The California pertussis outbreak of 2010

4 Aug

If you haven’t already heard, California is in the midst of a major outbreak of pertussis (whooping cough). The California Department of Public Health is predicting that this could be the biggest outbreak in 50 years.

Here is a graph from the CDC (via the LA Times) which shows the number of pertussis cases in the entire US as a function of time up to and including the 2004/5 outbreak:

That was not just the sort of cyclic bump seen every 4-5 years even with vaccines. That was a big outbreak. And, now, California is set to see an even bigger outbreak.

So far 7 infants have died. They were too young to be vaccinated. What is especially troublesome is that usually the worst part of the year starts in August. Here is a figure from the CDPH comparing this year to last year:

By this time last year, no children had died.

Why bring this up on an autism blog? Because unfortunately much discussion focuses on vaccines and pertussis is a vaccine-preventable disease. Many autism organizations promote under vaccination or skipping vaccination. Also, groups such as the self-named “National Vaccine Information Center” (NVIC) use autism as a major part of their message touting the dangers of vaccination. Because of this, these groups react strongly to accusations that these outbreaks are due to their activism. Such an accusation came from Nancy Snyderman of MSNBC

http://www.msnbc.msn.com/id/32545640

Visit msnbc.com for breaking news, world news, and news about the economy

Dr. Snyderman is an “unabashed advocate” for vaccines and points out that people who selectively undervaccinate put people like the immune compromised and the very young at risk.

As you might imagine, these strong comments brought a strong response. Becky Estepp of Talk About Curing Autism gave her response at the at the Age of Autism blog.

Barbara Loe Fisher of NVIC defended her group’s positions even before the MSNBC spot aired:

After watching the NVIC video I had a lot of questions. I posed a few of them to the California Department of Public Health. I appreciate them taking the time to reply:

NVIC states that there are outbreaks every 4-5 years and that “this is nothing new”. I asked CDPH:

There is an outbreak every 4 to 5 years (implying this is no big deal). I think this is correct as far as it goes, but the magnitude of this outbreak appears to be large. Is there public data on the size of previous outbreaks to compare this one to? I realize that will likely involve an estimate of the size of this year’s outbreak.

Yes, historically, there are “peak years” for pertussis every 3-5 years. This was true for other vaccine preventable diseases as well before they were controlled by vaccination. This is because once a disease sweeps through a population it takes at least a few years for adequate numbers of susceptible people to accumulate again in the population to allow sustained, widespread transmission of the disease. What is different about pertussis than other vaccine-preventable diseases such as measles, is that, unlike measles, neither pertussis vaccine or disease confers lifelong immunity. Pertussis susceptible people accumulate in the population via birth cohorts who are too young to be vaccinated, people whose immunity from vaccine or disease has waned, and people who are eligible to be vaccinated, but are unvaccinated.

The last peak year for pertussis in the U.S., including California was in 2005. This was a nationwide peak year with over 25,000 cases in the U.S, the most cases in 45 years, and over 3,000 cases in California, including 8 deaths. Although Tdap was first licensed in June 2005, not many people received it that year and it did not have an effect on the outbreak. We now have Tdap to use as a control measure that was not available in other peak years. Therefore, we are trying to increase the level of pertussis immunity in the population by encouraging the use of Tdap, particularly in people who have contact with infants.

California is having a peak year/epidemic in 2010. If current trends persist, there will be more cases in California this year than in 2005 and more cases than in 52 years (see attached document, which has been released to the public). Although some other states are reporting increases this year, no state has reported an increase similar to that seen in California, which has now had a six-fold increase from the numbers reported during the same time period in 2009, a non-peak year.

NVIC seems to be implying that parapertussis is the cause of the outbreak and that is not covered by the vaccine. Aren’t many cases, especially those hospitalized or the deaths, confirmed by PCR?

Parapertussis is also circulating and pertussis vaccine does not provide protection against parapertussis. However, we do not think parapertussis is the cause of our epidemic because most of the reported pertussis cases in California are laboratory confirmed to be pertussis. In addition, parapertussis does not kill healthy young infants. Tragically, there have been seven infant deaths in Calfornia this year, all of whom had laboratory confirmed pertussis.

