Pertussis (whooping cough) Bacterium Changes Itself To Avoid Detection In Those Vaccinated

whooping coughKey Points:
1.  Whooping cough (pertussis) bacterium is evolving and the current acellular vaccines (DTaP and Tdap) are not as effective in providing protection as they were just a few years ago

2.   Those that are vaccinated still are better protected than non-vaccinated, and in general have less severe illnesses than those that are un-vaccinated.

3.   We need a new, safer vaccine against pertussis, hopefully one with much less or no aluminum.

4.   We likely will be seeing many more cases of pertussis world-wide, reflecting the experience in Australia.

This is an important study and is well referenced regarding the changes we are seeing with pertussis around the world.  Here in Portland, Oregon, in my practice alone, we had 20 cases of pertussis during 2013, in all ages from infants to 18 years. Five of the twenty were unvaccinated and the other 15 were in fully vaccinated children. Most (>95%) of my patients are fully vaccinated against pertussis, so the five out of twenty represents a much higher infection rate, with vaccination providing some protection.

Australia has a population of 22 million, and they had 142,000 cases of pertussis from 2008 to 2012. This would be the equivalent of 2 million cases in the USA. Nine babies died during this 5 year period in Australia.  This would be the same as losing about 2 babies in Oregon, 17 in California, or 128 total in the USA from pertussis.  You can bet this would make news and it should. Worldwide, we need to brace ourselves for a possible significant increase in pertussis cases.

The new strains of pertussis no longer have the protein called pertactin, one of the three proteins in the vaccine.  It seems the pertussis bacterium without pertactin avoids our immune system better and also lasts longer for more efficient spread from person to person. 

TAKE HOME MESSAGE:  It will be more important than ever to avoid indoor crowds when you have an infant, get your pertussis vaccination on schedule (some protection is better than none in the middle of an epidemic), and future moms, please get your Tdap before you get pregnant so you can refuse injecting all that aluminum into your body while pregnant.  I still think it unwise to get the Tdap while pregnant.  The developing baby has no protection against aluminum and no studies have been done injecting aluminum into pregnant women or even primates.

The article from the CDC gives extensive details of the data from Australia, as well as references reflecting the experience around the globe. You can read it here…

 

 

Dr. Paul

 

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