Whooping cough, meningitis concerns sweep country

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by Dr. Art Mollen, Special to azfamily.com

GMAZ interview by Kaley O'Kelley

Posted on October 9, 2012 at 8:54 AM

Updated Tuesday, Oct 9 at 9:00 AM

Whooping cough vaccine protection wanes fast

Health experts say 2012 is shaping up to be the worst year for whooping cough in more than five decades.

Most children receive five doses of the combined diphtheria, tetanus, and pertussis (DTaP) vaccine.

A newer version of the whooping cough vaccine doesn’t last as long as the older version. Experts think that has contributed to the increase in cases across the nation.

The current available vaccines are the safest that we have ever had and they do protect against pertussis.

Some 26,000 cases of whooping cough had been reported to the CDC - -twice as many cases as were reported by this time last year.

There is an average of 1,000 new cases a week right now. The rise has been greatest among children between the ages of 7 and 10.

A booster shot of pertussis, tetanus, and diphtheria vaccine, known as Tdap, is recommended for pre-teens and unvaccinated adults. Most whooping cough deaths happen in young babies who have not been vaccinated.

Whooping cough is a disease that causes very severe coughing that may last for months. You can cough so hard that you hurt a rib.

Whooping cough, also called pertussis, is contagious. This means it spreads easily from one person to another.

Whooping cough can lead to other problems such as pneumonia.

You can get whooping cough more than one time, but you will be less likely to get it again if you get the shots as recommended.

Whooping cough is caused by bacteria that infect the top of the throat (pharynx) where it meets the nasal passages. The bacteria bother the throat, which causes coughing.

When someone with the disease coughs, sneezes or laughs, drops of fluid holding the bacteria are put into the air. The bacteria can infect others when they breathe in the drops or get them on their hands and touch their mouth or nose. After the bacteria infect someone, symptoms appear about seven to 10 days later.

Adults usually have milder symptoms than children. Symptoms of whooping cough, usually last six to 10 weeks, but they may last longer.

In stage 1, symptoms are like those of a cold. In stage 2, the cold symptoms get better, but the cough gets worse. The cough goes from a mild, dry, hacking cough to a severe cough that you can’t control.

Death count rising in meningitis outbreak

Patients in 23 states are being warned that the spinal steroid shots they received may have given them a deadly fungal meningitis.

Spinal shots with three specific lots of a steroid called methylprednisolone acetate.

It can take as long as four weeks for these symptoms to appear. When they do, they begin gradually and may look a lot like the symptoms of other conditions, fever, headache, nausea, weakness and confusion. Tests of spinal fluid show whether a person is infected.

Treatment isn’t easy. It requires intravenous infusions of one or two antifungal agents.

Fungal meningitis is very rare and, unlike viral and bacterial meningitis, it is not contagious.

Meningitis is a term used to describe an inflammation of the membranes that surround the brain or the spinal cord. Meningitis is a potentially life-threatening condition, leading to permanent brain damage, hearing loss and neurologic problems. Fever, lethargy and mental disorientation. The highest incidence of meningitis is between birth and 2 years of age. The childhood Hib, meningococcal, pneumococcal, MMR and varicella vaccines prevent many of the diseases that lead to meningitis and there is a meningitis vaccine that is recommended for teens. Viral meningitis is less serious.

People often confuse the early signs and symptoms of meningitis. In fact, meningitis may come on the heels of a flu-like illness or infection.

Bacterial meningitis symptoms may develop within hours or days. Viral meningitis symptoms may also develop quickly or over several days. Headache, and neck stiffness are the hallmark symptoms of meningitis. Fever, severe, persistent headache, neck stiffness, nausea and vomiting, confusion and disorientation, drowsiness or sluggishness, sensitivity to bright light, poor appetite.

In infants, symptoms may include fever, irritability, poor feeding and lethargy.

One out of five people contract the infection have serious complications. About 15% of those who survive are left with disabilities that include deafness and neurological problems. Bacteria and viruses are the two main causes of meningitis. Your risk also increases if you’ve had a recent upper respiratory infection. Babies, children and teens are at greatest risk. Symptoms of meningococcal meningitis may vary from case to case. The more common signs and symptoms are high fever, severe, persistent headache, neck stiffness.

A reddish or purple skin rash is a very important sign to watch for. Many colleges require that students get a meningococcal vaccine before moving into a dorm.

Meningococcal disease is a leading cause of bacterial meningitis in teens. Not all types of meningitis can be prevented by vaccines. Fortunately, immunization does protect against four types of meningococcal disease.

Some 2600 people get meningococcal disease each year, one-third are teens and young adults.

Which meningococcal vaccines are available? Three meningococcal vaccines are available; Menomune, Menactra and Menveo. These meningitis vaccines can prevent four types of meningococcal disease.

Menactra is the preferred vaccine for people age 9 months to 55 years old. Provide more lasting protection and decreases carrier rates of meningococcal bacteria. Menomune is the only meningococcal vaccine licensed for people over 55.

Either vaccine may be given at the same time as other vaccines. The current recommendation for teens is one dose at age 11 and one dose at age 16.

The CDC recommends a meningococcal vaccine for all children ages 11-18 or certain younger high-risk children, anyone who has been exposed to meningitis during an outbreak, people with certain immune system disorders or a damaged or missing spleen.

The American Academy of Pediatrics recommends the first dose of vaccine be given at age 11 or 12 and then a second dose, the booster, should be given between ages 16 and 18.


Dr. Art Mollen's practice is located at 16100 N. 71st St. in Scottsdale. For more information, call 480-656-0016 or log on to www.drartmollen.com.

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