From the desk of Doc Smo: Whooping Cough Update (article)

 

Public attention has been intensifying over concern that we are losing the war against a severe disease called whooping cough: a disease that we thought we had licked back in the 70’s. This highly infectious bacterial infection, that attacks a child’s bronchi, is making a major resurgence in the US.   Currently Washington State and California have gotten the brunt of what is now being called an epidemic.  In 2010 alone, 27,550 cases of whooping cough were reported in the US.

 

Here is the scary part of the evolving whooping story.  While being properly vaccinated reduces a child’s chances of getting infected by 8 fold, the majority of the cases of that have occurred in California and Washington state have been among young infants who have not completed their initial vaccines and among older children. What is particularly alarming to experts is that most of the cases in older children have afflicted ADEQUATELY VACCINATED CHILDREN clustering in the 7-10 year olds and the 13-14 year olds. In other words, the vaccine does not seem to be working since properly immunized children are coming down with the illness!

 

To understand this further, you need to know a little bit of the history of the vaccine.  Up until the 90’s, pertussis vaccine was made from the “whole cell” of the germ borditella pertussis. The vaccine worked very well but created a lot of side effects such as high fever and large swellings at the site of the shot.  In the “old days” of the whole cell DPT, we never gave the 18 month or 4-6 year booster in the legs because so many parents complained that they had to carry their children around for a few days if we gave it in their child’s leg!  We also didn’t give this vaccine to anyone over 6 years of age because they just couldn’t tolerate it.  Then came the acellular version of the DPT, also known as DPaT (the “a” standing for acellular).  This is the version of pertussis vaccine that we are using today that seems not to be giving very longstanding immunity. It just doesn’t work as well as the old whole cell version.

 

So the choice now seems clear.  Either we immunize everyone with more frequent doses of the modern acellular pertussis vaccine or we go back to the good old days with the whole cell vaccine and put up with the high fevers and large swellings. It will be interesting to see what the experts decide to do. Stay tuned and get ready to roll up your sleeves, I have a felling more shots are coming your way.

 

Smo Notes:

 

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6128a1.htm?s_cid=mm6128a1_e

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