Sawbones: Whooping Cough

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Hello, everybody, and welcome to Sawbones, a marital tour of Misguided Medicine.

I'm your co-host, Justin McElroy.

And I'm Sydney McRoy.

I left the heater on, Sydney.

I'm realizing in my effort to not lose toes to Frostbite down here in the McElroy Family Studios, Midwest.

I'm I have to turn the heater off.

Midwest?

Yeah.

This is not the Midwest.

Appalachia?

Is that better?

McElroy Studios in Appalachia?

I I don't know.

So Appalachia would be fair.

Yeah, we are the only...

We are the only McIlroy family studio.

Well, no, your dad.

Well, I mean, according to the

SAG AFTRA, me, Travis, and Griffin are all part of the mid-Atlantic region, but I don't think that that's.

It's better that we are not.

This is not Midwest.

There is a lot of dispute as to whether West Virginia is.

We're not Northeast,

but we're not the South.

Certainly not the South.

Don't mess that up.

Anyway, I don't think anyone knows Appalachia.

Our state is entirely subsumed in Appalachia.

We are Appalachia.

We are Appalachia.

We are Appalachia.

And don't come at me with any Appalachian.

Whoa.

It's Appalachia.

Wow.

Okay, so Sydney, today we're talking about pronunciation and why that figures into medicine.

I don't know, but I'm looking forward to defining it.

I feel like that's a valid intro, though, for something that's called pertussis or

whooping cough whooping cough or do you prefer do you prefer whooping cough or whooping cough it's a whooping whooping whooping whooping that is a very appalachian term i really hope that it has an appalachian terminology i i feel like it's probably not going to be authentically appalachian it's not can i tell you i am shocked we have not done an episode on this i was so convinced i thought it was like a classic disease like surely one of the classic diseases in sawbones the the early years, we must have covered.

Or at least in the college years.

It was, I Googled several times.

I searched through all of my drive.

And then I had to go.

I was a little low this month.

I don't know about you.

No.

My drive has been.

And then I had to search through, I had to resurrect my, my old laptop to look through my.

Did you open, did you go, did you go to open office?

Yes.

did you dig through your odts

i dug through my odts which are um a little glitchy it kept crashing i don't think this archives i meant to ask you is there a way to put those in my drive uh no

listeners don't email me

they're all my show notes from our earliest ones when i was still using open office just do what i've been insisting you do send it to the smithsodian they will be the best people to handle it they'll know the way to to deal with it, honey.

I can't be, I don't even have the gloves that they use.

I was, I don't remember.

I was using ODT.

I was using Open Office

well past when it was acceptable for me to not put these on a Google Drive or some other sort of cloud-based.

I don't end up with someone.

I'm going to go fight for the open, open software.

You know what we're going to get now?

We're going to get a lot of emails from a lot of word processing dorks.

We're like, actually, Open Office is stuck.

Can you for me, please?

It's been.

Don't call them dorks.

They know, honey.

At this point, they know.

They know a lot more about something that I obviously know almost nothing about.

Okay, so what?

So whooping cough, Sydney.

Whooping cough.

So I think it depends on where you live in the country right now.

You may be hearing a lot about pertussis or whooping cough.

It's the same thing.

Or you might not.

I know that currently there is an outbreak right here in the county.

in which we live.

Did you know that, Justin?

Good old.

Well, I do only because you mentioned it.

Well, actually, I've seen it on the news but yes i do know that and i there are a lot of people kind of freaking out i think they're like oh my gosh vaccine requirements have changed and now we have whoop and cough well okay that's not nothing has changed yet right

so

We that's not why.

They are changing here in West Virginia, though.

They wasted no time on our vaccine recommendations here, easing those.

Yeah, our complete idiot governor.

Wow.

not a lot of daylight not a room for equivocating there about our stupid horrible carpet bagger idiot governor who worked on behalf of the big pharmaceutical companies that helped destroy or tried to destroy we will not be destroyed we will not be destroyed patrick who is now our governor the work one of the oh man he's just one of the worst people it's like jim justice without the dog

i mean if you thought i mean you're all gonna listen welcome to jim justice rest of the day.

Oh, wait, if you've not met Jim Justice, you're going to love it.

