Lack of energy that could be an early sign of a killer coughing bug
As the peak season for whooping cough starts, one woman’s cautionary tale...
COMING down with whooping cough sounds like something that might have happened to Oliver Twist. When I tell people I’ve just had it, a common response is: ‘Does it still exist?’
But pertussis, commonly known as whooping cough, is very much still around: in fact, the number of cases last year was 430, more than double the 205 recorded the year previously.
For the very young, i t’s extremely dangerous — last year, two babies died from the disease. But you can get it at any age: I am 25.
Mid- July is the start of the peak season for catching whooping cough.
The problem i s that many people assume their childhood vaccination will protect them for life, but it won’t. Or they contract the highly contagious bug but don’t realise it’s the reason behind their lack of energy and hacking cough.
I certainly didn’t. And such is its insidious nature I didn’t even cough to begin with. I felt under the weather — tired, achy and lacking in energy, which I put down to stress and lack of sleep.
After nearly a week of feeling lousy, there was an abrupt change.
One night I suddenly doubled up in pain with sharp stabs shooting all over my back and down my chest (especially when I breathed in) and I was shivering furiously — little did I know these are early signs of whooping cough.
I felt better the following day, so went out in the evening, but on the way home I started feeling dizzy. I got off the train and fainted, hitting my head on the platform. I was out for about half a minute.
An our-of-hours doctor service advised me to call an ambulance. When the paramedics arrived, they said I was probably run down and concussed from the fall. They advised me to rest and go to hospital if there was any dramatic change in my condition.
Over the next 24 hours I became extremely sensitive to light, had no appetite, was nauseous and started losing my voice.
Yet I still wasn’t aware these symptoms showed whooping cough was taking hold.
AS I LEARNED later, it can take up to three weeks between contracting the bacteria and developing symptoms (though seven to ten days is average).
This long gap and the difficulty in spotting the condition mean the chances of infecting others is high, says Dr Gayatri Amirthalingam, a consultant epidemiologist in immunisation.
‘ Pertussis is very contagious. Patients are most infectious in the initial stage, when non- specific cold-like symptoms develop, and after the onset of the cough.’
Oblivious to all this, I rested, hoping to feel better soon. But I was so weak by the end of the second day after fainting I struggled to walk from my bed to the bathroom.
My mother was concerned and came to collect me and take me back to our family home so she could keep an eye on me.
By then I could hardly manage to sit up for more than an hour before needing to lie down. A few days later I passed out while sitting up in bed and my mother phoned for an ambulance.
At hospital a nurse checked my blood sugar and gave me an ECG (electrocardiogram) to monitor my heart, and a pregnancy test — which is standard practice for young women.
She found nothing, and whooping cough was not mentioned. I was confused and finding it hard to concentrate, so the on-call doctor said I might have a small bleed on the brain from the concussion. I was monitored in hospital overnight.
During the night, my blood pressure dropped extremely low to 90/59 (a normal reading is 120/80). A doctor examined me at 5am and said I had phlegm on my chest, but not to worry.
In the morning a consultant declared I had a bug, the effects of which had been compounded by concussion. I was discharged without a prescription and advised to rest and take paracetamol.
I stayed in bed for a few more days. It was only then that I started coughing — which is the most obvious sign of whooping cough — two weeks after I started feeling unwell. Within 48 hours I was up most of the night with an excruciating cough that left my ribs and back in agony.
I couldn’t breathe until the end of each bout when I’d gasp for air, sometimes retching. It was unlike any cough I’d had before and so loud that I woke everyone in the house. I took Benylin, ibuprofen and sucked Strepsils, but nothing seemed to help.
I booked an e mergency appointment with my GP — he immediately diagnosed whooping cough, nearly three weeks after my first symptoms, saying he’d seen an increasing number of adult cases.
I was prescribed a course of clarithromycin, the only antibiotic that can ease the cough.
But I didn’t understand how I caught whooping cough — after all, I was immunised against it as a baby as part of the standard six-inone jabs given to infants.
I had no idea the vaccine wears off by adulthood. ‘The relatively high incidence of confirmed whooping cough infection in ten to 14- year- olds i n 2012 suggests protection from the infant vaccine lasts up to about ten years,’ says Dr Amirthalingam.
‘While re-infection is possible, symptoms seem to be less serious in a vaccinated individual.’
The main symptom is a hacking cough, which continues at length in severe fits. The ‘whoop’ monicker comes from the sharp intake of breath the sufferer takes after a coughing fit.
Other symptoms may include a temperature, vomiting after coughing and a runny nose, all of which I had. Babies are at risk of further complications such as breathing difficulties, excessive vomiting, seizures, low blood pressure, dehydration and kidney failure.
Severe complications, such as pneumonia and brain damage, can prove fatal to infants.
Peaks in whooping cough cases occur every four years, but the reasons behind this are unclear.
‘The availability of a diagnostic blood test has improved our ability to confirm suspected cases of whooping cough, which may account for the rise in diagnoses,’ says Dr Amirthalingam.
‘ However, waning of vaccine-induced immunity also seems to have contributed to the increase during 2011 to 2012.’ The theory is that this waning of immunity is due to new types of the bug — just as new strains of flu develop annually — against which the existing vaccine might not work.
So should we expect to see a rise in cases this summer? ‘Whooping cough peaks between July and September,’ says Dr Amirthalingam. ‘So, we do anticipate an increase in cases over the next few months.’
VACCINATION pr o - grammes focus on babies and pregnant women. ‘That’s the only effective way to manage whooping cough,’ says GP John Arundel.
‘Mothers must make sure to get their babies immunised. That’s the most vulnerable age group and the jab offers about 90 per cent protection.’
Most instances of the disease are reported in babies under three months, but numbers have fallen since the HSE advised pregnant women to also get the vaccine in January this year. A campaign to have the vaccination offered free of charge to expectant mums has been unsuccessful so far.
Antibodies, produced as part of the body’s natural immune response against attacking bacteria and viruses, are passed from mother to unborn child, offering some protection until the baby is old enough for their jab.
After I had taken antibiotics for a week, my doctor said I was no longer infectious. All I could do was rest and wait until the bug worked its way through my system.
Two months on, I’m better, with no effects except a heightened susceptibility to tickly coughs. Whoop!