NVIC is also claiming that B. Pertussis may be mutating away from the vaccine strain, so the vaccine would be failing. Besides being at odds with her own assertion that the outbreak is due to parapertussis, is there evidence for this? Are the outbreaks in unvaccinated individuals? The comparison is, of course, most valid in the very young, where immunity will not have had the chance to wane.

We are not aware of any evidence that the currently circuclating strains of pertussis are not covered by the vaccine. Of the reported cases for whom we have vaccination information, most were unvaccinated or undervaccinated. None of the seven infants <3 months of age who died had received any pertussis-containing vaccines.

I have a lot more questions and there is much to deconstruct in the NVIC and TACA statements, but this is not the time for that.

Is the current outbreak due to the activities of groups like NVIC, TACA and the Age of Autism? Let me put it another way since accusations bring on such strong reactions from these groups: does it matter right now if they are at fault? People are dying. The goal right now is to minimize suffering and death. Vaccines do offer protection and could limit this outbreak.

About these ads

70 Responses to “The California pertussis outbreak of 2010”

  1. Daniel October 1, 2010 at 09:50 #

    Wow, havent read all posts, but my god are most of you sheep…
    Do you really believe that the pharmaindustry wants to make you healthy?? Have anybody reflected the fact that although people get more and more vaccine, and more and more medication of all kinds – at the same time we are sicker than ever??
    Do you really believe that so called “scientific evidence” that are paid for by pharma-industry is trustworthy??? Seriously??
    As some of you might recall, and the rest of you who dont – google it;
    A couple of years ago Bayer and Baxter got busted in court where the court proved without any doubt that the two companies, KNOWINGLY sold hemophiliac medicine which was contaminated with AIDS!!! They KNEW that it was contaminated with AIDS and still sold it… Thousands of people died in France, Spain and Japan (cause they sold it outside US).
    THESE ARE THE COMPANIES YOU PUT ALL YOUR TRUST IN!! THIS IS THE COMPANIES YOU ARE REFERRING TO WHEN SAYING VACCINE WORKS!
    PLEASE SHOW ME ANY EVIDENCE THAT HAS BEEN SCIENTIFICALLY AND OBJECTIVELY PROVEN, THAT VACCINES WORKS!!

    People like you all sickens me, calling us people who are able to think for ourself ignorant!! Take a look at yourself, you are the ones who are both ignorant and stupid!! Wake up for god sake… And you are calling this an autism blog?? And still dont see the connections? Or are you working for the pharma-industry?
    Even the FDA:s internal documents stated that there is NO WAY TO HIDE THE CONNECTION BETWEEN AUTISM AND VACCINES!!! THEY STATED THAT THE RELATIONSHIP BETWEEN VACCINES AND AUTISM IS ABSOLUTE LINEAR!!!!

    And you are saying there is no connection?? Either you are bought and paid for or you are just really really stupid…

  2. Kev October 1, 2010 at 10:46 #

    I love to read a good baseless rant. It always makes me chuckle.

  3. stanley seigler October 1, 2010 at 11:25 #

    [kev say] I love to read a good baseless rant. It always makes me chuckle.

    wonder if cancer victims got/get a chuckle from tobacco and asbestos science…

    as mentioned i dont believe VAXes cause autism and believe people should be vaccinated to prevent whooping cough…but it provides say what chuckles (not to mention irony) how some cherry pick which CYA “promotional” science they believe and defend.

    my VAx beliefs are based more on seat of pants sense and critical thinking parts of the equation vice the scientific proof part…oh/and i do believe in real NOT promotional/CYA science.

    stanley seigler

  4. Kev October 1, 2010 at 12:24 #

    Come on Stanley – cancer and autism are totally incomparable. You’re going for an emotive reaction there.

