Why Shift Work Tied To Higher Risk for Heart Attack (any alternatives)

What is Shift Work?

Shift work is an employment practice designed to make use of, or provide service across, all 24 hours of the clock each day of the week

EFFECTS OF SHIFT WORK

Everyone has a “biological clock,” a 24-hour schedule on which the body functions. This schedule is known as the circadian cycle. This cycle is introduced, maintained and reinforced in every person’s life. If this cycle is disturbed for just one day, it will take:

Five days for urinary electrolytes to adjust

Eight days for the heart rate to adjust

Six days for body temperature to adjust

 

Shift Work and Heart Attack

Scientists have known for a while that shift work upsets the body's natural body clock (circadian rhythm) and work-life balance

What is heart attack?

If the heart muscle does not have enough blood (and consequently oxygen) it dies and a heart attack occurs. Another name for a heart attack is myocardial infarction, cardiac infarction and coronary thrombosis. According to medical dictionary, a heart attack is "infarction of a segment of heart muscle, usually due to occlusion of a coronary artery". (Infarction = the process whereby an area of dead tissue is caused by a loss of blood supply).

A heart attack usually happens when a blood clot develops in one of the blood vessels that lead to the heart muscle (coronary arteries). The clot, if it is big enough, can stop the supply of blood to the heart. Blood supply to the heart can also be undermined if the artery suddenly narrows, as in a spasm.

What are the symptoms of a heart attack?

Chest discomfort, mild pain

Coughing

Crushing chest pain

Dizziness

Dyspnea (shortness of breath)

Face seems gray

A feeling of terror that your life is coming to its end

Feeling really awful (general feeling)

Nausea

Restlessness

The person is clammy and sweaty

Vomiting

What are causes of a heart attack?

Age –

Angina - angina is an illness where not enough oxygen is reaching the patient's heart

Blood cholesterol levels

Diabetes

Diet

Genes

Heart surgery

Hypertension (high blood pressure

Obesity, overweight

Physical inactivity

Previous heart attack

Smoking

What are the treatments for a heart attack?

The faster the heart attack patient can be treated, the more successful his/her treatment will be

Treatment during a heart attack

CPR (cardio-pulmonary resuscitation)

300mg of Aspirin

Hrombolytics

Painkillers

New scary study- Shift Work Tied To Higher Risk For Heart Attack, Stroke

An analysis that reviews studies covering over two million people finds shift work is associated with a higher risk for vascular events, such as heart attack and ischaemic stroke. The study is the largest examination of shift work and vascular risk to date. The researchers, from Canada and Norway, write about their findings in a paper published online in the BMJ on Thursday. They report that compared to regular daytime workers, shift workers had a 24% higher risk for coronary events, a 23% higher risk for heart attack, and a 5% higher risk for stroke.

Night shift workers had the highest risk for coronary events (41%). However, shift work was not linked to a higher risk of death (from any cause).

Why the Study?

Scientists have known for a while that shift work upsets the body's natural body clock (circadian rhythm) and work-life balance, and a number of studies have linked it to health problems, such as increased risk of high blood pressure and high cholesterol. A link with diabetes is also well-established, for instance, a Harvard-led study reported that rotating shift work is linked to higher risk for type 2 diabetes.And the link with cancer has already made a mark in the politics of occupational health since 38 Danish female night shift workers in 2008 were compensated after their breast cancer was officially recognized as an occupational illness. But, the link between shift work and vascular disease is controversial. The authors propose one reason could be the varying methods, populations and definitions of shift work and coronary events that previous studies have used. They also suggest previous analyses are now outdated: they "did not use validated tools for assessing studies, did not capture all available data, and did not apply quantitative techniques to compute summary risk estimates," they write.

What they found?

For their study, the international team, led by Daniel G Hackam, associate professor in the Department of Epidemiology and Biostatistics at Western University in Canada, pooled and analyzed the results of 34 studies covering 2,011,935 people and compared shift workers to regular daytime workers or the general population.

They defined shift working as working patterns that differed from regular daytime working (9 am to 5 pm), including evening shifts, irregular or unspecified shifts, mixed schedules, night shifts and rotating shifts.

Of the more than 2 million participants, 17,357 experienced some kind of coronary event, 6,598 had heart attacks (myocardial infarction), and 1,854 had ischaemic strokes. An ischaemic stroke is caused by a lack of blood supply in the brain.

