The Battle Against Whooping Cough Continues
Dec 13, 2011

While you’ll often hear public health departments warning of influenza this time of year,there is also reason to be concerned over another contagious disease.   It’s known as “whooping cough”, or pertussis, and it’s a highly contagious bacterial infection that can result in prolonged coughing spells that often lasting for weeks or even months. While one may think that coughing is just inconvenient, people with pertussis often cough violently and rapidly, over and over, until the air is gone from their lungs and they are forced to inhale with a loud “whooping” sound.  Pertussis can even lead to pneumonia, seizures, brain damage, mental retardation, and even death.
Statistics show that 50 out of every 10,000 people with pertussis will die and 90% of pertussis-associated deaths have been among babies less than one year old.  Since children are not fully immunized against pertussis until they receive all five doses of their DTaP vaccine (recommended at ages 2, 4, 6, 15-18 months and 4-6 years), infants are relatively unprotected and extremely vulnerable.  Since their bodies are unable to effectively clear the thick mucus from their chest if they do contract pertussis, the physical impact of this disease is often too much for them to handle.
While most children get immunized, under-immunization, as well as undiagnosed patients, can both contribute to the spread of pertussis.  For instance, children don’t always complete their immunization series.  Often, those who suffer with pertussis often mistake their illness as a persistent cold and never get properly diagnosed.  They often don’t realize that they could be spreading infection to others through the droplets in the air caused by their coughing and sneezing.  It even common for many teens and adults not to realize that their immunization has waned and that they need a Tdap booster shot in order to extend their protection.  That is why public health workers, doctors and even OB/GYNs, are now encouraging Tdap shots for adults, especially those who are in close contact with infants.
During a pertussis outbreak, children who have received all of their pertussis vaccinations are six times less likely to become infected than those who have never been vaccinated.   So in order to protect those too young to be vaccinated, we must rely on the concept of cocooning, where all the individuals around the child are immunized in an effort to shield the baby from possible exposure.  Fortunately, this concept is gaining traction, as more parents are beginning to understand the importance of community immunity.  However, there is still reason to be concerned.  Some parents are choosing not to immunize their children and some are using vaccine exemptions to send their children to school without the required pertussis immunizations.  This, combined with waning immunization of adolescents and adults seem to be resulting in a growing number of whooping cough cases nationwide, with some states seeing record-breaking years.
For instance, last year the state of California experienced a pertussis epidemic that has not been seen since the 1940’s, in the time period before a vaccination became widely available.  With over 9,400 confirmed cases, 10 infant deaths and untold hospitalizations, the costs of this epidemic includes treatment, surveillance, lost school and work time, as well as the lost of precious lives.  Now there appears to be similar concerns this year in states such as IllinoisNew York, Montana and others.
So while we are emphasizing the importance of influenza vaccination at this time of year, it’s also a good time to ensure you are immunized for pertussis.
As an expectant parent, you’ll want to read these stories of Landon Carter Dube and Callie Van Tornhout, and then send an e-card to your family and friends to encourage them to get vaccinated before they meet your new baby.  If you have a teenage child, listen to Emily and Zack’s story, as shared by Shot By Shot.  There personal experience with pertussis provides incentive to get that Tdap booster today.  Don’t take a chance with pertussis.

As Zach says, “Stay healthy.”  Emily adds, “Get the Tdap.”  Their mother suggests that everyone “get immunized so that you don’t have to go through what they did.”

Wouldn’t it be better to do what you can to prevent this disease now, than to later wish you had taken the time to get vaccinated?

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50 responses to “The Battle Against Whooping Cough Continues”

  1. MinorityView says:

    You say: “Statistics show that 50 out of every 10,000 people with pertussis will die…”
    I followed the link to Vaccinate Your Baby and they do not provide a reference for that statistic, nor could I find any way to contact the organization and ask for a link.
    I’m working on a blog article about pertussis but I always provide references so unless you can provide the study that supports that number I’ll have to either leave it out or highlight it as bad info.
    Thanks for any help you can provide, thanks!

    • Chris says:

      Interesting. Though you have a reputation for cherry picking. Here is a review of your work:

      The selective removal of vital information (highlighted by me in red) by the “Inside Vaccines” team distorts the entire findings of the paper, and is designed to fool readers into thinking the opposite of what the article actually concludes.