    And of course some science is promotional and therefore useless. However I lose interest in debating with someone who thinks I or people like me who don’t think vaccines cause autism are all pharma shills.

  5. Julian Frost October 1, 2010 at 13:27 #

    Wow, havent read all posts, but my god are most of you sheep…

    Perhaps you should read all the posts then. I found this website in January after learning about Fakefield. A few months ago, I went through the archives. Kev originally believed the vaccines causes autism line, but changed his mind after new data emerged. Some sheep he is.
    Or are you just a seagull commenter?
    (One who flaps in, makes a lot of noise, s***s on everything, and flies off)

  6. Chris October 1, 2010 at 16:25 #

    Erwin, here is a video about herd immunity that might help, but only if you open your mind to new information.

    As for Daniel… funny how having longer lifespans translates into humans being sicker!

  7. Catherina October 1, 2010 at 17:47 #

    Erwin Alber is an anti-vaccine activist currently trawling the web for new followers (turned up on Dr Bob’s earlier today as well). No red fish for trolls…

  8. stanley seigler October 1, 2010 at 18:47 #

    [kev say] cancer and autism are totally incomparable…of course some science is promotional… are all pharma shills.

    NOT going for anything…emotive or otherwise…just stating “my” fact (from years of observation) that people cherry pick scientific proof to suit their pro or con…and sense it in VAX discussions.

    of course anyone on the spectrum and parents/friends are not big pharma (BP) shills…which i did not say or mean to imply.

    i do NOT believe VAXs cause…certainly not resp for the epidemic, if there is one…but could possible trigger autism in some cases …

    BP has a profit motive to ignore/CYA a possible trigger…i am not an avid follower of VAX v Anti studies, so perhaps i missed BP acknowledgement of possible trigger.

    of course cancer and autism are totally incomparable. however the promotional/CYA science…used to prove nicotine is not addictive and Hg is not harmful (took BP years to remove it} and the science that allowed kids to play in asbestos for years…is comparable.

    it’s the same (well similar) science that writes ASTM (american society for testing of materials) Standards that are supposed to protect the end user…but many stds are written by the manufacturer’s tech staff (scientists) to give the mfg a competitive edge.

    my concerns is cherry picking “scientific proof” in discussions…40 some years of “causes and cures” leaves one most skeptical of either side of “true believer” arguments…especially where myopic profit is involved.

    stanley seigler

  9. Rachael October 30, 2010 at 16:31 #

    One thing they have not being completely forthright about is the fact that there is a disproportionately larger number of pertussis incidence and mortality in individuals of Hispanic ethnicity. In a June, 2010 bulletin, the ‘California Department of Public Health’ said that, “since 1998, more than 80 percent of the infants who died from pertussis have been Hispanic.” In fact, eight of the nine California infant deaths this year have been of Hispanic ethnicity. Immunization coverage among Hispanics, did not seem to play a role, nor did socioeconomic risk factors. Studies are needed to find the reasons, as to why these children have lower levels of immunity to pertussis and are more susceptible to severe consequences.

  10. Chris October 30, 2010 at 18:15 #

    So? It also turns out if you read the report that the older children who had pertussis were not Hispanic. You are cherry picking.

  11. Chris October 30, 2010 at 18:46 #

    Look at this report (something Rachael failed to include). Check out Chart #4… now figure out why the blue lines are higher for age ranges between seven and eighteen years old.

    Also remember than no child under six months old is fully protected from pertussis even if they have had all the required vaccines. That is not a “lower level of immunity” question, especially since they are few Hispanic children than white children getting pertussis at an older age.

    The numbers actually indicate a problem with income disparity and lack of insurance, not immigration. Especially since Mexico mandates vaccines and provides them for free.

    The issue is school age children who do not get vaccinated.

  12. Dawn November 1, 2010 at 13:28 #

    @Chris: thanks for the link. Sadly, reading the information, all of the infants (10) who died were 2 months of age or under, meaning NONE of them had the full series. The link actually stated that 9 of the 10 were Hispanic but since they were under 2 months of age, so they would not have had any vaccines for pertussis yet. This makes their ethnicity irrelevant, so Rachael’s comment shows her prejudice, not fact.

