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Vincent Iannelli, M.D.

Whooping Cough Outbreak

By July 21, 2010

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An outbreak of pertussis or whooping cough in California has likely caught many people by surprise, after all, most kids get vaccines to protect them against pertussis as infants and toddlers and a booster before they start kindergarten. There is even a newer tetanus booster shot (Tdap) that includes the pertussis vaccine to help teens and adults get renewed protection against pertussis, which is important, since the immunity that the pertussis vaccine offers is at its strongest for only about 3 years and then gradually decreases over the next 2 to 7 years.

So why is pertussis still a problem? Many teens and adults haven't gotten a Tdap vaccine yet, can still get sick with pertussis, and can infect infants who haven't completed their three dose primary series of pertussis vaccines when they are about six months old. The fact that some parents are refusing vaccines or using alternative immunization schedules likely isn't helping prevent these types of outbreaks of vaccine preventable infections either.

So far in California, there are 1,496 confirmed cases of pertussis, with the highest rates in children under six months of age. Younger infants also have the highest rates of hospitalization and all six deaths, so far, have been in younger infants.

To help combat this outbreak, the California Department of Public Health (CDPH) is urging that everyone get vaccinated against pertussis, including:

  • 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.

Even if you are not in California, this outbreak should be a reminder of how serious pertussis infections are and the importance of pertussis vaccines. Keep in mind that in addition completely the DTaP (Diphtheria, Tetanus, and acellular Pertussis) series of shots before starting kindergarten and getting a Tdap booster shot when they are 11 to 12 years old (or when they are older if they missed it), the Advisory Committee on Immunization Practices (ACIP) recommends that adults between the ages of 19 and 64 get a Tdap (Tetanus, Diphtheria, and acellular Pertussis) vaccine if it has been 10 or more years since their last tetanus booster shot.

Adults who will have contact with infants less than 12 months old, including parents, grandparents aged <65 years, child-care providers, and health care workers, should get a Tdap vaccine if they have not had one yet, even if it has been less than 10 years since their last tetanus booster.

Related:
Pertussis Symptoms
Whooping cough
Vaccine Preventable Illnesses
Vaccine Safety

Comments
July 22, 2010 at 12:05 pm
(1) Joe says:

Last year in New Jersey they had multiple outbreaks of pertussis (Whooping Cough) in elementary schools. Kids in elementary schools have had 5 shots to protect them from pertussis. Since New Jersey is the home to many vaccine manufacturers, they have the most stringent vaccine policy in the country. It was determined that over 99.9% of the kids who came down with pertussis were properly vaccinated. A cynic might say this vaccine does not even work. Would you still take the risk of seizures or brain injury knowing this fact? Not me. This article brings back memories of the fear mongering H1N1 p(l)andemic

July 22, 2010 at 5:09 pm
(2) Patricia Ruston says:

I’m much to old to deal with pertussis again. And, now I have COPD, heavenknows I don’t need a cough. So…I have an appt. tomorrow with the local clinic, I’m getting a booster shot, I think that’s best.

July 22, 2010 at 11:15 pm
(3) Evan Cirul says:

I live in Vallejo and I had this cough going on three weeks now. I went to the doctor and she said it was just a bad chest cold and gave me a prescription for a cough pill and Robitussin with Co-dine. Then last night, I had 3 bad cough attacks and went back to the Doctors. Got a different doctor and he did a better exam and told me that I had Whopping cough. I am 31 years old, and I hope I never get this again. Please if you have children that has not gotten there shots, Please go get them. I can only imagine what kids go through with this.

July 23, 2010 at 1:58 pm
(4) Vincent Iannelli, MD says:

“Last year in New Jersey they had multiple outbreaks of pertussis (Whooping Cough) in elementary schools. Kids in elementary schools have had 5 shots to protect them from pertussis. ”

“A cynic might say this vaccine does not even work.”

If the pertussis vaccine didn’t work, you would expect more of the cases to be in toddlers and preschoolers. Instead, like many other outbreaks, reviewing newspaper reports, the cases in New Jersey seem to be in older elementary and middle school kids, when immunity begins to wear off.

A press release from The Hunterdon County Department of Health in Flemington, New Jersey stated that of the 60 cases they had, ‘in the majority of the cases, the ages involved range from seven to 12 years. ‘ Assuming they got their last dose of DTaP at around age 4 years, before starting kindergarten, their protection would have peaked and begun to wane by then.

If more teens and adults got their Tdap vaccine, there would be fewer cases of pertussis around to infect these kids whose protection is wearing off and those infants who are unprotected and who can die from pertussis.

August 2, 2010 at 1:14 pm
(5) Edwin Metz says:

Well, the WHO and CDC are at it again. Creating massive public fear out of another “outbreak” for the purpose of making the vaccine companies rich. I urge people to go to Utube and watch the 10-part video by Dr. Russell Blaylock on the excessive vaccination of people, especially children, in America.

August 7, 2010 at 3:51 pm
(6) Linda Garner says:

While parents in developing nations have seen first hand the damage that vaccine-preventable diseases can cause, parents in industrialized nations have little understanding of their impact. Instead, for these parents, the focus has shifted from fear of the diseases to fear of the vaccines themselves. The internet has played a key role in the anti-vaccination campaign, fueled by alternative medicine practitioners who present their anti-vaccination views along with the products they promote as cures for the supposed harm caused by vaccines. (see above) These vaccine scares have had lasting harmful effects. Pertussis (Whooping Cough) has been especially difficult to eradicate, and remains one of the leading causes of death worldwide, resulting in 300,000 deaths per year. Pertussis vaccination does not provide lifetime immunity. People must receive booster vaccinations every 5-10 years to stay immunized. If adults fail to be re-vaccinated, the risk of Pertussis will remain high. Since Pertussis presents as a bad cold in adults and older children, and people with bad cold symptoms rarely stay home, this disease will continue to be a problem and more deaths will occur.

