Humza Khizer

A tetanus shot is essential to calm down tetanus symptoms. The tetanus vaccine with diphtheria and pertussis can save you from infection. Read more at Meri Sehat.

Conquering The 3 Musketeers: Diphtheria, Pertussis and Tetanus in Adulthood

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Saad Ullah Siddiqui

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I Am An Adult, Should I Be Worried About Getting Whooping Cough?

Overview

<a href="https://www.merisehat.pk/disease/whopping-cough">Whooping cough</a> is a very contagious disease, and while the infection is common in infants, people of all ages can contract it.

The symptoms of whooping cough are less severe in adults compared to children. Infants who are not vaccinated are at the highest risk of developing complications and severe symptoms from whooping cough.

&nbsp;

Understanding Adult Whooping Cough

Adults can also be affected by whooping cough; however, it is less severe compared to children<a href="#accordion">[1]</a>.

Their symptoms are less severe in contrast to children because their immunity is stronger from previous infections and vaccinations.

Bordetella pertussis causes whooping cough and this bacteria spread through the air when someone with the infection sneezes or coughs. The symptoms develop five to ten days after being exposed, but for some people, symptoms don&rsquo;t develop for weeks.

Whooping cough has three developmental stages:

&nbsp;

<h5>Stage 1</h5>

The early stage of the disease is very contagious. Furthermore, whooping cough has mild, cold-like symptoms, which last for one to two weeks. For example:

<ul>
	<li>Sneezing</li>
	<li>Runny nose</li>
	<li>Low-grade fever</li>
	<li>Mild cough</li>
	<li>Fatigue</li>
	<li>Watery eyes</li>
</ul>

&nbsp;

<h5>Stage 2</h5>

People develop a persistent and severe cough after some time, and it can leave them gasping for air. The whooping sound of the cough happens when people inhale sharply to catch their breath after coughing a lot. People remain contagious in the second stage, and the symptoms last from one to six weeks.

&nbsp;

<h5>Stage 3</h5>

The cough improves gradually in the final stage and the coughing fits decrease. People are not contagious when they&rsquo;re in stage 3. However, they are at risk of developing other infections, which slows down the process of recovery.

&nbsp;

A doctor diagnoses whooping cough through a person’s medical history and current symptoms.Moreover, doctors misdiagnose whooping cough as a common cold or respiratory infection in most adult cases due to the absence of severe symptoms in adults.However, if a doctor suspects whooping cough in an adult, certain tests are prescribed. These tests include a nasopharyngeal swab, where the doctor collects a sample of the mucus through the nose for the analysis of B. pertussis bacteria.

Whooping cough can lead to insomnia and adults can develop secondary complications from the cough. The violent coughing fits can cause fainting and fractures of the ribs.

The other potential complications in adults are the following:

<ul>
	<li>Difficulty falling asleep or sleepless nights</li>
	<li>Sleep apnea</li>
	<li>Weight loss</li>
	<li>Eye infections</li>
	<li>Pneumonia</li>
</ul>

&nbsp;

The treatment varies based on the duration of the illness and severity of the symptoms, which is usually antibiotics therapy.

Early treatment with antibiotics can reduce the severity and speed up the recovery. Moreover, it also prevents people from transmitting the bacteria. Your physician will prescribe antibiotics to you and your household.

According to CDC, antibacterial treatment is most effective during the first two or three weeks of infection, before the coughing fit starts<a href="#accordion">[2]</a>.&nbsp;

&nbsp;

Key Points

<ul>
	<li>Whooping cough usually occurs in children, but people of any age can be affected by it, even adults.</li>
	<li>Pertussis has the distinct coughing sound that sounds like a whoop.</li>
	<li>Using cough medications is not recommended in pertussis (whooping cough).</li>
	<li>Vaccinated people can also be carriers of whooping cough.</li>
	<li>Several steps can be taken for the management of pertussis and to prevent it from spreading to others.</li>
</ul>

&nbsp;

[1] Zycinska, K., Cieplak, M., Chmielewska, M., Nitsch-Osuch, A., Klaczkow, A., Hadzik-Blaszczyk, M., Kur, Z. and Wardyn, K.A., 2016. Whooping cough in adults: a series of severe cases. In Pathobiology of Pulmonary Disorders (pp. 47-50). Springer, Cham.

[2] Wirsing von König, C.H., Tacken, A. and Finger, H., 1991. Whooping cough in adults. Deutsche Medizinische Wochenschrift (1946), 116(17), pp.649-653.

Staff Writer

Introduction

<a href="https://www.merisehat.pk/disease/diphtheria">Diphtheria</a> is a bacterial infection which causes severe inflammation of the nose and throat.&nbsp; 
&nbsp;

In the past, diphtheria was considered a major cause of child related mortality in USA. For example, till the 1920s, 200,000 cases were reported annually in the United States. However, since then, enforcement and adherence to strict vaccination schedules has helped in significantly reducing the disease.&nbsp;&nbsp;

&nbsp;

Understanding the Diphtheria vaccine for adults

A <a href="https://www.merisehat.pk/disease/diphtheria">diphtheria</a> vaccine is a toxoid vaccine against Corynebacterium diphtheriae. Since it is usually paired with a tetanus vaccine, it can be referred to as a tetanus shot. 
&nbsp;

The different types include:&nbsp;

<ul>
	<li>DTaP which provides immunization against diphtheria, tetanus, and acellular pertussis in children.</li>
	<li>DT which provides immunization against diphtheria and tetanus in children&nbsp;</li>
	<li>Tdap which provides immunization against combined tetanus, diphtheria and acellular pertussis) in adolescents (preteens and teens) and adults.</li>
	<li>Td which provides immunization against tetanus and diphtheria in adolescents and adults 
	&nbsp;</li>
</ul>

The vaccine is safe and in most people is associated with mild side effects such as pain, redness and slight swelling at the site of injection. The vaccine is also safe to use in people with poor immune function and pregnant women.

