More than 21,000 people got whooping cough last year, many of them children and teens. That's the highest number since 2005 and among the worst years in more than half a century, U.S. health officials said Wednesday. Le Bonheur Infectious Disease Chief, Dr. Keith English provides some good information for parents who have questions and concerns regarding whooping cough. Here’s what he had to say.

Pertussis or whooping cough is a serious, potentially life-threatening infection that is particularly dangerous in young infants.  The best way to protect your children from pertussis is to make sure that they and everyone who lives in the home with them is immunized against it.

When does my child receive the vaccine
The primary immunization series for children includes the DTaP infant vaccine.  The first three doses of DTaP are given at 2, 4 and 6 months of age, and then boosters are later given at 15-18 months of age and at 4-6 years of age.

When will the vaccine take effect in my child
As with many other childhood immunizations, the pertussis vaccine provides greater protection after the 2nd and 3rd doses..

Should pregnant women and/or caregivers and close contacts be vaccinated
Protection of the most vulnerable infants - those less than 2 months of age who are not yet immunized and those 2-4 months of age who have only received one dose of pertussis vaccine- can only be accomplished by ALSO vaccinating close contacts of these young infants. This includes a first dose of the Tdap vaccine (this form is indicated for adolescents and adults) for teenagers and a booster dose of Tdap every 10 years for adults.  
It is particularly important for mothers of young infants to be immunized -- ideally, pregnant women should receive Tdap before pregnancy.  Otherwise, it is strongly recommended that Tdap be given shortly after delivery, before leaving the hospital or birthing center.  In situations such as a community outbreak of pertussis, the mother's physician should consider administering Tdap during pregnancy.

How is pertussis spread
Pertussis is spread by exposure to droplets in close proximity, usually within 3 feet, to a patient with pertussis who is coughing or sneezing.  One problem is that pertussis may be quite mild in teenagers or adults, who may spread the bacteria to a young infant at increased risk of severe disease.

As with other respiratory illnesses, good hand hygiene and avoiding contact with other children or adults with acute respiratory illnesses can also help limit the spread of pertussis.

For more information, visit www.cdc.gov/pertussis.

Due to the medication's candy-like appearance, it should be kept in child-proof containers

The U.S. Food and Drug Administration is warning that accidental ingestion of Tessalon (benzonatate) by children younger than 10 years can result in serious side effects or death.

Tessalon, approved by the FDA to treat symptomatic relief of cough in patients older than 10, may attract younger children because of the drug’s candy-like appearance – a round, liquid-filled gelatin capsule. The safety and effectiveness of benzonatate in children younger than 10 years has not been established.

“Benzonatate should be kept in a child-resistant container and stored out of reach of children," said Carol Holquist, R.Ph., director of FDA’s Division of Medication Error Prevention and Analysis. “The FDA encourages health care professionals to talk with their patients and those caring for children about the risk of accidental ingestion or overdose.”

A review of the FDA’s Adverse Event Reporting System database from 1982 through May 2010 identified seven cases of accidental ingestion associated with benzonatate in children younger than 10. Five of the cases resulted in death in children ages 2 years and younger. Overdose with benzonatate in children younger than 2 years has been reported following accidental ingestion of only one or two benzonatate capsules.

Common adverse events reported in the overdose cases included cardiac arrest, coma, and convulsion. Signs and symptoms of overdose can occur within 15-20 minutes of ingestion. Some of the deaths reported in children have been within hours of the accidental ingestion.

The FDA is also adding a new Warning and Precaution section to the benzonatate drug label to warn health care professionals about accidental ingestion resulting in overdose and death in children younger than 10.

Consumers and health care professionals are encouraged to report adverse side effects or medication errors from the use of benzonatate to the FDA's MedWatch Adverse Event Reporting program at www.fda.gov/MedWatch or by calling 800-332-1088.
 

Reports of pertussis cases, also known as whooping cough, are increasing, along with recent deaths in infants from the disease. Le Bonheur Infectious Disease Chief Dr. Keith English provides information for parents who have questions and concerns regarding whooping cough. Here’s what he has to say.

Pertussis (or whooping cough) is a serious, potentially life-threatening infection that is particularly dangerous in young infants.  The best way to protect your children from pertussis is to make sure that they and everyone who lives in the home with them is immunized against it.

When does my child receive the vaccine?
The primary immunization series for children includes the DTaP infant vaccine.  The first three doses of DTaP are given at 2, 4 and 6 months of age, and then boosters are later given at 15-18 months of age and at 4-6 years of age.

When will the vaccine take effect in my child?
As with many other childhood immunizations, the pertussis vaccine provides greater protection after the second and third doses.

Should pregnant women and/or caregivers and close contacts be vaccinated?
Protection of the most vulnerable infants (those younger than 2 months of age who are not yet immunized and those 2-4 months of age who have only received one dose of pertussis vaccine) can ONLY be accomplished by also vaccinating close contacts of these young infants. This includes a first dose of the Tdap vaccine (this form is indicated for adolescents and adults) for teenagers and a booster dose of Tdap every 10 years for adults.  
It is particularly important for mothers of young infants to be immunized; ideally, pregnant women should receive Tdap before pregnancy.  Otherwise, it is strongly recommended that Tdap be given shortly after delivery, before leaving the hospital or birthing center.  In situations such as a community-wide outbreak of pertussis, the mother's physician should consider administering Tdap during pregnancy.

How is pertussis spread?
Pertussis is spread by exposure to droplets in close proximity (usually within three feet) to a patient with pertussis who is coughing or sneezing.  One problem is that pertussis may be quite mild in teenagers or adults, who may spread the bacteria to a young infant who has an increased risk of severe disease.

As with other respiratory illnesses, good hand hygiene and avoiding contact with other children or adults with acute respiratory illnesses can also help limit the spread of pertussis.

For more information, see http://www.cdc.gov/pertussis/outbreaks-faqs.html

Research was released today indicating that instances of pertussis, or whooping cough are rising. We talked to Dr. Sandy Arnold, infectious disease physician at Le Bonheur Children’s Hospital and the University of Tennessee Health Science Center. Dr. Arnold’s input is below.

Pertussis, or whooping cough, is a bacterial infection characterized by a prolonged cough that can be severe, especially in very young children.  It is called whooping cough because infected people can have spells of cough during which it is difficult to breath, thus making an unusual sound called a whoop.  

Pertussis has three stages. The first stage lasts about seven - 10 days and is indistinguishable from the common cold. The next stage usually lasts several weeks and is the period where the most severe episodes of cough occur. Finally, the patient will enter a healing phase of the infection; this, too, can last several weeks.  Many serious complications can result from pertussis, particularly in young infants, including pneumonia, seizures and rib fractures.

The best way to prevent pertussis is to have your child vaccinated against the infection. In 2005, two new vaccines known as DTaP and Tdap were licensed. DTaP is for children younger than 7 years and has a higher concentration of pertussis than Tdap, which is intended for persons 10 years and older. The DTaP and Tdap vaccines are given as a shot in the muscle.

The usual schedule for infants is a series of four doses given at two, four, six and 15-18 months of age. A fifth dose, or booster, is recommended at 4-6 years of age, unless the fourth dose was given late (after the fourth birthday). All adolescents and adults younger than age 65 years should receive a one-time dose of Tdap.