Deadly Whooping Cough, Once Wiped Out, Is Back | Hacker News Reader

Deadly Whooping Cough, Once Wiped Out, Is Back

npr.org

29 pointscwan39 comments

I just want to highlight this part of the article for people who are about to close their window without reading it:

>The California epidemic has raised plenty of questions about the role of vaccination and the increasing numbers of parents who decide not to vaccinate their children. California’s Department of Public Health cites three schools in the state where 80 percent of parents have signed a “personal belief exemption” to keep their children from being vaccinated.

That just blows my mind.

I seriously can’t understand how these vaccinations aren’t mandated by law without exception. The point of vaccination is to protect public health from devastating communicable diseases, just like the point of fire codes are to protect the community from fires that could easily spread from building to building and destroy an entire city. It’s like being able to sign a ‘personal belief exemption’ saying you don’t believe in fire codes in order to exempt your house from them. I’m largely a libertarian, but I certainly don’t want my neighboring houses to all be firetraps.

> It’s like being able to sign a ‘personal belief exemption’ saying you don’t believe in fire codes in order to exempt your house from them.

More like exempting your office building from them.

The "personal belief exemption" should involve being quarantined with the other idiots who refuse vaccinations. At 80%, some neighborhoods seem to already be volunteering for that role.

I don't thing the metaphor holds up. If you vaccinate your child, why do you care if other children are vaccinated or not? Your kid is immune...

Many vaccines can only be given to older children.

Babies can not be vaccinated, and they rely on the fact that everyone around them is vaccinated and can not give them the disease.

I'll just quote Science-Based Medicine (http://www.sciencebasedmedicine.org/?p=516):

"The decrease in the number of disease carriers is vital to the prevention of bacterial infections. Vaccines are never 100% effective. Some people are genetically unable to respond to the vaccine, some have immunodeficiencies that preclude receiving vaccines or developing a response to the vaccine, some haven’t gotten around to vaccination or are too young to receive a vaccine. If you vaccinate a large number of people, besides preventing disease in an individual, it helps protect the vulnerable in a population. Vaccines prevent disease propagation."

"The vaccine [for whooping cough] is good, but not perfect. Vaccine efficacy is 64% for cases defined by mild cough, 81% for paroxysmal cough, and 95% for severe clinical illness (11). Note the vaccine is good for attenuating the disease, not preventing it entirely."

In addition to the point skoob makes, there are also the considerable economic and societal costs of an epidemic. These costs are borne by the society as a whole, and therefore the society as a whole has a prerogative to minimize contagious epidemics.

By your same reasoning, the Holocaust should not matter to you as long as you’re not a Jew or a homosexual. The point is that mass sickness has an appreciable effect on you even if you don’t contract the illness yourself.

boo Godwin.

This is the most important reason why: http://danamccaffery.com/

This is a pretty famous case in Australia, their baby died of whooping cough which she was too young to be vaccinated against which she caught due to poor vaccination rates in their area. They went public with what happened on national TV which drew the ire of a anti vaccination lobby group called AVN (i refuse to link them) which then pursued them publicly and privately to disprove or retract their statements.

The Health Care Complaints Commission is now investigating the AVN for breaches of the health care provider code but as with most government organisations it takes time.

Two reasons:

1: Vaccines have negative side effects, fire codes don't (except cost, but that doesn't count).

2: You can not force people to accept medical treatment. And if you change the policy you are going down a VERY slippery slope. Can you force a sex offender to take anti-testosterone injections? Can you force someone with bi-polar disorder to take a drug? What about someone with a mental illness who can not stand trial - can you forcibly medicate them?

To your second point, in some circumstances you can force someone with bipolar disorder to take a drug (Washington v. Harper) and you can force someone with a mental illness to take medication to make them competent to stand trial (Sell v. US).

>in some circumstances

It is very important to note that this only applies when a defendant is a danger to self or others. You cannot force a person with bipolar disorder to take medication if they have not committed a crime, or if they are not a danger.

Both cases also deal only with persons incarcerated- as opposed to "free".

False. Dr. Sell of Sell v. US was not a specific danger to others, his case deals with forced medication to restore competency to stand trial (for a serious crime) in the absence of danger to self or others. You are right, though, that he was in custody because he had been charged with a crime.

Vaccines are not an entirely personal choice. Many children can't be vaccinated due to an allergic reaction, and some vaccines require a series of injections before immunity is acquired. What saves them is herd immunity. Enough people have chosen not to vaccinate that herd immunity is being lost and these kids are at risk. What about their right to life?

In a political climate where one party's most frequently used phrase is "ram down our throats", this would just fuel the fire even more.

Especially with the momentum the Tea Party movement has.

I contracted whooping cough about 5 years ago at the age of 29. I had no idea what was wrong with me and it took 3 doctors to diagnose it correctly. I can't totally fault the doctor's diagnosis on the initial visit. When you have someone come into your office in late October in Minnesota complaining of coughing and respirator pain, it's probably something pretty common. I was on several different medications for 5 weeks. I would start to feel better while on the medication and then get worse when I finished the medication. At no time did the medication help completely, and my condition worsened at time went by. I had several chest x-rays and they all came back clean. The third doctor I visited finally took interest in my case and expanded the tests and came back with a diagnosis of whooping cough. After I found that out and did my own research (which include listening to sound clips), I knew it was the correct diagnosis. I had a 11-month old son at the time and my main concern was that he would contract it also. Thankfully, that never happened. It took me about 5 months before I was completely healed. I wouldn't wish that disease on my worst enemy. Every time you go into a coughing fit, you feel like you are going to die. I blacked out 3 times from coughing fits. They come up on you very fast and are very intense and uncontrollable. I also lost my voice for about 4 weeks. My advice is to get yourself (and your children if you have any) vaccinated...yesterday!

