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California Whooping Cough Cases "an Epidemic" 387

Posted by timothy
from the hooting-and-hollering-cough-looks-on-enviously dept.
As reported by the San Jose Mercury News, the state of California is "in the throes of a whooping cough epidemic, state health department officials announced Friday. Dr. Ron Chapman, director of the California Department of Public Health, said 3,458 cases of whooping cough have been reported since Jan. 1 -- including 800 in the past two weeks. That total is more than all the cases reported in 2013." Public broadcaster KPBS notes that of the 621 people known to have come down with whooping cough in San Diego county, the vast majority (85 percent) were up to date on their immunizations.
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California Whooping Cough Cases "an Epidemic"

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  • by Anonymous Coward on Sunday June 15, 2014 @11:31AM (#47240443)

    So there's 100 or so unimmunized kids who got sick in just that last two weeks?

    Without those kids, would the other 500 or so gotten sick?

    There's a reason it's called herd immunity.

    Fuck Jenny McCarthy. With a 50-year-old telephone pole that's had linemen up and down it with spiked shoes thousands of times. Soaked in gasoline. On fire. Up the ass.

    • by houstonbofh (602064) on Sunday June 15, 2014 @11:35AM (#47240455)
      Yes, they ignore the fact that those un-immunized 15% gave a nice reservoir for the illness to mutate and develop stronger strains, like illnesses do. And lets not bring in the fact that most Americans have piss poor immune systems to begin with, and the shots just make one facet stronger, not invincible.
      • by LifesABeach (234436) on Sunday June 15, 2014 @12:28PM (#47240643)
        Maybe you could site a reference, other than your body's exit point for your food. When one is immunized, one can handle the real thing quickly. That means the sickness cannot take hold, or not for long. There is a group of dumb ass American parents that believe that immunizing their children is a bad thing. These parents will face outcomes like child mortality, and child cripplings for the unlucky. The immunized children will not understand that their close friend is forever negatively altered because their friend's parents are so short sighted that because they don't see it, therefore it doesn't exist.

        This idea is applicable to other things. Short Sigtedness paralleled with business shows rapid depletion of its resources in exchange for an increase in profit; like a child that has more free time because it doesn't have to wait in line for a vaccine shot. Then when the resources run out, the business colapses; the outcome is the abandonment of its employees, and its customers; now the community is damaged, also the death of the business. The survivers must now spend time, money, and resources that they would not have to before; the impact cripples.
        • by Trepidity (597) <delirium-slashdo ... org minus author> on Sunday June 15, 2014 @12:46PM (#47240775)

          When one is immunized, one can handle the real thing quickly. That means the sickness cannot take hold, or not for long.

          Unfortunately that appears [informahealthcare.com] to be no longer be as true for whooping cough as it used to be: the currently circulating strains have diverged from the strains that were used to develop the vaccine, so protection is worse than it used to be.

        • Want to bet that as soon as (not if, not even when) their kids die or get crippled they start to look around for someone to sue?

          Stupid fucks. Just die off already.

        • by Millennium (2451)

          It doesn't sound to me like the grandparent was an antivaxxer. The rather unkind things they said about Jenny McCarthy should stand as a pretty strong argument that he (she?) isn't.

          But it's true: vaccines are not perfect. They give a big boost, and they can help a lot of people, but the fact is that some of their effectiveness really does depend on having very high participation: herd immunity helps the immunized almost as much as it helps the un-immunized. Which only makes it more of a travesty that the an

        • Maybe you could site a reference, other than your body's exit point for your food. When one is immunized, one can handle the real thing quickly. That means the sickness cannot take hold, or not for long.

          Unfortunately - that's not entirely true [cdc.gov], immunization against whooping cough is only partially effective. Worse yet, the effectiveness also fades over time. Even worse.... there's a possibility [sciencemag.org] that the vaccine may not stop an uninfected person from being a carrier.

          There is a group of dumb ass Am

      • by russotto (537200) on Sunday June 15, 2014 @12:39PM (#47240719) Journal

        Or maybe it's because the current acellular pertussis vaccine just doesn't work all that well.

      • I don't see why the illness should mutate more where it encounters less resistance, that is in the not immunized hosts.
        But OK, somebody will sure have studies on this, and hopefully they have been independently confirmed.

        Still it is the opposite phenomenon of what happens in hospitals: pathogens that manage to survive there become way difficult to remove. I also wonder what Darwin would have thought of less selective pressure leading to more mutations.

    • Having had had family members with whooping cough I looked into this. Adults are believed to be carrier's with silent symptoms. This year (2014) when adults get their physical they will very likely be offered an immunization for whooping cough. I just got mine since I was exposed to it. Although vaccines after the fact may not be useful for protection, the wisdom apparently is that the vaccine helps your body supress the silent infection. Not sure I understand why.