The analysis showed all these vascular events were significantly more common among shift workers than other people.

The researchers found that:

1. Shift work was associated with myocardial infarction (risk ratio 1.23, 95% confidence interval 1.15 to 1.31; I2=0) and ischaemic stroke (1.05, 1.01 to 1.09; I2=0). Coronary events were also increased (risk ratio 1.24, 1.10 to 1.39), albeit with significant heterogeneity across studies (I2=85%)."

By "significant heterogeneity" the researchers refer to the fact that there was a certain lack of consistency in research methods, assumptions, sampling criteria and definitions across the 34 studies they analyzed.

2. When they examined the possible sources of this lack of consistency in study methods, they found that "presence or absence of adjustment for smoking and socioeconomic status" was not one of them.

3. They also found that although the risk for vascular events was higher among shift workers, the results show they were at no higher risk of death from any cause.

Implications

The researchers say that although the relative risks they calculated are modest, because of the high frequency of shift work in the general population, the implications for public health are not insignificant.

For instance, if you applied these risks to Canada, where during 2008-09, nearly a third of workers were on shifts, then 7% of heart attacks, 7.3% of all coronary events, and 1.6% of ischaemic strokes could be due to shift working.

The findings should impact public policy and occupational medicine, say the researchers.

For example, shift workers could be educated about how to spot early signs of heart problems, and screening programmes could help identify and treat risk factors like high blood pressure and cholesterol in shift workers. The researchers call for further studies to find out which groups of shift workers are likely to be the most affected by these findings, and how overall vascular health is affected by changes in shift patterns.

(Source-BMJ)

SHIFT WORK: ALTERNATIVES

There are basically three major alternatives for shift work: 

1) Rapid rotation;

 2) Dedicated (permanent) shifts

 3) Slow rotation

1. Rapid rotation

Perhaps the most disruptive type of shift work is rapid rotation. This protocol is common in police work, where an officer must change from afternoon to day to night shift in the space of one week. In terms of disturbing one’s “biological clock,” rapid rotation is devastating. Past experiments by Dr. C.F. Ehret have demonstrated that rapid rotation caused such high disruption in laboratory animals that no Circadian rhythm could be detected. Body temperature and blood chemistry of these animals were in a constant state of flux. Dr. Ehret concluded that individuals who must face critical decisions (such as police officers) should not work rapid rotation shifts. Their performance levels are seriously affected especially in the early morning hours.

2. Dedicated (permanent) shifts

Permanent shifts are effective for reducing the problems of shift work. Such shifts eliminated the major cause of disruption: change. There is increasing evidence that fixed shift systems are more cost-effective than other protocols. Recently, many departments are moving to extended fixed shifts consisting of either 10 or 12 hour shifts.  Officers appear to like these extended hour shifts because they allow for more time off duty. Research in several police departments indicated a dramatic decrease in sick leave and an increase in productivity as a direct result of permanent shifts. Other departments conclude that their permanent shift program makes it easier to plan schedules.

Of course, the fixed shift approach is not perfect.  Twelve hour shifts, for example, can increase the risk of fatigue, especially on the midnight tour. Such shifts may also cause a morale problem, especially among younger officers who are involuntarily assigned to night shifts.  Many officers who work nights permanently tend to deprive themselves of sleep and “burn both ends of the candle.” This could lead to individual health problems, as well as poor work performance.

3. Slow rotation

A third type of shift protocol involves slow rotation. Slow rotation refers to changing shifts over an extended period of time. Dr. Ehret suggested that slow rotation is better than rapid rotation—better on the premise that it causes the least amount of disruption among officers who must change shifts. Ideally, Dr. Ehret states, slow rotation is the logical choice when permanent shifts are impossible. He recommends that officers not be required to change shifts for at least 4-5 weeks at a time. This allows for minimal disruption of the circadian cycle.

How hard is it to become an Olympian and some health/nutrition tips for future stars?

This is my 13th blog on London Olympics. In this blog you see how difficult is to become an Olympian. You can get this idea from different players.


Olympic Blog 12-Olympian Stephanie Rice tweets racy photos, Brother against brother for gold and 100 year-old torchbearer

Part 1-See all hard steps become an Olympian

To get this goal you need Grit, determination, money, sacrifice. We all know it's incredibly hard to become an Olympian. But many of us, jazzed up by the watching the Games on TV, still dream that we could do it if only. You imagine that bumping up your high school varsity training might have netted a spot on the team (I mean, you were the star player, right?). Or for the slightly less athletically accomplished, what if you zeroed in on one of those quirky sports like curling or target shooting?

