If you have paid attention to the news here in North Texas, you may have seen reports about an outbreak of pertussis, or whooping cough (as it’s more commonly known) in the Dallas-Fort Worth metroplex. What’s behind this outbreak?
Experts suggest it may be attributed to the recent trend of parents not vaccinating their children.
Why are parents foregoing vaccinations? It may have something to do with the lingering fear that vaccines may contribute to autism.
Back in 1998, a study in the journal The Lancet suggested that vaccines and autism were linked. However, this theory has never been proven since the original study and the journal has since retracted the original paper.
In fact, a recent study suggests that a similar outbreak of pertussis in California back in 2010 may have been caused in part by parents opting out of vaccinating their children.
Could that be true here in North Texas? We don’t quite know yet, but local infectious disease experts say it may be a contributing factor.
Cedric Spak, M.D., an epidemiologist and infectious disease specialist on the medical staff at Baylor University Medical Center at Dallas, says that contrary to popular belief, pertussis never really went away even after the vaccine that prevents it was developed.
Doctors tend to see very small outbreaks every three to five years, but nothing like recent trends.
In fact, the latest statistics say it’s the worst whooping cough outbreak in 50 years. As of Oct. 7, there were 2,652 pertussis cases in Texas, and most of the deaths have been in infants who are too young to be vaccinated.
To give you a comparison, 2012 was the worst year for pertussis cases since 1955, according to statistics.
Vaccines are considered a marvel of modern medicine. They have saved countless lives and prevented mass outbreaks of highly contagious and even deadly diseases like hepatitis, chickenpox, and diphtheria.
Back in the 50’s and 60’s when the polio vaccine was developed, families lined up to get their children immunized. Most of us have probably seen the scars on our parents’ upper arms.
Our grandparents knew all too well the devastating effects of this disease because more than 57,628 cases were reported in children in 1952 which is considered the worst polio outbreak ever: “That year, 3,145 children died, and 21,269 were left with mild to disabling paralysis.”
As a mother, I worry about my child’s health, but I also take for granted how protected he is from diseases my parents and grandparents feared.
My generation (Generation X and the Millennials) has never really experienced a public health scare like polio, measles or pertussis. I don’t know what it’s like to be fearful that my young child could catch a deadly disease through casual contact like coughing and sneezing.
And maybe that’s part of the problem. Have we become too complacent?
Dr. Spak says we may be practicing “individual health” and not “population health” like generations before us.
But what’s the difference between these two concepts?
Individual health is the equivalent of a parent who forgoes vaccinations because their child once developed a mild fever after receiving the pertussis vaccine. Therefore, they may think it was an inconvenience and harmful to their child’s health.
Actually, this is a normal response to a vaccine, and it means the immune system is responding well to it.
They may also have gotten a cold coincidentally around the same time. A mild fever is nothing compared to the symptoms of a potentially deadly disease like pertussis, explains Dr. Spak.
“Population health is when a person chooses to be vaccinated not only to protect themselves, but to protect the population as a whole. They do it for the ‘greater good’ so to speak regardless of the side effects like a sore arm or mild fever.”
But many parents these days assume that most of the diseases we vaccinate for are eradicated anyway so what’s the point in vaccinations?
“If everyone else is vaccinating their kids does it really matter if my child skips it? Won’t they be protected anyway?” Not necessarily, according to Dr. Spak.
“Children’s immune systems, especially young children under the age of 10, constantly change due to the maturation of the thymus organ which is located in the thoracic cavity above your heart,” explains Dr. Spak.
This organ is a special part of the immune system that changes dramatically throughout childhood to produce T-cells which are a key part of the body’s immune response.
A healthy thymus is one that has been exposed to infections and become stronger over time. That’s how vaccines work—they prime the body to prevent illness without giving an infection, said Dr. Spak.
“For example, a vaccine a child received at three-years-old may have worn off by the time they are nine due to this process. That’s why “booster” shots are so important. Boosters help rebuild immunity to certain diseases so that the child stays protected for a longer period of time.”
For example, Dr. Spak depicts a very realistic scenario to illustrate how this works.
Imagine a nine-year-old child, a fourth-grader whose parents have followed all the immunization guidelines. This child has been protected from pertussis for most of his life; however, one of his classmates has never been vaccinated because his parents feared that vaccines may cause autism.
The unvaccinated child contracts pertussis and develops a severe cough that lasts about three weeks. He still attends school because his teacher, family and classmates all assume he has allergies or a lingering cold.
The vaccinated child is not due for a booster shot until he is 10 years old, but little do his parents know that his initial vaccine has already worn off due to changes in his thymus organ.
If everyone else had vaccinated their child, this nine-year-old could theoretically be protected during this small window of time by what is known as “herd immunity.”
Everyone else around him is vaccinated so the risk of him contracting pertussis is very low. However, he sits next to the unvaccinated child in the class and therefore catches pertussis very easily.
The vaccinated child then misses up to 40 days of school and spends several days in the hospital because pertussis affects him more severely. He ends up behind in his school work and his parents have used up most of their vacation time at work to take care of their sick child.
“That’s the interesting part about diseases like pertussis. They affect everyone differently so one person may not develop the same degree of illness. This is true for all viruses as well, including cold and flu for example,” adds Dr. Spak.
There have also been reports that a pertussis vaccine given in the 90’s may not have been as strong as vaccines in the past. Therefore, it’s important for adults to be vaccinated as well.
PREGNANT WOMEN AND INFANTS
For younger children such as infants, pertussis can be extremely deadly. In fact, it almost always is, according to Dr. Spak.
That’s why the CDC recommends that pregnant women receive a pertussis vaccine in their third trimester to help protect themselves and their unborn baby.
“Once the baby is born, they are protected from pertussis for about the first two weeks of their life if the mother has been vaccinated. If the mother chooses to breastfeed, they will receive even more of the mother’s immunity until the time of their first pertussis vaccination at about two months old,” explains Dr. Spak.
The CDC also recommends that grandparents, anyone visiting the baby, caregivers, and those in close contact with the child in the first few weeks of life, should also receive the pertussis vaccine.
Grandparents take note: If you plan to visit your newborn grandchild check with your doctor to make sure you have immunity to pertussis. This can be checked by a simple blood test. If you don’t have immunity, go ahead and get the vaccine at least two weeks prior to visiting your grandchildren. This should give enough time for the vaccine to kick in.
As an expectant mother who is currently eight months pregnant, I have already received my pertussis vaccine as an extra precaution. I have also had a conversation with my parents to make sure they are aware of the CDC recommendations.
Even if the odds are in my favor, it never hurts to take extra precaution. To me, it’s not worth the risk especially when vaccines for diseases like pertussis are readily available and easy to come by.