Pertussis (whooping cough)

Caused by the bacteria Bordetella pertussis, this disease is highly infectious and most serious in babies.

The disease is spread through droplets in the air and it can develop from upper respiratory tract (windpipe) infections into pertussis pneumonia (lung infection).

Symptoms include coughing and ‘whooping’, which can continue for a few months.

Complications of the disease include hypoxic encephalopathy (lack of oxygen to the brain) leading to brain damage and possibly death.

Pertussis (whooping cough) is a disease which can be prevented by vaccination.

Vaccination recommended for routine childhood immunisation is listed on the National Immunisation Program (NIP) Schedule and funded for children under the Immunise Australia Program.

People in high risk occupations, such as health and child care workers, should consider receiving a booster against pertussis. Contact your doctor or State or Territory Health Department for more details. Currently, there is a Government Funded Programme to give the booster to parents and grandparents of new babies.

Who is most at risk?

• Any one who is not protected (by recent immunisation or by having had the infection before) can get whooping cough, including older children and adults.

• Most people who get the infection in Australia are adults or young people over about 11 years of age – even if they have been immunised as a baby.

• Babies are at most risk of having severe health problems from whooping cough. About 1 in 200 babies who get whooping cough before they are 6 months old will die from the infection.

How long does it take to develop?

A child or adult who catches whooping cough will usually start to be unwell about 7 to 10 days after being exposed to the infection.

Signs and symptoms of whooping cough

• After several days the long spells of coughing start, causing difficulty breathing during the spells. The child will have many quick coughs in one spell. There can be several spells of coughing each hour (with an average of 25 coughing spells per day).

• Young children often have a whoop after the coughing spell (when they can finally breathe in). They might vomit any food or drink that they have recently swallowed, during the cough or soon afterwards.

• Adults and older children may not whoop, but they will have coughing spells and they may feel tired (the coughing can interfere with sleeping), and generally unwell. It can be many weeks before it is recognised that the older child or adult has whooping cough.

• Finally, after several weeks or more, the coughing spells start happening less often and they stop happening about 2 to 3 weeks later. If the person gets a cold soon after having whooping cough, the coughing can start again for a while (much shorter than the original illness).

Diagnosis of whooping cough

• During an outbreak of whooping cough it is usually possible to diagnose whooping cough from the symptoms.

• Blood tests and tests on mucous from the nose or throat can be done to confirm that the illness is whooping cough. Xrays may be done to check how well the lungs are working.

What you can do

• Be sure you and your children have up to date protection by vaccination.

• It is important to check often that the child is eating and drinking enough.

• It seems that feeding a young child immediately after a coughing spell may mean the food and drink stays down. Feeding seems to trigger a coughing spell if the child has not coughed recently, but soon after a coughing spell, food and drink usually do not trigger another coughing spell.

• Children who are coughing often will be tired and uncomfortable (coughing can cause tummy pain from overused muscles). Some paracetamol or ibuprofen may help with aching muscles.

Immunisation

• Routine childhood vaccination covers whooping cough at 2,4,6 months and 4 years

• Immunisation of older children also protects babies under 2 months (when whooping cough can be very severe) because there will be fewer children in the community who can spread the infection to babies (babies are not protected by antibodies from their mother).

• There is now a vaccine to protect children over 10 years and adults.  This booster works if the person had a full set of immunisation as a baby.

Immunisation is recommended to be given with tetanus and diphtheria at the age of 15-17 years (one injection with three vaccines). This immunisation is provided free in Australia.

Preventing the spread of whooping cough

• Any person with whooping cough should be excluded from child care, kindergarten and school until 5 days after starting treatment, or if not treated, for 3 weeks from the start of symptoms.

Children who are unwell should not be at child care, kindergarten or school even if they are no longer infectious.  The teachers are not able to provide the care that sick children need.

• Any children under the age of 7 years who have not been immunised and have been in contact with someone with whooping cough should be excluded from child care, kindergarten or school for 14 days after the contact, or until they have been on antibiotic treatment for at least 5 days.