    The last baby was, according to the report, just 2 months of age, a former premie, who had received the first vaccine only 15 days before dying (given that the baby was a “former 28 week premie”, and knowing that vaccines may be delayed until they are ‘due date+2 months’ vs ‘birthdate+2 months’, I’m not really sure how old this baby actually was – 2 months from birth or 4 months from birth which would be ‘due date + 2 months’).

  13. JW January 6, 2011 at 19:58 #

    As a mother of an infant who suffered from pertussis and was hospitalized in ICU at 7 weeks – It took one trip to the ER and 5 Dr visits (3weeks) for the Dr to finally hospitalize her. Staying up all day and night from a month old because she would turn blue the cough so violent I would have to turn over and smack her on her back to keep her breathing. Dr would say just a cold and to young to do anything except nebulizer until she was so bad there was pinkish blood in her diaper from being so dehydrated….Finally the ICU Dr told me that unfortunately this is common with Pertussis Dr’s usually don’t look for or test for Pertussis because it was almost non existent and it is because people don’t vaccinate these rare childhood illnesses are on the comeback. Anyone who was in contact with my family caught it. My husband and my 2 year old also had it at this time, but because they were vaccinated it played out like a really bad cold. I was the only that didn’t get it; the hospital I delivered offers the Dtap to new mothers at birth at the time I had no idea how important this would be to me later. We are not Hispanic, I did breast feed, I had a C-section, I don’t believe any of that is relevant that the fact is it is highly contagious. I feel that if you went through what we did you would all vaccinate. I always believed to each their own and people are so extreme either way but others choosing not to vaccinate almost caused my daughter her life. We are so traumatized by the situation. Its just my opinion based on what we went through. She is a happy healthy little girl who amazes me everyday. On both sides we all just want to do what is best for our children.

  14. Ashlee December 13, 2011 at 09:59 #

    I just went to a lot of anti-vaccination websites and actually looked up some of the studies they referred too. The studies disproved their assertions. I don’t know if it’s just a lot of copy and pasting going on or if they didn’t understand the studies but it was ridiculous.

    One lady had in bold text that this company was advertising it was using human embryos for its vaccines so of course I went to her link. That’s now what it was advertising at all. The company is promoting it’s new recombinant DNA technology using a human cell line. One cell continuously divides with the right DNA so it can use that to make the vaccine INSTEAD OF human embryos. In another claim she states that infant formula is not a substitute for breast milk and that it’s DANGEROUS. Then she makes claims that are not supported by her small print and research citations. Or she cites these papers and studies – like vaccines call ministrokes that cause autism – based on the accusation made by one guy who has no independent documentation of any kind but he uses big words. That makes him a QUAKE!!

    From what I can see, anti-vaccine movement is being played. It’s like religion. Most people don’t have the time, skill, or knowledge to look up things themselves so they read it or hear it and it becomes true. Thus, cults and quakes. I’m not saying all the anti-vaccine studies are invalid, there are risks to vaccines, but the risk has been exaggerated way out of proportion. One one page they had in big letters and bold print infant dies 10 hours after being given the HIP vaccine (I think it was HIP). Really? There was no autopsy because it was in a poor part of India. I’m like really? My infant sister died within 10 hours of being breast fed. You make the connection.

Trackbacks/Pingbacks

  1. Tweets that mention Autism Blog - The California pertussis outbreak of 2010 « Left Brain/Right Brain -- Topsy.com - August 4, 2010

    [...] This post was mentioned on Twitter by Bora Zivkovic, Kev, Squillo, Deborah, RN, JD , Michael F Ozaki MD and others. Michael F Ozaki MD said: RT @Confutata: The California pertussis outbreak of 2010. The CA Dept. of Public Health answers some questions. http://bit.ly/doPvbV #vaxfax [...]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Follow

Get every new post delivered to your Inbox.

Join 1,103 other followers

%d bloggers like this: