The Dangers of Spring Cleaning

13 03 2013

spring-cleaning1Spring is nearly here. Does your yard beckon, displaying fast-growing weeds and frumpy foliage?

Mine calls to me, along with the garage, all of the windows, the closets, and every surface that is bespeckled with dust.

If you can’t fight the urge to clean, beware of the risks (you knew this was coming). If, however, you can resist the urge, feel free to use this list in your defense, should your SO wave a rake or sponge your way.

I can’t clean or do yard work . . .

—until I get my tetanus shot. Rusty nails, hoes, and rakes that are pokey and dirty, debris blown onto the yard from winter storms—they’re just waiting for me. (Swap out this Td shot for a one-time Tdap shot, get protected against tetanus, diphtheria, and pertussis.)

—because I saw mouse poop in the garage and I don’t want to get hantavirus by sweeping up those virus-laden bits. I have delicate airways. (There are safe ways to clean up mouse droppings, but the SO doesn’t need to know that.)

—as long as there are mosquitoes in this world. West Nile virus is everywhere! And I can’t wear mosquito repellent while doing yard work because it smells funny, although that’s not the case when I’m kayaking. Strange.

—while ticks live in this world. Lyme disease, Rocky Mountain spotted fever, Colorado tick fever—these are all insidious infections brought on by ticks. I believe I saw a tick on the bathroom wall last week. Possibly it hitched a ride on the dog, which shook it off while in the bathroom. I really have no other explanation.

These excuses are reasonable and clear. If your SO is having trouble swallowing understanding them, feel free to share our contact info.

By Trish Parnell





Whooping Cough – How Quickly it Spreads

10 12 2012

This Seattle mom shares the story of her infection, and consequently, that of her newborn son.





Pertussis Booster

1 10 2012

PKIDs’ advice nurse, Dr. Mary Beth Koslap-Petraco, discusses the staying power of the pertussis booster for teens and adults.

Listen now!

Right-click here to download (4min/2mb)





Whooping Cough Can Happen to You or Your Baby

19 07 2012

Whooping cough comes in waves. It’s not a problem every year, but we’re riding a wave right now.

We were on a telebriefing this morning with Dr. Anne Schuchat, director, National Center for Immunization and Respiratory Diseases (CDC), and Mary Selecky, secretary, Washington State Department of Health.

They reported that Washington state is a reflection of the national picture of this difficult-to-control disease.

Washington is in the midst of an epidemic, with 3,000 cases so far this year and nine infant deaths. Pertussis (whooping cough) is most dangerous for babies, and more than half who become infected are hospitalized.

In the nation, nearly 18,000 cases have been reported to date, with many states seeing higher numbers of infected than normal.

In 2010, there were 27,000 reported cases and 27 deaths, 25 of those who died were infants.

There has been a gradual and sustained increase of reported cases in the US, and the CDC is in the field trying to determine why that is.

Potential causes of increased numbers could be:

  • childhood vaccines provide immunity for a number of years, but that immunity wanes over time
  • there has been increased reporting of disease
  • there has been an increase in diagnosis of pertussis

In this current wave of disease, the highest rates of infection are among babies younger than one. Babies depend on those around to be immunized so that adolescents and adults won’t pass on the infection to the baby, who is too young to be fully protected by immunization.

There are also higher rates of infection in 10-year-olds, because early childhood immunizations have waned. A booster called “Tdap” (tetanus, diphtheria, acellular pertussis) is recommended for children 11 to 12 years old.

One odd thing that’s going on in Washington and elsewhere is that young people ages 13 to 14 years are also experiencing higher rates of infection. A theory as to a possible cause for this is that this group of teenagers is the first to have had acellular pertussis vaccine only as babies and young children, and no whole-cell pertussis vaccine.

In 1997, the switch was made from whole-cell pertussis vaccine to acellular pertussis vaccine in the US.

It’s just a theory. How that might affect immunity, if it does, is being investigated.