• The National Health and Medical Research Council in Australia recommends that anyone who has been exposed to whooping cough in the household or other close contacts (such as child care) should receive antibiotics for 10 days even if they have been immunised (see your doctor).

• Whooping cough is a notifiable disease in Australia. The State Government health service will be notified of proven cases of whooping cough so that they can assist in stopping the spread of the infection.

Questions often asked about immunisation against pertussis

Q: Does pertussis immunisation cause permanent brain damage?
A: No, it does not, and many studies have been done to show that there is no risk. A few babies become “floppy” for several hours after the injection. They always recover fully. However children who get ill with pertussis (especially babies) can have brain damage, and might die.

Q: Does the pertussis part of the vaccine (combined with tetanus, diphtheria, and in South Australia Hepatitis B vaccines) cause reactions such as fever and a sore spot where the injection was given?
A: The type of pertussis vaccine has been changed. Since this new vaccine (a-cellular pertussis) has been used, there have been many fewer children who get a fever or sore injection sites, but they get the same amount of protection.

Q: Do children still need to be immunised against whooping cough?
A: Yes, there have been regular outbreaks of whooping cough in Australia even in the last few years, and babies in Australia still die from whooping cough. In some countries where many children are not immunised against whooping cough, the numbers of children getting sick (and dying) with whooping cough is much higher than in Australia.

Q: How long does the protection from whooping cough last after immunisation?
A: For some people, the protection against whooping cough starts to get lower around the age of 12 years. A booster at 15 to 17 years is recommended and provided free of charge in Australia.

Q: Is it better to wait until my child is a bit older before having the whooping cough immunisation?
A: No. Waiting until your child is older is not recommended because it is when they are less than 12 months old that babies are most at risk. Many of the children over 5 months old who get whooping cough have either not been immunised or the immunisations have not been given at the recommended time.

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About side effects

Side effects are unwanted effects you may experience while taking a medicine. Sometimes they are serious, but most of the time they are not.

Side effects may occur when taking any medicine, including both prescription and non-prescription medicines. Non-prescription medicines include:

• those you buy over-the-counter in a pharmacy or supermarket

• complementary medicines, including herbal and ‘natural’ medicines, vitamins and minerals.

How common side effects can be

To explain the chance of getting a particular side effect, information supplied with most medicines uses the terms common, uncommon, rare and very rare.

Common up to 1 in 10 people

Uncommon up to 1 in 100 people

Rare up to 1 in 1,000 people

Very rare up to 1 in 10,000 people

Another way of thinking about the chance of a side affect is this: if the risk of a side effect is 1 person in 100—an uncommon side effect—then 99 of those 100 people are unlikely to get the side effect.

What to do if you get a side effect

If you experience a side effect that worries you, get advice from a health professional.

If taken correctly, medicines will help most people improve their medical condition. Only a few people experience unwanted effects.

If you experience a side effect that seriously affects your health, thinking, or ability to work, you may need to stop taking your medicine immediately and go to hospital.

You may need urgent medical attention.

In an emergency, call 000 and ask for an ambulance.

Weigh the risks and benefits

Before you start to use any new medicine, ask a health professional for advice.

This may be your doctor, pharmacist, dentist or complementary health practitioner. If this person has advised you to use a medicine, they have weighed the risks of unwanted side effects and the expected benefits of treatment. They will have considered things like your health and family history.

If you are concerned about the side effects of a medicine, ask a health professional:

• what are the benefits they expect the medicine to have?

• how often do people get side effects when taking the medicine?

• how serious can the side effects be?

• what are the risks of not taking the medicine?

Some side effects may sound serious, but you need to weigh these against the medicine’s expected benefits, as well as the risks of not using the medicine. For example, common side effects of some anti-cancer medicines include severe vomiting, tiredness and complete hair-loss, but most people with cancer choose to accept these side effects rather than do without the medicine.

Get information on your medicine

Before you start using a medicine, get information about it by:

• asking a health professional

• reading the label of non-prescription medicines

The label has all the information on how to use the medicine—and when not to use it.

