Whooping cough cases hit an all-time high in Vermont

Vermont is experiencing the most severe outbreak of whooping cough, or pertussis, in recorded history.

The Vermont Department of Health (DOH) has confirmed 293 cases of the highly contagious bacterial infection this year. And according to DOH spokesman Robert Stirewalt, that is a conservative calculation.

“We are probably over 300 cases now,” he said. “This is the most cases we have had in Vermont in one year since we started tracking it in 1980.”

Of those 293 confirmed cases, 72 occurred between Aug. 12 and Sept. 22 and almost half of those recent cases appeared in kids ages 5 to 18. Of the 72 recent episodes, Chittenden County had the highest incident rate with 17 confirmed cases, and Franklin and Lamoille counties followed up close behind with 14 cases each.

The last time Vermont had such a widespread outbreak of pertussis was in 1997 when 283 cases were confirmed. In 1996, 280 cases were reported, and 171 of them occurred in school-aged children.

The Centers for Disease Control and Prevention says vaccination is the most effective way to prevent the illness.

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Andrew SteinAndrew Stein

Comments

  1. Dorian Yates :

    The VT DOH Web site states that, “Immunization against pertussis usually prevents this disease in children.” However it appears that the VT DOH actual cases numbers seem to portray a contradictory picture. According to the State Department of Health, of the 211 pertussis cases from Jan 1 to Sept 5 in kids from 6 months to 18 years old, 91% of those were vaccinated—that is 192 of the Pertussis cases had received some level of vaccines. The highest number of cases were actually in those with the most vaccines—5 or 6 doses (157 of the cases‚ 74.5%) and the remaining 35 had received 1 to 4 doses of vaccine (about 17%), leaving 9% of the cases that had no vaccines. Similar percentages are seen in other states with Pertussis outbreaks.

    This sounds to me more like product failure. When 91% of Pertussis cases are vaccinated, and almost 75% of those are fully vaccinated, the vaccine is not working. If the vaccines were working then the numbers might look something in reverse—that 9% of those contracting Pertussis were vaccinated and 91% were not. But that is not what is happening in real time. Our tax dollars at work—Vermont spends $1,360,000 on Pertussis (DTaP) vaccines each year and the product is not working. It is time to rethink the strategy and build a better model of health and disease prevention, because this mousetrap is not working.

    • Andrew Stein :

      Thanks for your insightful comment, Dorian. We’ll have much more on this issue tomorrow or over the weekend.

  2. Dorian makes some important points here and the question she asks is something I also would like to ask: Why are we spending money on this vaccine product which we know does not work?

    There are many recent studies and articles showing problems with the efficacy of the pertussis vaccine and the science on this subject has been available for several years. Also, the organisms that cause whooping cough can be in the respiratory tract whether you are vaccinated or not. This is why the “blame game” during the vaccine debate this spring – when claims were made that possible whooping cough outbreaks were due to unvaccinated “exemptors” – made no sense whatsoever and caused a whole lot of confusion.

    Japan – 2010… Whooping cough outbreak is perhaps being caused by “a selective advantage in vaccinated human populations” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2863393/

    USA/Washington – 2012…Early waning of immunity might be contributing to increasing population-level susceptibility. http://jama.jamanetwork.com/article.aspx?articleid=1362036

    USA/California – 2010…Majority of cases were in fully vaccinated children; A spokesperson for GSK, one of the pertussis vaccine makers admits they have never studied the duration of the vaccine’s protection.
    http://www.reuters.com/article/2012/04/03/us-whoopingcough-idUSBRE8320TM20120403

    Australia – 2012…study showing a new strain or genotype capable of evading the vaccine may be responsible for the sharp rise in the number of cases….http://www.sciencedaily.com/releases/2012/03/120321105331.htm

    Israel – 2006…“Pertussis is considered an endemic disease, characterized by an epidemic every 2–5 years. This rate of exacerbations has not changed, even after the introduction of mass vaccination – a fact that indicates the efficacy of the vaccine in preventing the disease but not the transmission of the causative agent (B. pertussis) within the population.”http://www.ima.org.il/imaj/ar06may-2.pdf

