Some years ago, my daughter Katie (Cherokee/Choctaw), a healthy 24 year old, was living with a friend and working as a nurse’s aide. Katie’s friend offered her a place to stay and in return Katie agreed to help care for her friend’s baby when she was not working. That winter, Katie came down with cold-like symptoms and a cough. Her symptoms went on for weeks and she saw doctor after doctor in several different facilities. They figured she had a cold or bronchitis and gave her cough suppressant, telling her the cough would eventually go away. When I talked to Katie, she was very uncomfortable and exhausted from her cough. She seemed so frustrated that none of the medications she was taking worked. She just wanted the cough to stop.
It was really hard for me to see my daughter so sick. I wanted to be more aggressive about getting some answers. But she’s an adult, so I couldn’t do much. But since Katie wasn’t getting better, I finally encouraged her to come to the clinic where I worked as a registered nurse. This time, I personally asked the doctor who was seeing her to test for pertussis.
The doctor was skeptical and didn’t think she could have pertussis. So, I said “just humor me please” and the doctor agreed to order the test. All the medical staff was surprised when my daughter was diagnosed with pertussis a few days later. That’s because the pertussis cough in adults doesn’t always have the “whoop” sound, so it often goes unsuspected.
Katie has no idea how she was exposed to pertussis. But since she worked as a nurse’s aide, she could have been exposed at work, through a patient or someone else.
Following her pertussis diagnosis, both Katie and I worried that she might have exposed her friend’s baby to this disease. Pertussis can be deadly for infants and she had been helping care for the baby when she was sick. Katie urged her friend to take her baby to the pediatrician.We’re lucky that this story did not turn out to have a tragic ending. The baby turned out to be fine and Katie finally stopped coughing after about three months. As a self-described “germaphobe,” she had been extra careful to always wash her hands and cover her cough while near the baby. The potential was definitely there for this baby to be unwittingly exposed. But Katie’s friend and baby were lucky. I believe Katie’s hygiene practices were the only reason the baby did not get pertussis. If it were someone else, that might not have been the case.
I’m telling this story because much can be learned from my daughter’s experience. Providers in the community need to be aware that even healthy young people can get this disease—and spread it. Also, a persistent cough should be explored sooner than later. I think Katie’s diagnosis would have come sooner if she had a medical home. It took a lot of persistence to finally get to Katie’s true diagnosis. After being a witness to my daughter’s experience, I like to encourage anyone whose cough symptoms persist to seek care and ask about a pertussis test. Anyone who’s going near a baby should their wash their hands and get a Tdap shot.
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