      Then when forced to discuss your assertions you just decided to quit that forum.
      By the way, there were links on that page. It takes a bit, but you end up at the CDC, where all of that information is available. Just look at the CDC Pink Book Appendix G, but do not cherry pick the years (something you tend to do). In the last ten years it was about ten deaths out of ten thousand, but it was higher in earlier years. But the fact remains that it is more deadly to babies.
      The question is: why are you comfortable with babies dying from pertussis that you dither over details? What do you have against protecting them from pertussis by increasing herd immunity with the DTaP and Tdap?

  2. MinorityView says:

    Thanks for responding Chris. Found the numbers. They start high and go way down. Since the blog article doesn’t give a year in which this statistic applies or a range of years, I’d say that they are misrepresenting the likelihood of a baby dying of pertussis.
    Where did I say that I’m comfortable with babies dying of pertussis? That seems quite the jump from my perfectly valid request for a citation for a fact.
    I’d also like to point out that the numbers in the article are very inconsistent. Later in the article it says: “With over 9,400 confirmed cases, 10 infant deaths” which is one in every 940 cases and 100% in infants.
    At the top, in the quote I questioned it says: “Statistics show that 50 out of every 10,000 people with pertussis will die and 90% of pertussis-associated deaths have been among babies less than one year old.” which is one in every 200 cases.
    Since the CDC offers stats from 1950 through 2009 it does look to me as though someone cherry-picked a scary statistic and it was not insidevaccines.
    There is no reason that this blog or Vaccinate Your Baby couldn’t have linked to their source and indicated which year or average of years they were using to produce their number. Science requires citations. Seriously. So people can tell if you are cherry-picking or not.
    Take care!

  3. MinorityView says:

    Here is the link to appendix G
    I wonder why Chris didn’t include it in the comment?

    • Chris says:

      Because it is easily found. And you persevering on one statistic, but ignoring the message of the article:

      It even common for many teens and adults not to realize that their immunization has waned and that they need a Tdap booster shot in order to extend their protection. That is why public health workers, doctors and even OB/GYNs, are now encouraging Tdap shots for adults, especially those who are in close contact with infants.

      Now go and get your Tdap vaccine!

      • MinorityView says:

        Fortunately for me, I’ve never been vaccinated against pertussis. Which means that I’m not subject to the problem of Original Antigenic Sin (look it up). And that means that exposure to pertussis creates long-lasting immunity in my case, something which isn’t true with the vaccine.
        I’m so glad my parents and grandparents were vaccine critics. The gift that keeps on giving!

      • Chris says:

        There is no long lasting immunity from getting pertussis. If you want to be accurate, get at least that fact straight:
        Pediatr Infect Dis J. 2005 May;24(5 Suppl):S58-61.
        Duration of immunity against pertussis after natural infection or vaccination.

        A review of the published data on duration of immunity reveals estimates that infection-acquired immunity against pertussis disease wanes after 4-20 years and protective immunity after vaccination wanes after 4-12 years.

        The immunity from both the vaccine and getting the infection can wear off as soon as four years. Really, why are you willing to risk the 100 day cough and giving it to a vulnerable child?
        What is your solution to preventing pertussis deaths of infants too young to be vaccinated?

  4. Chris,
    Does the vaccine prevent transmission of the disease or just lessen severity?
    How many people a year in the US get pertussis?
    What are the side effects of the vaccine?

    • MinorityView says:

      Rick, you left out a good question:
      Is the death rate from pertussis based on reported cases or estimated actual cases? According to the CDC there are from 600,000 to 1 million cases of pertussis each year in the US. That would place the death rate a lot lower than the already unlikely number in the article.

      • Most people only see reported cases. If the 600,000 number was reported, a lot less freaking out would occur.

      • Chris says:

        The deaths are mostly babies who are too young to be vaccinated, and often in hospitals where the cultures are taken (so, yes, they are confirmed). And since you are still going on about the numbers and totally ignoring the point of the article, I now believe you either don’t understand it (which explains your habit of cherry picking), or you really just don’t care about the vulnerability of infants.

