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Whooping cough - A story of one family's loss |
A serious outbreak of whooping cough swept through Kyogle and Evans Head in northern New South Wales in 1986, just after Jean Newton had taken her new baby daughter home to Kyogle from Lismore Base Hospital.
At the time, a lot of coughs and sniffles were doing the rounds. First, two year old Joe picked up a nasty cough, then two week old Lara became unwell.
Mrs Newton was a bit worried about her two youngest and went to her doctor, but apart from the colds both seemed to be in reasonable health. However, Lara did not improve in the following weeks. When she was about two months old, nose swabs were taken as whooping cough was thought to be a possible cause, but the tests came back clear. According to Dr Sue Page, a Lennox Head GP, this may happen in some cases.
It was only after a chest x-ray that Lara was rushed to the intensive care unit at Lismore Base, before being transferred to The Mater Children's Hospital in Brisbane. She died a few hours later. The diagnosis was whooping cough.
"Death from whooping cough is usually caused by lack of oxygen to the brain following severe, prolonged coughing, but some children will die from the severity of their pneumonia," Dr Page said.
Whooping cough is a preventable childhood disease. The immunisation schedule starts at two months, with three doses of vaccine in the first year. Dr Page said a baby under one year was the most vulnerable: "The younger the baby, the more likely they are to develop severe complications or die from the disease if they have not been vaccinated."
Lara had not been able to get her vaccinations at two months because of the severity of her cold. When she died, she was only three months old.
Mrs Newton said it was a common misconception that whooping cough could be
identified immediately by the whoop that accompanied the cough attacks.
Dr Page agreed, and said very young babies may never develop a whoop, as was the case with Lara.
"I would describe the cough itself as uncontrollable spasms of coughing followed by gasps for breath, the characteristic whoops and often vomiting," she said.
"In babies, their smaller airways and more shallow breaths mean that there may not be enough time between coughing spasms to breathe properly, or they may stop breathing for a short period of time, and they may get oxygen-starved brain damage."
The figures Dr Page quoted to illustrate what whooping cough can do to babies under one year make grim reading: 60% must be hospitalised, 17% develop pneumonias which do not respond well to treatment, 2% have fits, 1% develop inflammation of the brain and one in 250 will die.1
Over the last few years, the percentage of children who are up to date with their whooping cough vaccination has been sliding. At the same time, the number of recorded cases of whooping cough has risen dramatically.
According to the Australian Bureau of Statistics, just under 60% of children were up to date with their vaccinations against whooping cough last year.2 Dr Page said 95% needed to be vaccinated for the population to be protected against whooping cough.
Some parents may be concerned about the effects of the vaccine. Local reactions such as redness and swelling are common, and a mild fever and irritability may occur. However, a serious reaction is very rare, according to Dr Page.3 She said the vaccine was safe, and a new version had been developed that had fewer side effects. It should be released soon.
Jean Newton is of the generation that remembers the ravaging effects of the childhood diseases now preventable through vaccine. Her older sister contracted polio before the polio vaccine became available. It amazes Mrs Newton that people are anti-immunisation or simply complacent about the issue.
So what is the answer to the low rates of immunisation in Australia, and in particular in the Northern Rivers of NSW?
Mrs Newton thinks reaching tomorrow's parents when they are teenagers might help: perhaps through schools and child care training courses. She believes the new Australian Childhood Immunisation Register will make a difference, as it is easy for busy parents to forget the immunisation schedule.
Mrs Newton has had two more children since the tragedy of Lara's death, Claire who is now eight years old and Emily, 15 months. Both are up to date with their vaccinations and Emily is your typical bouncing, into everything, smiling baby.
Going through the immunisation process again with Emily means she sees at first hand the low priority many younger mothers give immunisation. It saddens her. Especially as other outbreaks of whooping cough continue to occur in the Northern Rivers. As recently as last year, there were 190 notified cases in the Richmond district alone, according to figures from the North Coast Public Health Unit.4
"I think if you took people to see a child with whooping cough in hospital, and made them watch that child fighting for air after every cough attack, they would change their minds," Mrs Newton said.
"It is the most terrible thing to see and there's absolutely nothing you can do."
Her message is simple: immunisation against whooping cough would prevent these
deaths.
References:
1. Source for those under 1 year old: MJA, Vol 161, 5 Sept 94, by Margaret Burgess, physician
in preventive medicine, RAHC, Sydney.
2. Australian Bureau of Statistics, April 95, Children's Immunisation Australia' (ABS Catalogue No. 4352.0). Table 2, page 2.
3. Understanding Childhood Immunisation, CDHHS. Page 15
4. North Coast Public Health Unit, table of figures for Richmond
This article was published in local media in April 1996.
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