Home > Expert Insights, Preventable Diseases > Pertussis Problems Persist

Pertussis Problems Persist

Not enough can be done to ensure people are educated about the dangers of pertussis (also known as whooping cough).  That’s why I wanted to highlight a few of this week’s articles that focus on issues related to pertussis.

Brady’s Battle Proves Pertussis Can Present in Unexpected Ways

CommonHealth writer, Rachel Zimmerman, was familiar with Brady’s story that we highlighted on Shot of Prevention last week.  She recently wrote an article (located here) which addresses specific questions regarding whooping cough with detailed responses from the CDC.  She also included highlights from a recent interview she conducted with Dr. Ben Kruskal, a pediatrician and director of infection control and travel medicine at Harvard Vanguard and director of infectious diseases at Atrius Health.   When she asked what clinicians should do when confronted with infants like Brady, who had contracted pertussis, but didn’t exhibit the “classic” violent cough or whooping sound, Dr. Kruskal said this:

“Actually it turns out that most people who have whooping cough don’t show the classic signs of whooping cough. It’s really a substantial minority but still a minority of people who have it who have the classic clusters of cough that are so closely spaced that the patient has to take in this deep breath at the end of this cluster which produces the characteristic whoop.”

Accurate Diagnosis of Pertussis is Challenging

It’s probable that many cases of pertussis go undiagnosed and unreported, which  makes this particular disease difficult to identify and therefore difficult to manage.  Since this particular bacterial infection often presents like a bad cold many people simply don’t realize they are infected, and they unknowingly expose others to this contagious disease.  While the symptoms may linger, which is why pertussis is often referred to as “the 100 day cough”, most people will eventually recover.  However, whooping cough is especially devastating for infants and young children, whose small bodies have difficulty fighting off the persistent bacteria.

So when should you seek help for a cough?  You’ll want to bookmark today’s post on the PKIDS (Parent’s of Kids with Infectious Diseases) blog.  It has been written by Dr. Kristen Feemster, who is not only an Assistant Professor of Pediatrics at the Pereleman School of Medicine at the University of Pennsylvania, but also an attending physician in the Division of Infectious Diseases at The Children’s Hospital of Philadelphia.  She provides a thorough analysis of pertussis to include a detailed background of the disease, what symptoms parents should look for in infants, young children, adolescents and adults, as well as details about testing.

Pertussis Outbreaks Are Being Seen Throughout the Country

Unfortunately, Montana, Minnesota, Wisconsin, Florida, Illinois, Arizona and Washington are all states facing whooping cough outbreaks right now.  The CDC indicates that in 2010, there were 27,550 cases of pertussis cases reported and certainly many more that went unreported.  In 2011, several states suffered with concerning pertussis outbreaks, to include the state of California where several infants died.  And today, in the states that are seeing these current outbreaks, the numbers of pertussis cases are already much higher than they were at this time last year.

Week after week there are multiple articles in these areas trying to garner attention among residents regarding this public health concern.  You can do your part by sharing information with friends and family and especially expectant parents.  We want to ensure that no other child suffers as Brady did.  Or Carter. Or Callie.  Or Brie.  Or the many other infants who have lost their battle with pertussis.  You can choose from several different pertussis stories currently featured on the Shot By Shot website or check out this helpful fact sheet on Vaccinate Your Baby.  Whatever you do, please help us get the word out about adolescent and adult Tdap boosters and the importance of cocooning young children.  The more who know the more potential lives we can save.

  1. May 3, 2012 at 1:01 pm

    Pertussis is cyclical in nature, often despite vaccine rates. Funny how the CDC draws attention to the under-reporting of a disease, but all but ignores the under-reporting of vaccine adverse events. Typical biased nature of a corrupt organization.

    Like

  2. just visiting
    May 3, 2012 at 1:58 pm

    Apparently you didn’t see the news reports this morning that a California infectious disease expert has determined that 81 percent of the pertussis cases were in VACCINATED children, and I would guess you missed the interview with Reuters where GSK admitted they’d never studied the duration of efficacy for this vaccine.