• reading the Consumer Medicine Information (CMI)

CMIs are available free of charge for all prescription medicines and some non-prescription medicines. They contain information on the medicine, including possible side effects and what to do about them. If you do not get a CMI with your medicine, ask your pharmacist to print one for you.

• calling Medicines Line

Call 1300 888 763 between 9am and 6pm Eastern Standard Time.

Find out:

• what side effects are possible

• what action to take if a side effect happens

• how soon to act if a side effects happens.

Make sure all relevant people have this information. This could be your carers, the people you live with or your children’s school teachers.

Reduce the chance of side effects

Keep a list of all the medicines you are taking.

Include both non-prescription and prescription medicines.

Before your doctor or dentist prescribes you a new prescription medicine, tell them all the other medicines you are taking.

Before you choose a new non-prescription medicine, check the label or ask your pharmacist whether you can use the medicine.

If you are taking several medicines, find out whether they can be used at the same time.

Some medicines can interact and make you sick. Adding a new medicine may also reduce the effectiveness of the other medicines you are taking.

For all medicines, take the dose recommended by your doctor or written on the medicine label.

Check if there are things you need to do when taking the medicine, such as:

• taking the medicine with or without food

• taking it at particular times or days

• avoiding certain foods or alcohol

• having regular check-ups to monitor the medicine’s effects

• not driving

• avoiding recreational and illicit drugs.

When side effects can happen

Side effects depend on:

• the medicine

• your medical condition and general health

• what other medicines you are using at the same time.

Some side effects can happen soon after you start taking the medicine. You may not notice other side effects for weeks or months.

Side effects are most common when you start to take a medicine or increase the dose. This is because your body is adjusting to the medicine. These types of side effects usually pass within a few days or weeks and you will be able to keep taking the medicine without further problems.

Some side effects may not go away completely. You will need to weigh the benefits of taking the medicine against the side effects.

Before changing or stopping your medicines, ask a health professional for advice.

The Glucose Club is a unique company which provides lifestyle programs, education and support to people with metabolic health problems like obesity, diabetes, metabolic syndrome, high blood pressure, high cholesterol, to mention a few. We guide and support people into a lifestyle that will treat or prevent these metabolic conditions.

Click on the link below for more information about The Glucose Club.

http://www.theglucoseclub.com.au/

WHEN SHOULD I HAVE A CHECK-UP?

You need to consider having a sexual health check-up:

• At the beginning of a new relationship, particularly if you don’t plan to use condoms.

• If you have recently ended a relationship.

• If you have had unsafe sex or believe there was some risk to your health during a sexual encounter.

• If you have genital symptoms such as pain, discharge, itching or new lumps.

• If you think you might have an STI.

• If your partner has recently had an STI.

• If you want information on preventing pregnancy.

• Regularly, if you get paid for sex work.

• Regularly, if you have frequent changes in sexual partners.

• Regularly, if you have sex with people outside your relationship.

• If you are concerned about some aspect of your sexual health.

• Regularly, if you are sexually active and part of a population group in which there is a high frequency rate of STIs.

SHOULD I GET TESTED?

The decision to get tested for STIs is a personal decision. Your doctor can discuss with you what tests to have based on your sexual history and potential risk for STIs, but the decision of what tests to have remains yours to make.

Some people don’t like to get tested because they are concerned about their confidentiality. All health care settings do their best to maintain and protect your privacy and confidentiality. A range of measures are used to protect your confidentiality and the law requires that consultations with your doctor or any health professional are confidential (with some exceptions such as where someone is at risk of seriously harming themselves or somebody else, or if they suspect a young person is being subjected to physical, emotional or sexual abuse).

Before getting tested it may be worth discussing with your doctor the advantages and disadvantages of testing.

Some of the advantages of being tested include:

• Effective treatment of the STI and/or ongoing monitoring and management.

• Able to make better informed choices about your lifestyle and future plans.

• Ease of mind – comfort in knowing with certainty what illness you may or may not have.

