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Entries in Whooping Cough (6)

Wednesday
Sep122012

Whooping Cough Vaccine Protection Short-Lived, Study Warns

iStockphoto/Thinkstock(OAKLAND, Calif.) -- Protection against whooping cough declines during the five years after the fifth dose of vaccine is given to 4- to 6-year-old children, a new study suggests -- leading some experts to urge teens and adults to make sure they are up to date on all recommended booster shots.

An outbreak of whooping cough in California led experts to conclude that the current diphtheria, tetanus, acellular pertussis (DTaP) vaccine for children has not worked as well as the older version from nearly two decades ago, according to the study in Thursday's New England Journal of Medicine.

Whooping cough -- formally called "pertussis" -- is deadly for infants, with outbreaks occurring every few years despite vaccinations.

"We found that the effectiveness of the vaccine wanes 42 percent on average each year during the five years after the fifth dose," said Dr. Nicola Klein, the study's lead author and co-director of the Kaiser Permanente Vaccine Study Center in Oakland, Calif.

A new and longer-lasting vaccine has yet to become available.

Until then, "the current vaccine is safe and effective; it just doesn't last as long as we would like," Klein said. "And parents should know that some protection is better than no protection."

A tetanus booster shot is recommended starting around age 11 or 12 -- about five years after administration of the fifth dose. Health care workers, individuals age 65 or older, pregnant women and anyone with exposure to infants should get a booster shot, according to the U.S. Centers for Disease Control and Prevention.

As of Aug. 11, 46 states and Washington, D.C., reported increases in whooping cough compared with the same time period in 2011, according to CDC statistics. Provisional counts from the CDC's surveillance system showed that nearly 25,000 cases of whooping cough were reported through Aug. 24, with 13 deaths noted.

The majority of deaths continue to occur among infants younger than 3 months of age. The incidence rate among infants surpasses that of all other age groups. The second highest rates of disease are seen in children ages 7 through 10. Rates are also increased in 13- and 14-year-olds, according to the CDC.

In many states, five doses of the whooping cough vaccine are mandatory before a child enters school, Klein said. The first three doses in the series are typically given when an infant is 2 months, 4 months and 6 months old. The fourth dose is generally administered between the first and second years of life, usually at 15 months. And the fifth dose is recommended between ages 4 and 6, typically before kindergarten.

Despite the requirements, a large outbreak of whooping cough occurred in California in 2010 -- its peak incidence since 1958. The outbreak spurred Klein and colleagues to measure the degree to which protection wears off over time in school-aged children who had received the most recent version of the vaccine.

While this study focused on school-aged children in northern California, localized outbreaks of whooping cough have occurred elsewhere as well. In April, an epidemic was declared in Washington state. Other states with high rates of the disease this year included Wisconsin, Montana, Minnesota and Colorado, the CDC reported.

The disease tends to begin with cold-like symptoms and perhaps a mild cough or fever. A severe cough can take over one to two weeks after disease onset. Unlike the common cold, though, coughing fits can persist for weeks, until air has left the lungs and a loud "whooping" sound accompanies attempts to inhale.

An older form of the vaccine offered longer protection, but it was linked to more cases of fever and injection-site reactions. What's needed is a stronger vaccine.

On a positive note, "the findings have raised the attention of the manufacturers," Klein said of the study she led.

She hoped the results would encourage the development of more effective alternatives.

"Prevention of future outbreaks will be best achieved by developing new pertussis-containing vaccines that provide long-lasting immunity," the authors concluded in the study.

Copyright 2012 ABC News Radio

Tuesday
Jul312012

Whooping Cough Vaccine Too Weak to Protect Against Disease?

iStockphoto/Thinkstock(QUEENSLAND, Australia) -- The United States might see the highest number of cases of whooping cough in more than five decades this year, possibly caused by a weaker vaccine, many experts say.

The Diphtheria, Tetanus, acellular Pertussis (DTaP) vaccine for children has not been as effective in protecting against whooping cough as the older version that was available nearly two decades ago, according to a study published Tuesday in the Journal of the American Medical Association.