    Like

  3. Lara Lohne
    May 3, 2012 at 4:04 pm

    researchvaccines and just visiting have both provided very good examples of cherry picking data. To date, the best way to protect yourself, and the rest of the public you will come into contact with is with a vaccine. We are aware the vaccine is not as effective as some others, but still is more effective then not vaccinating at all. Have you had whooping cough? It isn’t fun. I suffered through it at the age of 16 and don’t wish to ever go through it again. Since there is no way to achieve life long immunity from whopping cough, I decided to get the boosters when needed. I wouldn’t even imagine what it must be like for an infant to suffer through it. At least I was aware of what was going on, even if I didn’t like it. Another thing, just visiting, and this seems to be forgotten all too conveniently often, is it possible (since you provided no link to cite your claim) that the vaccinations in those children were not complete? Most often, when reporting pertussis in a vaccinated child, the case is the full scheduled vaccinations have not been completed, therefore there would be no protection yet. Why is this so hard for us to come together and agree it is better to vaccinate and protect as best as we can then continue to let people suffer and infants and small children die? Can it really be that hard of a decision for all of us to make? Seriously?

    Like

  4. just visiting
    May 3, 2012 at 4:09 pm

    They were FULLY vaccinated. http://www.digitaljournal.com/article/323187

    Like

  5. just visiting
    May 3, 2012 at 4:13 pm

    You ask if I ever had whooping cough. Not to my knowledge. But I have had bad reactions to the Tdap, twice, 10 years apart. And just when you’re feeling better the doctor wants to go and give you your 10-year booster. Well no thanks. I thought I was going to die the last time. Both my allergist and rheumatologist finally said they guessed I was one of those people who better not get vaccines.

    Like

  6. Chris
    May 3, 2012 at 5:28 pm

    The Tdap has not been available for ten years, so how could that happen?

    And if you cannot get vaccines, then you should be making sure everyone around you does!

    Like

  7. Chris
    May 3, 2012 at 5:29 pm

    News articles are not science.

    Like

  8. just visiting
    May 3, 2012 at 6:18 pm

    A scientist did the study for crying out loud. An INFECTIOUS DISEASE specialist. It will take months for the news he just reported to get in a journal article. But you if want something other than newspaper stories, OK, try this:

    http://www.dor.kaiser.org/external/news/press_releases/Waning_and_Less_Effective_Acellular_Whooping_Cough_Vaccines_Likely_Contributed_to_the_2010_California_Whooping_Cough_Outbreak/ or

    http://www.internalmedicinenews.com/news/conference-news/infectious-diseases-society-of-america-conference/single-article/acellular-pertussis-vaccine-s-waning-immunity-caused-california-epidemic/71de9826f4.html (this is the CDC reporting it–is that good enough?)

    Like

  9. just visiting
    May 3, 2012 at 6:26 pm

    I don’t know where you got that Chris because ACIP is still recommending it. http://www.cdc.gov/vaccines/recs/provisional/Tdap-feb2012.htm — quote: “For adults aged 19 years and older who previously have not received a dose of Tdap, a single dose of Tdap should be given.”

    Like

  10. Chris
    May 3, 2012 at 6:36 pm

    Actually I would prefer stuff like the following:

    Impact of anti-vaccine movements on pertussis control: the untold story

    Pediatrics. 2009 Jun;123(6):1446-51.
    Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children.

    Am J Epidemiol. 2008 Dec 15;168(12):1389-96. Epub 2008 Oct 15.
    Geographic clustering of nonmedical exemptions to school immunization requirements and associations with geographic clustering of pertussis.

    JAMA. 2000 Dec 27;284(24):3145-50.
    Individual and community risks of measles and pertussis associated with personal exemptions to immunization.

    And the data you are posting is a reason to increase the numbers of Tdap boosters. Immunity to pertussis wanes as soon as four years even after getting the actual disease (even after coughing for three months), so it is not reasonable to expect a vaccine to provide better immunity. See:

    Pediatr Infect Dis J. 2005 May;24(5 Suppl):S58-61.
    Duration of immunity against pertussis after natural infection or vaccination.