• Detection of an unknown STI. Some STIs lead to infertility if left untreated.

• If you have HIV, you can treat many STIs and therefore minimise the impact it has on your immune system.

• Better able to make decisions about your sexual practice and safe sex strategies.

• If you have an STI, you can act to protect your sexual partners and tell former partners so they can act.

Some disadvantages of being tested include:

• You may become anxious and concerned while waiting for the results.

• Some STIs may have implications for your insurance coverage.

• Concern about others finding out about your health.

• Impact it may have on your partner, friends and family.

• You may become stressed or upset when you’re informed about your STI testing results.

EXAMINATION AND TESTS

Physical examinations can be embarrassing but they are an important part of a sexual health check-up. Your doctor will do his/her best to make sure you feel comfortable. You may want to consider whether you feel more comfortable undergoing a physical examination by a male or female, and therefore choose your IWGP doctor accordingly.

If you have concerns about a physical examination, discuss these with your doctor beforehand. Your IWGP doctor can explain what the procedure will involve.

A physical examination might involve:

• genital examination;

• swabs (long cotton bud) from the cervix, vagina or rectum, tip of the penis or back of the throat;

• blood tests for STIs;

• urine tests for STIs; and

• pap smear (smear taken from the neck of the womb) for early screening of cancer.

Remember you can say no to having any of these tests or have them at your next visit. Your IWGP doctor may recommend tests if he/she believes there’s a chance you have an STI.

Follow up

If tests are taken, then it is important that you return to your doctor for follow up. This allows you to find out the results of the test. Do not assume your doctor will contact you if the results are abnormal. It is your responsibility to chase them up!

If you have had symptoms, returning for follow up allows your HHMP doctor to monitor your treatment.

Informing partners

If you do have an STI, it is important to work out who else you have recently had sex with. This is so that your sexual partner/s can go and visit their doctor to get tested. This helps in reducing the continual spread of STIs.

Whether your partner/s need to be contacted depends on many factors including which STI you have and even whether it is possible to trace your sexual partner/s.

Your HHMP doctor will advise you on whether you should not have sex while your STI is treated or if the use of condoms or stopping specific sexual activities will protect your partners.

SEXUAL HISTORY

During a sexual health check-up you will be asked questions about your sexual history. These are standard questions that your doctor will ask every patient. While many questions are of a personal nature, you need to answer as honestly as you can as the information you provide will enable your HHMP doctor to better support your health needs. You can skip any questions you prefer not to answer.

Your doctor must respect your confidentiality. There are a limited number of situations where they can be required to report information, for example if they have serious concerns about you or someone else’s safety.

Questions may focus on:

• whether you have any physical symptoms

• any previous STIs you may have had

• sexual behaviour (e.g. what kind of sex you have had)

• relationship history (e.g. how may partners you’ve had)

• menstrual cycle and contraception (e.g. how regular your periods are)

• drug and alcohol use and

• general questions, if not already known, about your health and medication history.

Click the link below for Ozdocsonline information.

ozdocs-web-info-2009

Our IWGP doctors currently registered with ozdocsonline

Dr. Linda Mann
Dr. Dianne Chambers
Dr. James Best
Dr. Aline Smith
Dr. Jacky Korner
Dr. Sam Hay
Dr. Vanessa Moran
Dr. Tracey Purnell
Dr. Louise Harrison
Dr. Jenny Thai

INNERWEST GENERAL PRACTICE

PRIVACY POLICY

The ways in which this practice complies with the legislation and the NPPs is set out below:

Collection
It is necessary for us to collect personal information from patients and sometimes others associated with their health care in order to attend to their health needs and for associated administrative purposes.

Use and Disclosure
A patient’s personal health information is used or disclosed for purposes directly related to their health care and in ways that are consistent with a patient’s expectations. In the interests of the highest quality and continuity of health care this may include sharing information with other health care providers who comprise a patient’s health care team from time to time.

