Whooping cough update: Washington state epidemic hits 3400 cases
The Washington State Department of Health is reporting that as of August 4, 2012, the current whooping cough (Bordetella pertussis) epidemic has hit 3400 cases, over 15X more than the 214 cases reported at the same time last year. The epidemic has finally shown a big drop off in new reports this past week (pdf), although there are concerns that the numbers will increase against this fall as children return to school in the autumn.
Pertussis cases by week 2012 (red) vs 2011 (blue)
According to the Centers for Disease Control and Prevention, pertussis (whooping cough) can cause serious illness in infants, children and adults. The disease usually starts with cold-like symptoms and maybe a mild cough or fever. 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. In infants, the cough can be minimal or not even there. Infants may have a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. More than half of infants younger than 1 year of age who get the disease must be hospitalized. Approximately 1-2% of infants who are hospitalized from pertussis will die.
Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and you are forced to inhale with a loud “whooping” sound. This extreme coughing can cause you to throw up and be very tired. The “whoop” is often not there and the infection is generally milder (less severe) in teens and adults, especially those who have been vaccinated.
Whooping cough can be easily prevented with the Tdap or DTaP vaccine. The problem is that infants are not initially vaccinated until they are 2 months old, and are not fully immunized until they’re 6 months old, so they are susceptible to adults who may be infected. Adults may have lapsed immunity or may have not been vaccinated.
Of course, this epidemic is causing reexamination of our pertussis vaccines, which is an important future research direction. As I discussed previously, Tdap and DTaP vaccines seem to be showing a reduced protection over time. The CDC and FDA probably are examining new recommendations on vaccine intervals and development of improved vaccines. But clearly protection from a highly effective vaccine is substantially better than no vaccine at all. The antivaccination movement is already pushing the fact that the pertussis vaccine isn’t working so don’t get it. That’s such an insane idea, since the vaccine is at least 84-85% effective (and epidemiological studies seem to indicate a higher level) in preventing whooping cough. Given the risk of death and serious side effects from the disease, and little or no adverse effects from the vaccine, it’s an easy choice.
But still, the vaccine denialists want to use this epidemic as their “proof” of vaccine’s failure. Joe Mercola, Salesman-in-chief of junk medicine, wrote an article about it, and then confusing pertussis, a bacteria, with a virus is not leading me to confidence that he actually knows anything about medicine. Or that he claims “vaccines cause mutations” which shows his complete ignorance about the mechanism of evolution. Seriously, if you can’t get the basics of biology right, how can we seriously accept anything else he writes. He also tries out the “recombining of live attenuated viruses” that I debunked. I’m just an amateur blogger and I can rip apart his exaggerations, imagine what the real doctors say about Mercola.
Back to Washington, Science Mom at Just the Vax (I just love that name) wrote a insightful article, Washington State Pertussis Outbreak, mathematically analyzing the outbreak and the effectiveness of the pertussis vaccine. Science Mom’s conclusion is:
As we can see, more un/undervaccinated children have been infected with pertussis than fully vaccinated across all age bins. This translates to children ages 5-9 un/der vaccinated children are 6 times more likely to become infected with pertussis than fully vaccinated. Children ages 10-13 un/der vaccinated are 25 times more likely to become infected with pertussis than fully vaccinated. And un/der vaccinated children ages 14-18 are 6 times more likely to become infected with pertussis than fully vaccinated.
Is that clear to the vaccine denialists? Don’t vaccinate and your children are significantly more likely to get whooping cough. Don’t vaccinate, and there’s a significantly greater chance that your children could end up in a hospital. And a greater risk of dying. This risk is not higher with those who vaccinate, and if you thought that it was, then your understanding of statistics is at the same level as it is with Mercola’s understanding of evolution and virology, which is at zero.
Remember, Vaccines Save Lives.
[...] one of the worst whooping cough (Bordetella pertussis) epidemics in 70 years in Washington state, there is some good news. The New York Times has reported that the state, after passing a law that [...]
[...] cough (Bordetella pertussis) outbreak which has reached epidemic levels in areas like the Washington state, and has been considered one of the worst outbreaks in the USA during the past several decades. The [...]
There is a difference between effectiveness and efficacy. Huge difference. Stating that the pertussis vax is 85% effective is untrue. The Cochrane report states that the efficacy rate is 84-85%. That is not the same as effectiveness. A recent study showed, based on 2010 California data, that the vaccine is 24-51% effective.
