Whooping cough cases rising in U.S. as vaccine weakens over time

[Guest guest]

" Whooping cough can be fatal to infants under 6 months and health officials

worry the rise of pertussis around babies makes them more susceptible before

they start to get shots at age 2 months. From 1979 to 2002, 128 people died

from whooping cough, 117 of them were under 1 year old. "

Well, if babies are breastfed, they'll receive protective antibodies from

mum and won't need the shot. Wonder how many of these 117 under 1 year old

were breastfed?

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http://www.kentucky.com/mld/kentucky/news/breaking_news/11367693.htm

Whooping cough cases rising in U.S. as vaccine weakens over time

BY SETH BORENSTEIN

Knight Ridder Newspapers

COLUMBUS, Ohio - (KRT) - Whooping cough, a disease Americans figured they

whipped with the modern medical miracle of childhood vaccinations, is

soaring again throughout the nation in numbers not seen in decades.

When pediatric infectious disease specialist Dr. Dennis Cunningham of

Children's Hospital here tells parents that their child has whooping cough,

something he has been doing a lot lately, they often ask him: " They still

have that around? "

Down to barely 1,000 cases in 1976, pertussis - the scientific name for

whooping cough - steadily rose in 1980s and 1990s in America. Then it

jumped, first to 9,771 in 2002 and then to 11,647 in 2003. Preliminary

numbers for last year showed the case almost reached 19,000.

This year, even though it's not high season yet, whooping cough cases are

nearly double last year's level. It's on a pace to pass 37,000 cases. In the

first 12 weeks of 2005, there have been 3,445 whooping cough cases - more

than in 1981 and 1982 combined.

Scientists believe that the disease is infecting adolescents whose childhood

vaccinations are wearing off, so this spring federal health officials are

expected to approve and then recommend a new booster shot for young teens.

" Pertussis is a substantial public health problem in the U.S., " said Dr.

Broder, a Centers for Disease Control and Prevention medical

epidemiologist specializing in infectious childhood diseases.

It's hitting the heartland hardest. Kansas, Indiana, Wisconsin, Iowa, North

Dakota and Ohio have all seen large numbers of whooping cough recently.

Whooping cough can be fatal to infants under 6 months and health officials

worry the rise of pertussis around babies makes them more susceptible before

they start to get shots at age 2 months. From 1979 to 2002, 128 people died

from whooping cough, 117 of them were under 1 year old.

And most cases of whooping cough go undiagnosed.

" The amount of pertussis that is out there is underestimated by a very large

extent by our ability to recognize and treat the disease, " said CDC's

childhood infectious disease chief Dr. Trudy .

Ohio has been hit the hardest of any state this year with 441 cases so far,

more than the entire year of 2003. And Columbus' lin County has more

whooping cough than any other county.

" It's nowhere near slowing down in the community, " Cunningham said.

For awhile the lab at Children's Hospital in Columbus confirmed about 20

positive pertussis tests a day, and there was always an infant or two

fighting for breath and life in the neonatal intensive care unit, Cunningham

said.

The same week in March that Broder was lecturing public health officials at

an immunization conference about the renewed dangers of whooping cough, her

boss, CDC director Dr. Gerberding, pronounced that the United States

had essentially conquered German measles. Polio and measles have also been

vanquished in America with vaccines.

" It's the only vaccine-preventable disease that's increased in the last 10

years, " said Iowa state epidemiologist Dr. Quinlisk.

The major problem is that unlike other childhood diseases that have

vaccines, whooping cough's shots seem to wear off, after about five years.

Young children get a series of immunizations that go until about 6 years

old. But now public health officials realize that the immunity for whooping

cough wanes, unlike the lifelong protection we get from polio or German

measles shots. Even if you get whooping cough once, you can get it again,

unlike other diseases.

For many years, doctors didn't realize that pertussis immunity weakened.

" People were so pleased and the success was so great (from the vaccine,

which reduced the disease from hundreds of thousands of cases a year) that

there was a lack of interest in pursuing these very difficult questions "

about immunity waning, CDC's said.

One top expert in whooping cough, UCLA pediatrics professor Dr. Cherry

said waning immunity is one issue, but he also attributes the increase to a

change in vaccines about 15 years ago. The old whooping cough vaccine was

made from whole cells, but had problems with reactions, the new vaccine is

made from parts of cells so they don't produce as severe a reaction, he

said. However, he said the newer vaccines are slightly less effective.

CDC officials don't buy that explanation. They say the massive increase in

whooping cough is primarily in adolescents who have gone at least five years

since their shots, which is explained by waning immunity. Adults also are

getting whooping cough, but it often goes undiagnosed.

Last month, a Food and Drug Administration advisory committee recommended

the approval of two pertussis booster shots for teens, replacing a

tetanus-diphtheria shot with a combo tetanus-diphtheria-pertussis

vaccination.

Next month, the FDA is expected to approve the use of boosters and a month

later the CDC's immunization advisory panel will then likely recommend it

for teens. If it works after that, adults may get boosters years from now,

officials say.