In addition there are circumstances when information has to be disclosed without patient consent, such as:

• Emergency situations
• By law, e.g. mandatory reporting of some communicable diseases
• It may be necessary to disclose information about a patient to fulfil a medical indemnity insurance obligation
• Provision of information to Medicare or private health funds if relevant for billing and medical rebate purposes

There are some necessary purposes of collection for which information will be used beyond providing health care, such as professional accreditation, quality assessments, clinical auditing, billing, service monitoring activities, and disclosure to a clinical supervisor.

In general, a patient’s health information will not be used for any other purposes without their consent.

Data Quality
All patient information held by this practice relevant to the functions of providing health care will be maintained in a form that is accurate, complete and up to date.

Data Security
The storage, use, and where necessary, transfer of personal health information will be undertaken in a secure manner that protects patient privacy. It is necessary for the practice to keep patient information after a patient’s last attendance for as long as is required by law or is prudent having regard to administrative requirements.

Openness
This practice has made this and other material available to patients to inform them of our policies on the management of personal information. On request this practice will, generally, let patients know what sort of personal information we hold, and for what purposes, and how we collect, hold, use and disclose that information.

Access and Correction
Patients may request access to their personal health information held by this practice.
All request for access to personal health information will be referred to the practice Privacy Officer.

The practice encourages patients to ensure that information held is accurate and up to date and to amend any information that is inaccurate.

There are some circumstances in which access will be restricted or denied and the reason for this will be explained.

A charge may be payable where the practice incurs a cost in providing access. This is for administrative costs such as photocopying, etc.

This practice acknowledges the right of children and young people to privacy of their health information. Based on the professional judgement of the doctor and consistent with the law, it might be necessary at times to restrict access to personal health information by parents or guardians.

There is no cost for this service as it is covered by Medicare, however subsequent consultations dealing with medical issues arising from the health check would attract the usual practice fee.
The aim of the health check is to help find, prevent or lessen the effect of disease. After all, it is better to avoid disease than to treat it. This health check will give us the opportunity to look at your lifestyle and medical /family history to find out if you are at risk.

The health check would involve:
• updating your medical history and looking at your health issues
• doing tests (such as blood pressure tests, diabetes screen, cholesterol check, etc.)
• follow-up of any problems identified
• advice and information, for example-on how to make lifestyle changes to improve your health.

Pneumococcal vaccination

The pneumococcal bacteria can cause ear infections, pneumonia and more serious invasive disease such as meningitis and septicaemia. In Australia it is estimated that three in every 1000 children will have at lease one episode of invasive pneumococcal diseas by age five, and every year hundreds of children are hospitalised for treatment of pneumococcal infection.
An effective vaccine is available that protects against the seven types of pneumococcal becteria, which cause 85% of invsive pnemococcal disease in children younger than five. The Australian Standard Vaccination Schedule recommends vaccinating all Australian  children at ages two, four and six months. It also recommends all children up to age two are vaccinated against pneumococcal disease.

What is pneumococcal disease?
Pneumoccal disease is caused by infection with the pneumoccal bacteria. Most commonly it causes; middle-ear infections; pneumonia. The most serious invasive diseases caused by the bacteria are; septicaemia (where the bacteria infects the bloodstream); meningitis (infection of the lining of the brain). Invasive disease can be treated with antibiotics, however, the illness can have serious outcomes, including deafness and disability.  Although the risk is small it can be reduced by further vaccination.
How effective is the vaccine?
There are two types of pneumococcal vaccine available in Australia; a vaccine that can protect babies, children and adults against seven types of pneumococcal bacteria (Prevenar), and a vaccine that can protect older children and adults against 23 typess (Pneumovax 23). Up to age nine, children who are not in a high-risk group should be vaccinated with Prevenar because this vaccine is far more effective in children.

How safe is the vaccine?
The vaccine contains water, salt and sugars from the pneumococcal strains joined into a diptheria protein. It also contains aluminium to boost the body’s immune response to the vaccine. It does not contain antibiotics.
Need more information? The National Immunisation Program
http://immunise.health.gov.au/nip/public.htmP