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FAQs on Whooping Cough (Pertussis)

Pertussis or Whooping Cough is a highly contagious disease of the respiratory tract caused by
Bordetella pertussis, a bacteria that lives in the mouth, nose, and throat. Many children who
contract pertussis have coughing spells that last four to eight weeks. The disease is most
dangerous in infants and spreads easily from person to person, mainly through droplets produced
by coughing or sneezing. The first symptoms generally appear 7–10 days after infection, and
include mild fever, runny nose, and cough, which in typical cases gradually develops into a
spasmotic cough followed by whooping (hence the common name of whooping cough). In the
youngest infants, the spasms of coughing may be followed by periods of difficulty to catch a
breath. Pneumonia is a relatively common complication; seizures and brain dysfunction occur
more rarely. Untreated patients may be contagious for three weeks or more following onset of
the cough. Pertussis or whooping cough can be prevented by immunization.

How does whooping cough start out?
Whooping cough often starts with cold or flulike symptoms – sneezing, runny nose,
and a mild cough, which may last up to two weeks before the more severe coughing
spells begin. Your child may also have a fever. … The patient may cough up or vomit a
thick mucus

How common is whooping cough in the US?
Even with the success of pertussis (whooping cough) vaccines, the disease is still
common in the United States. Many cases are not diagnosed and so are not reported.
In recent years between 10,000 and 40,000 cases are reported each year.

How serious is the Whooping Cough?
Whooping cough—or pertussis—is a very serious respiratory (in the lungs and
breathing tubes) infection caused by the pertussis bacteria. It causes violent coughing
you can’t stop. Whooping cough is most harmful for young babies and can be deadly.

How contagious is whooping cough?
Infected people are most contagious up to about 2 weeks after the cough begins.
Antibiotics may shorten the amount of time someone is contagious. While pertussis
vaccines are the most effective tool we have to prevent this disease, no vaccine is
100% effective

How long does it take to get over whooping cough?
Pertussis disease can be divided into three stages: Inflammation of the mucous
membrane stage: can last 1–2 weeks and includes a runny nose, sneezing, low-grade
fever, and a mild cough (all similar symptoms to the common cold). Coughing stage:
usually lasts 1–6 weeks, but can persist for up to 10 weeks

Is whooping cough worse at night?
In this second phase of pertussis, coughing fits occur once every one to two hours
and are worse at night. The cough can be so severe that it can cause vomiting or
passing out. In older infants and toddlers, a gasp for air after a coughing fit can
sometimes produce a loud “whoop.”

Do adults get whooping cough?
Adults may not have the classic “whoop,” if they have a milder case of the disease.
Whooping cough is most contagious before the coughing starts, so the most effective
way to prevent it is to get vaccinated. The whooping cough vaccine for adults (and
adolescents) is called Tdap (tetanus-diphtheria-acellular pertussis).

What are the signs of whooping cough in adults?
In general, whooping cough starts off like a common cold. Symptoms can include runny
nose, low-grade fever, tiredness, and a mild or occasional cough. Over time, coughing
spells become more severe. Coughing may last for several weeks, sometimes 10
weeks or longer.

How do you get tested for whooping cough?
A nose or throat culture and test. Your doctor takes a swab or suction sample from the
area where the nose and throat meet (nasopharynx). The sample is then checked for
evidence of the presence of whooping cough bacteria. Blood tests.

How long does it take to get the results of a whooping cough test?
It is easiest to find it in the first 2 weeks but very unlikely after 3 weeks. But the patient
has often had it for 3 weeks before whooping cough is suspected. So it is unusual to
get a positive culture in whooping cough. In other words, if a swab is negative, the
patient can still have whooping cough.

Can whooping cough come back?
This is very common. When whooping cough is in its recovery phase, catching
another mild respiratory infection will cause all the bad whooping cough symptoms to
come back again, but only for the duration of the cold , then it will settle again. Q5.

Can you get whooping cough if you had the vaccine?
If you’ve been vaccinated and get pertussis, you are less likely to have a serious
infection. Typically, your cough won’t last as many days and coughing fits, whooping,
and vomiting after coughing fits won’t occur as often

How often do you need to be vaccinated for whooping cough?
All adults age 19 years and older need a one-time whooping cough booster vaccine.
The whooping cough booster, called Tdap, is a combination vaccine with tetanus and
diphtheria. Pregnant women need Tdap vaccine during the third trimester (between 27
and 36 weeks of every pregnancy).

How often do you need to get the Tdap vaccine?
All adults who have not yet received a dose of Tdap, as an adolescent or adult, need to
get Tdap vaccine (the adult whooping cough vaccine). Pregnant women need a dose in
every pregnancy. After that, you will need a Td booster dose every 10 years

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My kid hit his head! Does he need a CT scan?

Usually not. And getting the test when it’s not needed poses risks.

It’s natural to worry if your child falls and hits his head. But—perhaps prompted by the growing concern aboutconcussions, especially in sports—parents seem to be taking those accidents more seriously. The number of emergency room visits for head injuries in children has almost doubled in the past decade, according to the national Centers for Disease Control and Prevention.

