Boston Latin student diagnosed with whooping cough

Two dozen Boston Latin School students who may have been in close contact with that student are being urged to visit their own doctors this weekend, BPS confirms.

Some of those students may have to take a preventative course of antibiotics. Additional families were also notified.

In patients past infancy, the disease is rarely fatal, although it can mean weeks of persistent coughing.

Although young children are supposed to be vaccinated against the bacterial infection, the vaccine can wear off - and some parents refuse to let their children be vaccinated.

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    Comments

    Get Immunized

    Get your kids immunized, and if you're an adult, get a booster. My aunt had this about five years ago, and it is no joke. She got the antibiotics and was eventually OK, but it really cut her down and she was sick for weeks.

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    Curious

    this is the kind of stuff that adds up to COPD at old age

    Where did you hear this? Smoking, air pollution and indoor air pollution pop out as associated exposures in the Global Burden of Disease, but not infection (and pertussis in particular) to my knowledge.

    I have seen it as a comorbidity issue when someone is already exhibiting COPD development (in other words, something that can seriously and permanently harm or kill you if you have COPD and that you are more likely to get if you have COPD), however - but not as a potentially causal agent.

    Thanks. She, obviously, didn

    Thanks. She, obviously, didn't think "pertussis" right away, and just thought she had a really bad cold with a cough. When that wouldn't go away she went to the doctor who put her on antibiotics even before the test results came back. But, what everyone describes here about a slow recovery was exactly her experience.

    When all these cases of whooping cough started appearing along with measles, I went to my doctor and got boosters for both. Coincidentally I was also due for a tetanus booster, so it was three birds with two shots (two, right? The measles booster wasn't a two-shot thing, right?) I probably got a pertussis booster 10 years before that when I got my tetanus booster for that decade (doctor thought that my then-doctor could have given me a DTaP, but that it wasn't worth researching.) From now on, whenever my 10-year tetanus booster rolls around, I'm going to keep it simple and make sure that I get all the other boosters, and any new ones recommended to me, at the same time. I've got better things to do than come down with preventable, awful diseases.

    BPS requirements?

    Every year Roslindale Pediatrics gives me evidence of my daughter's immunizations. Every year I submit it to BPS.

    Is BPS just collecting this information but nevertheless not requiring parents to comply with regulations?

    Immunity wanes

    We are talking about kids who may not have had a booster, yet are fully vaccination compliant.

    There are two issues at play: 1) some of these kids are old enough to have waning immunity and 2) boosters are a recent recommendation for teens and adults, as such were previously believed to not be at risk of complications or to suffer badly if they did get pertussis.

    That thinking has changed, but only in the last couple of years. Fortunately for the students involved, they will not have as bad a case of pertussis because they likely were vaccinated earlier in life. Unfortunately, they can infect people with weak immune systems and those too young to vaccinate.

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    A requirement, sort of

    I'm a big fan of vaccinations, but when I was quizzing pediatricians at the other pediatric center in Roslindale, I asked what they would do if I didn't want to vaccinate my kid. It was an interesting answer, but the important part to this is that BPS kids need to have the necessary vaccinations, unless there is a compelling reason (religious, moral, or theoretically medical) why the kids aren't vaccinated. The pediatrician then asked "do you really want your kid to have to get all these shots when he's 5?"

    Religious exemption

    Massachusetts allows religious and medical exemptions to vaccination requirements.

    For a religious exemption, caselaw states that one just needs to express sincerely held beliefs, not belong to an organized religion that espouses them. The parent just needs to write a letter stating that something violates their sincerely held religious beliefs. They don't need to explain these beliefs.

    For medical exemptions, most mainstream physicians will only write one if the child has a condition in which the vaccination is going to cause serious harm. However, there are physicians who will sign off on the medical exemption for reasons such as a parent's choice for a child to naturally develop immunities, or beliefs not rooted in mainstream science. Unless a physician is doing active harm to a particular child (which not immunizing doesn't do to a SINGLE child -- slews of people not immunizing for stupid reasons does it to societies), they have a lot of leeway in terms of what they recommend and what they will sign off on. There are a lot of alternative therapies, some of which are quackery, and others of which are outright risky, that licensed physicians are not forbidden from engaging in.

    Some doctors are not up to speed on this

    I got a booster 15 years ago when it ripped through my department - my department head, a pulmonary physician, caught it in Central America and brought it back.

    Back then, nobody realized that it could be so nasty for adults, or so easily spread, so there were no boosters recommended.

    I got a booster again a couple of years ago, and a year later there was another scare. This time, a professor in his 60s brought it back from China and shared it with 200 people at a workshop. Oy.