Vaccine Denialist Society, you’re picking and choosing your data to fit your needs without fully explaining it. The lowest effectiveness was with those who did not receive the full vaccination schedule, to which you are personally opposed. It’s closer to the efficacy rate, in groups that received the full 5 doses. Moreover, because real science adjusts to new data, there will be adjustments to the vaccine schedule. Real science is not dogmatic as opposed to denialists and pseudoskeptics. But thanks for participating. I always have fun reading your Facebook page.
Was the lowest effectiveness in those that did not receive the full schedule? I don’t think so. Please back up your claim with numbers. Thanks Michael.
Sorry, that’s not how we roll here when dealing with science denialists. YOU made the original claim with some California study. Please provide a secondary study, a peer-reviewed meta-review published in a high impact journal. Do not play the confirmation bias game, trying to find the tiny bits of data that support your pseudoskepticism, whilst ignore the vast amounts of data that blast your dogma right out of the universe.
You see, arguments from ignorance indicate a lack of evidence on your part. So, let’s be clear here. You made the assertion. You need provide the data.
However, I’m drawing the line in the sand. You just can’t provide bad data that makes your uneducated minions happy, you have exceed the standards of someone with a brilliant education from a top school and many years of science research. I’m open minded, a true science skeptic, and willing to engage a denialist like you, but you’re not going to get away with your 2 minutes of silly googling. So either bring research that meets my standards. Or don’t bother.
You would like to believe that I deny science. It is precisely the science that leads me to not vaccinating. The science community has already shown and proven that the pertussis vax doesn’t work as it should and they have NO IDEA how long immunity actually lasts from the vaccine. In David Witt’s California study, it is proven and stated that the attack rates are the same among the vaccinated and un/der vaccinated. And in the unvaccinated with exemptions the attack rate is even lower in the unvaccinated.
Why do I have to provide a second study? What if no second study exists for the same cohort? Does that mean the first study is invalid? Seems to me you are the one playing the confirmation bias game.
What data do you think I’m ignoring that blasts my dogma right out of the universe? I’m curious.
Way to win an argument. Make crazy claims and insist that the other side verify them for you. Michael should just go read the CDC on the current outbreaks. They’ve said more than once that it isn’t lower rates of vaccination in children responsible.
Oh wait. I filled an article with links to high quality, meta reviews. You must be pointing out how Vaccine Denial Society wasn’t providing scientific evidence. I appreciate your support.
@[235022693246730:274:Vaccine Skeptic Society] You are a science denialist because you:
1. Use vague, exaggerated or untestable claims
2. Have an over-reliance on confirmation rather than refutation
3. Lack of openness to testing by other experts
4. Have an absence of progress of any type towards showing any evidence towards your claims
5. You exhibit personalization of issues
6. You use misleading language
You have not provided any evidence. You have not provided a secondary study (not a “second study”). You ignore and deny evidence that vaccines save lives, while inventing evidence that vaccines have safety issues. Aluminum. Autism. Mercury. Lulz.
That’s amusing Michael Simpson. Just because I didn’t link to the information, doesn’t mean it doesn’t exist. Really smart people would go look it up for themselves and determine if I’m right (which I am).
Looking over that list, it seems that you are describing the Vax Fanatic movement to a ‘T’. #3 is a big problem among the provax crowd. Actually 1 – 6 are.
And 5 and 6.
Do trials include the full range of the population? Healthy, unhealthy? With major and minor pre-existing conditions?
Fantastic post
Oh, yay, anti-medicine and anti-vaccination conspiracy theorists. Joy. Do they have anything new to say?
great one michael! go get em! and anyone who threatens you on this is a terrorist..
Michael, I agree with you. Those of us who suffer from chronic conditions (celiac, arthritis) would love a cure, but we don’t have a magic wand. I manage the celiac through avoiding gluten and the arthritis through Enbrel and exercise. If there was a vaccine that allowed me to eat semolina pasta and real sourdough bread, I’d be first in line for the clinical trial:)
There is a difference between effectiveness and efficacy. Huge difference. Stating that the pertussis vax is 85% effective is untrue. The Cochrane report states that the efficacy rate is 84-85%. That is not the same as effectiveness. A recent study showed, based on 2010 California data, that the vaccine is 24-51% effective.
