.

If it is pertussis does it matter if it is diagnosed at this late date?

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shoelace414 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 02:51 PM
Response to Original message
1. He's contaigus
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shoelace414 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 02:51 PM
Response to Reply #1
2. and it CAN kill. (usually very young children)
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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 02:55 PM
Response to Reply #1
4. Should I rush to take care of it?
I pissed the pediatrician off when I gave up on him for the specialist, now the pediatrician may be the only game in town until Monday.

Should I swallow my pride?
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flordehinojos Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:41 PM
Response to Reply #4
30. Absolutely. Call the Pediatrician. The stupid specialist doesn't seem to
know what he is doing.

When my son received his SECOND SERIES OF SHOTS (DPT) he got a very high fever following the shots. The pediatrician told us that he was NEVER TO RECEIVE ANY PERTUSSIS SHOTS because his reaction to the PERTUSSIS (WHOOPING COUGH) could be more dangerous to him than the whooping couhg.

I would swallow my pride and call the pediatrician... with my kid's health, and me worrying about what is going on... i would want to have the reassuring voice of his pediatrician tell me what is going on.

Good luck. and Good Health to your son.
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Ilsa Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 02:54 PM
Response to Original message
3. Did he have his DTP shots as an infant?
He should be fully immunized if he had his vaxes. There would have been either four or five of them, with a tetanus booster around age 10-12, and probably a booster of Diphtheria also.
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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 02:58 PM
Response to Reply #3
7. Yes his vaccines are up to date.
I even made sure he got the flu shot, but he is one of those kids that catches everything. From what I'm reading the vaccine can lose its effect in young adolescents, they will still get pertussis but a milder case than they otherwise would.
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LeighAnn Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:00 PM
Response to Reply #3
11. Outbreak where I live; Kids all immunized
There are several cases of this going around here, school kids that were fully immunized. Makes you wonder.
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sir_captain Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 11:05 PM
Response to Reply #11
47. vaccine
loses effectiveness over time...nothing to wonder about
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bicentennial_baby Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:40 PM
Response to Reply #3
28. Whooping Cough only covers up to age 10
After 10, you're not covered
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BrklynLiberal Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 02:57 PM
Response to Original message
5. Go to hospital emergency room and get treatment for him n/t
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Indiana_Dem Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 02:58 PM
Response to Original message
6. I work at a small hospital and we've been seeing alot more of it.
We've been isolating everyone who has a persistant cough, mostly children.
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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 02:59 PM
Response to Reply #6
9. OK, what should I do today?
He is at school as I type. He isn't all that sick when he isn't coughing. Is it imperative that I find out immediately or can it wait until the specialist is back on Monday?
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Indiana_Dem Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:43 PM
Response to Reply #9
31. Well, the minute the doctors suspect it, they've been
sending them directly to the Health Department if the office is closed, or the ER. You have to get a diagnostic test to find out. One night I worked, I heard one doctor sent 3 people to the health department to get tested all at once. This is a small town we're talking about, too. It's very contagious, and if you go to the ER, tell them immediately so they can get a mask on the possible infected one, and they will do a test to find out.

We had one who came in and they didn't find out until later the child had pertussis and practically the whole ER Department and Medical floor had to get antibiotic treatment due to exposure.

I think much of the spread has to do with immigrants coming in and having not been vaccinated against the virus. Also, the older you get, it is said that you lose your immunity over time despite the vaccination early in life, hence, the susceptability of the virus to immunocompromised people.
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shesemsmom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 08:27 PM
Response to Reply #31
38. Indiana Dem
where are you. I too work in small city hospital and have seem several case and have been treated
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Indiana_Dem Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:48 PM
Response to Reply #9
33. I would take my daughter immediately.
If you don't have a county health deparment available then go to the ER.
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RUDUing2 Donating Member (968 posts) Send PM | Profile | Ignore Fri Dec-10-04 02:59 PM
Response to Original message
8. 67% of normal is in the low yellow zone and should have resulted in a
prednisone burst...and/or an upping of the inhaled steroid for a short period.

did they do a sinus xray to check for an asymptomatic/chronic sinus infection? If that is the culprit it takes 21-30 days of a strong antibiotic to clear it up...a lesser dose will only knock it down..not out.