He's broke.

He's our senator now.

He's our broke senator who missed his first two votes because he doesn't like to do that.

He likes to coach basketball.

You see the picture of him rolling up to the airport in D.C.

And there is a, did you see it?

And baby dog in the

wagon.

He's in the scooter behind, and no one's even clocking him.

And then baby dog's in front of him and all the photos and everyone's taking pictures of baby dog.

Hey, guys, you are welcome.

I will say this, America.

If during the darkest times you want to have a laugh at Jim Justice to perk your spirits up, we have been doing that in West Virginia for quite some time.

It's okay.

It doesn't make you a bad person to laugh sometimes at Jim Justice and Baby Dog.

It will help you to get through some of the harder times.

Here in the resistance, we've been laughing at Jim Justice for a long time.

Yes, you can enjoy him and his dog.

And also, we have processed over here the difficulty of loving baby dog despite his owner.

It is okay.

That work is done.

That labor is settled.

You don't have to deal with that guilt.

Baby dog's fine.

You can like the dog.

You can like baby dog.

This is settled.

We here in West Virginia, our stupid governor has issued

an executive order

lifting or allowing for a religious exemption to vaccine mandates.

We have not had that in West Virginia.

West Virginia has been well ahead of other states in terms of strong vaccine mandates to protect people, especially children in our state.

We have lost that distinction just this year, thanks to Governor Morsey, because now we allow you to bring some piece of paper to your school that says, my religion says no vaccines.

And then you don't have to get vaccines.

And that's obviously dangerous.

So we may see more vaccine-preventable diseases.

We certainly will.

And if RFK becomes whatever Trump decides he's going to become, we'll probably see even more vaccine mandates lifted.

So let's talk about pertussis.

Let's talk about taking action so you don't have to feel afraid.

Because I think sometimes with these older diseases, we just get this sense that they were really bad and they killed everybody.

And then we got vaccines and thank goodness and now we're fine.

Yeah, before that, everybody died.

You're right.

And that now if vaccines, if people aren't getting vaccines, we're all going to die again.

And

that is not true.

Is there a a reason to be concerned and take it seriously?

Absolutely.

But

panicking doesn't help us right now because there's actions you can take.

So, pertussis outbreaks have been around since the 1500s that we know of, probably before that, but that's when you start to see descriptions of pertussis outbreaks.

I thought this was really interesting because, as I was researching, like who first described pertussis, usually that's what you find kind of in like the evolution of a disease, our concept of a disease, is you see some old-timey physicians who wrote like clinical descriptions.

I'm seeing this disease process.

It presents like this.

It tends to strike this age group.

These are the symptoms.

This is what happens next.

And you see these clinical descriptions of something and they usually give it some sort of weird name, you know, or like random, like just like the cough or something, you know.

And then it's a while before we connect that to any kind of germ or certainly an even longer while before we connect it to a treatment or a vaccine.

Does that make sense?

Yeah, for sure.

We have diseases, we've talked about them, I think, that have probably cloaked their existence for a long time because they have a similarity to another pre-existing disease.

So it probably took longer to like root out some of those.

Exactly.

Oh, this isn't a common cough.

This isn't whatever.

It's something new.

Yes.

Yes.

I mean, like.

And think about how wild that would need to be to, you need a lot of people experiencing it

like at different places, right?

Before it starts to become something that's like, oh, you know, this is different.

I think it's a new thing, especially when we can't perceive a lot of that stuff with

tools and whatever.

Without the right diagnostic tools, we didn't have them yet.

So

the credit for first describing this is most commonly given to a French physician named Guillamo de Bayou, who is also called the father of modern epidemiology.

He wrote a lot about like tracing disease, epidemiological methods of tracing disease, followed in Hippocrates' footsteps in the way he viewed medicine.

And in 1578, he wrote a clinical description of an outbreak of a respiratory disease in Paris.

He was also often called the Sydenham of France.

So

the

Sydenham of France.

You don't see

a big deal.

I mean, I don't think I need to tell, I mean, of all the people, I don't need to tell you that Sydenham is a civil parish in southeast London.

That's not

Thomas.

Dang it.