      • Chris says:

        If you are interested in accurate information then learn exactly how long immunity lasts after bacterial diseases:
        strep: no immunity
        tetanus: no immunity (if you survive)
        diphtheria: a few years
        pertussis: a few years, as few as four

      • Chris says:

        Or I should say, it provides the title of the video and prevents what it depicts.
        Have you had a Tdap vaccine? If not, go and get one at a clinic or local pharmacy. Help protect the vulnerable.

  5. Chris,
    You still have not answered if the vaccine stops transmission. Since the Appendix G from CDC shows 95% compliance was reached in 1996 and after yet in 2004 the CDC says that pertussis is Endemic and 600,000 cases occur each year. Where is the her immunity effect? Seems to be missing to me.

    • cia parker says:

      I don’t know if you’ll see this, I followed a link put on by Kelly to a continuation of this argument in May. My baby got the DTaP at 2, 4, and 6 months. If I had it to do over again, I wouldn’t let her get any vaccines. She caught pertussis at a La Leche League meeting at nine months old, and gave it to me. So the vaccine doesn’t stop transmission at least in some cases. They say in the epidemic in California two years ago, 92% of those who got it had been appropriately vaccinated. Probably many of them caught it from other vaccinated people. Immunity to the disease after a natural case of pertussis lasts between twenty years and life.

      • Kelly says:

        Immunity to the disease after a natural case of pertussis lasts between twenty years and life.

        This is blatant lie, cia. Natural immunity lasts 4 to 20 years compared the the vaccine that lasts 4 to 12 years. Natural immunity may give you a few more years compared to the vaccine but for that you have to suffer 3 months of coughing so bad you can’t breathe and risk spreading to others.

        They say in the epidemic in California two years ago, 92% of those who got it had been appropriately vaccinated.

        Who is “they”, cia? Are “they” anti-vaccine liars like yourself with an agenda to mislead people? What is the definition of appropriately vaccinated? An adult booster was recently added to the schedule and few people are aware of this booster. A big concern during the epidemic was how to make people more aware of this booster.
        You are also making a common mistake of citing a percentage instead of an attack rate. In a highly vaccinated population, it would be expected that most people were vaccinated. That does not mean the vaccine doesn’t work.

  6. Chris,
    Are you planning to answer my questions or just ignore them?
    Pertussis is unusual in that most children catch the disease from adults and not other children. It is estimated that every year in the United States between 600,000 and 900,000 adults and adolescents get pertussis!

    Here, we ask how aP vaccination affects competitive interactions between Bordetella species within co-infected rodent hosts and thus the aP-driven strength and direction of in-host selection. We show that aP vaccination helped clear B. pertussis but resulted in an approximately 40-fold increase in B. parapertussis lung colony-forming units (CFUs). Such vaccine-mediated facilitation of B. parapertussisdid not arise as a result of competitive release; B. parapertussis CFUs were higher in aP-relative to sham-vaccinated hosts regardless of whether infections were single or mixed. Further, we show that aP vaccination impedes host immunity against B. parapertussis—measured as reduced lung inflammatory and neutrophil responses. Thus, we conclude that aP vaccination interferes with the optimal clearance ofB. parapertussis and enhances the performance of this pathogen. Our data raise the possibility that widespread aP vaccination can create hosts more susceptible to B. parapertussis infection.

    Case definition has been particularly problematic in all of the recent DTaP vaccine efficacy trials. For uniform comparative purposes a case definition was suggested by a WHO expert committee.39 This definition required 21 days of paroxysmal cough plus laboratory confirmation of pertussis in the subject or household contact. There are 2 problems with this definition. The first is that a substantial number of B pertussis infections in unvaccinated children are mild and would not meet the case definition. The second is that all pertussis vaccines tend to modify duration and severity of disease rather than completely preventing illness.18,2326-29,35,36,40 Therefore, the WHO definition has made all vaccines look better than they are and it has tended to obscure differences between vaccines.

    Pertussis is considered an endemic disease, characterized by an epidemic every 2–5 years. This rate of exacerbationshas not changed, even after the introduction of mass vaccination – a fact that indicates the efficacy of the vaccine in preventing the disease but not the transmission of the causative agent (B. pertussis) within the population [19].