And “more and more parents arrive in the ER with the idea that their visit won’t be complete without a head CT,” says James Duncan, M.D., a radiologist at Washington University in St. Louis who had studied the overuse of CT scans. In fact, almost half of children with head injuries seen in emergency rooms now get CT scans. But about one-third of them are not needed, says the American Academy of Pediatrics.

In most cases a neurological exam, in­clud­ing questions about the injury and symptoms, can determine whether your child has a minor concussion. CT scans are necessary if the doctor suspects a skull fracture, bleeding in the brain, or other serious injury, or if your child was involved in a serious accident (like a car crash, falling off a bike without a helmet, or falling down five or more stairs) or is unconscious, has tingling on one side of the body, or suffers hearing or vision loss.

Read more about when children need imaging tests for hits to the head, with advice from the American Academy of Pediatrics.

—David Schipper

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What really works against bug bites

Would you rather be eaten alive by mosquitoes and ticks that can carry debilitating—and even deadly—diseases or douse yourself in harmful repellents full of potentially dangerous chemicals? Almost three-quarters of Americans say they worry more about insect-carried diseases, such as West Nile and Lyme as well as newer threats like chikungunya and Powassan, according to a recent Consumer Reports survey of 2,011 U.S. adults.

Here’s the real dilemma, though: Most people also say that safety is key when they choose a repellent, but only about a third think the products now on the market are safe for adults. Even fewer—23 percent—think the repellents are safe for kids.

If you’re conflicted about what to do, we have good news: For the first time ever in Consumer Reports’ tests of insect repellents, new, safer products—made with milder, plantlike chemicals—were the most effective. (Check our insect repellent Ratings and buying guide.) The top scorers outperformed products that contained deet, a chemical that did best in our previous Ratings but can cause serious side effects.

The active ingredients in the top repellents are chemically synthesized compounds that are similar to or come from natural ingredients. The secret sauce in the best-scoring Sawyer product is picaridin; in the Repel it’s oil of lemon eucalyptus. They are not side-effect-free, but “those problems are much less severe than deet,” says Urvashi Rangan, Ph.D., executive director of Consumer Reports’ Food Safety and Sustainability Center. “Still, all repellents should be used sparingly and only for the time you need them—especially on children and older people.”

That’s why an effective bug-avoidance strategy requires a full arsenal. Our new tests identify non-chemical approaches that offer some relief (setting up a fan on your back patio, for example) and those that don’t help much if at all (think citronella candles, wristbands, and “all-natural” products with geraniol, lemongrass, and rosemary oils).

What bugs a bug most?

To find effective spray-on repellents, we went to an outside lab and tested 15 pump sprays and aerosols. The products contained deet, oil of lemon eucalyptus, picaridin, a chemical called IR3535, and products made with natural plant oils.

Our brave testers had a different repellent applied to each of their forearms and, 30 minutes later, reached into an 8-cubic-foot cage containing 200 disease-free, female mosquitoes in need of a blood meal to lay their eggs. We used culex mosquitoes (the kind that transmit West Nile and are most active between dusk and dawn) and aedes (a variety that likes to feed on humans, is active all day long, and carries chikungunya). Our experts watched and recorded bites every hour.

A repellent failed if a tester was bitten two or more times in one 5-minute session, or once in two consecutive sessions. For ticks, we marked each tester’s bare arms with three lines, then released, one at a time, five disease-free deer ticks to crawl on them. The repellent failed if two ticks crossed into the treated area.

The top-performing products contained 20 percent picaridin and 30 percent oil of lemon eucalyptus. They kept mosquitoes and ticks away for at least 7 hours. Two deet products also earned at least Very Good scores, and the repellent that was 15 percent deet outperformed the 25 percent deet product, possibly because of its inactive ingredients. The IR3535 products didn’t make our list of top sprays. Some of the plant-oil products couldn’t ward off the aedes mosquitoes for even half an hour.

The scoop on deet and its alternatives

Deet (N, N-diethyl-meta-toluamide) has been the go-to insect repellent since it was introduced in the 1950s. But consumers are still confused by it: 64 percent of people we surveyed admit that they don’t know how much deet a repellent should contain for it to be considered safe. And balancing safety and effectiveness is tricky. Products with 15 percent or more deet do work, though concentrations above 30 percent are no better, past tests have found. And deet, especially in high concentrations, can cause rashes, disorientation, and seizures. That’s why we say you should avoid repellents with more than 30 percent deet and not use it at all on babies younger than 2 months. But go too low—such as 7 percent deet—and it won’t stop bites for long.

Picaridin and oil of lemon eucalyptus—two repellents introduced in the last decade—make good alternatives to deet. Here’s why.

They work. The repellents we tested that contain 20 percent picaridin and 30 percent oil of lemon eucalyptus (p-Menthane-3,8-diol) warded off mosquitoes for at least 7 hours and kept deer ticks away for at least 6 hours. But the concentration is important: A spray that contained just 5 percent picaridin performed worse than the 7 percent deet product we tested.