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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:02 PM
Response to Reply #8
14. It had been about six weeks since his last predinsone burst,
for severe poison ivy. I told the doctor I'd rather avoid it if at all possible so he didn't push it, I have some at home so I could start it at any time.
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RUDUing2 Donating Member (968 posts) Send PM | Profile | Ignore Fri Dec-10-04 03:06 PM
Response to Reply #14
19. is he on an inhaled steroid? If so ask your doc about adding an extra
dose for a few days. We go that route before trying the prednisone..and have had good results..

also is he using both albuterol and atrovent? Atrovent helps quite a bit when there is coughing involved...we have had the best luck altrenating the two..do the albuterol and two hours later do the atrovent, etc..so there is never a down period for the meds..

And make sure he uses the albuterol before taking his inhaled steroid so that it gets in deeper.

Oh yes he does use a spacer w/his albuterol doesn't he?

I agree about wanting to hold off if possible, but it sounds like he really does need the prednisone..
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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:10 PM
Response to Reply #19
20. Yeah, he is using Advair 500.
That was the compromise when I requested we put off the steroids. Otherwise he is only using albuterol.

He does not use a spacer with the albuterol, I'm sure we have one somewhere, he hasn't had an exacerbation in some time so we aren't at the top of our game.
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RUDUing2 Donating Member (968 posts) Send PM | Profile | Ignore Fri Dec-10-04 03:22 PM
Response to Reply #20
24. if he isn't using the spacer he is only getting about
50% effectiveness from the albuterol.

also remember that while the serevent in the advair starts working immediately, the flovent has to build up effectiveness. It takes about 7 days for this and up to 30 days for it to reach its full effectiveness...

Definately hunt up the spacer and I would also ask about getting an atrovent inhaler..

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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:40 PM
Response to Reply #24
27. I'll start him on the spacer when he gets home.
Thanks.
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Amaya Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:00 PM
Response to Original message
10. Please take him to a doctor immediately
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havocmom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:01 PM
Response to Original message
12. The vaccine they give babies DOES NOT give lifetime protection
Pertussis is undiagnosed and on the rise. The vaccine seems to wear off in ten years or better, so healthy teens and adults are getting this nasty bug.

We have it up here and it seems to recur. I find the only thing that helps my husband and I is fenegreek. He takes it in capsules and I brew up tea from seeds, drink the tea and eat the boiled seeds. Tastes awful but lets me sleep at night and function better during the day. I cannot take a lot of meds and the bronchial dilators usually prescribed are very bad for me. Fenegreek seems to do wonders without side effects (beyond making me smell like it :P )

Don't know what the standard treatment is for it when it finally does get diagnosed. I know that coughing til you puke and nearly pass out is not fun. Easy to see how this could be fatal for small kids or frail older people.

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spotbird Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 07:52 PM
Response to Reply #12
36. But it isn't a serious illness in adults, is it?
I thought it was one of those things that was only bad for infants.
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havocmom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 09:43 PM
Response to Reply #36
40. Not AS serious for MOST adults.
Edited on Fri Dec-10-04 09:46 PM by havocmom
But, it knocked me down for weeks on end, so I wouldn't take it lightly. Really exhusting and all the hard coughing detatched a retina. I still have some bad bouts of coughing until I vomit up any water in my stomach and see flashing lights, and we are talking 2 years later, so I am not convinced it really goes away.

Edit to add: my daughter has a friend who is a pathologist and she has done some Y - incisions on people she is sure had pertussis that went undiagonised. She is appalled at how MDs in private practice miss it in teens and adults and said it will be a major problem in the US VERY soon.
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another5bdem Donating Member (43 posts) Send PM | Profile | Ignore Sat Dec-11-04 02:27 AM
Response to Reply #36
51. Unvaccinated infants can get it from older kids
while it may or may not be too serious for your son, making sure you have it diagnosed and treated may help protect infants or those with a compromised immune system.

But what do I know?

Hope he gets better soon.

:-)
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DemExpat Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:01 PM
Response to Original message
13. Maybe whooping cough is becoming resistant to
the vaccines, or wears off after a few years...

:shrug:

DemEx

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sir_captain Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 09:47 PM
Response to Reply #13
42. Vaccine only lasts about 10 years
as it always has
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Cuban_Liberal Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:02 PM
Response to Original message
15. Take him to the ER **today**.
Edited on Fri Dec-10-04 03:04 PM by Cuban_Liberal
Better yet, take him to a university medical center, if there's one close at hand. His lung-function is borderline, and I bet his oxygen-saturation isn't all that great. I used to be a paramedic, and your son is being under-treated.
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Rambis Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:02 PM
Response to Original message
16. Go to the ER now!
.
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Cheswick2.0 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:05 PM
Response to Original message
17. if it were whooping cough you would hear a very strange
barking cough with some vocalization to it.