Pertussis vaccine is the most effective approach to preventing infection. Unvaccinated kids have an eight times higher risk of infection compared to vaccinated kids.

Vaccinated kids who get pertussis have milder symptoms, shorter illness, and are less infectious.

In 2010, only eight percent of adults in the US had a history of the Tdap booster.

Throughout today’s telebriefing, Dr. Schuchat and Ms. Selecky emphasized the need for pregnant women and all adults and adolescents to be vaccinated to protect not only themselves, but the babies in their lives, as most babies who are infected acquire that infection from adults and teens around them.

This surge in pertussis cases isn’t just in the US. Australia’s rate of pertussis infection right now is even higher than that in the US, and Canada is struggling.

Moms and dads are losing their babies to this disease. Whooping cough is so infectious—you could be infected and pass it on to a co-worker who then takes it home to his newborn daughter.

Because pertussis is underdiagnosed, many people are infected but don’t know it.

Ask your pharmacist, your doctor, or even your employer about getting the pertussis booster shot. Please.

By Trish Parnell

Image courtesy of CDC





Mat Releases are Good!

11 06 2012

We’ve all written more press releases than we can count, and they do the job they’re supposed to do. But, here at PKIDs, we’re also quite fond of mat releases. They reach smaller publications by the hundreds and chances are, the words we write will get published without editing.

They’re a good way to get our news into communities across the country.

A mat release is a short feature story (approximately 400 words) written by you or someone in your organization. It’s distributed to small regional or local daily or weekly newspapers through a service such as NAPS or PR Newswire.

The story is usually run as-is by the editors, but is sometimes given a little editing. Small newspapers like mat releases because most don’t have the budgets to hire enough reporters to create all the features they need or would like, and a mat release is a ready-made story.

Mat releases are usually not too topical, as they take time to get into circulation and they’re picked up and used by editors for months after the release date.

If you include some sort of contest or other fun component in your mat release, it will increase the likelihood of its being picked up by editors. This isn’t always possible, but keep this approach in mind.

Artwork (usually a photo) will need to be included in any mat release you distribute. Editors love artwork and will sometimes use a story, or a bit of it, just to get artwork into their papers.

What A Mat Release Isn’t

Mat releases are not press releases. In a mat release, you share information in the format of a feature story that is of value or interest to a large group of people. You don’t “advertise” your services or products.

Cost

As a nonprofit, you should get a discount from the distributor. Even so, mat releases aren’t cheap—costing about $5,000. The upside is that they eventually reach lots of readers, so they’re considered a solid way to spend funds.

Writing

Distributors work with you on the writing of your mat release. They want you to be happy and will be diligent about editing and improving your work, if you need the help.

You have about 400 words to tell a story and share your important information.

Sample Mat Release (writtten for a program we did a few years ago, with notes on content)

Silence the Sounds of Pertussis

(The headline matters, so take your time to come up with something of interest.)

(NAPS)—New parents know to vaccinate their babies to protect against a number of childhood diseases. But what about vaccinating themselves to keep from spreading illnesses to their child? (This makes readers curious, so they want to read further.)

Most parents do not think of whooping cough, also known as pertussis, when they think of potential threats to their child’s health. However, this disease is making a strong comeback in the U.S., with a total of more than 25,000 reported cases in 2004 alone. (A strong fact that sets the expert tone of the piece and lets the reader know this is a serious problem.)

Luckily, there is a simple way to ease new parents’ minds: immunize mom and dad with the whooping cough booster. (They’ve heard the problem, and now they know there’s a solution. They want to find out more.)

Because of the growth of this disturbing trend, new mom and award-winning actress Keri Russell is teaming up with the nonprofit organization, Parents of Kids with Infectious Diseases (PKIDs), to launch a public awareness campaign: Silence the Sounds of Pertussis. The initiative aims to educate new parents about the dangers of this disease (especially to babies), and to encourage them to get the Tetanus, Diphtheria and Pertussis booster (called the Tdap vaccine) to keep their babies safe. (Here’s your solution to the problem: Talk about your program, clinic, or other topic you want people to know about.)