  10. In the Journal of Theoretical Biology they discuss the failure rate of the pertussis vaccine in New Zealand.
    The obtained figures indicate that in New Zealand the effective vaccination rate against pertussis is lower than 50%, and perhaps even as low as 33% of the population. These figures contradict the medical statistics which claim that more than 80% of the newborns in New Zealand are vaccinated against pertussis (Turner et al., 2000). This contradiction is due to the mentioned unreliability of the available vaccine. The fact that the fraction of immune population obtained here is considerably lower than the fraction of vaccinated population implies a high level of vaccination failure

    Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States.
    The odds of having a history of asthma was twice as great among vaccinated subjects than among unvaccinated subjects (adjusted odds ratio, 2.00; 95% confidence interval, 0.59 to 6.74). The odds of having had any allergy-related respiratory symptom in the past 12 months was 63% greater among vaccinated subjects than unvaccinated subjects (adjusted odds ratio, 1.63; 95% confidence interval, 1.05 to 2.54). The associations between vaccination and subsequent allergies and symptoms were greatest among children aged 5 through 10 years.
    DTP or tetanus vaccination appears to increase the risk of allergies and related respiratory symptoms in children and adolescents. Although it is unlikely that these results are entirely because of any sources of bias, the small number of unvaccinated subjects and the study design limit our ability to make firm causal inferences about the true magnitude of effect

    The timing of immunization affects the development of diabetes in rodents.
    Administration of human vaccines to diabetic prone newborn animals starting before 2 weeks of age prevented the development of diabetes while administration of the pertussis vaccine starting at 8 weeks of life was associated with an increased incidence of diabetes

    • Chris says:

      Not on mice, and more recent:
      Pediatrics. 2001 Dec;108(6):E112.
      Childhood vaccinations, vaccination timing, and risk of type 1 diabetes mellitus.

    The effects of whole-cell pertussis vaccine wane after 5 to 10 years, and infection in a vaccinated person causes nonspecific symptoms (3-7). Vaccinated adolescents and adults may serve as reservoirs for silent infection and become potential transmitters to unprotected infants (3-11). The whole-cell vaccine for pertussis is protective only against clinical disease, not against infection (15-17). Therefore, even young, recently vaccinated children may serve as reservoirs and potential transmitters of infection.

    • Chris says:

      Duration of immunity against pertussis after natural infection or vaccination.:

      A review of the published data on duration of immunity reveals estimates that infection-acquired immunity against pertussis disease wanes after 4-20 years and protective immunity after vaccination wanes after 4-12 years.

      You don’t get long lasting immunity even after suffering three months of coughing due to pertussis. So get that Tdap!

      • cia parker says:

        Chris, that’s crazy. If you get the disease and you’re older than four months old, you cough for a long time, even months, but most people, including my daughter and me, don’t feel particularly sick between bouts of coughing. You get long-lasting immunity. If you get the DTaP you’re taking your chances with many well-researched and fairly common adverse events, and the immunity, if any occurs (and it often doesn’t) may wear off in as little as three years. So don’t get that Tdap, but do quarantine your newborn if there’s any pertussis around.

      • Kelly says:

        Yes, cia, if you get pertussis you are very sick for a very long time. I know you need to minimize the seriousness of the disease and lie about vaccine risks so that you can justify lying to people.
        Natural immunity is not long-lasting. In addition, the price of this natural immunity is exposure of infants that are most susceptible to serious complications from pertussis.
        The Tdap is the best bet in terms of protection of a newborn because it is impossible to quarantine a family for over 6 months to a year. Quarantine would mean no outside contact with the world, no employment, no shopping, no visits from relatives. That is crazy.

    • Chris says:

      And is a Nirvana fallacy to think that a vaccine can offer better protection than the disease. If the immunity from the disease itself wears off as soon as four years, then don’t expect the vaccine to give you lifelong immunity.
      So go to you local pharmacy and get yourself a Tdap booster!

