Gill Stannard

Monday, April 27, 2009

whooping cough

What is whooping cough?

Caused by the Bordetella pertussis bacteria, it is highly contagious and spread through droplets from the mucosa (eg: nose and mouth). The incubations period lasts 7-20 days. The initial symptoms are of a typical head cold which then develops into a lasting, paroxysmal cough. The cough classically has a “whoop” sound as the person breathes in. This is may be more distinguishable in a child rather than an adult.

In the western world there is usually a whooping cough epidemic every 2-4 years.

You can hear how whooping cough sound in a child and an adult.

Who gets whooping cough?

While pertussis is thought of as a childhood disease, in Australia with an infant vaccine rate of at least 90% the majority of people who develop the disease in this country are over the age of 15. But adult cases often fall under the radar.

Whooping cough in babies is sometimes fatal. The majority of deaths form the bacteria are in those under 6 months old. In adults the disease is much milder and rarely deadly.

According to the latest edition of the Australian Prescriber 10–35% of subacute coughs in adults are due to pertussis. As the symptoms are milder than in children and there may be little or no “whoop”, this may be a conservative estimate. In adults the cough is often persistent, giving it the name of the “100 day cough”. A specimen is needed to grow a culture to determine if pertussis is the cause. However even with a diagnosis there is no miracle cure for the condition. Australian Prescriber and the Cochrane collaboration conclude that antibiotics may reduce the infectious period but do not change the duration of the symptoms.

The biggest problems associated with adult pertussis are difficulties sleeping due to the spasmodic cough; the force of the cough causing urinary incontinence or a broken rib and a small number of people may develop pneumonia.

Why is whooping cough so common when we have such an effective immunisation campaign?

While Australia has one of the best immunisation uptakes in the world there are still some issues with the pertussis vaccine. No vaccine is 100% effective. Pertussis immunisation has a lower than normal rate of preventing a fully immunised child from developing the condition, with only 59-89% effectiveness. The vaccine offers immunity for approximately 4-6 years, requiring frequent boosters once the first three shots in the first 6 months of life take effect.

For those who have acquired the disease naturally, that too doesn’t offer life long immunity but secondary attacks are usually mild and often unrecognized.

How can naturopathy help you get over whooping cough?

While prevention is always the key with natural therapies, pertussis is a particularly tenacious virus and therefore even healthy children and adults can succumb. If there is an outbreak near you consider taking a good quality echinacea extract at full dose and follow the other prevention guidelines.

For adults with the dreaded “100 day cough” in my experience if treated early enough with herbs and nutrients if can decrease the duration of the symptoms by a number of weeks but there is no evidence based medicine review to support this.

Obviously rest is important. With sleep disturbances due to the hacking cough, getting enough rest is a big problem. This is time to cut your schedule back to the bare minimum.

Use warming spices such as aniseed and cinnamon in your hot drinks and food. Cook with plenty of onion and garlic and remember to increase the amount of orange vegetables in your diet. It is a good idea to skip the flour and dairy while you are have a lot of phlegm.

Steam inhalations can soothe the spasmy cough as well as deliver some anti-infective constituents to the lungs. Add 1 or 2 drops of cypress, eucalyptus or tee tree essential oil to a bowl of hot water and breath in slowly, covering your head and bowl with a towel to trap the steam.

As it can be difficult to move the mucus out of the lungs onion cough syrup makes a simple home remedy to help thin the phlegm and make it easier to expel. Slice a brown onion, cover with runny honey and leave covered in the fridge. After a couple of hours the syrup is formed. Adults take 1 tablespoon 3 times a day to increase expectoration.

A qualified herbalist might treat with the following herbs:

Immune support include: echinacea, astragalus, olive leaf, wild indigo, thyme.

Respiratory antispasmodics include: sundew, mullein and elecampane

Soothing demulcent herbs include: licorice (not the confectionary kind) and marshmallow.

For nighttime relief wild cherry is a natural cough suppressant. Generally a suppressant is only used to help someone get some sleep.

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