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17 Jun, 2014 22:39

California's deadly whooping cough epidemic blamed on anti-vaccine campaign

California's deadly whooping cough epidemic blamed on anti-vaccine campaign

A new outbreak of pertussis - better known as whooping cough - in California has reached epidemic levels. And, as with the recent resurgence in the number of measles cases, an anti-vaccine campaign is being blamed.

Between the beginning of the year and June 10, nearly 3,500 pertussis cases have been reported in California, with over 800 new cases in the past two weeks alone, the California Department of Public Health (CDPH) reported on Friday. Two infant deaths have been reported in the latest epidemic.

“Preventing severe disease and death in infants is our highest priority,” CDPH director Dr. Ron Chapman said in a statement. “We urge all pregnant women to get vaccinated. We also urge parents to vaccinate infants as soon as possible.”

“Infants too young to be fully immunized remain most vulnerable to severe and fatal cases of pertussis. Two-thirds of pertussis hospitalizations have been in children four months or younger,” the statement went on to say.

The disease gets its name from a high-pitched “whoop” of a cough that leaves its victim gasping for air. Infants are most vulnerable to the “100-Day Cough,” but adults can be affected as well, especially if they have not received a booster for the vaccine. Julia Ioffe, senior editor at the New Republic, wrote of her debilitating battle with whooping cough:

At this writing, I have been coughing for 72 days. Not on and off coughing, but continuously, every day and every night, for two and a half months. And not just coughing, but whooping: doubled over, body clenched, sucking violently for air, my face reddening and my eyes watering. Sometimes, I cough so hard, I vomit. Other times, I pee myself. Both of these symptoms have become blessedly less frequent, and I have yet to break a rib coughing—also a common side effect. Nor do I still have the fatigue that felled me, often, at my desk and made me sleep for 16 hours a night on the weekends. Now I rarely choke on things like water, though it turns out laughing, which I do a lot of, is an easy trigger for a violent, paralyzing cough that doctors refer to not as a cough, but a paroxysm.

In 2010, the disease, which is caused by the bacterium Bordetella pertussis, spread across the state of California, with 9,120 reported cases and ten infant deaths. It was the highest spike of pertussis since 1947. At the time, only 91 percent of California kindergarteners had been vaccinated.

A study published in the medical journal Pediatrics in October 2013 laid the blame for the outbreak on an anti-vaccine campaign. The researchers tracked the number of parents who filed for nonmedical exemptions (NMEs) from the state’s vaccination program with reported whooping cough cases. The study discovered 39 statistically significant clusters of high NME rates and two statistically significant clusters of pertussis cases, and found that those within an exemption cluster were 2.5 times more likely to live in an area with an outbreak of whooping cough.

Measles outbreaks (purple) worldwide and whooping cough (green) in the U.S., thanks in part to the anti-vaccination movement. (Council on Foreign Relations), (image from www.latimes.com)

The anti-vaccine movement began in Great Britain in 1998, when physician Andrew Wakefield published a now-discredited study linking the Measles Mumps Rubella vaccine (MMR) with the onset of autism. After being found guilty of “serious professional misconduct” and banned from practicing medicine in the UK due to his fraudulent research, Wakefield moved to Austin, Texas and began his campaign anew. This time, he found a willing ally in former Playboy Playmate Jenny McCarthy. From there, it took hold.

“The movement that was once a fringe freak show has become a menace, with foot soldiers whose main weapon is their self-righteousness,” Ioffe wrote. “For them, vaccinating their children is merely a consumer choice, like joining an organic food co-op or sending their kids to a Montessori school or drinking coconut water.”

Pertussis symptoms occur in three stages, according to WebMD. The first is like a cold, which can last from several days to two weeks. After that, the cough gets worse, and the whooping fits begin. The other cold symptoms get better. This stage can last two to four weeks, or even longer. In the final stage, the cough gets louder and fits still occur, though the sufferer begins to feel better and grow stronger. “This stage may last longer if you have never had the vaccine,” WebMD cautions. “How bad your symptoms are also depends on whether you've had the vaccine and how long ago it was.”

Whooping cough cases have spread rapidly in the United States this year, with a 24 percent increase nationally in the number of cases, compared to January through April of last year, according to the Centers for Disease Control and Prevention.

The CDC recommends adults age 19 and older receive the Tdap vaccine (which also prevents against tetanus and diphtheria) if they have never been vaccinated or to get a booster shot if they have. The agency recommends the DTaP vaccine for children younger than 7, with a booster at age 11.