    Bottom line: the booster is now recommended for adults, because adults are vectoring it into the adult population (not to mention unvaccinated kids, but that isn't the whole problem). Get it done!

    Sounds like you had boosters

    Sounds like you had boosters after a known exposure to pertussis. What's the recommendation if there's no known exposure (but, like, I ride public transit, so there must be some exposure)? Am I wrong to assume that I'm OK with every decade, as long as I'm not knowingly exposed?

    Current recomendations

    Get one!

    http://www.cdc.gov/Vaccines/vpd-vac/pertussis/default.htm

    Health officials now recommend that adults and adolescents receive one dose of the Tdap booster vaccine to protect against whooping cough. It is especially important that those in contact with infants younger than 12 months of age are up-to-date with pertussis vaccinations. The Tdap booster is recommended in place of one dose of the Td (tetanus-diphtheria) booster.

    I was fortunately vaccinated before the second exposure in 2012. I also travel internationally, so my doctor suggested another dose in 2011. Good thing!

    Pertussis

    I got Pertussis (a weaker form of whooping cough) as an adult a few years ago. My immunization had worn off so I am partly to blame but I also blame the la-di-dah, carefree, overly-trusting-of-bullshit-medicine woman I was dating at the time, who I came to find out had not immunized her children.

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    Possibly

    My doctor said Pertussis, but he may have been simplifying it for me.

    You're right, I was ridiculously sick and even after I got antibiotics (~2.5 weeks after the onset of symptoms) and that cleared up a lot of problems, I still had a horrible cough for the next ~4-5 weeks.

    The 100 Day Cough

    I had it too, a few years ago. When it first came on, it hit me like a ton of bricks! My doctor said it's sometimes called the 100 day cough, and indeed it did hang on at least that long for me. I would not wish pertussis on anyone!

    For many years, when almost every child received vaccinations, whooping cough became extremely rare. It's a shame that an irrational fear of vaccinations has allowed this scourge to resurface again.

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    It's not entirely that, though

    I know a decent number of people in their 20s who had whooping cough despite getting all their vaccines diligently. It turns out that the whooping cough vaccine was changed in the 90s, and the new formulation requires more boosters than the old one, but it took the medical community until now to figure this out. So a lot of people born in the 80s had no clue their immunity had worn off, and therefore weren't advised to get boosters.

    I think they've changed the vaccine guidelines by now, though.

    Immunity wanes over time. I

    Immunity wanes over time. I had my immunizations in the 70s, and I got my first booster (on my own initiative) a few years ago. If you're an adult, and haven't knowingly had a DTaP within the past decade, get yerself one.

    As everyone is sharing experiences, it's a really terrible illness. I wouldn't wish it on anyone.

    On a side note

    people who are knowingly sick should stay at home, don't go into work, school, etc..then pass it along to a zillion other people. Just because you took OTC drugs to relieve the symptoms doesn't mean you're now OK. I know several perfectly intelligent people who do this all the time, and it's not that the can't take the time off or work from home, they can. One of them got pneumonia because she took all the OTC drugs to subdue her cough, the cough being the way the body heals itself.

    Influenza and colds not infectious past day three

    Trust me - you can't even extract virus from nasal secretions past that point - the symptoms are all due to the immune system going ballistic past the point of active infection.

    So stay home on days 1 and 2, and the vast majority of the time you will not be infectious if you go back sniffling on day 3.

    Most people don't know that they have pertussis, however, which can be infectious longer.

    Just like most people don't have trust funds and nice jobs and workplaces and schools that understand that staying home a couple of days prevents workplace epidemics.

    Always Wash Your Hands After Handling The Ⓣ

    So-called "hand sanitizers" are not as good as thorough hand washing. It's a good habit to always wash your hands when arriving home or to work, especially after riding on the Ⓣ. Do it as you arrive, before going to your office/desk or touching anything else. Thirty seconds of prevention can help avoid days (or weeks) of miserable illness.

    This is probably going to

    This is probably going to sound really gross, and also really obvious to anyone in the healthcare field, but during my first year in Boston, it seemed like I was catching a cold about every six weeks. This went on for a few months until I finally realized that maybe washing my hands every time I got off the T was a good idea. And, guess what, the colds pretty much stopped. These days, I also try to wear gloves or mittens for as long as I can when I'm riding the T (not in a freaky, why-is-she-wearing-gloves-in-July way, but more of an October to April thing.)

    All depends on the disease

    Some diseases make you infectious before you even know you are sick. For most diseases, it is the first few days you are feeling lousy.

    And with pertussis, antibiotics get rid of infectivity but not necessarily symptoms, so you can be coughing long after you are not able to infect everyone.