# 4751
Once upon a time, not so very long ago, Whooping Cough infected more than a 160,000 Americans each year, and killed about 5,000 of them.
All that began to change in the 1940s when the first whole-cell pertussis vaccine combined with diphtheria and tetanus toxoids (DTP) was introduced.
In what was a remarkable success story, by 1976 the number of reported cases reached a record-low of 1,010 cases, a decrease of 99%.
But since then, the number of cases has increased ten-fold, and on average 8 to 40 deaths now occur each year.
That resurgence is due in part to the reluctance of some parents to get their kids vaccinated, but is also due to a lack of adults getting their recommended booster shots.
Exactly a month ago I blogged on the growing California Pertussis outbreak (see California: Pertussis Epidemic). Since then, at least 500 more cases have been detected, putting California on track for having the worst year for Pertussis in half a century.
Pertussis, or `Whooping Cough’ is a highly contagious bacterial infection that can cause serious illness and even death. It is sometimes called the `hundred days cough’, because it can take months to get over.
Although it is thought of as a `childhood’ disease, anyone of any age can catch it.
Whooping cough outbreaks are cyclical, with outbreaks occurring every 3 to 5 years. California saw its last big outbreak in 2005, with more than 3,000 cases reported.
Prevention is through vaccination, but since the vaccine offered is `inactivated’ (contains no live bacteria), it requires repeated doses during childhood and a booster shot as adults.
The CDC has a simple, 2-page pamphlet on the DTaP vaccine.
This latest appeal comes from the California Department of Public Health.
CDPH BROADENS RECOMMENDATIONS FOR VACCINATING AGAINST PERTUSSIS: IMMUNIZATION KEY TO CONTROLLING WHOOPING COUGH
Date: 7/19/2010
Number: 10-048U
Contact: Al Lundeen, (916) 4407259)
SACRAMENTO
To protect Californians against the current epidemic levels of pertussis (whooping cough) health experts at the California Department of Public Health (CDPH) today broadened recommendations for immunizing against pertussis and reiterated the importance of getting vaccinated.
“We are facing what could be the worst year for pertussis that this state has seen in more than 50 years,” said CDPH Chief of the Center for Infectious Disease Dr. Gilberto Chávez, who also is the state’s epidemiologist. “We are urging health providers to broaden their use of the pertussis vaccine and we are urging Californians to take the simple step of getting vaccinated to prevent pertussis.”
- In addition to the typical series of childhood pertussis immunizations, CDPH now recommends an adolescent-adult pertussis booster vaccine (Tdap) for:
- anyone 7 years and older who is not fully immunized, including those who are more than 64 years old,
- women of childbearing age, before, during, or immediately after pregnancy, and
- other people who have contact with pregnant women or infants.
“Considering that immunity from pertussis vaccine or disease wears off and that most adults are susceptible to pertussis, now is the time for Californians to get immunized to protect themselves and their families,” said Chávez. “In particular, all family members and caregivers of infants should get the booster vaccine.”
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Pertussis has reached an epidemic level in California. For the first six months of this year, 1,496 cases of pertussis were reported, a five-fold increase from the same period last year when 258 cases were reported. In addition, approximately 700 possible cases of pertussis are under investigation.
Since this alert was released, a 6th child has died from Pertussis in California. Five out of the six fatalities have been in infants under the age of 3 months – too young to receive the vaccine.
Which is why health officials urge that the general community get vaccinated, in order to protect those that cannot be immunized.
And that means adults and children.
In recent years more parents are filing “personal belief exemptions” to avoid vaccinating their children.
Although California, like all states, requires that all students be vaccinated against Whooping Cough before entering school, parents can ask for their children to be exempted from the program if vaccines run contrary to their religious or personal beliefs.
The following information comes from the Johns Hopkins Bloomberg School of Public Health.
VACCINE EXEMPTIONS
It is law in all US states that children be properly immunized before attending school. However, in addition to medical exemptions offered in each state, 48 states allow for religious exemptions and 21a states allow personal belief exemptions for daycare and school.
(Click to view)
Other states, including Idaho, Arkansas, and Texas are reporting outbreaks of Pertussis this year as well.
Again from Johns Hopkins:
October 10, 2006
High Rates of Pertussis Found in States with Easy Immunization Exemptions
Saad B. Omer
States that easily permit parents to opt out of vaccinating their children for nonmedical reasons are at increased risk of pertussis (whooping cough), according to a new study from researchers with the Johns Hopkins Bloomberg School of Public Health, the University of Florida and the Centers for Disease Control and Prevention (CDC).
States that easily grant exemptions or offer personal belief exemptions have higher nonmedical exemption rates than states that offered only religious exemptions. The study is published in the October 11, 2006, issue of the Journal of the American Medical Association.
While (mostly mild to moderate) adverse effects have sometimes been associated with the Pertussis vaccine, their incidence has dropped since the adoption of the acellular or DTaP formulation in 1991.
The vaccine is widely regarded as being both safe and effective. This from the From the Immunization Action Coalition
What side effects have been reported with this vaccine?
About 20%-40% of children have some local reaction such as pain, redness, or swelling after the first three doses of DTaP. Such local reactions seem to be more frequent after the fourth and/or fifth doses. A temperature of 101° F or higher is reported in 3%-5% of DTaP recipients. Less common reactions (e.g., persistent crying, higher fever, febrile seizure) are rare and generally occur in fewer than 1 in 10,000 doses.
If a child has a medical reason not to receive the pertussis vaccine, they can and should still be vaccinated against diphtheria and tetanus with DT (pediatric) vaccine.
The most frequently reported side effects following vaccination with Tdap are headache, generalized body aches, and tiredness.
Whether due to activism or apathy, a declining rate of vaccination for preventable diseases like Whooping Cough will almost certainly lead to more cases – and more deaths – in our communities down the road.