Olympic Blog 11-Where to watch Olympic Games free both on the go and at work

Let us see the numbers what it really takes to become an elite athlete fit for Olympic glory.

Martial arts

5 Sessions per day martial arts expert Travis Stevens trains in order to prepare for London 2012. A typical schedule: 7-8:30 am, Weight training. 9-10:30 am, Judo. 11-11:30 am, Sprints. 2-3 pm, Cross-training. 6:30-8 pm, Judo. 10-11 pm, Running.



Swimmer



12,000. The calories swimmer Michael Phelps eats every day to replenish the energy he burns training. That's more than enough to feed a family of four.

Gymnast

100. Chin-ups executed by gymnast Shawn Johnson during conditioning sessions when she was in eighth grade.

Skeleton racers

85. Miles per hour skeleton racers achieve hurtling headfirst and unprotected down curving tracks that can drop as many as 50 stories in a few minutes.

Triathlete

35. Hours per week British triathlete Jonny Brownlee works out--rain or shine. That breaks down to an average of eight hours swimming, 10 hours running, 17 hours biking, plus hitting the gym for weight training.

Olympic blog 10-Who is the hottest swimmer in Olympic Federica Pellegrini (Italy) or Rebecca Adlington (UK)?

US gold winner get $25000

25,000. Dollars that a gold winner medal on Team USA receives. Silver earns $15,000 and bronze nets $10,000. And, if you don't win or get sponsorship? Zero. The United States government does not support athletes financially or with health insurance, unlike some other countries. The USA Track and Field Foundation estimates that fewer than 50% of competitors ranked in the top ten in their event earn more than $15,000 a year from sports.

Blog 10-What is best to watch at the London Olympics each day?

Swimming



10. Miles per day world record holder Janet Evans swam per day, six days a week in her bid to return to competitive swimming after a 16-year hiatus. That's 330 lengths of an Olympic size-pool.

Tennis


One Year that Maria Sharapova's mom had to spend waiting for a visa to travel from Russia to the United States to see her then-seven-year old daughter who was already training in Florida.

Soccer injury

90. Percent of players on the current U.S. Women's Soccer Team who have had at least one surgery for a sports-related injury.

Blog 9-Why Croatian Player Antonija Mišura Is Most Beautiful Woman at Olympics

Part 2 -Health tips to become an Olympian



The brilliance and determination of Olympians can inspire us to participate in more sporting activities, however, most of us prefer to sit on the couch and watch as the athletes excel on television. In order to spur us spectators on, many athletes have released some Olympic health tips to help us achieve gold in our personal health routines and implement exercise and sport into our regular lifestyles.

For many individuals, developing a career and raising a family often stands in the way of managing a healthy lifestyle and exercising. However, there is always that spectacular minority who set an example to the rest, for example those who are providing us with Olympic health tips.

Sophia Warner



Paralympic athlete Sophia Warner reached the peak of her career at the mature age of 37. The lighting fast sprinter won silver in her class at the 2011 World Championships, thanks to a rigorous training schedule. In between caring for her two children, Warner trains for six hours a day, five times a week. For balancing such an act she gets gold for determination, thus remaining determined is her number one Olympic health tip

Blog 2-Some Weird, Funny, interesting, quirky and cool fact of 2012 Olympic Games

Debbie Flood



Not everyone can manage such heavy training, but rowing Olympian Debbie Flood offers her Olympic health tip quote; “Not everybody wants to do as much training as an Olympian but everyone is capable of getting fitter and achieving in sport!" Flood advises that there are a variety of ways to keep fit, such as joining clubs or the gym, doing exercises at home or doing recreational walks in the countryside.

Always set yourself a goal, no matter how big or small, to be your primary source of motivation. When things start to get tough, think back to that goal in order to push you forward. Another top Olympic health tip is to respect your body and get excellence out of yourself. According to Flood, sports and exercise is good for body, mind and spirit.

Blog 8th-Olympians Who have posed Nude for Magazines

Jessica Ennis


World heptathlon championship and Olympic poster girl Jessica Ennis also gave her Olympic health tip. According to her, to be truly fit training must be progressive.