They’re safer. Picaridin is made to resemble the compound piperine, which occurs naturally in black pepper plants. Oil of lemon eucalyptus comes from the gum eucalyptus tree. Both have less serious side effects than deet has. Oil of lemon eucalyptus can cause temporary eye injury. The Food and Drug Administration says it should not be used on children under age 3. Of the two, picaridin is a better choice for kids, although it can cause some irritation of skin, eyes, and lungs.

How to safely use insect repellents

Proper use is essential, even with safer products. That means:

• Apply repellents only to exposed skin or clothing (as directed on the product label). Never put it on under clothing. Use just enough to cover and only for as long as needed; heavy doses don’t work better.

• Don’t apply repellents over cuts, wounds, or irritated skin.

• When applying to your face, spray first on your hands, then rub in, avoiding your eyes and mouth, and using sparingly around ears.

• Don’t let young children apply. Instead, put it on your own hands, then rub it on. Limit use on children’s hands, because they often put their hands in their eyes and mouths.

• Don’t use near food, and wash hands after application and before eating or drinking.

• At the end of the day, wash treated skin with soap and water, and wash treated clothing in a separate wash before wearing again.

The danger in the bite

Mosquito-borne diseases

West Nile was reported in 47 states last year and killed 85 people in the U.S. Chikungunya isn’t as widespread—yet—or as deadly. Of the almost 2,500 cases reported in the continental U.S. since January 2014, there were no deaths, and only 11 cases were from bites received in the continental U.S. (all in Florida). The rest were brought back from the Caribbean, Asia, or Africa. But experts worry that chikungunya may be prone to large outbreaks in urban settings. The mosquitoes that carry it bite all day long. Plus, roughly 70 to 90 percent of infected people develop symptoms, compared with 20 percent of those infected with West Nile.

What to do. See a doctor if you develop signs of either disease: fever, headache, and body aches for West Nile; and fever and joint pain for chikungunya. Both are viral, so antibiotics won’t help. But over-the-counter pain relievers can ease symptoms.

Tick-borne diseases

Lyme disease affects about 300,000 people each year, mostly in the Northeast and Upper Midwest. But that geographic reach is expanding, and doctors in new areas may be less familiar with the disease. Other tick-related diseases include Rocky Mountain spotted fever, most often in North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri; babesiosis, in the Northeast and Upper Midwest; ehrlichiosis, in the Midwest and South; and an emerging virus, Powassan, mainly in the Northeast and Great Lakes region.

What to do. See a doctor if you develop a bull’s-eye rash accompanied by flu-like symptoms, which indicates Lyme. Prompt treatment can stop the infection and prevent more serious complications, such as joint pain and facial paralysis (Lyme disease); heart, joint, or kidney failure (Rocky Mountain spotted fever); blood clots and bleeding (babesiosis); difficulty breathing or bleeding disorders (ehrlichiosis); and neurological problems (Powassan).

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What’s your bike helmet habit?

Do you faithfully wear a helmet every time you hop on a bike? And even if you do, are you sure you’ve got it on right? If not, you’re at risk of head injury and worse if you fall, whether on a city street or a bike trail.

If you always wear a bike helmet, congratulations. You’re doing better than the nearly 60 percent of Americans who admit they never wear one when out riding their bikes. But Consumer Reports found that even among helmet wearers, there’s still some room for improvement.

When our staffers observed 570 adult bike riders at a bike riding event near our New York office, we found that though most (84 percent) of the adults were wearing a bike helmet, 20 percent of them had loose chin straps, and about 10 percent of the helmets were on lopsided, meaning riders had them pushed too far back on their heads.

Nearly all the 55 children we observed were wearing helmets—a good thing since it’s a New York state law anyway for kids 14 and younger. But more than one-third of the children had loose chin straps or cockeyed helmets. A helmet has to fit snugly to protect you, and it needs to be level, with the front edge no more than an inch or so above your eyebrows.

Of the one-third of riders who stopped to take our informal survey, 83 percent were wearing helmets, and most of those people told us that their helmet was less than four years old. (Consumer Reports’ experts say you should get a new one if your helmet is gouged or cracked or you’ve been in an accident, even if it doesn’t look like it has been damaged.)

About half told us they had been in a bike accident; most said they were wearing a helmet at the time, and that it protected them.

Most riders paid $21 to $50 for their helmets. The features that were most important to them, in order, were: Fit and adjustability, comfort, and price. Only a fraction admitted that style was a feature they looked for. The 17 percent of survey takers who weren’t wearing a helmet gave these reasons for not wearing one: They were uncomfortable, too difficult to adjust, or too expensive. In our bike helmet tests, we score all of these factors.

There are no state laws forcing adults to wear helmets while cycling, but many cities and towns do require it, and a bill introduced in California this year would make wearing a helmet mandatory for all adults statewide. Twenty-one states and Washington, D.C., already have helmet laws for kids.

Nearly 90 percent of our survey takers said they knew about New York’s helmet law for kids, and that’s good news, says Ilene Marcos, who owns a bicycle shop with her husband in Mount Kisco, N.Y. “People come to our store with their helmet literally in pieces. They say they have no doubt that their helmet saved their life.”

—Sue Byrne

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