A recent study out of the University of North Carolina found that parents are the source of more than 50 percent of infant cases of whooping cough.

“When I found out that parents were infecting their children with this dangerous disease, I asked my doctor what I could do to prevent it from happening to my infant son,” Keri Russell said. “He recommended that my husband and I get the Tdap booster.” (Get some quotes in the piece from spokespersons/experts as this helps keep it personal.)

The Tdap is strongly recommended by the CDC for anyone who has close contact with a baby.

In adults, whooping cough symptoms often disguise themselves to look like a common cold, making the disease difficult to diagnose and easy to spread. (More facts to enhance the piece.)

Babies under 12 months of age are not only the most vulnerable to whooping cough, they are also the age group for which the infection is most life-threatening. Babies too young to have completed their primary vaccine series account for the majority of pertussis-related complications, hospitalizations, and deaths. In fact, more than 90 percent of pertussis-associated deaths were among babies less than six months old.

“The good news is that whooping cough is a problem that has a solution,” said Dr. Gary Freed, Professor of Pediatrics at the University of Michigan Medical School. “If every new and expectant parent receives the Tdap booster before or immediately after the birth of their baby, we could really reduce the risk of young babies getting whooping cough. If you provide care for a baby, talk to your doctor about how to protect him or her from pertussis.”  (The “ask” or what you want the reader to do.)

For more information on how you can help Silence the Sounds of Pertussis, visit the PKIDs website. (Give them contact information so they can find out more.)

Bottom Line

Are mat releases worth the cost?  Yes, if you can include that cost in a grant budget, it is worth it. Mat releases stay out for months and continue getting picked up long past the point you’d think they would. This release that we’re sharing in the blog ran for months and months. We were surprised (and happy) at the shelf life it had, and at the number of editors who ran it.

If you have any mat releases you’d like to share with others, put them in the comments section. We’d all benefit from seeing them!

Remember, these are not advertisements or advertorials. Keep them as features full of information people want, and editors will pick up the stories.

This article comes from PKIDs’ Communications Made Easy program.





Whooping Cough Booster Shot – Gotta Have It!

14 05 2012

(Welcome to the CDC folks again! Today they’re talking about whooping cough and the booster shot kids need.)

Another fitful night. A mom lies awake, listening helplessly as her child coughs and coughs. This mom knows tomorrow will be another day of school missed. Soccer practice missed. And for her, another day of work missed. She wonders wearily when it will end.

This cough is whooping cough, also called the “100-day cough” because of its long duration. And the child? Not an infant, as one might expect, but a preteen, 11 years old.

Whooping cough—or pertussis—is a serious and very contagious respiratory disease that can cause long, violent coughing fits and the characteristic “whooping” sound that follows when a person gasps for air.

Whooping cough has been on the rise in preteens and teens. In 2009, a quarter of the 16,858 cases of pertussis reported in the United States were among 10- through 19-year-olds.

Most children get vaccinated against whooping cough as babies and get a booster shot before starting kindergarten or first grade. But protection from these vaccines wears off, leaving preteens at risk for infection that can cause prolonged illness, disruptions in school and activities, and even hospitalization.

To boost immunity, the Centers for Disease Control and Prevention (CDC) recommends the Tdap vaccine for all 11- and 12-year-olds.

“It’s important for preteens to get a one-time dose of Tdap to protect themselves and those around them from whooping cough,” says Anne Schuchat, MD, director of CDC’s National Center for Immunization and Respiratory Diseases. “Young infants are most vulnerable to serious complications from pertussis and can be infected by older siblings, parents, or other caretakers.” For infants, whooping cough can be deadly.

“Unfortunately, the most recent survey shows that only a little more than half of teens have received the Tdap vaccine,” says Dr. Schuchat. “By taking their preteen to get Tdap, parents can protect their child and help stop this disease from spreading.”

