What and Why?
Whooping cough is unusual among the infections of childhood. Breast feeding conveys no specific protection against it, although breast milk strongly upholds your baby’s general immunity and maximizes his chance of an uncomplicated recovery from the disease.
It is usually caused by a germ which is very insensitive to antibiotics, so that conventional treatment is very unsatisfactory. Its worst effects arise not from the germ directly, but from a chemical toxin produced by it which makes the nerves in your wind-pipe extremely sensitive, causing the spasmodic cough which gives the disease its nick-name. Coughing spreads the germ about a good deal, especially within your family.
You are infectious from a few days after you catch the germ, which grows in your wind-pipe producing catarrh, slight fever and coughing within another week. After two weeks of this the infection settles, but the cough really gets into its stride. You simply cannot stop once you have started, until you are so empty of air that your face goes blue and you are about to faint; then a long whistling breath in sets you up for the next coughing spasm. Once you have seen it, the pattern is quite unmistakeable.
The cough is so intense that your eye or nose may bleed, and its weakening effect open you up to all sorts of complications — earache, bronchitis) and pneumonia, epileptic fits, and ulceration of the affected parts of your throat. If the catarrh gets too thick to be expelled the force of the cough recoils on your lungs, rupturing some of the gas exchange bubbles and over-inflating the small tubes leading to them. This is bronchiectasis, a life-long sump where pus collects unless you up-end your chest regularly to empty it.
You are out of circulation for at least five weeks, and may take another three months to recover anywhere near your best. But the toxin can persist in your wind-pipe for several months more, long after the infection has died out, giving an encore whenever a cold rekindles it.
Whooping cough ranks with meningitis and antibiotic-resistant bacterial food poisoning (see head injury), the last infections left which commonly causing severe problems in Western countries. Ten thousand cases are reported annually: only five die, but many more have some permanent damage, and all lose three months of their lives to the disease. Prevention offers the only effective control, and a vaccine for this purpose became available in Britain during 1957.
Whilst in principle this seemed like the answer at first, it has some drawbacks in practice. The vaccine is not perfectly effective; one recipient in five gets little or no protection. And there are more positive snags. About one baby in 100,000 who receives the full course of three injections may suffer permanent brain damage — less rare than with any other commonly injected vaccine. Publicity about this risk has drastically reduced uptake of pertussis vaccine, and there is no doubt that babies who have ever had brain damage, neurological symptoms or irritability should not be given it.
What can I do?
Advice to maintain and maximise health
1. Do not wait until vaccination age to begin protecting your children against pertussis. There are many things you can do right from birth. The most important is isolation of your baby within the family circle. Resist going back to work before six months.
2. Take all the precautions you would use to prepare for and reinforce other immunisations.
3. Homeopathic treatments: Homoeopathic potencies have been prepared from the catarrh of pertussis patients, and used to prevent the disease. It is given as drops or a tablet at long intervals, contains no chemical substance or germ material and appears to be utterly harmless. Insufficient research has been done in this country to establish its effectiveness but 70% protection is claimed from experience abroad, which is close to the best the injection achieves. It cannot be obtained except on prescription however, and public policy is firmly against it. This is a pity, because it should be explored. Maybe your doctor would consider it, if you or your health visitor were to discuss it with him. It could be used to protect your baby until he is old enough to take injections reasonably well.
4. Immunisation: Wait until you baby begins to wean himself (about six months — see infancy) before even considering injections. By that time, however, the risk of permanent damage from pertussis infection is much less. By school age, immunization is no longer offered. So you can bide your time, all being well.
5. Public policy at present favours commencing immunization at six weeks, to start protection as young as possible. But your baby’s immune system is nowhere near ready at this age, and many other measures are available to cover this period. To inject tiny babies with anything is inhumane and diminishes general vitality and immunity for several weeks afterwards. A few have a more localized type of physical reaction, a tender hot swelling at the site of the injection which may last a week. This often is a reaction to the aluminium compound used to intensify the effect of most injected vaccines; it should be excluded from later doses. Very occasional severe reactions do occur with this vaccine, and that damage cannot be undone. You should be cautious if your baby either may have inherited a tendency to epilepsy from a close member of his family, or was premature, or showed any sign of nervous irritability, feebleness, or brain damage shortly after birth: your paediatrician will have reported this to your doctor. If in doubt immunize later, or not at all.
6. Pertussis infection — should it occur — in a healthy child be no worse than a cold, but for the coughing bouts. Early antibiotic treatment may help prevent them, but ordinary cough medicines are no use at all. Try Drosera 3 2-hourly, and give it or Pertussin 30 to everyone else night and morning as a preventative. Otherwise try anthroposophic Pertudoron, obtainable if appropriate on prescription from replete: you will need first to consult our doctor. At the catarrhal stage, try Aconite 3 every two hours; once spasmodic coughing has begun, try Ipecac 3 instead. Use Honey Cider Vinegar (see recipes for health) after coughing bouts. Pertussin 30 is useful during recovery.
- NHS Choices
- Health Protection Agency (HPA) – Information and Research about Whooping Cough
- NHS Immunisation Information