Okay, hold on.

thomas

famous english physician ah yes famous for observations medicae which became

a standard textbook of medicine there you go two centuries if i'm not mistaken we've talked about him a lot a lot of people call him the english hippocrates making this person the french english hippocrates

so He wrote this description back in 1578 of mainly kids between four and ten months who got fevers and then a cough.

They said that they at the time would call it the quinta or quintana is what they would call the cough.

You would get this lung irritation.

It could be pretty severe and then all of a sudden your throat would swell up and you would get this sort of

strange cough where it was like you couldn't get air out.

You can see where this is going to go eventually.

Why it was called the quinta he even says like he's not really sure why at the time they thought maybe that the cough sort of sounded like quinta

which is hard for me to i kept trying

like that well that's not i mean we're gonna get to the point where we call it whooping cough is it maybe it sounds like a whoop maybe everybody got it at a lakinta so they they they called it that because they all were at the lakinta at the time i don't think lakinta was around yet you don't think i don't think it's a fabled storied brand i mean i i guess maybe i don't know uh others think it's because quintana is because it repeats every four to five hours, which there are paroxysms of the cough.

So, we'll get to there's different phases, but like the idea that for a while you're not coughing a lot and then you would get this sort of bout of intense coughing with this weird sound that you would make.

This is true.

Now, I don't know that every four to five hours is necessarily the case, but so maybe it came from there.

Um, but anyway, there was this description, there wasn't a lot about like what to do or anything, just like this happened.

Now, what was interesting is as I was reading about the history of Pertussis,

there's some dispute here

because this is from 1578, but then I found this other article from an Iranian medical journal that talked about the first report of epidemic pertussis,

which was actually in 1502 from a Persian lithograph from 1502.

This report actually comes from Bahadal Razi, who was a very well-known Persian physician.

But I think that what is really interesting is there's a complete description of the disease itself which he called there were there were two epidemics in Herat and one in Ray

he reported on them like I said this is like a century before Bayou does it and he named it

public cough

for what he called it okay public cough but he talked about the idea that maybe this is some sort of agent that enters the lungs via some sort of pollution.

He was very focused on the idea that maybe pollution could lead to this, especially like moisture in the air.

Perhaps a miasma.

Yes.

I mean, this is kind of similar to a miasma theory of disease, definitely.

But I mean, it is an infectious agent that enters through the lungs is accurate.

You breathe in.

He's not wrong.

So, and then you get this cough, and then you get the periods of cough that are so severe that you could stop breathing, that you, you know, turn blue.

He talks about how you can cough so hard, you turn blue.

that some people die from it, that children seem to get it more.

And then even threw out there that maybe

ginger would be something effective at treating it.

And so, I think what is interesting, and then it was funny because then I was reading another article where they just had a sideways mention of while we typically credit this French physician with the first description of this, there was probably an earlier Korean text that mentioned it that I couldn't find where they were referencing.

But I think what the point is, is that, and this is important for sawbones in general, we get so hung up on

Western texts and descriptions of medicine.

This is a common problem.

I'm not going to speak for the entire scientific community, but I know it happens in medical history a lot.

And we disregard anything that didn't come from the West.

Like, it happened there first, and it's somewhere in Europe or the U.K.

or the U.S.

wants to claim it.

It doesn't become legitimized until Western medicine recognizes it.

Exactly, which I just think is important to point out that

when you're looking for the history of something, expanding your search beyond where you usually look and the countries and the origins, you know, it's not just Hippocrates.

It's not just all these Hippocrates.

I think it's an important

reminder to us.

But anyway,

we didn't know exactly what protussis was yet.

We have these descriptions of this cough.

We kind of know that it hits kids worse than adults.

We know that it tends to look like a cold at first, but then it gets these terrible coughing spasms and that you could stop breathing and die from these terrible coughing spasms.

We have this suggestion that maybe ginger helps, but we're not really sure.

And we know that it's spread, it seems to be spread, or at least we wouldn't have known necessarily person to person, but we definitely see it as an outbreak type thing, right?

Whether or not I'm giving it to you or it's the air we're both breathing, one way or another, it's something that people get in big groups.

It's not an isolated disease.