Almost 20,000 cases of whooping cough, also known as pertussis, have been reported so far in the United States, compared to nearly 8,579 cases seen this time last year, according to the U.S. Centers for Disease Control and Prevention (CDC).

As many as 95 percent of whooping cough cases might result from the waning immunity of people who were initially vaccinated but have not gotten the booster vaccine, according to Dr. William Schaffner, chairman of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn.

The original vaccine, which contained a small amount of inactivated whole bacteria, was a crude form that brought with it side effects like fever and swelling at the injection site, but it was considered lifelong lasting at preventing the disease. In the late 1990s, it was substituted for a so-called cleaner vaccine that only used small particles of the bacteria and was considered safer but might not be as effective long term.

"That makes getting the booster shot more important," Schaffner said.

The government recommends that children get vaccinated in five doses between ages 2 month to 6 years. Children around age 12 are recommended to receive a booster shot.

"Despite its efficacy, it looks that over time some of the protection does start to wane and decrease," said Dr. Charles Foster, staff physician in the Center for Pediatric Infectious Diseases at the Cleveland Clinic.

Even the booster shot might not as effective in warding off whooping cough among older teens and adults, according to the CDC. In some cases, older teens who contracted the disease had received their booster, the agency told ABC News. Increasing rates have been seen in 13 to 14 year olds, who would have received their booster about two years prior.

"No vaccine is 100 percent effective," Foster said.

The body's immune response wanes over time. And if there's no exposure to this vaccine after a few years, then the protection might decrease, Foster said.

"But there's pretty good data that the vaccine is mostly effective in patients who have the full course of the vaccine," he said.

A spokesman for GlaxoSmithKline, the company that makes the vaccines, says the company has reviewed the number of cases of pertussis this year.

"We are not in a position at this time to draw specific conclusions from the data, but we anticipate working closely with the CDC and other public-health authorities to fully understand what factors may be contributing to the increased incidence of pertussis currently being seen in Washington and to a lesser extent in other states in the U.S.," the spokesman said in a written response to ABC News on behalf of the company.

In the study published in the Journal of the American Medical Association, researchers in Queensland, Australia, looked at 58,000 children who either received series of shots with the old vaccine, a full series of the current vaccine, or a combination of both between 1999 and 2011. One-hundred twenty-three children who received the series of the current vaccine developed whooping cough compared with only 90 children who received the full series of the old vaccine. Those who received the combination of doses seemed to have the highest protection, the study found.

"The challenge for future pertussis vaccine development is to address the benefit-risk, trade-off highlighted by our study, and to develop vaccines that induce long-lasting protection from the first dose, without the adverse events associated with DTwP [old vaccine] use," the authors wrote.

Even with the study findings, some experts aren't convinced that a revival of the old vaccine or a new combination vaccine might be a better alternative.

"There are benefits and risks and you have to balance the two," said Foster, who cited weighing the risks between adverse events of the old vaccine against the waning immunity of the current.

Vaccines requiring a booster shot are no less effective than other kinds of vaccines, Foster said.

"The current vaccine is still effective and people need to make sure children are up to date in the series of vaccines and teens, adults, and pregnant women get the pertussis vaccine," he said. "Vaccination remains the best way to prevent pertussis."

Copyright 2012 ABC News Radio

Friday
May042012

Emergency Funds Released to Curb Whooping Cough

Office of Gov. Chris Gregoire(OLYMPIA, Wash.) -- Washington Gov. Chris Gregoire is tapping into emergency funds to help contain a whooping cough epidemic spreading throughout the state. The $90,000 in crisis cash will be used to boost vaccination awareness.

“These actions will help state and local health leaders get vaccine into people’s arms so we can stem the tide,” Gregoire said Thursday in a statement.

Washington has seen more than 1,130 cases of whooping cough this year, up from 117 cases in the same stretch last year.

“I’ve been following the epidemic closely and the continued increase in cases has me very concerned about the health of our residents. I’m especially concerned about the vulnerable babies in our communities that are too young to be fully immunized,” Gregoire said.