We are fortunate to live in America where we can receive vaccinations against diseases that are still killing many worldwide. Along with Utube videos created by vaccine scare-mongers, you can find videos of helpless infants gasping for breath. Perhaps that will help balance the information.

September 16, 2010 at 2:03 pm
(7) Lory says:

My Mom was born in 1914 and had 3 older siblings that died of diptheria and whooping cough. These children were born in 1901, 1903 and 1905. All before immunizations. We need to remember the past even though we have never seen these kinds of deaths in infants.

October 24, 2010 at 7:11 pm
(8) Nurse and Mother says:

Somethings to consider….

many of the disease we now vaccinate for were “erradicating” themselves through natural course well before the invention of Penicillin and vaccinations began. Clean water and education around hygiene lead to
perceived health from these illnesses NOT the vaccines.
As healthcare providers we promise to “do no harm’ NOT to prevent each and every human being from dying. We live in a natural world (though we are “unnaturally living more and more) and as long as there are people and animals and plants and water there will be illness.
Bacteria,fungus,viruses live on us, in the water in the animals and plants.. as it should and will always be..if we continue to create “false security” against these “illnesses (which are natural occurances by the way) with “antibacterial this and that/ pesticide sprays/vaccines and drugs to “cure” what ails us, we will erradicate the very nature of our health and our planet.

Is it possible Polio still exists we just call it……Chronic Fatigue Syndrome? or Guillane Barre…..?
is it possible these diseases we believe to have been eradicated are here to stay —we just keep changing the names and inventing new “treatments,new cures,new drugs???……
Just an educated thought…

October 27, 2010 at 12:46 pm
(9) Fred says:

To Nurse and Mother, I fear it is outdated and unrealistic attitudes like yours that create these outbreaks in the first place. You say these diseases were eradicating themselves well before penicillin and vaccines…then how do you explain the thousands of people who suffered from polio? It also worries me that you are a nurse, you should know better!!

October 28, 2010 at 12:08 am
(10) John says:

Fred, death rates from polio and pertussis were, in fact, significantly improving long before vaccinations were implemented, for the reasons that others alluded to: improved hygiene, sanitation, etc. The oral polio vaccine was actually causing more cases of polio than the incidence in unvaccinated children. That’s why it was taken off of the market in the U.S. Of course, it’s still used in 3rd world countries for mass vaccinations. Why? Because it’s muc cheaper.

Before the chicken pox vaccine, those who contracted the normally benign disease would develop an immunity to varicella zoster (“shingled”) for ~10 years (the virus enters into a latent state). Whenever an adult is re-exposed to a child with chicken pox, the immune system of the adult produces antibodies again (“amnestic response”), and that person is protected from shingles for about another 10 years.

That was until the chicken pox vaccine came out. Now there are not many children for adults to be exposed to, so the incidence of shingles has skyrocketed since the chicken pox vaccine. So what next? The shingles vaccine, of course (which is ineffective). Vaccines have taken mostly benign, self-limiting diseases in small children (the contraction of which confers life-long immunity), and instead raises the age of contracting the diseases to adolescents, teens, and young adults (including pregnant women), where these diseases are much more aggressive and debilitating. The vast majority of children who developed polio, by the way, never developed any neurologic signs or symptoms.

Most of the outbreaks of pertussis (whooping cough) are in those who are fully vaccinated (usually >80%).

You ought to do some research on this.

October 28, 2010 at 12:33 am
(11) John says:

By the way, Dr. Iannelli, I’d be curious to know how many of those 60 kids had younger siblings <2 months old (or for any "outbreak" demographic, for that matter). Would you happen to know?

November 5, 2010 at 7:40 pm
(12) Tina says:

My kid is 3 and has three older brothers 6,9,10. My 3 yr old is positive for whooping cough. For 3 weeks I thought he just had a cold but his cough was getting worse. Finally get him checked and positive. Other kids are symptomless. All kids are up to date on all shots. How did the 3 yr old get it if he is immunized? I came from Germany where chicken pox is not vaccinated against. Lived here and many years later I go back and I get shingles. Maybe my lack of exposure to chicken pox brought on the shingles like John mentioned. Confusing for sure and I count my blessings that so far kids are all fine from getting vaccines here.

November 6, 2010 at 2:46 pm
(13) John says:

Tina,

Your presumption is probably correct, in that you likely developed shingles because of your lack of exposure to children with chicken pox. As an FYI, I’m a medical oncologist, so I’m not just a lay person researching this. If you’d like an excellent book on this, geared for lay persons, check out “Vaccines, Are They Really Safe & Effective”, by Neil Miller. It’s only 106 pages long, and has plenty of graphs to illustrate the trends of disease with and without vaccinations. The much heavier duty version is called “Vaccine Safety Manual, For Concerned Families and Health Practitioners, by the same author. I would definitely get the first book, regardless. It’s good to be educated on this. Here’s also an interesting
for you to browse:

http://childhealthsafety.wordpress.com/graphs/

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