Tag: whooping cough

Are Reported Pertussis Cases up by 114% Since 1967?

We know that we are seeing more pertussis cases these days.

Although the last few years have been better, 2012 was an especially bad year, with at least 48,277 cases and tragically, at least 4 deaths.

Are Reported Pertussis Cases up by 114% Since 1967?

How does that compare to the the pre-vaccine era?

Cases are still well below what they were in the pre-vaccine era, before we were routinely using DPT and DTaP vaccines.

Reported cases of pertussis are still down from the prevaccine era and there are far fewer deaths, from 37 deaths in 1967 to 6 in 2015.
Reported cases of pertussis are still down from the prevaccine era and there are far fewer deaths, from 37 deaths in 1967 to 6 in 2015.

What about the idea that pertussis cases are up 114% since 1967?

While that may be true, the first thing you should ask yourself when looking at Lauren Novelli’s little graph, is why did she choose 1967?

Reported Pertussis Cases Are Down Since the Pre-Vaccine Era

We did start using a new vaccine in 1967, but it was the measles vaccine, not the DPT vaccine. Vaccines against diphtheria, pertussis, and tetanus had been available for some time and were used more routinely beginning in the 1950s.

And that explains the drop in pertussis cases from just over 120,000 in 1950 to about 40,000 in 1959.

More importantly, even as pertussis cases are increasing again, we aren’t seeing as many people dying from pertussis.

In 2018, there were 13,439 reported pertussis cases and 10 deaths.
In 2018, there were 13,439 reported pertussis cases and 10 deaths.

Is that because of better hygiene, sanitation, and nutrition?

No.

We had those in most of the United States in the 1950s and 60s. The big change is that even though the current pertussis vaccine might not be perfect, having issues with waning immunity, it can still protect you from severe disease.

Vaccinating against pertussis is far from useless and there is absolutely no evidence of dormant bacteria carriers being triggered into becoming active infections.

This is pure propaganda, but you should expect no less from someone who describes themselves as an intuitive nurse and sells CBD oil.

More on Reported Pertussis Cases

Making a Better Pertussis Vaccine

So we know that we need a better pertussis vaccine.

DTaP and Tdap just aren’t doing the job that they should be doing.

Whooping Cough is back, again.
Whooping Cough is back, again.

So when will we get one?

Making a Better Pertussis Vaccine

Since anti-vaccine folks are always talking about the 300 new vaccines in the pipeline, you would think that we would have had several new pertussis vaccines by now…

Unfortunately, we don’t.

What we do have is some good candidates, including:

  • new acellular pertussis vaccines, either with more antigens or an adjuvant
  • a new live attenuated nasal vaccine, BPZE1
  • new whole-cell vaccines with reduced endotoxin contents (so should have fewer side effects that then original whole-cell pertussis vaccine – DTP)

Before you get too excited, keep in mind that none of these vaccines will be available in your pediatrician’s office any time soon. Developing a new vaccine takes a lot of time.

BPZE1 has started phase 2a trials though.

What do we do until we get new pertussis vaccines?

“We should be more vigilant than we have been in the past to recognize and treat pertussis in all age groups so that transmission to young infants is reduced. Most important (although not discussed in this review) is to ensure that all pregnant women receive the Tdap vaccine between 27 and 36 weeks’ gestation with each pregnancy. Also, we should consider routinely administering Tdap vaccine every 3 years to all adolescents and adults who were primed with a DTaP vaccine.”

James D. Cherry on The 112-Year Odyssey of Pertussis and Pertussis Vaccines—Mistakes Made and Implications for the Future

We should keep using the pertussis vaccines we have!

Vaccines work, even when they aren’t as effective as we would like.

More on Making a Better Pertussis Vaccine

Do Pertussis Vaccines Work Against Pertactin-Negative Pertussis Bacteria?

Whooping cough is back!
This is not the first time that whooping cough has come back. We also saw a rise when folks got scared to use the DTP vaccine in the 1970s and 80s.

Pertussis vaccines aren’t perfect.

Few people claim that.

But what’s the problem with them?

Most experts think that the main issue is waning immunity.

While the acellular pertussis vaccines (DTaP and Tdap) that replaced the more effective whole cell pertussis vaccine (DTP) do work, the immunity they provide does not last as long as we would like.

They still work better than not getting vaccinated at all though.

Pertactin-Negative Pertussis Bacteria

What about the fact that we are starting to find pertactin-negative pertussis bacteria?

Does that mean that Bordetella pertussis, the bacteria that cause pertussis or whooping cough, have mutated and are causing a pertussis resurgence because they are resistant to the vaccine?

“CDC is currently conducting studies in the United States to determine whether pertactin deficiency is one of the factors contributing to the increase in the number of reported pertussis cases. CDC will continue to closely monitor the situation and evaluate all available scientific evidence before drawing any conclusions. There is also no suggestion that these new strains are causing more severe cases of pertussis.”

CDC on Pertactin-Negative Pertussis Strains

While an interesting theory that the anti-vaccine movement has latched on to, the answer seems to be no.

While pertactin-negative pertussis are certainly a thing, there is already evidence saying that they are not driving pertussis outbreaks – evidence that anti-vaccine folks like to ignore:

  • pertactin is only one of the components (antigens) of the pertussis bacteria that are in pertussis vaccines that help them to induce immunity. Others can include filamentous hemagglutinin, chemically or genetically detoxified pertussis toxin, and fimbrial-2 and fimbrial-3 antigens.
  • pertussis vaccines continue to be effective against pertactin-negative Bordetella pertussis bacteria
  • pertactin-negative Bordetella pertussis bacteria have not been found in all areas experiencing outbreaks of pertussis, as you would expect if they were driving these outbreaks
  • the first pertactin-negative Bordetella pertussis bacteria were found as early as the 1990s, long before we started using the current acellular versions of pertussis vaccines and before we started seeing an increase in outbreaks.

Also of note, pertactin-negative Bordetella pertussis bacteria do not cause more severe symptoms than pertactin-positive bacteria.

“Although pertussis vaccines aren’t perfect, vaccination remains our best prevention tool and we should continue to maintain high levels of DTaP coverage among children, sustain Tdap coverage in adolescents and increase Tdap coverage in adults and pregnant women. ”

CDC on Coughing up the Facts on Pertussis

Most importantly, it should be clear that pertussis vaccines work as we are not seeing pre-vaccine era levels of pertussis, even as we do see some outbreaks.

What To Know About Pertactin-Negative Pertussis

Pertactin-negative pertussis bacteria are not driving outbreaks of pertussis or whooping cough, and they have not become resistant to pertussis vaccines.

More About Pertactin-Negative Pertussis Bacteria