But in order to figure out what it is and how we stop it, you've really got to figure out what the, well, first we have to believe in germs.

Yeah.

Germs believed in us, but we didn't yet believe in germs.

Germs knew we were all around.

Germs had faith.

Germs had faith in us, but we didn't have faith in germs yet.

That didn't come until the germ theory of disease.

And then that's when we start digging around to try to figure out like, okay, you're sick.

I need to get some of your sputum and I need to look at it under a microscope or I'm going to take a, if it's something else, I'm going to take a piece of your liver.

I'm going to take a...

an autopsy and take chunks along whatever we're going to look at things try to find the germ find the find the bug and then in 1906 is when we finally were able to isolate the organism.

There were a bunch of organisms being found, thought possibly partussis.

They went through the same, yeah, I don't, I don't want to belabor it, but you go through the process.

You take some stuff from a sick person, you look at it under a microscope, you find this bacteria, you put that bacteria in an animal, probably, not usually another human.

We weren't doing that.

all the time.

And then see if the animal gets sick with the same thing.

And then you would take it out of the piece of the animal, look at it under a microscope.

Do you see the same bug?

There you go.

Right.

Yeah.

Okay.

Got a vaccine.

And they found Bortotella pertussis, the bacteria responsible for pertussis, which we then named pertussis because.

Because of the name.

Because of the name.

Yeah.

You wouldn't have called it pertussis first.

That would have.

Then once we figured it out.

Wild.

And this is a critical step.

If you're going to know treatments, cures, vaccines, you got to get the bacteria or virus, the agent that is responsible for it.

And then we can start testing it against different things to fix it.

And we can start working on a vaccine against it because we got to figure out what piece of it makes your immune system react.

And how can we put that piece of it in you without making you sick?

So,

what does protusis do?

And how do we fight it?

I'm going to tell you after we go to the billing department.

Let's go.

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We're as shocked as you are that we have not fallen into some sort of horrific scandal or just turned into a big crypto thing.

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All right, Sydney, I'm ready to do my part against pertussis.

First of all, I think it's important to understand sort of the process of pertussis.

Like, what is whooping cough?

What is it?

What happens?

What does it look like?

How would you know if you had it?

So the bacteria is mainly going to attach to, there are these little hair-like projections called cilia that line our airways.

And the bacteria attaches to those and then releases this toxin that creates a lot of swelling and inflammation.

This is why you get some of the most distinctive symptoms.

If you imagine you just got really super swollen airways, which makes breathing hard

and why you can have worse clinical outcomes from it depending on if you get treated or not.

It is spread through close contact, spread through the air and droplets.

So breathing around somebody can give it to them.

Obviously, coughing

around them.

And then following exposure, it takes about five, seven days before you're going to get any symptoms.

So that's your incubation period.

There are three phases of this disease.

The first is that incubation phase where the bacteria has gotten in you from another person and now it's growing.

It's multiplying and growing.

Then follows what's called the catarol phase.

This is going to look like a cold.

At first, you're not necessarily

caterol.

Catarall, okay.

Catarall.

And you're going to have, you know, cough, maybe sore throat, fevers, chills.

You're going to look like you've got a cold.

This would be the easiest time for us to diagnose it because you're actually going to have a lot of the bacteria in your system at this time.

So like if we were to test you for it, we would be most likely to catch it at this point.

The problem is it looks like a cold and not everybody is going to go in and get checked out.

And even if you do, my index of suspicion that it's whooping cough.

What does that mean?

I mean, I guess we know with two context clues, what that means.

Yeah, like my,

how concerned I would be, how high that would be on my list of diagnoses.

If I have a differential diagnosis, so when somebody comes in sick, the thing that the doctor should be doing in their head is creating a list that is the differential diagnosis.

What do I think you could possibly have?

Now, sometimes that list is like, it's one thing.

I took your blood pressure.

It's high.

You have high blood pressure.

You know, sometimes it's pretty straightforward.

But with something like a respiratory illness, that list is pretty long.

And a lot of the stuff on it, we don't even know because then there's all the random viruses we can't test for that we just say, I got a cold.

Just stuff happening.

So if you come in with cold-like symptoms, especially this time of year,

I'm not going to initially think whooping cough.

