Cocooning the family to protect infants from whooping cough

Infant being treated for pertussis infection. ©CDC, 2012.

Over the past year or so, there have been several outbreaks of whooping cough (Bordetella pertussis), including one that reached epidemic levels in Washington state, which has been considered one of the worst pertussis outbreaks in the USA during the past several decades. The disease lead to 18 infant deaths in the USA during 2012.

The original DTP vaccine (diphtheriatetanus and pertussis) became available in the USA in 1948 and was critical to dropping the number of cases of whooping cough from 260,000  in 1934 to less than a few thousand per year in the 1990′s. The Advisory Committee on Immunization Practices (ACIP) recommends (pdf) that children should get 5 doses of DTaP (the replacement for the original DTP vaccine), one dose at each of the following ages: 2, 4, 6, and 15-18 months and 4-6 years. Those children who are not completely vaccinated according to these ACIP recommendations for pertussis are considered to be “undervaccinated.” 

Whooping cough is a serious disease that has significant complications for children:

  • 1 in 4 (23%) get pneumonia (lung infection)
  • 1 or 2 in 100 (1.6%) will have convulsions (violent, uncontrolled shaking)
  • Two thirds (67%) will have apnea (slowed or stopped breathing)
  • 1 in 300 (0.4%) will have encephalopathy (disease of the brain)
  • 1 or 2 in 100 (1.6%) will die

Even in adults, there are substantial complications, such as broken ribs from coughing, that can have a significant impact on the overall health of the individual.

One of larger concerns with recent outbreaks of pertussis has been that adults with lapsed immunity or unvaccinated older children may pick up the infection, then pass it to these unvaccinated or partially vaccinated infants (usually less than 1 year old). 

Continue reading “Cocooning the family to protect infants from whooping cough”

Infant in North Carolina dies of whooping cough

whooping-cough-coccoonThe North Carolina Department of Health and Human Services reported that a three-week old child died of whooping cough (Bordetella pertussis) last week.

As the report states, a child cannot be vaccinated with DTaP (the vaccine for diphtheriatetanus and pertussis) until they are about 2 months old. However, because infants are susceptible to whooping cough, all adults, children, friends, relatives, everyone, who is in contact with that child should be vaccinated against pertussis, a process called cocooning.

When an antivaccination militant says “my unvaccinated child won’t hurt your child”, this is where their lies are uncovered. For example, an unvaccinated older child may have whooping cough, and the parent take him or her to a pediatrician for the horrible cough, and that infected child passes it to other children.

In this case, the NC Department of Health and Human Services has not reported how the child may have contracted the deadly disease, so we can only speculate. Continue reading “Infant in North Carolina dies of whooping cough”

Undervaccinating against pertussis puts children and community at risk

whooping_cough-babyOver the past year or so, there have been several outbreaks of whooping cough (Bordetella pertussis), including one that reached epidemic levels in Washington state, which has been considered one of the worst pertussis outbreaks in the USA during the past several decades. The disease lead to 18 infant deaths in the USA during 2012.

The original DTP vaccine (diphtheriatetanus and pertussis) became available in the USA in 1948 and was critical to dropping the number of cases of whooping cough from 260,000  in 1934 to less than a few thousand per year in the 1990′s. The original vaccine contained what was called “whole-cell” pertussis, which includes all of the antigens of the pertussis bacterium, partially because it wasn’t understood (and to some extent still not fully understood) which antigens on the bacteria actually induce the proper immune response to have the body destroy a pertussis infection. In the late 1990’s, the Advisory Committee on Immunization Practices (ACIP) recommended that the USA switch to the acellular form of the vaccine, known as DTaP (a pediatric vaccine to immunize against diphtheria, tetanus and pertussis) or Tdap (the older children/adult version of same vaccine). Continue reading “Undervaccinating against pertussis puts children and community at risk”

Updated: make religious vaccine exemptions more difficult to obtain

flu church vaccineA recent report indicated that US state legislatures are beginning to pass laws that make it more difficult for parents to obtain so-called personal exemptions to vaccinations before children attend public schools. According to the author, Tara Haelle, “Each US state sets its own vaccination policies, and most will not generally allow children to attend public school unless they have been vaccinated against diphtheria, tetanus and pertussis (whooping cough)hepatitis B; the Haemophilus influenzae bacteriummeasles, mumps and rubellapolio; and varicella (chicken pox).” In general, most states require that students meet the Centers for Disease Control and Prevention schedule (pdf) for children between 0 and 6 years old, which is set by the Advisory Committee on Immunization Practices.

All states allow legitimate medical exemptions from the immunization schedule before a child enters school, because of certain medical conditions that might make vaccinations problematic for young children. Some of these medical issues are: allergies to some of the components in the vaccines, immunocompromised conditions, family history of seizures, and other issues outlined in the General Recommendations on Immunization of the Advisory Committee on Immunization Practices. These medical exemptions are extremely rare, but are very important. A licensed medical doctor is the only one that should provide this exemption. Continue reading “Updated: make religious vaccine exemptions more difficult to obtain”

State legislatures making vaccine exemptions more difficult to obtain

Outstanding news. Tara Haelle reported in Nature News & Comment that US state legislatures are beginning to pass laws that make it more difficult for parents to obtain so-called personal exemptions to vaccinations before children attend public schools.

According to Haelle, “Each US state sets its own vaccination policies, and most will not generally allow children to attend public school unless they have been vaccinated against diphtheria, tetanus and pertussis (whooping cough); hepatitis B; the Haemophilus influenzae bacterium; measles, mumps and rubella; polio; and varicella (chicken pox).” In general, most states require that students meet the Centers for Disease Control and Prevention schedule (pdf) for children between 0 and 6 years old, which is set by the Advisory Committee on Immunization Practices.

All states allow legitimate medical exemptions from the immunization schedule, because of certain medical conditions that might make vaccinations problematic for young children. Some of these medical issues are: allergies to some of the components in the vaccines, immunocompromised conditions, family history of seizures, and other issues outlined in the General Recommendations on Immunization of the Advisory Committee on Immunization Practices. Continue reading “State legislatures making vaccine exemptions more difficult to obtain”

Protecting infants from whooping cough by cocooning

Infant being treated for pertussis infection. ©CDC, 2012.

This year, 2012, was one of the worst whooping cough (Bordetella pertussis) outbreaks in the USA for the past 70 years, which included an outright epidemic in Washington state. Some of the reasons for the spread of the disease were a reduced whooping cough (Dtap) vaccination rate and reduced effectiveness of the Dtap (or TDaP) vaccine. Whooping cough is a serious disease, especially to children under the age of one year old, who have not been fully vaccinated. According to the Centers for Disease Control and Prevention, of those infants who are hospitalized with pertussis about:

Make vaccine exemptions more difficult to obtain

A study recently published in the Journal of Infectious Diseases, Medical Exemptions to School Immunization Requirements in the United States–Association of State Policies With Medical Exemption Rates (2004-2011), found that more parents get medical vaccination exemptions for their kindergarten children in states in which they are easier to obtain. A perfectly predictable result, based on anecdotal observations of the arguments that I’ve observed on the internet.

The study found that the number of medical exemptions was relatively low during the seven years of the study period, but the rate was more than 6X higher in states with relatively easy medical exemption criteria when compared to states with more difficult exemption standards. As I reported previously, as more parents get vaccine exemptions, herd immunity can be impacted, and children in schools with low immunization levels can face outbreaks of diseases that were once thought rare. Continue reading “Make vaccine exemptions more difficult to obtain”