<h5>&nbsp;</h5>

<h5>Storage Of vaccine</h5>

The vaccines need to kept in cold, but not freezing temperatures&nbsp; 
&nbsp;

<h5>Effectiveness Of vaccines&nbsp;</h5>

Among vaccinated persons, about 95% develop immunity against the infection. Proper vaccination has reduced diphtheria by 90% globally between 1980 to 2000. 
&nbsp;

<h5>Why Are Diphtheria Vaccines Necessary?</h5>

Diphtheria is a highly contagious bacterial infection which can lead to severe complications: pneumonia, lung failure, and paralysis. It is associated with high mortality rates, e.g., 1 in 10 diphtheria patients die from it. 
&nbsp;

A diphtheria vaccine offers the best protection against this deadly infection. 
&nbsp;

<h5>Who Should Get Vaccinated?</h5>

People of all ages should get the diphtheria vaccine, including pregnant women, since it provides protection to the newborn from getting whooping cough in the first few weeks/months of life. 
&nbsp;

<h5>Are There Any Side Effects Of The Vaccine?</h5>

The vaccine is well tolerated by most people. Some mild side effects are possible, but are usually self-resolving. These include:&nbsp; 
&nbsp;

<ul>
	<li>Body aches</li>
	<li>Headache</li>
	<li>Loss of appetite, nausea, and perhaps vomiting.</li>
	<li>Low fever</li>
	<li>Local skin reactions at the site of injection, such as redness or swelling. 
	&nbsp;</li>
</ul>

<h5>How Effective Is The Diphtheria Vaccine?</h5>

DTaP, DT, Td and Tdap vaccines are 95% effective against diphtheria for up to 10 years. Since protections wanes over time, it is necessary that adults get a Td or Tdap booster shot every 10 years to maintain their immunity.&nbsp; 
&nbsp;

The CDC recommends adult vaccinations with the Tdap vaccines for the following:&nbsp; 
&nbsp;

<ul>
	<li>Adults who have never been vaccinated against diphtheria.&nbsp;</li>
	<li>Mothers who were not vaccinated in their childhood against diphtheria&nbsp;</li>
	<li>Health workers who are in direct contact with patients</li>
	<li>People who are going to travel in countries where pertussis is extensively present</li>
	<li>Attendants and health care staff (parents, grandparents, babysitters) who look after infants under 1 year&nbsp;</li>
	<li>Pregnant women in 27-36th week of pregnancy; this protects newborns from whooping cough in first few months of life&nbsp;&nbsp;</li>
	<li>People older than 65 years 
	&nbsp;</li>
</ul>

Boosters are recommended for all adults after every 10 years.

&nbsp;

The following adults should discuss and inform their health care providers prior to vaccination and booster shots:&nbsp; 
&nbsp;

<ul>
	<li>People allergic to any component in the vaccine.&nbsp;</li>
	<li>People suffering from seizures or another nervous system problem</li>
	<li>Guillain-Barr&eacute; syndrome (GBS) patients&nbsp;</li>
	<li>History of severe reaction to the vaccine in the past</li>
	<li>Suffering from severe illness including high fever</li>
</ul>

&nbsp;

Conclusion

A severe allergic reaction is a very rare occurrence. However, if it happens, these are the presenting signs: 
&nbsp;

<ul>
	<li>Hives</li>
	<li>Pale skin</li>
	<li>Dizziness</li>
	<li>Weakness</li>
	<li>Hoarse voice</li>
	<li>Rapid heartbeat</li>
	<li>High fever</li>
	<li>Behavior&nbsp;changes</li>
	<li>Breathing difficulties like wheezing 
	&nbsp;</li>
</ul>

If you experience any of the above mentioned symptoms after getting vaccinated, seek immediate medical attention. 
&nbsp;

<ul>
	<li>Diphtheria is a highly contagious bacterial infection, and is considered as a priority notification disease in Pakistan. Thereby, any presenting cases should be informed to the local health authorities immediately.&nbsp;&nbsp;</li>
	<li>Diphtheria is easily preventable with vaccination.</li>
	<li>Since immunity wanes over time, it is recommended that adults get booster doses after every 10 years.&nbsp;</li>
	<li>Boosters are recommended between the ages of 19-65.</li>
</ul>

Diphtheria, available at https://www.hhs.gov/immunization/diseases/diphtheria/index. retrieved on 27th June 2022.

[2].MedlinePlus Medical Encyclopedia: Diphtheria immunization (vaccine)". Archived from the original on 2 March 2009. Retrieved on 27th June 2022

[3].Diphtheria vaccine: WHO position paper- August 2017" (PDF). Wkly. Epidemiol. Rec. 92 (31): 417–435. 4 August 2017. hdl:10665/258681. PMID 28776357.

[4].William (May 2012). Diphtheria Epidemiology and Prevention of Vaccine-Preventable Diseases (12 ed.). Public Health Foundation. pp. 215–230. ISBN 9780983263135.