Right.

So I'm not going to test you for whooping cough.

So you're going to go home.

And maybe I said, like, you don't have flu or COVID because everybody tests for that now, but I didn't tell you anything else.

Okay.

Then it's going to evolve into the next phase, which is this severe paroxysmal cough, meaning comes and goes with a tonic.

Paroxysmal.

Comes and goes.

Paroxysmal comes and goes.

With severe mucus secretion, and then that can even lead to what we call post-tussive emesis.

That means post-after tussive cough emesis throw up.

You cough so hard you puke.

Got it.

That can happen with other illnesses as well.

That's a good idea.

Someone said he coughs so hard he puked, and then one of his other doctor friends is like, wow, that took so long.

I got so bored while you were saying that.

We got to come up with a faster, more complicated way of saying cough, so hardy puke.

Post-tussive emesis.

Nailed it.

Shot at one, Greg.

I'm glad we keep you around.

Which, again, that is not unique to pertussis.

It can happen.

I mean, it definitely happens in pertussis.

I mean, it's coughing so hard you throw up.

So it seems like anything that makes you cough hard.

Right.

Yes, that can happen with lots of things.

So the coughing fits.

Because you're coughing really hard because your airways are really swollen and you're trying to get all of this mucus out.

Okay.

And

when you do that, there was this sound that that a lot of people with it, especially children with it, tended to make, which sounded like whooping.

This is where the name whooping cough starts.

How would you define whooping, though?

Are you trying to make me whoop?

No, it's just you said it sounds like whooping.

So what does that sound like?

Whooping, I mean.

I've never,

no, I've had, I've taken care of patients with whooping cough.

I would not say that I thought that they sounded like they were whooping.

But obviously back in the 1900s, people very much thought that they sounded like they were whooping because they called it whooping cough.

Honey, if you haven't whooped yet, I don't know what to tell you at this point in your life.

I mean, I've been whooping, I don't know, several times a day.

You should have started whooping a while ago.

That's what I'm saying.

I don't know what to tell you.

What are you scared of?

What do you think a whooping sounds like?

Like a whoop.

Do a whoop.

Like whoop.

There it is.

No, I don't think that's the sound they're making when they cough.

Coughed.

No.

Tag team back again.

It's coughing so hard.

You lose a friend.

What I would say is these are tightened airways.

And so they're going to make high, not like that.

They're going to make high-pitched sounds.

Basically.

This is going to last for like two weeks.

So it's a long.

God, I would leave.

If someone sounded like that, can you imagine that for two weeks of that?

I don't think it's exactly like that.

No, thank you.

And what makes this a diagnostic challenge is that at this point.

If I test you for it, you actually have less of it in your blood.

What we're dealing with is that

toxin that was released is what's causing this at this point, not the bacteria itself.

So it's hard for me to find it in you because now all that we're dealing with are the consequences of all that toxin.

Does that make sense?

Yeah, I think so.

Okay.

So it made it a bit now.

I will say back in the 1900s when there were multiple outbreaks of this, it would have been much easier to diagnose because you would see it a ton.

So like as a physician practicing, I would see so many cases of it that it would be easy for me to diagnostically recognize it.

I think the challenge nowadays is it's hard to test for at this point.

And most of us have not routinely seen whooping cough in our careers.

That's what we're up against now.

Now, as with most respiratory illnesses, if you have preexisting lung problems, it could be worse for you.

And then, specifically for pertussis, children and especially infants tended to get it the worst.

That's where we see the scariest disease progress is among the youngest patients.

And throughout the 1900s, you saw seasonal outbreaks with as high as 10% mortality rate in children.

So it was a big deal

for sure.

Whenever there's something like this that is a big deal, we start thinking, instead of just treating, which is great, treatment is great.

Is there a way to prevent it?

Can we make a vaccine and prevent this disease?

They came up with one.

It's kind of interesting.

Pretty quickly after 1906, when we discovered the bacteria, they came up with a vaccine that would help with the symptoms of it.

It was almost like a, it wasn't a prevention.

It was once you get it, we could give you a vaccine that would help.

That was not very popular.

It took a while to come up with one that could actually prevent it.