      • by EvilSS (557649) on Sunday June 15, 2014 @12:43PM (#47240745)

        Having had had family members with whooping cough I looked into this. Adults are believed to be carrier's with silent symptoms. This year (2014) when adults get their physical they will very likely be offered an immunization for whooping cough. I just got mine since I was exposed to it. Although vaccines after the fact may not be useful for protection, the wisdom apparently is that the vaccine helps your body supress the silent infection. Not sure I understand why.

        This. The immunity imparted by the pertussis vaccine was not as long lived as previously thought. Combine that with a larger community of unvaccinated children (some due to medical reasons but many due to parents choosing not to) and we get a resurgence of whooping cough. This problem has been know and building for quite a while now but the other problem is that adults tend to not keep up on their tetanus boosters. I know back in 2007 when I got my last booster they had already started giving adults Tdap (Tetanus, diphtheria, and pertussis), as opposed to the Td vaccine that used to be the norm for adults.

        • The "ap" part of "Tdap" stands for "acellular pertussis", not just "and pertussis". The acellular variant of the vaccine has fewer side-effects, but also provides less protection, and less long lasting protection.
          • by EvilSS (557649)

            The "ap" part of "Tdap" stands for "acellular pertussis", not just "and pertussis". The acellular variant of the vaccine has fewer side-effects, but also provides less protection, and less long lasting protection.

            Thanks for the correction. Now what is the name of the vaccine for overly-pedantic commenter?

    • And sideways, you forgot!

    • Lets not heap abuse on McCarthy: that's pointless. She did suffer a tragedy: her kid does have a disorder (possibly not autism, by the way). When she started her ill-advised crusade, the Wakefield papers suggesting a link between autism and vaccines hadn't been retracted yet. And according to wikipedia, she hasn't made public statements against vaccinations since 2011.

      Instead, blame the media for reporting on what celebrities think and junk science. They should have known better. They are the ones w
    • by Greyfox (87712)
      What the fuck is up with that anyway? When I was growing up, they wouldn't even let you in the school if you didn't have your immunization papers. I don't care if you are afraid of "toxins" and use Cherokee hair tampons, if you're not getting your kids their shots you're endangering them and everyone else's kids. That should be enough grounds for child services to decide that you're an unfit parent and remove your kids to protective custody. We need to stop coddling stupid bitches in this country.
  • by ColdWetDog (752185) on Sunday June 15, 2014 @11:34AM (#47240453) Homepage

    It's much safer. Stock up on Doritos and Dr. Pepper and wait the epidemic out.

    Pertussis is a big deal and, as usual, the media is Doing It Wrong. For most adults, pertussis is annoying (very annoying) but not life threatening. It is also rather contagious and worse, it is most contagious early on when one's symptoms are mild and non specific. So when you are sick, stay in the basement. Wash your hands. Communicate with the rest of the world via Slashdot.

    For young children it can be fatal, hence the importance of immunizations.

    What is pretty clear is that the primary immunization series works pretty well (not perfectly). Immunizations of adults doesn't work well at all. What TFA didn't make clear was how immunized the adults were. They would be up to date if they had received their primary children's series but no adult Dtap (typically given as part of a tetanus immunization, not directly 'for' pertussis). But we know that the pertussis component of Dtap wanes after five years. So even if you were technically up to date by tetanus standards, you'd be behind for pertussis.

    We've known this for decades. What I can't figure out is why a pertussis only booster hasn't been marketed. We have the vaccine, we have much of the data. It would be fairly easy to do. (Insert favorite rant about the Medical Industrial Complex here.)

    • by EvilSS (557649)

      It's much safer. Stock up on Doritos and Dr. Pepper and wait the epidemic out.

      That may actually be MORE dangerous to your health! :)

      • However, sarcasm is fairly innocuous.

        • by lgw (121541)

          You must be new here. Everyone knows Cheetos are the food of choice for the Slashdot basement virgin legions! No other snack food leaves proper orange fingerprints on your D&D character sheet, c'mon.

    • Re: (Score:3, Informative)

      by sconeu (64226)

      I actually *had* pertussis back in 2001 (my '60s vintage vaccine wore off). It is horrible, I was coughing to the point of vomiting.

      I hope the anti-vaxxers all get it and drop dead from it.

  • by Vellmont (569020) on Sunday June 15, 2014 @01:38PM (#47241069)

    The article is terrible. The CDC has a very good FAQ on the pertussis vaccine.

    http://www.cdc.gov/pertussis/a... [cdc.gov]

    Q: Can pertussis be prevented with vaccines?