    “If you look over time, this means that whatever your DTaP vaccine was worth to begin with, at 3 years it’s 32% and at 5 years it’s 16% of your initial effectiveness,” Dr. Baxter told meeting attendees.
    He characterized DTaP as both wonderful and problematic. “They’re just not as good as the whole-cell vaccines,” he said. But part of the problem with the latter is that parents don’t want to return to a vaccine that could have severe adverse effects.
    What’s more, it’s hard to get a good read on how effective the acellular vaccine is, the investigator said. When DTaP showed up, pertussis had been wiped out because whole cell “is that good,” Dr. Baxter said. There wasn’t a way to study how well DTaP vaccines really work, other than by determining whether they produced antibodies to certain antigens. Although they work as well or better at actually producing antibodies, that didn’t mean they work as well, he observed.

    Pertussis adjuvant prolongs intestinal hypersensitivity.
    Our findings indicate nanogram quantities of PT, when administered with a food protein, result in long-term sensitization to the antigen, and altered intestinal neuroimmune function. These data suggest that exposure to bacterial pathogens may prolong the normally transient immune responsiveness to inert food antigens.

    • Chris says:

      In rats! And not even the adjuvant used in the American Dtap!
      That is some very blatant cherry picking, Mr. Neubrander. And has nothing to with the Tdap.

    • Mark Williams says:

      More like rat-picking. I think it’s safe to say Rick Neubrander is not a credible source of information with regards to vaccines.

      • cia parker says:

        I thought he was very credible and impressively well-informed.

      • Kelly says:

        That is because you lack the critical thinking skills to make an informed decision, cia. Instead you just parrot back the misinformation told to you by others.

  16. Chris says:

    I answered the question in the way it should be answered. In most cases it prevents disease, in some it only prevents the worse symptoms. It does not do any good in preventing pertussis in infants if they are too young to get it. So you need to create a cocoon of protection around the infant by making sure as many as possible are up to date with Dtap and Tdap vaccines.
    Mr. Neubrander, what is your plan to prevent infant deaths from pertussis?

  17. Chris says:

    Mr. Neubrander, in case you did not notice: what is your plan to prevent pertussis deaths in infants too young to get the Dtap?
    And have you received a tetanus booster with the Tdap? If not, why not?

  18. I agree with Chris. No vaccine is 100 per cent guaranteed effective. But all vaccines offer better protection than no vaccines. And for infants too young to benefit from vaccination it is very important that those around them are fully vaccinated. Not just family and friends but the child of a stranger with a persistent cough who sits next to them in the doctor’s waiting room. Citing research into the possible drawbacks from vaccination ignores the main issue. Pertussis has known consequences. It is usually fatal to infants and causes immense distress and possible long term debilitating consequences to those who survive. Neither Minority View nor Rick Neubrander have provided any evidence that is even close to challenging the pro-vaccine message of the article.

  19. Stop smoking and stay away from second-hand smoke. Smoke of cigarette irritates your throat and as a result, it worsens your coughing.

  20. Len Bustin says:

    I had a cough that persisted. I went through an entire prescription of antibiotics and still had it. One day, I had a yen for sardines and the coughing stopped for that day. When I ate oily fish for several days, the cough went away. My aunt had a cough, I told her, she ate salmon and it went away. Must be something natural in fish that helped.

  21. drsuzanne says:

    If you read through this paper, you will find references to the truth that the vaccinated are more apt to carry and spread pertussis. In addition, the statistics show that vaccination has NOT decreased the incidence of pertussis in communities. What is happening, is that the naturally immune are disappearing (dying) and being replaced by the vaccinated. This is why we are seeing more pertussis. In addition, doctors are looking for it because of all the hype. I wonder what would have happened if MY doctor in the 1970’s checked me for petsussis when I was whooping my head off year after year? But my doctor didn’t check because I was vaccinated.

    • Kelly says:

      Shame on you Suzanne for misleading parents with your dangerous pseudoscience. The special report describes a fake treatment for pertussis and not the epidemiology of pertussis. Vitamin C does nothing to treat pertussis and you are so inept that you fail to realize you admit this in your special report.
      First of all, homeopathy, really?
      Right there I know you are someone that is incapable of understanding science and medical treatment, but your report contains other errors that indicate you are incompetent as a doctor.
      From your special report:

      A recent study2 confirms that natural immunity to whooping cough lasts at least 30 years, whereas the immunity from a vaccine lasts 3 years, and after adult boosters, all antibodies have disappeared within a year.