Doing the same training everyday will not help you achieve your goal. Therefore training must be regular, yet different. In order for it to become a habit, training must also be fun otherwise motivation will soon decrease. Whether your sport is on the field or in the pool, these Olympic health tips will get you right on track.

Olympic Blog 1-Sexy Female Olympians to watch in Olympic

What are the dangers of Indoor Tanning (Tanning Misunderstandings)?

What is Indoor Tanning?

Ads for tanning salons, sun lamps and tanning beds promise a bronzed body year-round, but experts agree that ultraviolet (UV) radiation from these devices damages the skin and poses serious health risks. Sunburns and tans are signs of skin damage. Deliberate tanning, either indoors or out, increases your risk of melanoma and non- melanoma skin cancer.

Tanning -Myths and Reality

Here are some claims commonly made about indoor tanning – and the facts.

Get a beautiful tan indoors without increasing your risk of skin cancer.

The lamps used in tanning booths and beds emit two forms of ultraviolet (UV) radiation – UVA and UVB. UVB rays penetrate the top layers of your skin and are most responsible for burns. UVA rays penetrate to the deeper layers of skin and often are associated with allergic reactions, like a rash. Both UVA and UVB rays damage the skin and can lead to skin cancer. What’s more, scientists say, tanning can cause premature aging, immune suppression, and serious eye damage.

Indoor tanning is safer than the sun because the environment is controlled.

Sun lamps may be more dangerous than the sun because they can be used at the same high intensity every day of the year. Radiation from the sun varies in intensity with the time of day, the season, and cloud cover. Studies show that many people who tan indoors get burns.

Indoor tanning is approved by the government.

No U.S. government agency recommends the use of indoor tanning equipment. And the International Agency for Research on Cancer (IARC), part of the World Health Organization, also has concluded that tanning devices that emit UV radiation are more dangerous than previously thought. IARC moved these devices into the highest cancer risk category.

Indoor tanning is a safe way to increase vitamin D levels.

Vitamin D has many roles in human health. For example, it is essential for promoting good bone health. While UVB radiation helps your body produce vitamin D, you don’t need a tan to get that benefit. In fact, 10 to 15 minutes of unprotected natural sun exposure on your face and hands 2 to 3 times a week during the summer gives you a healthy dose of vitamin D. You also can get vitamin D from food: good sources include low-fat milk, salmon, tuna, and fortified orange juice.

Difference between Indoor Tannings vs. Sunlight

The sun's rays contain two types of ultraviolet radiation that affect your skin: UVA and UVB. UVB radiation burns the upper layers of skin (the epidermis), causing sunburns. UVA radiation penetrates to the lower layers of the epidermis, where it triggers cells called melanocytes) to produce melanin. Melanin is the brown pigment that causes tanning. Both UVA and UVB rays contribute to  skin  aging. Both types also can cause potentially cancerous changes in your cells' DNA. And, according to a recent study, radiation from just 10 indoor-tanning sessions in 2 weeks can suppress a person's cancer-fighting immune system.

Tanning beds use UVA light, but UVA rays penetrate the skin more deeply than UVB rays, so they can cause just as much — if not more — damage. Plus, the concentration of UVA rays from a tanning bed is greater than the amount of UVA rays a person gets from the sun. And despite manufacturer claims, some tanning lamps do also emit UVB light.

So if you try indoor tanning, you'll absorb far more rays in the long run, significantly age your skin, and put yourself at even greater risk for skin cancer.

What Tanning Salons Don't Tell You

Studies show that users of tanning beds and tanning lamps have much higher risks of basal and squamous cell carcinoma, the two most common types of skin cancer. Doctors also know that young people are more at risk for melanoma, the most serious kind of skin cancer. It used to be that mostly older people got melanoma, but doctors now see more people in their twenties (or even younger) with serious cases of skin cancer.

Don't rely on tanning salons to let you know about the risks of using their product — they're in business to make money, after all. Sometimes employees actually don't know much about the damage tanning beds can do. They mistakenly believe they are safer than the sun, even though they can do as much damage or more.

Laws are changing to protect consumers, but some states are farther along than others when it comes to passing tanning bed laws. In most places, it's up to the salon to watch out for customers and maintain their equipment.

How to Minimizing tanning Risk

People who have tanned in the past already have skin damage — even if they can't see it yet — and need to be very cautious about additional UV exposure. Everyone (even those who tan easily) should wear sunscreen or sun-protective clothing (or both) while outdoors, and have their skin checked periodically by a dermatologist for suspicious moles or other lesions.