Is that the case?
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MuseRider Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:05 PM
Response to Original message
18. My husband and I and both of our immunized sons
got whooping cough while on vacation at Disney World about 15 years ago. It was very odd at the time for immunized people to get it but we did and it was awful. Go to the doctor and get checked out. It can kill, most likely not your older son but still, it is best to do all you can.
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Cheswick2.0 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:13 PM
Response to Original message
21. here is a page where you can listen to what the cough sounds like
Edited on Fri Dec-10-04 03:17 PM by Cheswick2.0
with and without the whooping and also child and adult males coughing.


http://www.whoopingcough.net/symptoms.htm
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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:16 PM
Response to Reply #21
22. The link's missing.
Thanks.
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Cheswick2.0 Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:17 PM
Response to Reply #22
23. fixed it on edit
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RUDUing2 Donating Member (968 posts) Send PM | Profile | Ignore Fri Dec-10-04 03:32 PM
Response to Reply #21
26. another site to check out breath sounds..
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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:41 PM
Response to Reply #21
29. The cough the same, but he hasn't become as
breathless as the one on the tape.

Thanks for the link.
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Cuban_Liberal Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:46 PM
Response to Reply #29
32. His function and Oxy sat's worry me.
67% is borderline, and he can't be getting much above 90% on his sats, so I'd really take him in to an ED now. If I saw him in the field with the symptoms you're describing, we'd have transport him to an ED 'stat'...
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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:50 PM
Response to Reply #32
34. I'll swallow my pride and call the regular pediatrician.
The boy will be home from school soon.

It hasn't been that nutty to not be super aggressive about this, he seems well enough when he isn't coughing. This morning he was more tired than usual though.
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Cuban_Liberal Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:51 PM
Response to Reply #34
35. Good decision.
Always better to be on the safe side, especially when it involves a respiratory problem. Good luck!

:hug:
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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 10:58 PM
Response to Reply #35
44. Follow-up
The pediatrician's office had no appointments by the time I called, they weren't particularly worried about a kid with a cough who otherwise doesn't otherwise seem sick. They didn't laugh out loud at my questions about pertussis, but were sufficiently condescending.

There is no change in the boy's cough, he does not gasp with the cough, which seems to be the hallmark of pertussis.

I called the local health department, I was informed that the person who could answer questions about pertussis would be available on Monday. The person answering the phone did say she didn't know anything about it at all, but I had the impression that that is how she answers every question.

He isn't sick but he wants to be around me all the time, which is very, very unusual these days.
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sir_captain Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 11:02 PM
Response to Reply #44
45. Honestly
as long as you're around him, I doubt there will be any real problem to wait until Monday, and I think it'd be a bit much to go to the ER for a cough. Just take him to the ped or health dept. on Monday, and if you're really worried about whooping cough, keep him at home over the weekend so that he doesn't infect others.
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Lone_Wolf Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 03:27 PM
Response to Original message
25. My understanding is Whooping cough causes VERY hard coughing fits...
almost to the point of vomiting. Additionally, there is a very characteristic whooping sound as the person quickly inhales to get air into their lungs after it was expelled by coughing.
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sir_captain Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 09:48 PM
Response to Reply #25
43. Having had it, I can confirm that this is true
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Changenow Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 11:05 PM
Response to Reply #25
48. Yeah, I think I fell into the trap
that a little knowledge is a dangerous thing.

But I'm still worried...
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shesemsmom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 08:22 PM
Response to Original message
37. pertussis
Edited on Fri Dec-10-04 08:25 PM by shesemsmom
is highly contagious and even if he was vaccinated at an early age as most children are these day the effectiveness of the vaccine wears off after a few years. It is called Whooping cough because it has a distinctive *whoop*. Though this is not always the case. The best one to make that diagnosis is his Doc. If he has it he needs antibiotics. Call you Doc aspa and tell him what you may suspect. He may want to see him away from others as he would be very contagious. Also at this time they are not giving booster shots for pertussis. They say that it may be more dangerous to give them. Crazy notion huh
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LeftyMom Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 08:28 PM
Response to Original message
39. He needs vitamin C
Pertussis isn't that unusual in teens since the vaccine wears off by then. It's not a danger nrmally, but should be monitored due to his athsma. Give lots of vitamin C, I prefer the powdered kind (he'll excrete the excess, it's water soluble.)