And what's nice is that only humans host pertussis.

That makes it a little easier, right?

You can, I found some cases where we did accidentally give it to animals in zoos, like non-human primates in zoos.

So it is possible through prolonged contact with humans that you could give it to another primate.

All right.

Good to know.

I'm sure the gorillas would really appreciate that.

So don't, if you have pertussis, please stay away from the gorillas.

Yeah, they've got it hard enough.

But generally, we are the only host for this.

So

it took a while.

They started working on, like I said, here's what you have to do when you make a vaccine.

You're either going to take the whole bacteria.

find a way to make it inactive so it can't make you sick, and then a way to get it in your body so that you get an immune response without an illness, or you're going to take pieces of it.

Well, initially in 1939, they made a whole cell vaccine.

Basically, they took the entire bacteria, they inactivated it, and then injected it in people, and you got a really robust, strong, meaning strong immune response.

Good.

So this was good.

This is all the way back in 1939.

In the late 1940s, and you probably have heard of this, they very classically combined vaccines back then.

Anytime that they could, instead of giving you, you know, 20 shots, the more we can combine so that you get fewer needles the better and they combined it in the late 1940s with diphtheria and tetanus vaccines to become the dtp or now it's called the dtap but it wasn't then d-tap now and i'll tell you why at the time it was the dtp okay so great we have this great vaccine that has a whole cell inactivated pertussis vaccine in it it's got a diphtheria vaccine in it and it's got a tetanus vaccine in it those are other diseases we've talked about on other episodes

However,

even though we were seeing like this great success from it, so as you move into like the 80s,

with the pertussis vaccine, with vaccine mandates, with childhood vaccine schedules, you're seeing fewer and fewer cases of whooping cough.

Right.

Right?

This is great.

But what happened with whooping cough is the same story that happened with a lot of these vaccine-preventable diseases.

As you stop seeing the worst cases, when you get to generations of people like us

who have never seen a child struggle with pertussis, I've never seen that.

I don't know what that would be like.

I certainly, as a parent, don't know the terror of that.

You start to get people shifting towards focus on the side effects of the vaccine.

Now,

in many cases, the concern over vaccine effects is not true.

It's stuff that people made up or completely invented.

Misattributed, whatever.

The thing with the pertussis vaccine in particular is that it was a whole cell vaccine.

It was very reactogenic, meaning it got a really strong immune response, but it also did have some local inflammation as side effects.

So like you could get a fever, you could get some redness and swelling at the injection site.

It was a little more likely to trigger some of those things.

And what's because we were giving it to kids, what you could also see is that it triggered a fever.

And then it is possible because we know that febrile seizures are a thing, that some people, especially in children, they can get a fever and have a seizure afterwards.

There were some cases of that.

This is not unique to the pertussis vaccine or to, you know, any side effects.

It's just, that can happen with fevers.

So anyway, the focus starts to shift on, are there problems with this vaccine?

Is it dangerous?

Should we be giving it to kids?

All of the usual rhetoric.

The vaccine is worse than the disease.

That isn't true.

Nope.

But if you've never seen the disease, maybe you think that.

You think that.

So

you start seeing the wholesale pertussis vaccine being blamed for a bunch of stuff.

There's a TV documentary.

There was a group form called Dissatisfied Parents Together, and then they became the National Vaccine Information Center, which continues to provide a lot of misinformation about vaccines.

A bunch of parents refused to vaccinate their kids.

There were personal injury lawsuits.

Congress passed the National Childhood Vaccine Injury Act to protect vaccine manufacturers, but now it is.

Anyway, the point is there was all of this concern.

Yeah.

And we see people not taking the vaccine.

And at this point, it's rolled in with diphtheria and tetanus.

So they're not getting any of those because everybody's freaking out about the whole cell pertussis vaccine.

And I say whole cell pertussis vaccine because at this point, there was a Japanese physician or Japanese scientist, Yuji Sato, who started working on an acellular pertussis vaccine basically said hey what if we just take the parts of it that get the immune reaction and put that in a vaccine instead of the entire cell so they took he took the toxin and another aspect the filamentous hemoglutinin created an acellular cellular pertussis vaccine introduced it at first in japan and then that soon was taken up by a lot of especially high-income countries mainly who had this sort of outrage about the vaccine.