    And if you cannot get vaccinated due to previous reactions, it is in your best interest to encourage as many people as possible to get the Tdap booster (available at most pharmacies), and lobby the ACIP to decrease the time between Tdap boosters.

    Because of waning immunity, and the vaccine is effective between 50% to 90% (age, length after vaccine, etc), there is a reason more vaccinated people get pertussis: There are more of them. Some herd immunity arithmetic:

    Take 1000 people (ignoring the infants under 2 months who cannot be vaccinated, or babies under a year who can only be partially vaccinated), if 5% refuse vaccines then the numbers are:

    950 vaccinated persons (assuming full schedule)
    50 unvaccinated persons

    The pertussis vaccine is actually only about 80% effective, so the numbers are:

    760 protected persons
    190 vaccinated but vulnerable persons
    50 unvaccinated persons

    There is an outbreak and it gets spread to 20% of the population, then:

    760 protected persons without pertussis

    38 vaccinated persons get pertussis
    152 vaccinated person who may still get pertussis

    10 unvaccinated persons get pertussis
    40 unvaccinated persons who may still get pertussis.

    This is how more vaccinated persons get the disease than unvaccinated. Even if the infection rate was at 100%, there would still be more of the vaccinated getting the diseases because there are more of them!

    Like

  11. Chris
    May 3, 2012 at 6:47 pm

    The ACIP only approved the Tdap in 2005. Let see, it is now 2012, subtract 2005 and you get seven years.

    You said “bad reactions to the Tdap, twice, 10 years apart.” So how could you have had the Tdap twice ten years apart when it only became available seven years ago?

    And again, if you had a bad reaction to the Td or Tdap, then you really need to make sure that everyone around you is vaccinated to protect yourself. Though, unfortunately, there is no such thing as herd immunity from tetanus.

    Like

  12. lilady
    May 6, 2012 at 2:59 am

    “Just visiting”…why did you say that you were given Tdap twice…and both times you had a reaction to the vaccine?

    I think you should read the ACIP/CDC recommendations that you actually linked to. The recommendation are for a ONE-TIME-ONLY “booster” immunization with Tdap vaccine.

    BTW, there is no such thing as “herd immunity” against diphtheria either, and a young woman “vaccine refuser” contracted diphtheria on a foreign trip, and died from the disease.

    Like

  13. cia parker
    May 6, 2012 at 10:42 am

    I talked about the Reuters report here last month, I think it was actually 92% who got it in California two years ago had been appropriately vaccinated, but those aren’t the kind of facts that go down well on this site. And I’ve pointed out the cyclical nature of pertussis, huge jump in numbers worldwide every 44 months, on average, and then it goes down again. My daughter was damaged by the DTaP at 18 months (wiped out her only two words, and she didn’t say another word until 34 months old), Ginger Taylor’s son got autism from it, many die of “SIDS” from it, one in nine children get asthma from it, many get allergies or seizure disorders from it. My daughter got the natural disease pertussis at 9 months after getting the vax at 2, 4, and 6 months because the vax isn’t very effective, and even many vaccinated people still catch it and transmit it. The disease usually isn’t very serious in everyone over four months old, it wasn’t in my nine and ten months old daughter (it lasts a long time) which means that newborns should be kept in as strict a quarantine as possible until they are four months old. Even if they are among those who might eventually be protected by the vaccine, babies get no immunity from the vaccine at all until they are older than four or six months.
    And I guess everyone here saw that the Vermont House of Reps voted last Thursday 133-6 to protect parents’ rights to refuse vaccination for their children. One of the legislators commented that “the most dangerous place in the woods is between a mother bear and her cub.” Because there are thousands of moms like me who are outraged that our children were damaged by vaccination like my daughter autistic from the hep-B vax at birth that I had said I didn’t want her to get, and we want to warn others to protect their children from the dangers of being made pincushions by the pharmaceutical companies overjoyed at the profits to be made here.

