25 Nov 2015

I is for Immunisation

It was early spring. At a gathering of friends my son began to cough. His face turned red. He calmly got up and walked away doubled over. Concerned adults looked on. One jumped up and asked “is he choking?” This was the aftermath of whooping cough - the 100-day cough.

On a grey rainy day, listening to the radio, a segment on whooping cough was announced. There’s a spike in whooping cough (NSW Health recorded 3134 cases in 2014 and 8621 cases so far in 2015). Guest, Peter Collignon, ANU Medical school, spoke about timely molecular tests, which detect the DNA of bacteria that cause whooping cough.  The infectious nature of this respiratory disease produces toxins which damage airway linings. Infants have very little protection and are at higher risk. The vaccine has 75% + immunity, waning over time.

Prof Peter McIntyre, Children’s Hospital at Westmead speaks in an informative short film. Parents explain the tragic death of their infant who had whooping cough, asking “why don’t people know, why don’t adults know they need a booster?”

For my family, the beginning of spring had seen us with whooping cough, times four.  The first person to get sick in the family had become the guinea pig.  I consulted Healthdirect Australia which explains early identification and a specific antibiotic that lessens symptoms.

It took three appointments with GPs before we were on the right track to diagnosing whooping cough. By this time my second whooping cough victim was also moving from coughs to night time coughs, gasps and some vomiting. Whooping cough can be difficult to identify unless it is picked up in the first few weeks.

Health authorities advocate best protection is through immunisation. Immunisation may have problems but leads to herd protection.  The Australian government report, Immunisations myths and realities, responds to arguments against vaccination. Whooping cough is still here but immunised people are much less likely to have severe complications.

"babies in a cloud of cotton wool"
Pregnant women are encouraged to get free vaccinations passing on some level of immunity. Also fathers, grandparents and anyone around newborns are encouraged to have boosters. Someone said “It is a bit like wrapping babies in a cloud of “cotton wool”.

Campaigns such as Save the date to vaccinate, Apps to download or printed immunisation schedules are helpful reminders.

Emotionally draining for families

Doctors inform and we benefit from their clinical experience and knowledge of evidence based medicine. This is invaluable. When people get sick under these circumstances there are a lot of intangibles which can be emotionally draining. Where did it come from and who else is affected? For parents who are lacking sleep, asking the right questions can be difficult. I found it helpful to call Healthdirect or NSW Health, Communicable Diseases. The National Centre for Immunisation Research and Surveillance, NCIRS provides consumer resources.

I heard varied medical advice amongst families about diagnosis, nasal or throat swabs, test result waiting times, staying home or not whilst waiting, who should take the antibiotic, be given a booster or stay home if symptom free.

In my neighbourhood, none of the three chemists stocked the antibiotics for children in liquid form. Parents with sick children, trailed about trying to commence the antibiotic as soon as possible.

Adolescents take part in school immunisation programs. Some avoid their injections. Department of Health shares tips for parents about how to make this easier, reducing fear and apprehension. Teens who don’t want to line up in a large hall may find medical practices with experienced nurses and doctors reassuring.

AWCH Child Health Library has a number of useful resources to help prepare yourself and your child for a vaccination:

An end to whooping cough?

In September I wrote, “Its night-time and I hear my children coughing, sometimes in unison, gasping for air and gagging. The oldest didn’t get early diagnosis or antibiotics and the coughing started a month ago.” An end to whooping cough is not in sight but will awareness change its impact?

Jillian Rattray
AWCH librarian
November 2015