Whooping cough is the unofficial moniker for pertussis, a contagious bacterial infection that causes uncontrollable coughing interrupted by whooping gasps for air. The infection is preventable with the dTap vaccine, a series of five shots that boost immunity against diphtheria, tetanus and pertussis.

The first dose of dTap is given two months after birth, making infants particularly vulnerable to whooping cough from unvaccinated adults. About 75 percent of newborns who come down with whooping cough catch it from a family member, studies found.

“Pertussis is very serious, especially for babies. It’s vital that teens and adults are current on their immunizations because they’re often the ones who give whooping cough to babies,” state Secretary of Health Mary Selecky said in a statement.

The state Department of Health has pledged an additional $210,000 to the vaccine awareness effort.

“In my 13 years as secretary, this is the first time I’ve had to use the word ‘epidemic’ about disease in our state,” Selecky said. “We’re headed for unprecedented numbers of cases. We’ve got to keep spreading the word to help prevent the spread of illness.”

The U.S. Centers for Disease Control and Prevention has approved the redirection of federal funds designated for other immunizations to buy more than 27,000 doses of pertussis vaccine for adults who are uninsured or underinsured, Gregoire said.

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Copyright 2012 ABC News Radio

Thursday
Mar292012

Washington State Hit Hard by Whooping Cough

iStockphoto/Thinkstock(OLYMPIA, Wash.) -- Whooping cough is spreading throughout the country, and now the extremely contagious bacterial disease that causes violent coughing is hitting the state of Washington particularly hard.

Numbers released this week show that whooping cough cases have risen to 549 in 2012.  At this time last year, there were 88 pertussis cases in the state, said Tim Church, communications director of Washington’s Health department.  The annual number of cases will likely exceed the 950 yearly total that the state saw in 2011.

“We’re seeing a nasty streak in pertussis cases and we’re absolutely concerned about it,” Church told ABC News.

Church said kids need to be protected on both sides, and the health department is encouraging all parents and adults to make sure they’re up-to-date on their vaccinations.

“The vaccine we get as children typically wears off as an adult,” said Church.  “You’re no longer immune, and, if you do get whooping cough, the folks around you are in danger, as well.”

Doctors typically give whooping cough patients five days of antibiotics.  Health officials encourage the entire family of the patient to go on antibiotics, as well.  But more importantly, get vaccinated, they say.  The dTap vaccine, a shot that prevents diphtheria, tetanus and pertussis, is readily available to the public.

Church said the health department is currently on a media blitz to make sure the public is aware of the rising pertussis cases.

“We are working on a radio PSA announcement and aggressively reaching out to media,” said Church. “We have had calls with local health departments to make sure we’re all on the same page and we’re providing additional information to health care providers and centers on the vaccine.”

While people of all ages can come down with whooping cough, even if they’ve been vaccinated, it’s particularly dangerous for newborns’ systems because they don’t have the immunity or vaccine to fight off the infection.  Studies show that about 75 percent of newborns that come down with whooping cough get it from a family member.  Of all deaths from pertussis between 2004 and 2008, 83 percent were children less than 3 months old.

Because of the high rate of whooping cough in infants, the Centers for Disease Control and Prevention recently recommended that pregnant mothers get vaccinated with dTap.

Copyright 2012 ABC News Radio

Tuesday
Dec062011

Whooping Cough Hits Hard in Illinois

Hemera/Thinkstock(CHICAGO) -- Whooping cough continues to spread throughout the U.S., with the collar counties of Illinois hit particularly hard by the contagious bacterial disease that causes violent coughing.

As of Monday, nearly 500 cases had been reported in McHenry, DuPage and Lake counties in Illinois, the Chicago Tribune reported, but health officials say that cases are likely much higher due to many people who will go undiagnosed. Thirty to 40 new cases around the state are being reported each week.