I upvoted you for the personal account. I live in Sydney, Australia and our area currently has a whooping cough outbreak.

I'm only aware of this because we have a 3 month old son. When we were making out antinatal visits to the hospital there were whooping cough awareness signs everywhere.

We both had tests, I had the antibody but my girlfriend didn't, so she had the vaccination.

I had whooping cough when I was very young, so young I don't remember it at all. But thanks for highlighting your experience.

Beyond the photocopied flyers on the walls in the hospital, I know nothing about whooping cough (and until just now I didn't even realize it was a serious illness) and I'm pretty sure the general public doesn't either.

You can help kill Whooping Cough again. Get a DTAP booster.

Your GP can give it to you, or if you happen to be in San Francisco there's a clinic at 101 Grove Street that will give you the shot for just $10.

Thx for that tip -- I may just bike over there.

How did it die in the first place? Is there conclusive evidence that it was the vaccination and not just due to a cumulative effect of better hygiene, better diet and better living conditions? And when and how did it resurrect itself? These questions need to be answered, because if there was an incorrect assumption in any of the previous answers, the current solution may not be as good as we'd hope...

"And when and how did it resurrect itself?"

Immigration and tourism from countries with less vaccination.

Combined with reduced vaccination in the US.

That's right ($35 for most folks, $10 for people with very young kids), they're doing walk-ins for the pertussis booster right now (http://sfcdcp.org/pertussisiz.html). Everyone under 1 or with a kid under 1 (including pregnant women) should get the shot ASAP.

http://sfcdcp.org/AITCcontact.html:

Mon, Wed, Thurs, Fri 9:00 am - 4:00 pm Tues 9:00 am - 3:00 pm

Can we rename it "Jenny McCarthy Whooping Cough"?

If you think that is scary, this is what I think is scary:

http://www.nytimes.com/2010/08/12/world/asia/12bug.html

More and more bacteria are finding the route to antibiotic resistance, MRSA is already quite a problem in some areas causing patients transferred from one hospital to another to be quarantined on the off chance they might be carrier.

The whooping cough is a serious risk to infants but mortality for adults is quite low.

I've actually had MRSA. For many cases they just use different antibiotics for it, combined with physically cleaning the infection site. Mine was small, but my mom had a much larger infection which simply took more time and effort to apply similar techniques. (Fun fact: walking into a student health clinic with a MRSA sore on your arm, walking to the nurse's desk, holding up your arm and asking "what's this?" will get you seen very promptly!)

Turns out the primary treatment for antibiotic-resistent bacteria is to use older antibiotics. Bacteria only become resistant to antibiotics that have recently been used--antibiotics that have fallen out of use, there's no evolutionary pressure for bacteria to remain resistant to, so within a number of generations of not encountering that antibiotic, bacteria are suddenly vulnerable to it.

The medium term solution is to have between 4 and 6 generations of antibiotics, so hopefully we can just cycle around them as the bacteria catch up. Antibiotic resistance is nothing new, it's just another problem to be solved. NDM-1 may or may not be a major curveball. Personally, until I know for sure, I'll leave the worrying up to the people whose job it is to worry about such things and try to avoid going to India for any elective surgeries anytime soon.

Never heard of a booster for this. Will ask at my next physical.

Everyone should be vaccinated against stupidity, a.k.a. that thing called education.

Sigh. Whooping cough back because everyone's afraid of the non-threat of vaccines. Bed bugs back because everyone's afraid of DDT.

Uninformed wusses are killing us all.

I avidly read this as another antivax story, but it doesn't seem to be one; rather, the issue here is that adults need to get DTAP boosters. Who knew? Not me.

Apparently that's new: in the US at least, Tdap was only approved in 2005, and replaced Td (the previous standard bundled tetanus/diptheria every-10-years booster) in most recommendations/clinics around 2006-2007. So adults who haven't had a tetanus booster in the past 3-4 years didn't get the one that includes whooping cough, and probably don't even know about the change (I got my last booster in 2003, and didn't know that it was different now).

... And now I understand why my doctor gave me a tetanus booster last month without even asking if I had had one in the last ten years. (I think I have, but I'm not sure, and I never turn down free tetanus boosters if the doctor offers one.)

It's both. There's a cluster of "crazy hippy" people in and around Marin who are convinced vaccinations are responsible for every modern ailment. I've met, and tried unsuccessfully to reason with a few of them.

The DTAP booster may be our best shot (haha) at routing around them though. Even if they won't vaccinate their children, if enough adults get regular DTAPs we might be able to get enough herd immunity that whooping cough dies out again.

I know it's not as simple as "the tea party, pro-ignorance, anti-science, pro-middle-ages movement is responsible for this." But there is no doubt in my mind that the rise of anti-vaccine ignorance played a good part.

I understand where you're coming from, but the anti-vaccine people I've met tend not to be tea-party types. They're hippies. Very liberal, and often convinced that the "medical establishment" is out to get them.

The tea-party I've met are not anti-vacine. In fact, most of them have a very ill opinion of those "hippies ignoring their doctors".

Comparing vaccines to DDT seems backwards to me.

Perhaps we're more afraid of DDT than we should be, but DDT is moderately toxic and has a soil half-life of up to 15 years. (Compare this to a few weeks for Malathion or a few months for Glyphosate.) Bed bugs suck, but they never killed anybody.

Compare this to measles or whooping cough where the vaccine is very safe and the diseases can permanently scar or kill victims.

Bed bugs never killed anybody, but malaria sure does. There are definitely areas of the world where the net positive action for human well-being is a liberal application of DDT.

And they never stopped doing surface application of DDT.

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