Vaccine Denialist Society, you're picking and choosing your data to fit your needs without fully explaining it. The lowest effectiveness was with those who did not receive the full vaccination schedule, to which you are personally opposed. It's closer to the efficacy rate, in groups that received the full 5 doses. Moreover, because real science adjusts to new data, there will be adjustments to the vaccine schedule. Real science is not dogmatic as opposed to denialists and pseudoskeptics. But thanks for participating. I always have fun reading your Facebook page.
Was the lowest effectiveness in those that did not receive the full schedule? I don't think so. Please back up your claim with numbers. Thanks Michael.
Sorry, that's not how we roll here when dealing with science denialists. YOU made the original claim with some California study. Please provide a secondary study, a peer-reviewed meta-review published in a high impact journal. Do not play the confirmation bias game, trying to find the tiny bits of data that support your pseudoskepticism, whilst ignore the vast amounts of data that blast your dogma right out of the universe.
You see, arguments from ignorance indicate a lack of evidence on your part. So, let's be clear here. You made the assertion. You need provide the data.
However, I'm drawing the line in the sand. You just can't provide bad data that makes your uneducated minions happy, you have exceed the standards of someone with a brilliant education from a top school and many years of science research. I'm open minded, a true science skeptic, and willing to engage a denialist like you, but you're not going to get away with your 2 minutes of silly googling. So either bring research that meets my standards. Or don't bother.
You would like to believe that I deny science. It is precisely the science that leads me to not vaccinating. The science community has already shown and proven that the pertussis vax doesn't work as it should and they have NO IDEA how long immunity actually lasts from the vaccine. In David Witt's California study, it is proven and stated that the attack rates are the same among the vaccinated and un/der vaccinated. And in the unvaccinated with exemptions the attack rate is even lower in the unvaccinated.
Why do I have to provide a second study? What if no second study exists for the same cohort? Does that mean the first study is invalid? Seems to me you are the one playing the confirmation bias game.
What data do you think I'm ignoring that blasts my dogma right out of the universe? I'm curious.
Way to win an argument. Make crazy claims and insist that the other side verify them for you. Michael should just go read the CDC on the current outbreaks. They've said more than once that it isn't lower rates of vaccination in children responsible.
Oh wait. I filled an article with links to high quality, meta reviews. You must be pointing out how Vaccine Denial Society wasn't providing scientific evidence. I appreciate your support.
Vaccine Skeptic Society You are a science denialist because you:
1. Use vague, exaggerated or untestable claims
2. Have an over-reliance on confirmation rather than refutation
3. Lack of openness to testing by other experts
4. Have an absence of progress of any type towards showing any evidence towards your claims
5. You exhibit personalization of issues
6. You use misleading language
You have not provided any evidence. You have not provided a secondary study (not a "second study"). You ignore and deny evidence that vaccines save lives, while inventing evidence that vaccines have safety issues. Aluminum. Autism. Mercury. Lulz.
That's amusing Michael Simpson. Just because I didn't link to the information, doesn't mean it doesn't exist. Really smart people would go look it up for themselves and determine if I'm right (which I am).
Looking over that list, it seems that you are describing the Vax Fanatic movement to a 'T'. #3 is a big problem among the provax crowd. Actually 1 – 6 are.
And 5 and 6.
So? Effectiveness is how well it works in practice. Efficacy is how well it works in the trials. Other than the setting, what's the "Huge difference"?
Do trials include the full range of the population? Healthy, unhealthy? With major and minor pre-existing conditions?
Fantastic post
Oh, yay, anti-medicine and anti-vaccination conspiracy theorists. Joy. Do they have anything new to say?
great one michael! go get em! and anyone who threatens you on this is a terrorist..
Michael, I agree with you. Those of us who suffer from chronic conditions (celiac, arthritis) would love a cure, but we don't have a magic wand. I manage the celiac through avoiding gluten and the arthritis through Enbrel and exercise. If there was a vaccine that allowed me to eat semolina pasta and real sourdough bread, I'd be first in line for the clinical trial:)
You mention what “real doctors” say about Mercola. Are those the doctors whose “healing” methodology is to prescribe pharmaceuticals to cover symptoms?
Oh, the old “Big Pharma” ad hominem. You must have actually meant to prescribe pharmaceuticals that actually cure diseases because they are tested in clinical trials that are published in peer reviewed high impact journals. This is opposed to Mercola’s fake products that do nothing and are not tested in double blind clinical trials, results of which are published nowhere.