“This is a vaccine-preventable illness,” Debra Quackenbush, spokeswoman for the McHenry County Health Department, told ABC News. “Parents should make sure children are up-to-date on their vaccinations. If you have a cough that seems to linger and it doesn’t seem to go away, get it checked out by the doctor just to be sure.”

Quackenbush said 172 cases of whooping cough have been reported in McHenry County, Illinois, and she expects that number to continue to grow. The number is a stark contrast to the nine cases that Quackenbush said the county recorded all of last year.

If a person comes down with whooping cough, doctors will give the patient five days of antibiotics. Health officials encourage the entire family of the patient to go on antibiotics, as well. But more importantly, get vaccinated, they say. The counties have made the tDap vaccine, a shot that prevents diphtheria, tetanus and pertussis, readily available to the public.

Quackenbush said it’s hard to say why the collar counties have been hit so hard this year, but it’s likely a combination of factors.

“Some people aren’t vaccinating their children,” said Quackenbush. “They try to skate by without vaccines, but what people don’t realize is that, at the beginning of the 20th century, thousands of people died from this particular illness. These vaccines save thousands of lives.”

Nearly a dozen states recently passed laws that require parents to prove that their middle and high-school aged children received a whooping cough vaccination. The law was prompted by a whooping cough outbreak that killed 10 babies and sickened about 9,000 people last year in California.

While people of all ages can come down with whooping cough, even if they’ve been vaccinated, it’s particularly dangerous for newborns’ systems because they don’t have the immunity or vaccine to fight off the infection. Studies show that about 75 percent of newborns that come down with whooping cough get it from a family member. Eighty-three percent of all deaths from pertussis between 2004 and 2008 were in children less than 3 months old.

Because of the high rate of whooping cough in young infants, the Centers for Disease Control and Prevention recently recommended that pregnant mothers get vaccinated with Tdap.

Copyright 2011 ABC News Radio

Friday
Dec022011

Newborn Nearly Dies After Contracting Whooping Cough

Dr. Lisa Farkouh(DENVER) -- Leena was born a happy, healthy baby, but two weeks into her life, she developed a severe cough.  Doctors told her mother, Dr. Lisa Farkouh, that Leena only had a cold, but the symptoms continued and worsened.

After a battery of tests and a cough so severe that it would leave Leena unable to breathe, she was diagnosed with whooping cough -- an extremely contagious bacterial disease that causes violent coughing -- and pneumonia at 6 weeks old.  She was admitted into the neonatal intensive care unit.

"Death rates are so high in babies who get whooping cough because they have no immunity and they haven't started their vaccinations," said Farkouh, a maternal-fetal medicine specialist at Presbyterian-St. Luke's Medical Center in Denver.  "She coughed for six months, but luckily she's now a healthy 2-year-old.  My concern is that other babies out there won't be as lucky."

Whooping cough is a highly contagious upper respiratory bacterial infection that causes violent and uncontrollable coughing.  The disease is easily spread from person to person when tiny droplets containing the bacteria move through the air.

Farkouh said she has racked her brain trying to figure out how Leena contracted whooping cough.  She said the baby was not exposed to unhealthy people who visited.  She assumes that someone in the community exposed Leena to it.

Dr. Anne Gershon, director of pediatric infectious disease at Columbia University Medical Center, confirmed Farkouh's belief that babies often come down with whooping cough, also called pertussis, through others in the community.

"These days, adults are getting pertussis and some doctors are unaware of this or don't think it is possible for an adult to have this infection," said Gershon. "Today, a lot of pertussis probably spreads from teenagers and adults who have lost immunity to this infection. We have also come to realize that having had pertussis once in the past does not necessarily mean that it won't occur again."

Farkouh, who has become an advocate for whooping cough vaccinations, said pertussis, the medical term for whooping cough, saw a 2,000 percent increase in the U.S. in 2010.

In response to the push for vaccinations, California and nearly a dozen other states recently passed laws that require parents to prove that their middle and high school aged children received a whooping cough vaccination.  The law was prompted by a whooping cough outbreak that killed 10 babies and sickened about 9,000 people in California last year.

Copyright 2011 ABC NEws Radio







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