And the DTP became the DTAP for acellular pertussis, not a whole cell.

So now it is the D-Tap, which remains to this day the vaccine that you get.

Now, in countries where the D-Tap is in use, we do see periodic resurgences of it.

Prior to any like vaccine laws kind of breaking down, the great thing about this vaccine is it has fewer side effects.

The downfall is that it doesn't last quite as long.

So we still need to get boosters of it at least every 10 years.

Although for some people, it could, that immunity, that immune response could wane as fast as five years.

The older vaccine,

stronger reaction lasted longer.

This one, not so much a reaction, doesn't last quite as long as it is one of the downfalls of it.

So we do see these epidemic cycles even before we start getting into vaccine laws and all that kind of stuff.

I have treated pertussis in my career.

Years and years ago, I saw cases of pertussis, especially among adults who don't get their boosters very well.

And then if you also take a population of adults who have maybe chronic lung disease, so we have a lot of people who smoke in our area and have chronic lung disease, they're at higher risk, right?

So what do you do with all this information?

Freak out.

No.

Panic.

No.

Bang.

First of all, I think I had it.

First of all, you know what vaccines you need.

Kids get the D-tap

at two, four, six months, between 15 and 8 months, between 4 and 6 years, and between 11 and 12 years.

That's the regular scheduled recommended vaccines.

I would highly recommend, you know, discuss that with your provider, keep on schedule.

And by the way, at 11 and 12, it switched to the TDAP.

The D-Tap and the T-DAP are the same in terms of what they vaccinate you against, but they're flipped because of amounts of stuff.

Okay.

Because they're for kids and adults.

But it's the same.

They're protecting you against the same thing.

Adults get the T dap when they're pregnant.

So I got it both times around between 27 and 36 weeks.

And then every 10 years is the recommendation.

If you're not sure, if you don't know, it's okay to get it.

Please go discuss with your medical provider.

You got it when I was pregnant with Cooper.

Great.

So you should be fine for now.

If someone gets pertussis, we can generally treat them with azithromycin.

For the most part,

that is the treatment for it.

Azithromycin is also known as

a ZT.

No.

ZPAC.

A ZPAC.

Yes.

A lot of people have heard of the ZPAC.

It's a very common antibiotic.

Most of the time, a ZPAC, and we can treat pertussis.

That's a good thing.

That doesn't mean that it's a big, it's not a big deal, but it is treatable.

If you're allergic to that, we can use Bactrim.

So there's other options.

And there is prevention dosing.

If you know you've been exposed, you can go in and get azithromycin preventative dosing to keep you from getting pertussis.

So there are ways to prevent it.

There are ways to treat it.

All this being said, we are not having these outbreaks right now because of any new idiot policies.

But

this is the kind of thing, whooping cough, measles, these are the things we will see more of as vaccine mandates are weakened across different states and then maybe federally.

What you can do

is make sure you're up to date on your vaccines.

Make sure anybody you're responsible for, if you're a guardian for anybody, that they're up to date on their vaccines.

Encourage other people.

I just this morning was encouraging someone, hey, if you haven't gotten your TDAP in 10 years, go get a TDAP.

Help local health departments, your local healthcare providers, pharmacies, a lot of people carry this vaccine.

It's widely available.

For most of us, we can tolerate it just fine.

It makes your arm a little sore, and that's about it.

Obviously, if you have concerns, if you're allergic, if, you know, any other, talk to a healthcare provider.

But make sure that you are getting your vaccines.

If you are sick and you're not getting better, please go seek treatment.

And then healthcare providers, our job is to remember that whooping cough is still a thing.

It is not just an old-timey disease.

It is around now.

We are seeing it now.

And we will be seeing more of these as vaccine mandates are loosened.

So you've got to keep that.

in your mind.

Thank you so much for listening to our podcast.

We hope you learned something today.

And we want to thank the taxpayers for the use of their song medicines as the intro and outro of our program.

And thanks to you for listening, my friend.

That's going to do it for us.

Until next time, my name is Justin McElroy.

I'm Sidney McElroy.

And as always, don't drill a hole in your head.

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