The Birmingham age-herald., 1914-08-23
WHOOPING COUGH SUBJECT
 OF CUNNINGHAM BULLETIN

rooms Articles used by the patient may also communicate the disease It is in- troduced with the inspired air. The pe- rod of incubatiok Is from seven to 10 days. Sixteen days after exposure means that the disease will not develop. The disease is not contagious during the stage of incubation, but it is from the onset through the early, active and convalescent stages, covering a period of from four to eight weeks
 Course of the Disease
 The disease appears with the symptoms of cold-coush nasal discharges, fever ishness, etc. The eyes are red face at less paroxysmal and dry. This is the ca tarrha1 stage.
 After a week or 10 days the second or jaroxy stage arrives. This is char acterized by paroxysms of coughing. usu- ally 10 to 20 coughs which, like all coughs, is eXpiratory, until all the air possible is coughed up, together with approximation. During the coughing spell the child may get blue in the face, the neck veins pull sate and the child looks like it has lost i, it's breath. Soon, however, there is an in- take of air, which makes a loud noise called the "whoop'' and Is quite char acteristic. There may be a few slight coughs after this, when the patient seems to be all right, until the next paroxsym. This characteristic whoop is necessary to make a positive diagnosis. During epi- denies, however, whooping cough may be suspected during the catarrhal stage. Very often there is vomiting at the time of the paroxysm, and children should be nursed or fed soon after the paroXysm, in order that nourishment may be re- tained. The disease lasts from onset to | convalescence from four to eight weeks.
 Complications
 Whooping cough itself is not often fatal, | except in the very young or very old, in whom the constant paroxysm of cough ing leads to exhaustion. But through it's complications the mortality is often rather Ligh. These complications are chiefly capillary bronchitis, broncho- pneumonia, rarely lobar pneumonia, and tuberculosis. There are other and rarer complications, one of which very rare. is a hemorrhage in the brain from the severe coughing, l causing paralysis on one side. The writer has seen one such case. Special care must be exercised to prevent these eomplica- tions, which, however. may occur re- gardless of preventive measures.
 Prevention
 1 Owing to the fact that children with 1 whooping cough usually have the disease | for several days before a diagnosis is
 made, and during which time the disease I is especially contagious. and owing to the fact that the open air is very impor- | tant in the treatment and management 1 of the disease, the isolation of the pa I tient, which is the only method, is very 1 difficult 1t is very rare that a case of whooping cough in family fails to n- 1 feet all of the children, and possibly adults also. However, isolation should be attempted but not at the expense of the | patient by depriving ample fresh air. All utensils and clothing used by the patient should be sterilized by boiling, and old cloths burned. Dogs and cats should be l kept away from patients, and out of their rooms, as they may contract the disease and communicate it to other dogs and cats, and to people also. During cOnval- l essence, and indeed during the whole at tack where the patient is able, there should be more or less outdoor life | Where families have grounds-yards, gar dens, etc., this can be done with safety l to the public; but where the public parks l or streets are the only places for outdoor | life, the public is exposed to it. It has been suggested that patients with whoop | ing cough should be kept from gather | ings, and should wear a red cross or | their arms as sign to others to keeT | away from them. An ordinance to tha ] effect should be passed by city authori | ties. To keep children confined for iron four to eight weeks would be very dan | gerous as it would invite complications l and predspose to tuberculosis.
 | In next bulletin cerebro-spinal feve | will be discussed.
 R. M. CUNNINGHAM, M. D., | City Health Officer.