    Netherlands – 2009…“An important issue is whether vaccination has selected for the ptxP3 strains. Several lines of evidence support this contention.” “Based on mathematical modeling, vaccines designed to reduce pathogen growth rate and/or toxicity may result in the evolution of pathogens with higher levels of virulence” The authors “propose that waning immunity and pathogen adaptation have contributed to the resurgence of pertussis, although other factors such as increased awareness and improved diagnostics have also played a role.”http://wwwnc.cdc.gov/eid/article/15/8/08-1511_article.htm

    Finland – 2005…“Pertussis is an infectious disease of the respiratory tract caused by Bordetella pertussis. Despite the introduction of mass vaccination against pertussis in Finland in 1952, pertussis has remained an endemic disease with regular epidemics.” and “During the last decade, the number of pertussis cases has increased in countries with high vaccination coverage rates including Finland.”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1233997/

    FInland – 2005…“Reemergence of pertussis has been observed in many countries with high vaccination coverage. In the United States, reported cases of pertussis in adolescents and adults have increased since the 1980s, despite increasingly high rates of vaccination in infants and children. At the same time, clinical B. pertussis isolates have become antigenically divergent from vaccine strains. This observation has raised the question of whether vaccination has caused selection for the variant strains, and whether the reemergence of pertussis in vaccinated populations is due to vaccination not protecting against these antigenic variants as effectively as it protects against vaccine type strains. On the other hand, vaccine-induced immunity wanes over time, and pertussis is not only a childhood disease but also a frequent cause of prolonged illness in adults and adolescents today.”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294326/

    Finland – 1998…Despite vaccine coverage of 98% both pertussis and para-pertussis outbreaks appeared in Finland. Their conclusion was that, “Bordetella infections are common in an immunized population, and B parapertussis infections apparently are more prevalent than previously documented.”http://jama.ama-assn.org/content/280/7/635.full

    By the way – this is a nationwide problem of product failure that must be taken up with vaccine makers; we should not allow ourselves to be fooled by clever and opportunistic CDC/PHrMA marketing tactics. Forcing a vaccine mandate on citizens of VT or any other state would not have solved the problem of product failure. West Virginia, for example (which allows medical exemptions only), has also had a pertussis outbreak this year.http://www.dhhr.wv.gov/oeps/disease/Documents/WV_HAN_59.pdf

  3. sandy reider MD :

    Dorian Yates is quite right in stating that the pertussis vaccine is not very effective. This current outbreak has nothing to do with unvaccinated children. Does anyone really believe that adding a 7th pertussis vaccination will do anything but shift the next predictable whooping cough outbreak ( they typically occur every 3-5 years ) into a slightly older cohort as the vaccine efficacy rapidly wanes ? The current CDC strategy will require frequent booster shots for both children and adults to be effective in suppressing these outbreaks …. let’s be careful what we wish for !
    Sandy Reider MD

  4. Steven Smith :

    There is a discussion of the issue that I found well reasoned at

    http://www.nejm.org/doi/full/10.1056/NEJMp1209051

    • Lisa Mackenzie :

      At the very end of the discussion are two words in blue print, DISCLOSURE NOTICE. If one clicks through, one finds that Mr. Cherry MD has been a paid as a consultant for Sanofil Pasteur and Glaxo Smith Kline, manufacturers of the pertussis vaccines. Dr. Cherry appears to have been working for them as a consultant to Mexico and Denmark and Latin American organizations since 2009. He is paid to promote their products and has a clear conflict of interest.

      The DISCLOSURE NOTICE of potential conflicts of interest link is here
      http://www.nejm.org/doi/suppl/10.1056/NEJMp1209051/suppl_file/nejmp1209051_disclosures.pdf

      I thought I’d dig a little more and found that an investigation by the Watchdog group and KPBS examined the issue of paid consultants for the vaccine manufacturers
      http://www.kpbs.org/news/2010/dec/15/whooping-cough-experts-rely-vaccine-companies-mone/

      In May of 2012, Mr. Cherry wrote a similar paper that was published by the American Academy if Pediatrics titled Why Do Pertussis Vaccines Fail? It’s here
      http://pediatricsde.aap.org/pediatrics/201205?pg=44#pg44

      • Steven Smith :

        Agreed. Clear conflict of interest. But also a discussion that points out both how far the vaccine is from ideal and how far it is from worthless, that points out the data for and against antigenic drift as the cause of the recent rise in cases, and that acknowledges the low quality of the data we are working from.

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