How many of them actually “cure” diseases as oppose to just address the symptoms? And when I say cure, I mean address the cause. Does insulin cure diabetes? No. Do SSRI’s cure depression? No. Do statin drugs cure high cholesterol? No. Do blood pressure meds cure hypertension? No. And would those journals be the ones with a large proportion of their advertising revenue coming from pharmaceutical companies? http://www.ncbi.nlm.nih.gov/pubmed/16523984
You actually have no scientific proof of any of your statements. First, there is no cure for type 1 diabetes. But if you don’t take insulin to reduce blood sugar, you will certainly die of diabetic complications. If you have any evidence otherwise please provide them. You will win a Nobel Prize for that information. There is no cure for depression, but SSRI’s suppress the serotonin levels such that the depression is reduced to the point where the patient can be responsive to therapy and can become highly functional. You totally misunderstand how evidence based medicine works, but that’s because your knowledge of medicine seems to flow from 2 hours of google searches and not on 10-20 years of research, study, and experience. Your cognitive bias is showing.
By the way, linking to a 7 year old publication that was done on a 12 year old study of advertising that shows absolutely nothing about editor content is amusing. It shows a logical fallacy based on your lack of evidential support of your non-scientific knowledge of science.
You think your woo beliefs do anything whatsoever is laughable. Science based medicine applies the best available evidence gained from the scientific method to clinical decision making. You and that liar Mercola just invent stuff.
I guess you better inform this fellow that he did not cure himself of diabetes by changing his diet and lifestyle.http://www.diabetes-warrior.net/2010/01/24/mystory/ You and your ilk are really sad. You’ll kill yourselves and others before you admit there can be any other therapy other than one pharmaceutically based.
Obviously, you have a limited knowledge of diabetes. You switch from discussing Type 1 Diabetes, which absolutely cannot be cured at this time, to a link to Type 2 Diabetes which can be “cured” if you lose weight, though that is not necessarily true. In fact, some Type 2 diabetes is permanent, and providing one anecdotal story without a randomized clinical trial provides no information on how to treat a broad base patient population. Weight loss as a treatment for Type 2 diabetes is well known to every physician in the world. There are no known treatments for Type 1 diabetes but insulin.
I’m extremely knowledgeable about metabolic diseases and endocrinology. So, you can refrain from ad hominem attacks, because they really lack any standing in an intelligent discussion.
Furthermore, you conflate symptoms with the diseases. Type 1 diabetes symptoms are excessive thirst, excessive urination, weight loss, high blood glucose, fatigue and increased hunger. The disease is caused by decreased insulin output in response to blood sugar levels. One injects insulin to respond to increased blood sugar to cause a decrease in blood sugar. That is called a treatment. It is not a cure, because there is not a cure available at this time. So you also conflate a “cure” for “treatment.”
You do the same thing for depression. The symptoms for Major Depressive Disorder can be anything from increased sleep to change in eating habits. SSRI’s treat the underlying disease by changing levels of neurotransmitters. Again, the treatment is treating the underlying disease. The symptoms merely tell the physician about the disease.
I hope you this little lesson on diabetes, depression, and medical terminology is clear to you.
I think it is really intellectually dishonest to describe evidence-based medicine (also known as “medicine”) as pharmaceutically-based. Doctors do not go to medical school to learn how to prescribe medications but how to diagnose and treat illness. They do not mask symptoms but found out the actual real causes (read: not worms or yeast or whatever the woo-du-jour happens to be), and treat the patient. I have left a doctors without a prescription more times than not. I have been given advice about dietary and lifestyle changes. And I have never been sold a doctor’s self-branded supplements in order to help expand his multi-million dollars mansion (read: Mercola).
Nancy Keeler Nancy I think you are a pharma shill. Here in the UK Tylenol is called Calpol and I notice you are associated with Cal Poly Pomona. Coincidence? I think not.
Brilliant, Autismum. Exactly the type of “connecting the completely unrelated dots into an unproven conspiracy theory that I will state as a fact” in which these people engage.
Autismum…that is some absolutely thorough investigative work on your part. And Cal Poly Pomona is in California, a well known location for woo and anti-vaccination education.
You mention what "real doctors" say about Mercola. Are those the doctors whose "healing" methodology is to prescribe pharmaceuticals to cover symptoms?
Oh, the old "Big Pharma" ad hominem. You must have actually meant to prescribe pharmaceuticals that actually cure diseases because they are tested in clinical trials that are published in peer reviewed high impact journals. This is opposed to Mercola's fake products that do nothing and are not tested in double blind clinical trials, results of which are published nowhere.