    A: Yes. Pertussis, or whooping cough, can be prevented with vaccines. Before pertussis vaccines became widely available in the 1940s, about 200,000 children got sick with it each year in the US and about 9,000 died as a result of the infection. Now we see about 10,000–40,000 cases reported each year and unfortunately about 10–20 deaths.

    Pertussis vaccines are recommended for people of all ages. Infants and children should get 5 doses of DTaP for maximum protection. A dose is given at 2, 4 and 6 months, at 15 through 18 months, and again at 4 through 6 years. A booster dose of Tdap is given to preteens at 11 or 12 years of age.

    Any adolescents or adults who didn't get Tdap as a preteen should get one dose. Getting Tdap is especially important for pregnant women. It’s also important that those who care for infants are up-to-date with pertussis vaccination. You can get the Tdap booster dose no matter when you got your last regular tetanus booster shot (Td). Also, you need to get Tdap even if you were vaccinated as a child or have been sick with pertussis in the past.

    Learn more about preventing pertussis.

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    Whooping cough can be deadly for babies. Learn how to protect them through vaccination. See this infographic.

    Q: Why is the focus on protecting infants from pertussis?

    A: Infants are at greatest risk for getting pertussis and then having severe complications from it, including death. About half of infants younger than 1 year old who get pertussis are hospitalized, and 1 or 2 in 100 hospitalized infants die.

    There are two strategies to protect infants until they're old enough to receive vaccines and build their immunity against this disease.

    First, vaccinate pregnant women with Tdap during each pregnancy, preferably at 27 through 36 weeks. By getting Tdap during pregnancy, mothers build antibodies that are transferred to the newborn, likely providing protection against pertussis in early life, before the baby can start getting DTaP vaccines at 2 months old. Tdap also helps protect mothers during delivery, making them less likely to transmit pertussis to their infants.

    Second, make sure everyone around the infant is immunized. This includes parents, siblings, grandparents (including those 65 years and older), other family members, babysitters, etc. They should be up-to-date with the age-appropriate vaccine (DTaP or Tdap) at least two weeks before coming into close contact with the infant. Unless pregnant, only one dose of Tdap is recommended in a lifetime.

    These two strategies should reduce infection in infants, since health data have shown that, when the source of pertussis could be identified, mothers were responsible for 30-40% of infant infections and all household members were responsible for about 80% of infections.

    It's also critical that healthcare professionals are up-to-date with a one-time Tdap booster dose, especially those who care for infants.

    Learn more about infant complications.

    Top of Page

    Q: Do pertussis vaccines protect for a lifetime? If I've had whooping cough, do I still need a pertussis booster?

    A: Getting sick with pertussis or getting pertussis vaccines doesn't provide lifelong protection, which means you can still get pertussis and pass it onto infants.

    Pertussis vaccines are effective, but not perfect. They typically offer high levels of protection within the first 2 years of getting vaccinated, but then protection decreases over time. This is known as waning immunity. Similarly, natural infection may also only protect you for a few years.

    In general, DTaP vaccines are 80-90% effective. Among kids who get all 5 doses of DTaP on schedule, effectiveness is very high within the year following the 5th dose – at least 9 out of 10 kids are fully protected. There is a modest decrease in effectiveness in each following year. About 7 out of 10 kids are fully protected 5 years after getting their last dose of DTaP and the other 3 out of 10 kids are partially protected – protecting against serious disease.

    Our current estimate is that Tdap vaccination protects 7 out of 10 people who receive it. Since Tdap vaccines were only licensed in 2005, we don't yet have results on long-term vaccine protection. We're still working to understand how that protection declines over time or might differ based on which vaccine was received during early childhood (i.e., DTaP or DTP). CDC will be conducting an evaluation in collaboration with health departments in Washington and California to better understand how long Tdap vaccines protect from pertussis. The data from these evaluations will help guide discussions on how best to use vaccines to control pertussis.

    Keeping up-to-date with recommended pertussis vaccines is the best way to protect you and your loved ones.

    Learn more about protection from vaccines and infection.

     
    Q: Do pertussis vaccines protect from severe disease?

    A: If you've been vaccinated and get pertussis, you are less likely to have a severe infection. Typically, your cough won't last as many days and coughing fits, whooping, and vomiting after coughing fits won't occur as often. When vaccinated children get pertussis, fewer have apnea (life-threatening pauses in breathing), cyanosis (blue/purplish skin coloration due to lack of oxygen), and vomiting.

    Learn more about pertussis symptoms.

    Top of Page

    Q: Why are reported cases of pertussis increasing?

