Monday 20 November 2017

Persist with medication to clear whooping cough

Whooping cough is a result of an infection of the bacteria Bordetella Pertussis
Whooping cough is a result of an infection of the bacteria Bordetella Pertussis

Nina Byrnes

Advice from our GP on the best treatment for a bad cough and on long-term treatment for high blood pressure.

Question: I have had a bad cough for the past two weeks. It started with a runny nose and sore throat. I get fits of coughing. These can be severe. Is there anything I can do?

Dr Nina replies: Persistent coughing can be distressing and uncomfortable, both for those affected and people around them.

Any cough that is lingering or severe should be checked by your doctor. The cough you describe sounds a lot like whooping cough. Whooping cough is an illness that occurs due to infection with the bacteria Bordetella Pertussis. This is transmitted through close contact with those infected or through contaminated droplets in the air produced in coughing.

There are three phases to the illness. The first phase is similar to the common cold. You may have a sore throat, runny nose and slight fever. About seven to 14 days into the illness, the main coughing bouts start. Bouts of coughing may be intense and frequent.

The face may go red and vomiting may occur after these. After a bout of coughing there may be a loud whooping noise when you breath in, though this only occurs in about half of those affected. This phase usually lasts two weeks or more. During the recovery phase coughing bouts become less frequent and ease off, but this can go on weeks to months.

Whooping cough is extremely infectious in the first three weeks. Treatment during this time can reduce infectivity. The illness can be very severe in young children, leading to vomiting, reduced feeding and dehydration. Pneumonia can be a complication.

Whooping cough is included in the basic vaccination programme of most countries. In Ireland, doses are given at two, four and six months. Unfortunately, immunity is not lifelong and so most infections now occur in those who were not vaccinated or in older children and adults whose immunity has waned.

Babies under the age of six months are especially at risk of serious complications and it is for this reason that vaccination is recommended to all pregnant women between weeks 27 and 36 of their pregnancy. Immunity then passes to the newborn baby, protecting them until they receive their own vaccines starting at two months.

Whooping cough is treatable with antibiotics. If diagnosed within the first three weeks you may be prescribed an antibiotic. A five-day course reduces infectivity though the cough may persist once the bacteria have cleared.

Question: My GP started me on blood pressure treatment a year ago. I have really worked to improve my health since then. I've lost weight, reduced salt and started exercising more. Can I stop my medication now?

Dr Nina replies: There is nothing like being diagnosed with an illness to shine a light on lifestyle as a means to health.

Maintaining a healthy weight, taking part in regular exercise and watching the salt in our diets are all very important in the management of high blood pressure.

High blood pressure doesn't cause any symptoms. It is often picked up on a routine check by your doctor and treatment may be started straight away. Many people find it difficult to get their heads around the diagnosis and find it even harder to commit to regular medication when they feel well. Side effects can also be a problem. The temptation to stop medication can be strong.

It is important to stress that blood pressure medication, once started, is normally for life. There are a few rare exceptions. Those who have lost huge amounts of weight or who had an underlying cause that has resolved are the exception.

If your blood pressure readings are normal now this simply shows the medication is working. It is very likely that if you stopped, it would climb again. If you have lost significant amounts of weight and your blood pressure readings are at the lower end of normal, you could discuss reducing your medication but this should only be under the supervision of your doctor.

Don't be disheartened by this news. Many blood pressure tablets not only control your blood pressure but also provide protection to your heart and blood vessels. Maintaining a normal blood pressure also significantly reduces your risk of heart attack, stroke and other vascular conditions. Medication is not a negative thing in this instance.

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