How many of them actually "cure" diseases as oppose to just address the symptoms? And when I say cure, I mean address the cause. Does insulin cure diabetes? No. Do SSRI's cure depression? No. Do statin drugs cure high cholesterol? No. Do blood pressure meds cure hypertension? No. And would those journals be the ones with a large proportion of their advertising revenue coming from pharmaceutical companies? http://www.ncbi.nlm.nih.gov/pubmed/16523984
You actually have no scientific proof of any of your statements. First, there is no cure for type 1 diabetes. But if you don't take insulin to reduce blood sugar, you will certainly die of diabetic complications. If you have any evidence otherwise please provide them. You will win a Nobel Prize for that information. There is no cure for depression, but SSRI's suppress the serotonin levels such that the depression is reduced to the point where the patient can be responsive to therapy and can become highly functional. You totally misunderstand how evidence based medicine works, but that's because your knowledge of medicine seems to flow from 2 hours of google searches and not on 10-20 years of research, study, and experience. Your cognitive bias is showing.
By the way, linking to a 7 year old publication that was done on a 12 year old study of advertising that shows absolutely nothing about editor content is amusing. It shows a logical fallacy based on your lack of evidential support of your non-scientific knowledge of science.
You think your woo beliefs do anything whatsoever is laughable. Science based medicine applies the best available evidence gained from the scientific method to clinical decision making. You and that liar Mercola just invent stuff.
I guess you better inform this fellow that he did not cure himself of diabetes by changing his diet and lifestyle.http://www.diabetes-warrior.net/2010/01/24/mystory/ You and your ilk are really sad. You'll kill yourselves and others before you admit there can be any other therapy other than one pharmaceutically based.
Obviously, you have a limited knowledge of diabetes. You switch from discussing Type 1 Diabetes, which absolutely cannot be cured at this time, to a link to Type 2 Diabetes which can be "cured" if you lose weight, though that is not necessarily true. In fact, some Type 2 diabetes is permanent, and providing one anecdotal story without a randomized clinical trial provides no information on how to treat a broad base patient population. Weight loss as a treatment for Type 2 diabetes is well known to every physician in the world. There are no known treatments for Type 1 diabetes but insulin.
I'm extremely knowledgeable about metabolic diseases and endocrinology. So, you can refrain from ad hominem attacks, because they really lack any standing in an intelligent discussion.
Furthermore, you conflate symptoms with the diseases. Type 1 diabetes symptoms are excessive thirst, excessive urination, weight loss, high blood glucose, fatigue and increased hunger. The disease is caused by decreased insulin output in response to blood sugar levels. One injects insulin to respond to increased blood sugar to cause a decrease in blood sugar. That is called a treatment. It is not a cure, because there is not a cure available at this time. So you also conflate a "cure" for "treatment."
You do the same thing for depression. The symptoms for Major Depressive Disorder can be anything from increased sleep to change in eating habits. SSRI's treat the underlying disease by changing levels of neurotransmitters. Again, the treatment is treating the underlying disease. The symptoms merely tell the physician about the disease.
I hope you this little lesson on diabetes, depression, and medical terminology is clear to you.
I think it is really intellectually dishonest to describe evidence-based medicine (also known as "medicine") as pharmaceutically-based. Doctors do not go to medical school to learn how to prescribe medications but how to diagnose and treat illness. They do not mask symptoms but found out the actual real causes (read: not worms or yeast or whatever the woo-du-jour happens to be), and treat the patient. I have left a doctors without a prescription more times than not. I have been given advice about dietary and lifestyle changes. And I have never been sold a doctor's self-branded supplements in order to help expand his multi-million dollars mansion (read: Mercola).
Nancy Keeler Nancy I think you are a pharma shill. Here in the UK Tylenol is called Calpol and I notice you are associated with Cal Poly Pomona. Coincidence? I think not.
Brilliant, Autismum. Exactly the type of "connecting the completely unrelated dots into an unproven conspiracy theory that I will state as a fact" in which these people engage.
Autismum…that is some absolutely thorough investigative work on your part. And Cal Poly Pomona is in California, a well known location for woo and anti-vaccination education.
[...] pertussis) year-to-date. Wisconsin has the highest rate of infection, while Washington, as I have discussed on a number of occasions, has one of the highest total number of pertussis infections. Increases in pertussis outbreaks by [...]