My son had it earlier this year, he caught it from his babysitter. It's really not a big deal, just keep him away from small children and the elderly until he feels better.
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sir_captain Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 11:04 PM
Response to Reply #39
46. This is not good advice
A) Vitamin C isn't proven to do really anything.
b) It is possible to take so much Vit C that it cannot all be excreted (if you don't believe me, read up on how kidneys work)
c) Whooping cough is incredibly contagious and is a public health risk and needs to be treated with antibiotics as such.
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LeftyMom Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-11-04 02:12 AM
Response to Reply #46
50. ...
The families I know that have dealt with pertussis (since my son reacted badly to a vaccine I've come to know a lot of non-vaxing families, so I know a fair amount) have found that vitamin C helps. Sure, to much of anything is harmful, but it would take an awful lot of vitamin c to reach that point. A friend of mine reccomends a pinch of ascorbic acid powder in water for every 15 lbs of body weight, once a day when you're healthy and twice a day when you're sick. Since the powder doesn't taste at all good, I thing it would be awful tough to take too much.

I understand that pertussis is contagious, that's whey I said I'd keep him away from persons at risk. I don't think antibiotics are the answer though, they won't hasten the speed of his recovery but he'll make a lot of spiffy resistant bacteria while he's on them. If he feels well enough that he was at school today he really doesn't need antibiotics.
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sir_captain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-11-04 02:56 AM
Response to Reply #50
52. See, that's where you're wrong...
it doesn't matter how he feels if he has whooping cough. He can feel great, won't have a fever, he won't have nausea, but he'll still be extremely contagious. One needs to take the antibiotics in order to kill the bacteria and render oneself not contagious. If he takes the full course of anti-biotics as directed by his physician then there should not be a problem with resistant bacteria (which are mainly caused by people not taking all their medicine.) This is the *very* situation in which anti-biotics are completely necessary!
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sir_captain Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Dec-10-04 09:46 PM
Response to Original message
41. No
I've had it. It's exceedingly contagious and needs to be treated with strong antibiotics (usually Biaxin.) The symptoms *do not* go away--the antibiotics will make it so he's not contagious anymore (assuming this is what he has, of course.) In Chinese, it's called "The Hundred Day Cough" and honestly, that's about right--you just need to wait for it to go away by itself, and that can take a couple of months.

It can be tested for, so get him to the pediatrician.
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WarNoMore Donating Member (530 posts) Send PM | Profile | Ignore Fri Dec-10-04 11:16 PM
Response to Original message
49. I had whoopin cough when i was three years old.
I still remember it-- I must have coughed to the point of throwing up because I remember standin over the toilet. I don't know of ant lasting effects but it was tiring and scary.
Whatever, it's a worrisome time for you, I'm sure everything will be fine.
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leftofthedial Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-11-04 02:58 AM
Response to Original message
53. they had a moderate outbreak here too
we thought my 11-year-old daughter had it, but tests were negative.

Nasty stuff. Lasts for frigging ever. Everyone can catch it and it is especially awful for older people.

Apparently vaccinations were far less effective than the pharmo assholes claimed.
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sir_captain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-11-04 03:05 AM
Response to Reply #53
54. Neh...
it's always been known that the vaccine, like many vaccines, conferred resistance for a limited amount of time. But since it's a really bad disease for the very young and the elderly, it's still completely worth it. Well, except that there's a very small chance of brain damange with the vaccine, which is why the brits don't use it.
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leftofthedial Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-11-04 03:11 AM
Response to Reply #54
55. when our family doctor gave vaccinations when my kids started school
the claim was that the vaccine was 95%+ effective. Take the PDT and never worry again.

When my daughter got her recent cough (not pertussis, though they did blood work because of the local outbreak), he complained that they had since lowered the claimed efectivenes to the 75% range.
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sir_captain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-11-04 03:14 AM
Response to Reply #55
56. Effectiveness is different from duration...
I'm under the impression anyway, that it's never been claimed to confer lifetime protection.

There are lots of vaccines like this...it's not that uncommon.

But yeah, I hear you on the complaints about the pharmaceutical companies...I certainly have no great love for them either.
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