You don't have to go without that sun-bronzed look. The new generation of self-tanners and spray-on tans offer easy, realistic results at a reasonable price. Just be sure to use a daily sunblock with an SPF of at least 15 when you go outdoors since fake tanners don't protect you against sunburn!

New Research-There Is No Such Thing as a Safe Tan: GW Researchers Break Tanning Misconceptions

A new study conducted by GW School of Medicine and Health Sciences (SMHS) researchers Edward C. De Fabo, Ph.D., Frances P. Noonan, Ph.D., and Anastas Popratiloff, M.D., Ph.D., has been published in the journal Nature Communications. Their paper, entitled "Melanoma induction by ultraviolet A but not ultraviolet B radiation requires melanin pigment," was published in June 2012. This is the first time that UV-induced melanin formation (tanning), traditionally thought to protect against skin cancer, is shown to be directly involved in melanoma formation in mammals," said De Fabo, who is professor emeritus at SMHS. "Skin melanoma is the most lethal of the skin cancers. Our study shows that we were able to discover this new role for melanin by cleanly separating UVA from UVB and exposing our experimental melanoma animal model with these separated wavebands using our unique UV light system designed and set up at GW. Dermatologists have been warning for years there is no such thing as a safe tan and this new data appears to confirm this.

Their research uses a mammalian model to investigate melanoma formed in response to precise spectrally defined ultraviolet wavelengths and biologically relevant doses. They show that melanoma induction by ultraviolet A (320-400 nm) requires the presence of melanin pigment and is associated with oxidative DNA damage within melanocytes. In contrast, ultraviolet B radiation (280-320 nm) initiates melanoma in a pigment-independent manner associated with direct ultraviolet B DNA damage. The researchers identified two ultraviolet wavelength-dependent pathways for the induction of CMM and the study describes an unexpected and significant role for melanin within the melanocyte in melanoma genesis.

Also new is our discovery that UV induction of melanin, as a melanoma-causing agent, works when skin is exposed only to UVA and not UVB radiation. This is especially important since melanoma formation has been correlated with sunbed use as many epidemiological studies have shown. One possible reason for this is that tanning lamps are capable of emitting UVA radiation up to 12 times, or higher, the UVA intensity of sunlight at high noon. Melanin plus UVA is known to cause photo-oxidation, a suspected, but still to be proved, mechanism for the formation of melanoma as we describe in our study, De Fabo said.

(Source- Journal Nature Communications)

Why this deadly Whooping cough is making a comeback in North America.

What is Whooping Cough?

Whooping cough (pertussis) is an infection of the respiratory system caused by the bacterium Bordetella pertussis (or B. pertussis). It's characterized by severe coughing spells, which can sometimes end in a "whooping" sound when the person breathes in.

It mainly affects infants younger than 6 months old before they're adequately protected by immunizations, and kids 11 to 18 years old whose immunity has started to fade. It mainly affects infants younger than 6 months old before they're adequately protected by immunizations, and kids 11 to 18 years old whose immunity has started to fade.

Signs and Symptoms

The first symptoms of whooping cough are similar to those of a common cold:

•runny nose

•sneezing

•mild cough

•low-grade fever

After about 1 to 2 weeks, the dry, irritating cough evolves into coughing spells. During a coughing spell, which can last for more than a minute, the child may turn red or purple. At the end of a spell, the child may make a characteristic whooping sound when breathing in or may vomit. Between spells, the child usually feels well.

Although many infants and younger children who become infected with B. pertussis will develop the characteristic coughing episodes and accompanying whoop, not all will. And sometimes infants don't cough or whoop as older kids do. Infants may look as if they're gasping for air with a reddened face and may actually stop breathing (called apnea) for a few seconds during particularly bad spells.

Adults and teens with whooping cough may have milder or atypical symptoms, such as a prolonged cough (rather than coughing spells) or coughing without the whoop.

Watch as this Whooping cough is very Contagiousness

Pertussis is highly contagious. The bacteria spread from person to person through tiny drops of fluid from an infected person's nose or mouth. These may become airborne when the person sneezes, coughs, or laughs. Others then can become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses. Infected people are most contagious during the earliest stages of the illness for up to about 2 weeks after the cough begins. Antibiotics shorten the period of contagiousness to 5 days following the start of antibiotic treatment.

