Whooping Cough Making a Come Back in the US

I have been silent in the blogs as of late due to the pharmacy getting busier but I saw a headline today that I thought I should comment on.  The CDC states that pertussis bacterial infections aka whopping cough has hit a 50 year high in the US.  In Washington state earlier this year the Washington State Secretary of Health declared a pertussis epidemic. Preliminary counts indicate that more than 17,000  cases of pertussis were reported to CDC through July 12, 2012. 10 pertussis-related deaths have been reported during that same time period. The majority of deaths continue to occur among infants younger than 3 months of age.  World wide this disease is still very much a common deadly disease estimated by the World Health Organization to cause 50 million cases and 300 000 deaths occur every year.  Rates in developing countries are estimated to be as high as 4% in infants. 

Pertussis is caused by the bacteria Bordetella pertussis which can cause a highly contagious respiratory disease resulting in violent coughing fits.  The difficulty in getting breaths in between coughs gives the distinct whooping sound upon inspiration.  This disease is spread primarily through respiratory droplets from person to person.  Complications can include apnea (slow or stopped breathing), seizures, pneumonia, cracked ribs from coughing and death.  

Pertussis is a vaccine preventable disease.  This is given in the same vaccine as tetanus and dipherthia.  Children should receive 5 total doses from the age of 2 months to 4 years.  Adults are now recommended getting a booster as immunity wanes over time.  The seriousness of the disease is considerably less for adults but the idea is to prevent the transmission to infants that are most at risk for serious complications.  You might have read about "herd immunity" in reference to vaccine preventable disease.  This is the theory that proposes that if we attain high vaccination rates (depending on the disease but usually stated above 94%) this will significantly reduce the spread and resulting epidemics.  With this vaccine we are woefully short of that goal.  Only 70% of children have received all five vaccinations and adult booster rates are at an abyssmal 8%.  

The low vaccination rate could be a result of several different factors. The awareness of the need of the booster  is most likely quite low.  Anyone that regularly sees a physician would have been asked about vaccinations status and given the dose if needed.  Pharmacists are in a perfect position for education and administering vaccinations outside of a physician's office.  Larger employers should also promote immunization clinics for their employees and families.  

Another possibility is the perception of the unimportance of vaccines.  For some people they may think that since they are healthy and maybe the disease may not be serious as an adult that the vaccine is a waste of time.  Again the increased vaccination rate will lower the transmission rate to those that are most susceptible to the disease.  There are those that cannot be vaccinated due to age or other disease states and we should be interested in protecting those individuals. 

There is also so much misinformation out there about vaccinations.  Anyone educated by Google University will be inundated by false statements, conspiracy theories, pseudoscientific claims and "alternative" means of prevention.  Without getting properly educated on these matters it is very easy to be swayed by arguments that you see on the interwebs.  The fear that vaccinations, particularly the measles, mumps, rubella (MMR) vaccine, cause autism is still very much alive.  Though the physician that stirred things up back in the late 90's has been thouroughly discredited  and epidemiologic studies find no link, this idea persists.  For some reason in this country we seem to care about what celebrities think on issues that they know nothing about.  Jenny Mcarthy of Playboy fame weighs in regulary on this issue and further muddies the waters.  I don't know about you but I prefer my science from scientists not from famous people that are famous for being famous.  It would be like getting my climate change info from Rush Limbaugh which by happenstance is not actually a climatologist at all but tries to play one on the radio.

There is also a perception that some of the vaccines protect against diseases that are no longer an issue.  'Maybe my gradmother was worried about measles, mumps, diptheria, whooping cough but those never happen any more' said the person that is lulled into a false sense of security.  These bacteria and viruses never truly go away but with the advent of vaccines have made them such rare occurences that we lose sight of how serious these diseases can be.  It wasn't that long ago that parents regularly lost children to these diseases.  All of these can come back as we are beginning to see with pertussis if we become lax with proper vaccinations.  Ask your physician or pharmacist for more information and many pharmacies are able to administer the booster shot to adult individuals.

Cheers

Steven Jensen PharmD. owns Jensen's Community Pharmacy in the Oaks Plaza off of East Michigan Ave.

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