Tdap is one of three vaccines CDC specifically recommends for preteens. The others are the meningococcal vaccine, which protects against meningococcal disease, including bacterial meningitis, and, for girls, the HPV vaccine, which prevents cervical cancer. Boys and young men can get HPV vaccine to prevent genital warts. Of course, the flu vaccine is recommended for everyone six months and older.

Preteens should also be up-to-date on so-called childhood vaccines to prevent hepatitis B, chickenpox, polio, measles, mumps, and rubella.

These recommendations are supported by the American Academy of Pediatrics, the American Academy of Family Physicians, and the Society for Adolescent Health and Medicine.

To learn more, visit CDC’s adolescent vaccine website or call 800-CDC-INFO.





When to Seek Help for a Cough

3 05 2012

As a parent, you may wonder whether you or your child with a cough has pertussis, but when you go to the doctor, he or she may not agree or even suggest testing.

The truth of the matter is that the accurate diagnosis of pertussis is challenging. Classic symptoms such as severe coughing spells and the inspiratory whoop are striking and strongly suggest pertussis, but they are not always present, especially in previously vaccinated or previously infected adolescents and adults. Additionally, as described in Dr. Cherry’s recent post, available tests are most sensitive early in disease when the bacteria is present in the nose, but this is often before pertussis is suspected. Accurate diagnosis also depends upon the likelihood of having been exposed to someone with pertussis. Communities across the U.S. are experiencing pertussis outbreaks and many children and adults present to their health care provider with a cough.

So, how do doctors know what to look for?

Background
Pertussis occurs in ALL age groups but is most severe in young infants. While pertussis-containing vaccines have been available since the 1940s, pertussis outbreaks continue to occur every year in the U.S. The number of reported cases has been increasing steadily since the 1980s, especially among young infants and adolescents. According to the Centers for Disease Control and Prevention (CDC), more than 27,000 people were diagnosed with pertussis in 2010.

Pertussis is most severe in young infants who are too young to have received any or all doses of vaccine; in fact, about 3 of every 4 infants less than 6 months old develop complications like pneumonia or seizures and about 1 of every 100  infants less than 2 months old die. Unfortunately, many infants get pertussis from adolescents and adults who don’t realize that they have it.

Pertussis is transmitted in respiratory droplets by coughing and sneezing, and people with pertussis can be contagious for up to 3 weeks after developing symptoms. Pertussis is so contagious that when someone in the house has it, virtually everyone else in the house that is not immune will also get it. In fact, studies have shown that if ten unimmunized people are in a room with someone who is infected, 8 or 9 of them will also develop pertussis.

Vaccination is the most effective way to prevent pertussis, but protection is not lifelong. Vaccination is highly effective, however, it does not prevent all disease and immunity decreases over time. This is also the case after natural infection and is why even people who have had pertussis before should still get a booster dose. This decreased immunity through time is also why we have seen an increase in pertussis among adolescents and adults.

What Parents Should Look For
The official set of symptoms used to identify cases of pertussis is:

A cough that lasts for at least 14 days and either episodes of multiple, rapid coughs without any break, whooping when breathing in or a cough so severe that vomiting occurs.

However, it is important to realize that symptoms are not always typical, especially in previously vaccinated older children, adolescents and adults. The way that pertussis presents depends upon your age and vaccination status:

Infants and young children
The most ‘typical’ presentation occurs in young children:

  • Stage 1 –   Pertussis starts with mild cold symptoms like runny nose, mild cough and watery eyes  This stage typically lasts for about 1 to 2 weeks.
  • Stage 2 –  Despite resolution of other symptoms, severe cough develops.  ‘Whooping cough’ refers to episodes of multiple, rapid coughs without any break.  The episodes can be so severe that the lungs run out of air resulting in a forced inhalation that sounds like a ‘whoop.’  The cough can also be accompanied by vomiting.    Infants and children can look quite ill when coughing but appear well in between episodes.  This stage can last for 1 to several weeks.
  • Stage 3 –  The coughing episodes begin to resolve and become less common over several weeks  to months.
  • All Stages – Fever is not a major symptom of pertussis.