    Like

  14. cia parker
    May 6, 2012 at 11:06 am

    research vaccines and just visting both made excellent points based on factual information which just isn’t information which supports your arguments. Like you don’t only bring up information which you think supports your position? Some say catching pertussis and recovering from it confers life-long immunity, Dr. Hans-Peter Studer in Vaccination: A Guide for Making Personal Choices says on page 50 that it confers resistance to catching it again for about twenty years. In either case, that is much better immunity than that from the vaccine, which may confer immunity in the cases in which it works at all (and in many it doesn’t) for as little as three years. I had it, my daughter had it, it was dramatic and alarming, ten coughs per breath, my daughter coughed up sheets of mucus at the end of every coughing fit, but I didn’t (I caught it from her), but it wasn’t dangerous, and we both made a complete recovery. It was tedious and uncomfortable, she coughed over a month, I coughed over two months, but we were both over the age of danger, and I’m glad we went through it and improved our immune system functioning and acquired long-lasting immunity to it. And I’m sure you realize, Lara, that most of the children who caught pertussis and transmitted it in California two years ago were in the 7-12 age range. The number of dangerous side effects is much increased in those older than seven, which is why they haven’t given booster shots to those older than seven up until now. I’m sure that will change in the future when the medical establishment fully realizes that all they have to do is dismiss and deny, no matter how close in time a severe side effect occurs after the vaccine. So sure, give it to them every year, and then act mystified about all the paralysis, epilepsy, learning disorders, asthma, peanut allergies, and deaths that occur shortly after the vaccine.
    Come on, Lara, we can’t just come together to push vaccination unless we all agree that it’s all right to just write off all the people, both children and adults, who are seriously damaged by this and other vaccines. Randall Neustaedter says: “Pertussis vaccine is one of the most reactive vaccines ever developed. The acellular vaccine has been plagued by the same problems as the previous whole-cell vaccine. Parents who choose to give the pertussis vaccine risk seizures and brain damage in their children. Although other vaccines have taken the spotlight in recent years, pertussis still remains the classic toxic vaccine. The measles/autism phenomenon has caused droves of parents to avoid MMR. The meningococcal vaccine reactions in England caused worldwide shock. And the hepatitis scandal forced the vaccine industry to answer for their conflicts of interest in front of congressional committees. But no other vaccine has approached the cumulative damage inflicted by the pertussis vaccine. The vaccine industry’s denials of pertussis vaccine reactions is unforgivable. Parents should never forget the tragedies associated with this vaccine.” (The Vaccine Guide 234)

    Like

  15. cia parker
    May 6, 2012 at 11:09 am

    Some people would say (and I understand that you aren’t one of them) that it would be immoral to push others to take a dangerous vaccine, hoping to protect themselves, when they know it would be dangerous to take it themselves.

    Like

  16. Kelly
    May 6, 2012 at 11:20 am

    The key here cia, is the word “dangerous”. If you are allergic to the vaccine, that doesn’t make the vaccine dangerous to other people. Peanuts are dangerous for people with peanut allergies, but are just fine for people not allergic.

    And speaking about morality. Some would say (and I understand that aren’t one of them), that repeatedly lying so that harm may come to others is immoral.

    Like

  17. cia parker
    May 6, 2012 at 11:22 am

    It used to be that the pertussis vaccine was not allowed to be given to anyone over seven years old, because the rate of severe reactions in them was even greater than the already high rate of reactions in those under seven. Then seven years ago Big Pharma decided to see if they could push the envelope and advocate a new Tdap for those over 12 years old. Just visiting provides an example of why it was a bad idea to permit the pertussis vaccine in the older age group, as they had a severe reaction to it and almost died. Very severe reactions in adults are occurring, but swept under the carpet, in the guise of protecting young babies from pertussis, the only ones who are sometimes in danger from it. Pretty soon they’re going to expand the age range down to seven, and just dismiss and deny all those severe reactions too.
    Many doctors aren’t that responsible in purveying vaccines. I was given the DPT eight times by the time I was eleven. The last time I was eleven, so was in the danger range when it was not recommended that it be given. When I got a tetanus booster when I was nineteen, both arms were paralyzed for two days, brachial plexus neuropathy, a reaction thought to occur in those who still have a lot of mercury in their bodies from previous vaccines, and the new mercury reacted with it. And I later developed MS as another consequence. If doctors are assured as often as the rest of us are that vaccines are very necessary and very safe, why should they not just shoot up anyone who is a willing victim or offers up their children.

