Could she have pertussis?

[joannqn]

Sixteen days ago, my 9 month old infant, was in the ER getting checked out after a bad fall off the bed. In the room next door, the child had pertussis. At one point during our stay the child and mother were walking in the hall but were quickly ushered back into their room (which is how I knew what they were there for). Our door wasn't closed the whole time either, and I used the restroom while the nurse held her in the hall way.

 

I told the doctor that my infant was NOT vaccinated for pertussis. He had no concerns whatsoever, telling me that the air vented to outside, making exposure unlikely.

 

The last couple of days, it has seemed like she was coming down with a cold. She has a little bit of dried bits of mucus around her nose, a VERY slight fever, and an occasional cough. Most of the time, she seems happy and fine. Once or twice a day for the past two or three days, she's had moments where she seemed to be feeling bad/sick/cranky. She's also cutting her upper front teeth (they are visible under the gums), and I'm sick with normal stuff (ear, sinus infection type stuff), and my 3 year old has a runny nose.

 

Would you be concerned? Our pediatrician has very short Sunday hours for urgent needs. The Mayo clinic says early symptoms look like the common cold. It also says early testing can detect it better and early antibiotics can lessen the severity. DH says "why? (take her to the doctor) She just has a cold." He's the same father who thought DD was overreacting when her eye got hurt and didn't take her in: turned out to be a scratched cornea. So I know he under-reacts.

 

Opinions from nonvaxers would be especially helpful. My other kids, including my 3 year old aren't vaccinated either. The recommendation is immediate vaccination of all family members on the fast schedule possible, and with our family history, I'd live in fear of reactions for a few weeks after each one.

[myfunnybunch]

Once or twice a day for the past two or three days, she's had moments where she seemed to be feeling bad/sick/cranky. She's also cutting her upper front teeth (they are visible under the gums), and I'm sick with normal stuff (ear, sinus infection type stuff), and my 3 year old has a runny nose.

 

I'd chalk it up to a cold or teething, particularly since she seems to be fine for periods of time. Sounds like normal teething symptoms, especially since it seems to come and go, and if others around her are having cold symptoms as well, it could be a cold.

 

If she starts acting more sick--constant coughing, higher fever, lethargy that doesn't go away--I'd have her checked. But she sounds fine for now, even if she's uncomfortable, poor sweet. And if you're still not sure or just want some peace of mind, call the urgent care clinic to see if they'd like to see her or what you should be watching for.

 

Cat

[jplain]

You may want to do a little more research on whether or not antibiotics really improve pertussis symptoms. My understanding is that if anything, antibiotics prolong the number of days of coughing, but they do shorten the infectious period.

 

In any case, I wouldn't worry much aside from keeping her away from other infants until she is well. :grouphug:

 

(Really, your child probably has more to fear from random adults than children when it comes to pertussis. Unless an adult has had a booster, s/he has lost the immunity s/he acquired from childhood vaccination. For that reason, un-boosted adults will always serve as a resevoir of pertussis. Any long term (> 3 weeks) cough in an adult should raise suspicion of pertussis. But it often goes unrecognized, as in adults there is no whooping sound to the cough.)

Edited May 9, 2010 by jplain

[Cera]

I would take her in and have her tested (probably tomorrow morning but maybe today). The worry that it was pertussis wouldn't be worth saving the time and money to me.

[SonshineLearner]

Well, if she does, you want antibiotics RIGHT away, because I've seen the difference between my children that received the antibiotics and not...

 

:)

[klmama]

If you call to ask the nurse if you should go in or not, she'll tell you to bring her in for a test, just as a precaution, whether or not she thinks it sounds like pertussis. However, you also run the risk of exposing yourselves to whatever other illnesses people there for urgent care may have, and getting those is more likely with colds already. It might be better to wait until tomorrow to test, when more of the patients will be at the clinic for routine check-ups. I would probably wait until tomorrow and call first thing in the morning so you can get an earlier time slot.

[Perry]

 

You may want to do a little more research on whether or not antibiotics really improve pertussis symptoms. My understanding is that if anything, antibiotics prolong the number of days of coughing, but they do shorten the infectious period.

There's some evidence that antibiotics lessen the severity if started during the catarrhal stage (first few days, when symptoms are mainly runny nose and mild cough). But pertussis is rarely diagnosed this early. If started during the paroxysmal stage, you're right; the purpose is to decrease transmission.

[jplain]

Perry, good to know, as my kids haven't yet received DTaP. Thank you!

[kalanamak]

 

Opinions from nonvaxers would be especially helpful. My other kids, including my 3 year old aren't vaccinated either. The recommendation is immediate vaccination of all family members on the fast schedule possible, and with our family history, I'd live in fear of reactions for a few weeks after each one.

 

FYI, there is a very cough-y cold going around in your area. No pertussis alerts are out. And, pertussis is considered a "large droplet" contagion, with only 3 or 4 feet of distance needed to prevent transmission.

[joannqn]

FYI, there is a very cough-y cold going around in your area. No pertussis alerts are out. And, pertussis is considered a "large droplet" contagion, with only 3 or 4 feet of distance needed to prevent transmission.

 

That helps!

 

What I'm reading is if the doctor washed hands properly, and I did when I used the restroom, then there was no exposure.