      The recent “study” you refer to isn’t a study at all but rather a mathematical model and directly contradicts real epidemiological studies that show

      Protective immunity after infection was probably never lifelong and wanes after 7–20 years. Duration of immunity after either wP or aP immunization does not appear to substantially differ and likely lasts 4–12 years in children.
      So you don’t know the difference between a real study and mathematical modelling and you cherry-pick the lesser evidence to support your quack treatment. Why is that Suzanne? Are you ignorant to the pathogenesis of pertussis, which means you have no business telling people how to treat the disease or are you purposefully misleading people? Either way, it does not speak well of your credentials.
      You go on to say that

      Vitamin C will neutralize these toxins while the body is mounting a proper immune response, which takes weeks.

      Oh really? Have any evidence that vitamin C neutralizes the toxins, especially when the illness is over within weeks? You just made all that up, didn’t you? Pertussis is really scurvy? A sign of a quack is one that has to redefine medical terms to make their hypothesis work.
      Pertussis is a toxin-based illness which means if the toxin is neutralized, the disease should stop. That is how the vaccine works to prevent pertussis and lessen the symptoms. You seem to understand this because later on you say

      You have to continue the vitamin C for up to three months. It does not stop the disease. Vitamin C clears away the toxins, and makes the coughing much, much milder, and increases the ability of the body to deal with the bacteria and develop immunity naturally.

      Suzanne are you so ignorant about pertussis that you fail to realize that the toxins are the disease? If vitamin C does not stop disease, then vitamin C is not neutralizing the toxins.

      The information provided here stems from a wide body of literature that demonstrates vitamin C to be extremely safe and instrumental in the biochemical recovery from Bordetella pertussis (whooping cough).

      Funny, if there is a wide body of literature that supports this protocol, why don’t you cite any of it? Why don’t other doctors use this protocol if it really works? Could it be that doctors investigated vitamin C as a treatment and it was found to be ineffective in 1938?
      So basically, in your special report you inadvertently admit that vitamin C does nothing to treat pertussis, which was known by doctors since 1938.

      • drsuzanne says:

        The toxins are the disease, yes. And where do the toxins come from? Even the antibiotics doctors dole out, according to your own literature do not decrease the duration of disease. If you are going to argue that vitamin C does nothing to neutralize the toxins of pertussis, then I am just hitting my head against a wall. And the ultimate proof that you have no valid argument is that you have to attack me personally. LOL. I’m quite sure my credentials will whoop your credentials butt any day.

      • Kelly says:

        The toxin is produced by the bacteria Suzanne. Are you really that ignorant that you don’t know that?
        I’m not claiming that antibiotics decrease the duration of the disease, Suzanne. The only way to prevent pertussis is the vaccine. There is no treatment. That’s the point. You are peddling a fake treatment that was discredited in 1938.
        I didn’t attack you personally, Suzanne. I attacked your misinformation with science. You think your credentials whoop my credentials when I have to explain the basics to you? Your credentials mean squat when you demonstrate your extensive ignorance on the topic.
        For other readers: Notice how Suzanne does not offer any evidence to support her claims. Instead she “appeals to authority” by implying that her credentials give her superior knowledge of the topic. This is a logical fallacy.

    • Kelly says:

      the statistics show that vaccination has NOT decreased the incidence of pertussis in communities.

      Wrong. Pre-vaccine the number of pertussis cases was more than 150 cases/100,000. Post-vaccine the number of pertussis cases was 1 case/100,000.
      Even with the recent increase in pertussis cases, the incidence rate is still 3X less than pre-vaccine era at it’s maximum of 55.2 cases/100,000.

      the vaccinated are more apt to carry and spread pertussis.

      Really? This paper says otherwise, where the unvaccinated where 23X more likely to have pertussis than the vaccinated.

  22. drsuzanne says:

    And Chris, I think Rick knows how to treat pertussis with vitamin C, as you ought to know too. The reason you need to know is because the vaccinated siblings of the infant may very well give it to the infant. And if that infant is susceptible, it will need loads of vitamin C.

  23. […] needless to say, when it comes to pertussis, I understand the concerns.  This is why I was so grateful to see the school nurse and our local Health Department trying […]

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