    Like

  18. Kelly
    May 6, 2012 at 11:25 am

    And last month you were corrected on your “facts”, but here you are, lying again.

    Once again, vaccines don’t cause autism, and this time you have contradicted yourself in the same post. DTaP at 18 months supposedly caused your daughters autism AND hepB vaccine at birth also caused her autism. Nevermind that neither vaccine causes autism and your daughter isn’t vaccine injured.

    I’m outraged at the lies you tell, cia, so I’m here to warn others about your constant falsehoods so others may not be mislead to put their children in harm’s way and the dangers of listening to the lies of the anti-vaccine movement.

    Like

  19. cia parker
    May 6, 2012 at 11:25 am

    The diphtheria vaccine is not very effective either, most of those who got it in an outbreak in Chicago in 1969 had been appropriately vaccinated for it. Most of those who got it in the ex-Soviet Union in the late’80s and ’90 ahd been appropriately vaccinated for it, but got it anyway, as well as those who got it in Australia and New Zealand at that time. And it killed huge numbers of those who got the vaccine, many of whom died within minutes of getting the diphtheria vaccine.

    Like

  20. Kelly
    May 6, 2012 at 11:38 am

    Some say catching pertussis and recovering from it confers life-long immunity

    Some would say that, but they would be wrong.

    I had it, my daughter had it, it was dramatic and alarming, ten coughs per breath, my daughter coughed up sheets of mucus at the end of every coughing fit, but I didn’t (I caught it from her), but it wasn’t dangerous, and we both made a complete recovery.

    A disease that leads to coughing fits and a lungs full of mucous is dangerous, cia, because you need to breathe in order to live. You have this habit of trying to minimize the dangers of the disease while lying about supposed vaccine risks. A proper risk assessment would include the real risks of the vaccine, not the fantasy risks you make up.

    The number of dangerous side effects is much increased in those older than seven, which is why they haven’t given booster shots to those older than seven up until now.

    No, that is incorrect. A booster shot wasn’t available until a few years ago. Now that there is, we can do more to prevent a dangerous disease and people coughing fits for months at a time so bad they can’t breathe.

    So sure, give it to them every year, and then act mystified about all the paralysis, epilepsy, learning disorders, asthma, peanut allergies, and deaths that occur shortly after the vaccine.

    There have been no deaths caused by this vaccine, cia. Furthermore, the vaccine doesn’t cause paralysis, epilepsy, learning disorders, asthma, nor peanut allergies. You have been provided with evidence why this is a false statement, yet you keep lying about it. Why?

    Parents who choose to give the pertussis vaccine risk seizures and brain damage in their children.

    Again, this is another lie.

    When will you stop lying cia?

    Like

  21. Kelly
    May 6, 2012 at 11:40 am

    No cia. The vaccine was reformulated so that the risks were eliminated, that is why it has a different name.

    MS is not caused by vaccines cia.

    More lies. All cia does is lie, lie, lie.

    Like

  22. Kelly
    May 6, 2012 at 11:50 am

    If the diphtheria vaccine is not very effective, why isn’t diphtheria running rampant and only recent cases have occurred in unvaccinated people?

    Those in the ex-Soviet Union had not been appropriately vaccinated because the public health infrastructure fell apart when the Soviet Union collapsed.

    The concern in Australia and New Zealand at that time was due to low immunization rates. http://www.health.gov.au/internet/main/publishing.nsf/content/cda-cdi2112-pdf-cnt.htm/$FILE/cdi2112b.pdf

    And it killed huge numbers of those who got the vaccine, many of whom died within minutes of getting the diphtheria vaccine.

    Citation needed. When the rest of your posts can be confirmed as lies, it is most likely this is a lie too and we can safely assume this is the case until you provide evidence to the contrary.

    Like

  23. Lara Lohne
    May 6, 2012 at 12:14 pm

    Sorry cia but since they do not provide any citation for their points, they can’t be taken as factual just because I’m a trusting person (which I am, but some things need validation before they can just be taken as truth). There is never life long immunity from pertussis, vaccine derived or wild virus infected. It was agony living through at 16. I didn’t wish my children to suffer so they were vaccinated and I got boosters for it.