    A: Since the early 1980s, there has been an overall trend of an increase in reported pertussis cases. Pertussis is naturally cyclic in nature, with peaks in disease every 3-5 years. But for the past 20-30 years, we've seen the peaks getting higher and overall case counts going up. There are several reasons that help explain why we're seeing more cases as of late. These include: increased awareness, improved diagnostic tests, better reporting, more circulation of the bacteria, and waning immunity.

    When it comes to waning immunity, it seems that the acellular pertussis vaccine (DTaP) we use now may not protect for as long as the whole cell vaccine (DTP) we used to use. Throughout the 1990s, the US switched from using DTP to using DTaP for infants and children. Whole cell vaccines are associated with higher rates of minor and temporary side effects such as fever and pain and swelling at the injection site. Rare but serious neurologic adverse reactions including chronic neurological problems rarely occurred among children who had recently received whole cell vaccines. While studies have had inconsistent results that the vaccine could cause chronic neurological problems, public concern in the US and other countries led to a concerted effort to develop a vaccine with improved safety. Due to these concerns, along with the availability of a safe and effective acellular vaccine, the US switched to acellular pertussis vaccines.

    Learn more about DTaP waning immunity Adobe PDF file [140 KB, 1 page] and pertussis outbreaks.


    Q: I've heard about parents refusing to get their children vaccinated and travelers to the U.S. spreading disease; are they to blame for pertussis outbreaks?

    A: Even though children who haven't received DTaP vaccines are at least 8 times more likely to get pertussis than children who received all 5 recommended doses of DTaP, they are not the driving force behind the large scale outbreaks or epidemics. However, their parents are putting them at greater risk of getting a serious pertussis infection and then possibly spreading it to other family or community members.

    We often see people blaming pertussis outbreaks on people coming to the US from other counties. This is not the case. Pertussis was never eliminated from the US like measles or polio, so there's always the chance for it to get into a community. Plus, every country vaccinates against pertussis.

    Learn more about pertussis in other countries.

    Top of Page

    Q: Are most coughs pertussis and does everyone with pertussis "whoop"?

    A: There are a lot of causes behind a person's cough and not every cough is pertussis. In general, pertussis starts off with cold-like symptoms and maybe a mild cough or fever. But after 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. The best way to know if you have pertussis is to see your doctor, who can make a diagnosis and prescribe antibiotics if needed.

    The name "whooping cough" comes from the sound people make gasping for air after a pertussis coughing fit. However, not everyone with pertussis will cough and many who cough will not "whoop."

    Teens and adults, especially those who haven't been vaccinated, may have a prolonged cough that keeps them up at night. Those who do get the coughing fits say it's the worst cough of their lives. And the cough may last for weeks or months, causing major disruptions to daily life and complications like broken ribs and ruptured blood vessels.

    Infants may not cough at all. Instead, they may have life-threatening pauses in breathing or struggle to breathe. Any time someone is struggling to breathe, get them to a doctor right away.

    Learn more about pertussis symptoms.

     
    Q: Are pertussis bacteria changing and causing an increase in pertussis cases?

    A: CDC is evaluating potential causes of increasing rates of pertussis, including changes in disease-causing bacteria types ("strains"). Unlike a foodborne illness where one strain causes an outbreak, multiple types or strains of pertussis bacteria can be found causing disease at any given time, including during outbreaks.

    Learn more about CDC's Pertussis Strains.

    Top of Page

    Q: How contagious is pertussis?

    A: Pertussis spreads easily from person to person through coughing and sneezing. A person with pertussis can infect up to 12 to 15 other people. That's why being up-to-date with pertussis vaccines and practicing good cough etiquette are so important.

    Many infants who get pertussis are infected by older siblings, parents or caregivers who might not know they have the disease. If pertussis is circulating in the community, there's a chance that even a fully vaccinated person of any age can catch this very contagious disease. But if you've been vaccinated, your infection is usually less severe.

    If you or your child develops a cold that includes a severe cough or a cough that lasts a long time, it may be pertussis. The best way to know is to contact your doctor.

    Learn more about pertussis transmission.

     
    Q: Doesn't herd immunity protect most people?

    A: Herd immunity, or community immunity, is a situation in which, through vaccination or prior illness, a sufficient proportion of a population is immune to an infectious disease, making its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are typically protected because the disease has little opportunity to spread within their community. Since pertussis spreads so easily, vaccine protection decreases over time, and acellular pertussis vaccines may not prevent colonization, we can't rely on herd immunity to protect everyone.

    Vaccines are the most effective tool we have to provide protection against pertussis. It's important that everyone get their recommended pertussis vaccines to protect themselves.

    Learn more about vaccine coverage.

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