Babies are less likely to show these classic symptoms. They tend to have coughing associated with gagging or gasping and ”apneic’ episodes, during  which they briefly stop  breathing.  Infants and young children may also turn blue during coughing spells because they can’t get enough oxygen due to the severe, repeated coughing. Young infants may also show no interest in eating and might experience seizures. 

If parents notice any of these signs or symptoms, they should have their child seen by a health care provider right away for testing and antibiotics—this is especially important for young infants since they are at the greatest risk for severe disease. Antibiotic treatment can decrease the duration of symptoms and make them less severe, but it is most effective when given early in the infection.  Antibiotics also help decrease the likelihood of spreading pertussis to others.

Adolescents and adults
Older children, adolescents and adults with pertussis are more likely to have milder symptoms that can mimic other cough illnesses, especially if they have been immunized or previously infected, however, they can still develop severe disease:

  • The primary symptom is often a persistent cough lasting at least 7 days, usually without a fever.
  • Severe coughing episodes and whooping may occur, but is more common in unimmunized individuals.
  • Coughing episodes can be severe enough to cause rib fractures, difficulty sleeping, poor bladder control, damage to the lung cavity and even bleeding in the brain.  Vomiting with cough can also occur and is considered to be highly suggestive of pertussis in adults.
  • The average duration of cough in adults is 1 to 1 1/2 months.
  • Adolescents and adult who recently had pertussis may experience a return of symptoms if they get another respiratory infection shortly after recovering.

Because older children, adolescents and adults are less likely to have typical symptoms, they often are not tested or treated, and unknowingly spread pertussis to others. Pertussis should therefore be considered in anyone with a coughing illness with no fever or a mild fever, especially if they have been around someone with pertussis or a cough illness or they have regular contact with infants and young children who are at risk for severe disease.

A Final Word about Testing
Testing for pertussis is most sensitive in the first 3 to 4 weeks of infection. Bacteria that cause pertussis can usually be detected from the very beginning of the illness through the first two weeks of the cough stage; however,  in people who have been vaccinated, like adolescents and adults, the bacteria may not be detectable for even that long. Since adolescents and adults often do not go to the doctor until late in their illness, there may no longer be any bacteria present. Therefore, choice of test is important:

  • Bacterial culture is the gold standard but it is difficult to perform, takes a long time (up to 2 weeks) and is less likely to be positive later during the disease or  in previously immunized individuals.   It is most sensitive when performed within 2 weeks of cough onset.
  • Pertussis PCR is now widely available, very sensitive and provides results quickly.   Bacteria can be detected even 7 days after taking antibiotics, but false positives can also occur.  PCR tests should NOT be done on anyone without symptoms, even close contacts of confirmed cases.  PCR tests are most sensitive when done within 4 weeks of cough onset.
  • Serology is a test that is performed on blood samples and detects antibodies to pertussis.  This test is usually positive by the time a patient decides to see the doctor about a cough. However, because young infants don’t make antibodies to the protein that the test measures, it is not useful in infants.  In people who were previously immunized, false positives may occur, so doctors need to look at relative levels of antibodies.  This test is most useful in adults and adolescents because testing is usually done too late for culture or PCR tests.  Serology testing can be performed within 2-8 weeks of cough onset.  If the test is done too early in the infection, it may be falsely negative.

Parents who suspect pertussis in themselves or their children should discuss their concerns with their healthcare providers. Providers should be able to help in determining the best approach for making a diagnosis and managing treatment. 

Kristen A. Feemster, MD MPH MSHP
Assistant Professor of Pediatrics
Pereleman School of Medicine at the University of Pennsylvania
Attending Physician, Division of Infectious Diseases
Physician-Scientist at the Vaccine Education Center
The Children’s Hospital of Philadelphia