    You actually are contradicting yourself in this post. You have stated in comments on previous blogs that your daughter and you both had pertussis and it was no big deal. Here you say it was “dramatic and alarming.” Your daughter coughed for a month, you coughed for two. I had it for three months and came out with permanent damage to my lungs and a strong desire to never experience it again. My point though is, if something is no big deal, it can’t also be dramatic and alarming, that would be contradiction.

    You provide no citations for your claims. Since scientific research has shown multiple times your claims are incorrect and vaccines save lives, hundreds, even thousands of lives every year, (not to mention pain and suffering of those that would have survived infection) compared to pre-vaccine eras, I believe the data that can be supported by factual evidence.

    You forget cia, I know how it is to be anti-vaccine, I’ve been there, lived it, breathed it, got pertussis because of it. But the research, when you realize it isn’t fake, but real, can’t be denied. A funny little quote that’s been going around facebook recently says, “Plugging your ears doesn’t make the truth go away” You need to remember that cia. Just because you choose to believe something else, doesn’t mean the science is wrong, it means you are deceiving yourself and now you are also attempting to deceive others by preying on their emotions rather then providing them with facts. You have been proved wrong time and time again and yet you still bring up the same, tired arguments that have been debunked over and over. It’s time to stop, before you cause someone real harm.

    Like

  24. Chris
    May 6, 2012 at 12:50 pm

    Empshasis added:

    Diphtheria in the former Soviet Union: reemergence of a pandemic disease.:

    However, changes in the immunization
    schedule during this period encouraged less intensive vaccination of children. Use of an alternative schedule of fewer doses of lower antigenic content (adult formulation) vaccine was allowed beginning in 1980; in 1986, the school entry booster dose was dropped, lengthening to 7 years the interval between recommended childhood booster doses after a primary series (Table 2)…..snip… In addition, a vocal antiimmunization movement</b? received favorable press coverage in an atmosphere of increased distrust of government during perestroika (1985 to 1991).

    Successful Control of Epidemic Diphtheria in the States of the Former Union of Soviet Socialist Republics: Lessons Learned:

    Among children in the Soviet Union, the reported coverage with diphtheria vaccine was consistently >90% from the 1960s until the beginning of the 1980s. However, during the 1980s, changes in immunization policy, medical practice, and public acceptance of immunization led to less intensive immunization of children.

    In conclusion:

    The diphtheria epidemic forced a new generation of clinicians, laboratorians, and epidemiologists worldwide to relearn old lessons and develop new methods in the prevention, control, and treatment of diphtheria. Similarly, a new generation of the public in the NIS and Baltic States needed to relearn the threat of epidemic diphtheria and the benefits of immunization. The human cost of these learning curves shows the need to maintain training of health care professionals in communicable diseases in industrially developed countries and for communication to the public regarding the continuing challenges posed by these diseases. The reemergence and international spread of nearly forgotten diseases, such as diphtheria, reinforce the warning sent by the spread of AIDS—communicable diseases remain a priority health problem for all.

    Again, Ms. Parker, please stop lying.

    Like

  25. lilady
    May 6, 2012 at 11:16 pm

    @ CIA Parker: I “Googled” your statement about a diphtheria outbreak in Chicago during 1969…and the only websites that show up are whale.to and rense.com.

    We are still waiting for your citation about this outbreak…whale.to and rense.com do not qualify as reliable citations.

    Like

  26. Luann Hearron
    November 14, 2012 at 12:50 am

    Peanut allergy is the most common cause of deaths from food allergy. Allergy to peanuts affects 1.3% of the general population. ‘

    Take a peek at our very own blog page as well
    http://www.melatoninfaq.com/

    Like

  27. November 14, 2012 at 1:52 am

    Is the above comment to be considered spam? I’m not sure what peanut allergy has to do with pertussis and the topic of this post…

    Like

  28. lilady
    November 14, 2012 at 2:52 am

    It is spam…or a spam bot, Lara.

    Like

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