I heard third hand that my 3 year old daughter was exposed to whooping cough (pertussis). She was at a play group with a fully vaccinated child, who was diagnosed with the highly contagious infection a few days later. I was totally unprepared for what was to come, because my daughter is also vaccinated against pertussis. Here are 6 things to consider if this happens to you.
1. Figuring out the symptoms: The child had a very mild cough that the mother dismissed as a common cold. A well exam and test later revealed that it was indeed whooping cough. If this mother missed it, then it's likely that I could. I called our pediatrician to ask what symptoms I should be looking for. If a child is vaccinated and contracts whooping cough, they may not cough with the "whoop" that is characteristic of the illness. It might be a very mild cough with no fever and may behave like a mild common cold.
2. Exposure = immediate doctor visit: Because of the close contact my daughter had with this child, the doctor requested that I bring her in immediately for testing. This sounded harmless to me, so I agreed. We had plans for Labor Day weekend and if for some reason she tested positive, then it was obviously better to stay home. However, I should have paid more attention to the urgency in the nurse's voice when I scheduled the visit. She demanded that prior to arrival at their office that my daughter not come into contact with anyone whatsoever. The poor kid even stood awkwardly in the middle of the sick waiting room under instruction not to touch a single chair or toy.
3. The whooping cough test: The doctor took a giant skinny Q-Tip looking thing and shoved it up (it looked like it was pretty far up there) both nostrils to gather samples. Tears and panic erupted. I admit, it looked pretty uncomfortable. After that, my daughter coughed (possibly from having the test?) and with lightning speed, we were prescribed antibiotics and put in quarantine. We were told that even if she hadn't of coughed, the result would have been the same because San Diego County is having a difficult time controlling the outbreak. I can't find this in writing anywhere, but I was told that the County is mandating exposed children to be treated immediately.
4. Quarantine and medication: We were prescribed a "Z Pak" of Azithromycin which is a generic for Zithromax. The medicine is a pink liquid, so I assumed that I could hide it in some strawberry ice cream or similar and get it down. My daughter is terrible at taking medication. The taste is so bitter and strong that there is no way it could be hidden in food. In fact, despite me warning my daughter it was going to taste horribly, she threw up the entire first dose. She managed to get the rest down ok, with bribery. The dosing was one teaspoon on the first day and 1/2 teaspoon for 4 days after that. This means that we were in quarantine for 5 long days, but I was expecting to get the test results on the 4th or 5th day. The results came in on the 6th day. Nothing would have changed for my daughter if her test was positive, because the Z Pak would have been finished. However, a positive result would have meant that our entire family would begin immediate treatment for whooping cough. I am not sure if we all then would have been quarantined for another 5 days. Her test result was negative, so luckily we didn't have to find out.
5. Why whooping cough is on the rise: Our pediatrician said that it's a combination of 3 things. First, the vaccine itself is not 100% effective. I've read online that different studies show it's anywhere from 80-95% effective. Secondly, it's because some parents did not vaccinate by choice, likely due to a speculated link between vaccines and autism. Lastly, as I've already mentioned before, it can be difficult to identify whooping cough in a vaccinated child.
6. How to get the vaccine: Whooping cough cases are on the rise in many parts of the country. People with insurance are encouraged to see their primary care physicians. If you don't have insurance, it's possible that your county health department may be offering free vaccine clinics.
I admit that I took a few hours to think about what I was going to do, prior to picking up the Z Pak at the pharmacy. I was not at all convinced she had whooping cough and am not a fan of administering antibiotics unless necessary. My initial thought was to quarantine our family until the test results came back and if they were positive, to then proceed with the antibiotics and stay in quarantine (which by then be almost 2 weeks and overlap her first week of school). After speaking with my husband, we decided that if it is a county requirement, we should proceed as directed. We are also in the middle of remodeling my house so quarantining the three of us is next to impossible, since we can't live in our own home.
If this happens to you, what would you do? (Obviously I'm not a doctor so please consult yours.)
*Katie Dillon writes La Jolla Mom, an award winning lifestyle site about spa, travel, parenting, homekeeping, food, wine on Wednesdays and local happenings. She lives in La Jolla with her husband and preschool aged daughter, and is a proud member of the Yahoo! Motherboard.