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Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Whooping Cough & Immunizations

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Child Getting Vaccinated
The U.S. Centers for Disease Control and Prevention (CDC) recently announced that 21,000 people in the U.S. were reported to have suffered last year from whooping cough (pertussis, caused by the bacteria Bordetella pertussis). This is the highest number of reported cases in the U.S. since 2005. The cases were seen mostly in children and teenagers, with California leading the list of contributors to this alarming statistic. Whooping cough does not carry a high mortality rate, but can certainly cause a person to be seriously ill. Coughing bouts may be of a severity to cause broken ribs. It is not uncommon for a person stricken with whooping cough to be ill for up to four weeks.

Immunization is highly effective, and should be properly carried out for all those who are eligible. If you are going to be traveling out of your native country, you should certainly be immunized prior to the trip. The disease is very contagious, so routine hygiene precautions (such as washing hands) cannot be relied upon to guarantee protection. Being properly immunized is the best precaution.

The CDC advises as follows:

Diphtheria, Tetanus, and Pertussis Vaccines

There are several formulations of vaccines used to prevent diphtheria, tetanus, and pertussis. Some are combined with vaccines to prevent other diseases and reduce the total number of shots that someone receives at one office visit. In the U.S., DTaP, Tdap, and Td vaccines are most commonly used.

Upper-case letters in these abbreviations denote full-strength doses of diphtheria (D) and tetanus (T) toxoids and pertussis (P) vaccines. Lower-case “d” and “p” denote reduced doses of diphtheria and pertussis used in the adolescent/adult-formulations. The “a” in DTaP and Tdap stands for “acellular,” meaning that the pertussis component contains only a part of the pertussis organism.

DTaP is given to children younger than seven years of age; Tdap and Td are given to older children and adults.

Children should get five doses of DTaP, one dose at each of the following ages: two, four, six, and 15-18 months, and four to six years.

Td is a tetanus-diphtheria vaccine given to adolescents and adults as a booster shot every 10 years, or after an exposure to tetanus under some circumstances. Tdap is similar to Td but also containing protection against pertussis. Adolescents 11-18 years of age (preferably at age 11-12 years) and adults 19 through 64 years of age should receive a single dose of Tdap. For adults 65 and older who have close contact with an infant and have not previously received Tdap, one dose should be received. Tdap should also be given to seven to 10 year olds who are not fully immunized against pertussis. Tdap can be given no matter when Td was last received.

With Regard to Vaccine Safety

Some children should not get DTaP vaccine or should wait. Consult with your health care provider.

  • Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine.
  • Any child who had a life-threatening allergic reaction after a dose of DTaP should not get another dose.
  • Any child who suffered a brain or nervous system disease within seven days after a dose of DTaP should not get another dose.
  • Speak with your doctor if your child:
    • had a seizure or collapsed after a dose of DTaP
    • cried non-stop for three hours or more after a dose of DTaP
    • had a fever over 105 degrees Fahrenheit (40.5 degrees Centigrade) after a dose of DTaP
    • has a history of previous seizure(s)
    • is suspected to have an underlying neurologic disease

Some of these children should not get another dose of pertussis vaccine, but may get a vaccine without pertussis, called DT. DTaP should not be given to anyone seven years of age or older. Ask your health care provider for more information, particularly if your immune system is suppressed by an illness or by medications. Detailed information for medical providers about vaccine side effects, adverse reactions, contraindications, and precautions may be found on the CDC website at http://www.cdc.gov/mmwr/preview/mmwrhtml/00046738.htm.

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Tags: Just for Kids , On the Road , Staying Safe

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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