How to prevent Whooping cough

Whooping cough can be prevented with the pertussis vaccine, which is part of the DTaP (diphtheria, tetanus, a cellular pertussis) immunization. DTaP immunizations are routinely given in five doses before a child's sixth birthday. To give additional protection in case immunity fades, the American Academy of Pediatrics (AAP) now recommends that kids ages 11-18 get a booster shot of the new combination vaccine (called Tdap), ideally when they're 11 or 12 years old, instead of the Td booster routinely given at this age.

The Tdap vaccine is similar to DTaP but with lower concentrations of diphtheria and tetanus toxoid. It also can be given to adults who did not receive it as preteens or teens. This is especially important for those who are in close contact with infants, because babies can develop severe and potentially life-threatening complications from whooping cough. An adult’s immunity to whooping cough lessens over time, so getting vaccinated and protecting yourself against the infection also helps protect your infant or child from getting it.

As is the case with all immunization schedules, there are important exceptions and special circumstances. Your doctor will have the most current information. Experts believe that up to 80% of non-immunized family members will develop whooping cough if they live in the same house as someone who has the infection. For this reason, anyone who comes into close contact with someone who has pertussis should receive antibiotics to prevent spread of the disease. Young kids who have not received all five doses of the vaccine may require a booster dose if exposed to an infected family member.

How long this infection

The incubation period (the time between infection and the onset of symptoms) for whooping cough is usually 7 to 10 days, but can be as long as 21 days.

Duration

Pertussis usually causes prolonged symptoms — 1 to 2 weeks of common cold symptoms, followed by 2 to 4 weeks (sometimes more) of severe coughing. The last stage consists of another few weeks of recovery with gradual clearing of symptoms. In some children, the recovery period can last for months.

 

When to get Professional Treatment

Call the doctor if you suspect that your child has whooping cough. To make a diagnosis, the doctor will take a medical history, do a thorough physical exam, and take nose and throat mucus samples that will be examined and cultured for B. pertussis bacteria. Blood tests and a chest X-ray also might be done.

A confirmed case of whooping cough will be treated with antibiotics, usually for 2 weeks. Many experts believe that the medication is most effective in shortening the duration of the infection when given in the first stage of the illness, before coughing spells begin. But even if antibiotics are started later, they're still important because they can stop the spread of the pertussis infection to others. Ask your doctor whether preventive antibiotics or vaccine boosters for other family members are needed.

Some kids with whooping cough need to be treated in a hospital. Infants and younger children are more likely to be hospitalized because they're at greater risk for complications such as pneumonia, which occurs in about 1 in 5 children under the age of 1 year who have pertussis. Up to 75% of infants younger than 6 months old with whooping cough will receive hospital treatment. In infants younger than 6 months of age, whooping cough can even be life threatening.

Home Treatment

If your child is being treated for pertussis at home, follow the schedule for giving antibiotics exactly as your doctor prescribed. Giving cough medicine probably will not help, as even the strongest usually can't relieve the coughing spells of whooping cough. The cough is actually the body’s way of trying to clear respiratory secretions. (Due to potential side effects, cough medicines are never recommended for children under age 6.)

During recovery, let your child rest in bed and use a cool-mist vaporizer to help loosen respiratory secretions and soothe irritated lungs and breathing passages. (Be sure to follow directions for keeping it clean and mold-free.) In addition, keep your home free of irritants that can trigger coughing spells, such as aerosol sprays; tobacco smoke; and smoke from cooking, fireplaces, and wood-burning stoves.

When to Call the Doctor

Call the doctor if you suspect that your child has whooping cough or has been exposed to someone with whooping cough, even if your child has already received all scheduled pertussis immunizations.

Your child should be examined by a doctor if he or she has prolonged coughing spells, especially if this spells:

•make your child's skin or lips turn red, purple, or blue

•are followed by vomiting

•are accompanied by a whooping sound when your child breathes in after coughing

•is having difficulty breathing or seems to have brief periods of not breathing (apnea)

•is lethargic

 

Why this deadly Whooping cough is making a comeback in North America.

 

The first effective vaccine for whooping cough was developed in 1940. Before that, the respiratory infection killed thousands each year -- and it may be making a comeback. Hundreds of cases are being reported in nine states. Washington State has declared an epidemic, with 1,484 cases. Heidi Bruch of Seattle did everything she was told during her pregnancy. Unfortunately, that didn't include getting a booster shot against whooping cough. She caught the disease and passed it to her two-week-old daughter, Caroline. My heart just sank. Oh my gosh" said Bruch. "I had inadvertently given my newborn a potentially fatal disease. It was a horrible feeling.

Caroline recovered after a month in the hospital, but it was touch-and-go. Dr. Wendy Sue Swanson is a pediatrician at the Everett Clinic in Mill Creek, Wash. Her county has seen 264 cases so far; that's more than the entire state had last year at this time. Newborns and infants in particular are at highest risk for complications," Swanson said. "They can have a serious, life-threatening pneumonia. They can have pauses or cessation in their breathing, where they stop breathing. Eighty-two percent of cases have been in children under age 18. All four fatalities in Washington since 2010 were infants.

Children get their first three doses of whooping cough vaccine at two, four and six months

 According to the Centers for Disease Control, 95 percent of kids in the U.S. get those first vaccinations. But immunity wears off over time. The CDC said adults need one booster shot after age 18. But today only 8 percent of adults get that recommended booster. Washington Secretary of Health Mary Selecky is urging people to get immunized. This is

about taking care of yourself, your family, but also your community," said Selecky. As a parent, you don't want to go through this," said Bruch. Having this booster available: It's a no-brainer. Go and get it.Last year, the CDC began recommending that pregnant women be vaccinated against whooping cough for two reasons: To protect mothers like Heidi Bruch; and because protective antibodies pass to a child before birth, which helps newborns too young to be vaccinated themselves.

So, why are we seeing such a rise in whooping cough right now? Isn't it a vaccine-preventable disease? Is it simply because some parents are choosing not to vaccinate their kids? Well, it would be terrific if 100 percent of children were vaccinated, but it's not that simple a solution. Infectious diseases are much more complex. Here are some important facts about whooping cough:

1. Whooping cough epidemics occur in cycles and tend to peak roughly about every three to five years. The last major epidemic was in 2005, so we were destined to see an uptick in infections this year.

2. Immunity to whooping cough does not last forever -- even if you are vaccinated for protection or you had the disease before. Immunity wears off over time (listen up, adolescents and adults!). That's why it is so important to get the whooping cough booster vaccine, called Tdap (for tetanus, diphtheria, and pertussis).

3. Babies cannot receive their first vaccination for whooping cough until they are 2 months old. Even then, they do not have adequate immunity until they have received at least three doses of whooping cough vaccine DTap (at 6 months). So, babies rely on those around them to be protected by vaccination and not spread the infection to them. Up to 80 percent of babies get whooping cough from a loved one in their household (most often, it's contracted from their moms).

4. Adults often don't know they have the illness. It may look like a common cold at the beginning of the infection; then it becomes a cough that just lingers (whooping cough is also known as the "100 Day Cough"). People are contagious up to about two weeks after the cough begins.

 

What can be done to fight this this deadly Whooping cough

These are the latest recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP):

1. Adults ages 65 and up should get Tdap if they will be around infants who are younger than 1 year of age. (Previously, only those ages 64 and younger were advised to get the vaccine.)

2. Adults ages 65 and up can get Tdap as their tetanus booster if they have never received Tdap before.

3. There is no minimum time frame between the dose of Td (for tetanus and diphtheria) and giving a Tdap booster (originally it was recommended to be five years between, then two years between).

Because of the latest major outbreak, California has expanded its vaccine recommendations beyond the standard vaccination schedule. Californians who are age 7 and up who are not fully immunized; women of childbearing age, before, during or immediately after pregnancy; and anyone who has contact with pregnant women or infants should receive a booster shot for whooping cough. I know that many adult medical practices do not stock the Tdap vaccine, but ask for it, and your doctor may get it for you. If you cannot get it from your doctor, call around to your local pharmacy or even grocery store, if it has a pharmacy department.

In addition to being vaccinated, be sure to watch for signs of whooping cough:

1. A persistent cough after having symptoms of a common cold.

2. A hacking cough that is much worse at night.

3. Coughing spells that include trouble catching one's breath at the end of the spell, vomiting at the end of the spell, lips turning blue, or face turning red with the spell.

4. Making a high-pitched "whoop" noise at the end of the coughing spell.

5. A low-grade fever throughout the course of the disease.