Hundreds of UC Berkeley students and employees lined up outside the campus health center Thursday for free vaccinations after a mumps outbreak infected up to 20 students.
A spokeswoman for the health center said the university and state public-health officials expected to vaccinate more than 1,000 people by the time the clinic closed at 6 p.m. The university will hold another free clinic from noon to 6 p.m. Oct. 14.
The state Department of Public Health was monitoring the rare outbreak this week. A department spokesman said he had no update on the number of students infected. Seven cases had been confirmed and 13 other students were being tested.
Although health officials initially wondered whether the outbreak started with students who had not been vaccinated, a spokeswoman for the city of Berkeley said all the patients had received the two recommended doses before becoming ill.
Source: Contra-Costa Times, 7th October 2011.
DeVries et al. (June 16 issue)1 describe a patient with vaccine-derived poliomyelitis. We were unable to clear chronic, asymptomatic, neurovirulent poliovirus infection in a similarly antibody-deficient patient despite the use of antiviral therapy, breast milk, and oral immune globulin.2 In our patient, the mean IgG trough levels were 1000 mg per deciliter, and paralysis did not develop during an estimated 29 years of poliovirus infection. Neutralizing antibodies against his own poliovirus isolates were detected in his replacement immune globulin by the National Institute for Biological Standards and Control.3 In the patient described by DeVries et al., the IgG trough levels were 438 and 648 mg per deciliter before the onset of paralysis, and the immune globulin–replacement product had recently been changed. Since immunity to enteroviruses is primarily antibody-mediated,4 adequate immune globulin replacement is key for the prevention of paralysis in immunodeficient poliovirus carriers. Where possible, replacement immune globulin should be tested for antiviral activity against poliovirus isolates from such carriers until new antiviral agents that can cure this condition are available.5
Source: N Engl J Med 2011; 365:1355October 6, 2011. http://www.nejm.org/doi/full/10.1056/NEJMc1108814
he rough and tumble of macho French league rugby has been curtailed by an unexpected source -- an epidemic of mumps.
The virus, normally associated with children, has forced the French rugby union league (LNR) to postpone next weekend's Basque derby between Biarritz and Bayonne after another Top 14 game was called off for the same reason.
"Because of an epidemic of mumps within the Lyon squad (...) the LNR has decided, as a precaution, to postpone the Biarritz v Bayonne game," the LNR said in a statement on Monday.
The LNR explained it made the decision to avoid possible contamination by the Biarritz players as they faced Lyon on Oct. 22.
The Bordeaux v Lyon game was postponed last week because Lyon players were suffering from mumps.
Source: Reuters, 31st October 2011.
Exposing the inefficacy of oral polio vaccine (OPV), a Swabi child has tested positive for polio despite being administered seven doses of vaccines over a period of time, health officials said here on Tuesday.
Official sources told Dawn that the National Institute of Health, Islamabad had found poliovirus in the blood of Asif Khan, 27-month-old son of Azeem Shah, a resident Narangi in Razar tehsil of Swabi district.
According to them, also in the day, reported another new polio case in North Waziristan agency, taking the number of children hit by the crippling disease this year to 12 in Khyber Pakhtunkhwa, 38 in Fata and 136 in the country.
The officials said nearly half of the new cases in Khyber Pakhtunkhwa and Fata had contracted polio despite receiving OPV raising doubts in the people`s minds about its efficacy.
They feared that the people living in the areas where such cases were reported might turn vaccinators away.
Officials said only five of the seven new polio cases in the province couldn`t be given polio drops due to their parents` refusal for one reason or the other, adding that the remaining received up to seven doses of vaccines.
A few years ago, a Peshawar lawyer questioned OPV efficacy but the health department didn`t heed it.
When contacted, Dr Imtiaz Ali Shah, focal person for polio eradication in Khyber Pakhtunkhwa, told Dawn that OPV should be administered to children in every immunisation campaign until they reached the age of five years.
He said despite vaccination, children were at the risk of contracting polio as OPV was administered to increase their immunity to the crippling disease and that there was no guarantee in presence of other viruses that they won`t contract polio.
Dr Imtiaz said OPV remained didn`t produce intended effects if the child suffered from diarrhoea, low mineral level or low immunity.
Source: Dawn.com, 2nd November 2011.
Health officials confirm a student at Pink Hill Elementary School in Lenoir County has been diagnosed with Whooping Cough.
The Lenoir County Health Department tells Nine On Your Side a 5-year-old boy was diagnosed with Whooping Cough, or pertusiss - a highly contagious bacterial infection. No word on when the child first became ill. Officials say the boy was previously vaccinated, and that chances of getting Whooping Cough with immunization is very unlikely.
They say he didn't get all the doses due to vaccine reactions. Number of doses needed for immunity varies by country.
Source: Eyewitness News, 31st October 2011.
An investigation into an outbreak in a high school in a town that was heavily hit by the virus found that about half of the cases were in teens who had received the recommended two doses of vaccine in childhood — in other words, teens whom authorities would have expected to have been protected from the measles virus.
It's generally assumed that the measles vaccine, when given in a two-dose schedule in early childhood, should protect against measles infection about 99 per cent of the time. So the discovery that 52 of the 98 teens who caught measles were fully vaccinated came as a shock to the researchers who conducted the investigation.
"That's the real question. How could that have happened?" said Dr. Gaston De Serres, an infectious diseases expert with Quebec's public health agency and one of the authors of the study.
Source: CBC News, 20th October 2011.
The measles outbreak in Canada continues to occur in both vaccinated and unvaccinated individuals and is causing concern over vaccine effectiveness, according to a presentation here during the IDSA 49th Annual Meeting.
“While this still ongoing outbreak feeds largely on unvaccinated individuals, the high proportion of cases who received two doses raises concerns on vaccine effectiveness,” Philippe Belanger, MSc, Ministère de la santé et des services sociaux du Québec, Montréal, told Infectious Diseases in Children. “However, the take-home message is still to get vaccinated.”
Source: Pediatric Supersite, 23rd October 2011.
In the recent past, we encountered 3 cases with jaundice, who were investigated for HBsAg and turned out to be positive. All the three had received the 3 doses of hepatitis B vaccine within 5 years of presentation (presented after 1 year, 1½ years and 6 months after 3rd dose). There was a mixed opinion among pediatricians that the HBsAg was positive because of vaccine, vaccine failure, or reinfection. In this context I seek the following clarifications:
Does the Hepatitis B vaccine result in positive HBsAg in a child, if so for how long after immunization.
Does seroconversion after vaccination mean the conversion of HBsAg positive (positivity due to vaccination) to negative as the antibody tests are not available all the time.
After the 3rd dose, if a patient comes with jaundice and is positive for HBsAg on investigation, should it be taken as vaccine failure due to the vaccine per se, or a new infection.
Source: Indian Pediatrics 2000;37: 1388-1389. http://www.indianpediatrics.net/dec2000/dec-1388-1389.htm
In his reply to the above questions, a medical scientist says this:
1. Does HB vaccination make a child HBsAg positive?
The HB vaccine consists of purified HBsAg, which is injected into the child’s tissues. Therefore, the child’s body now contains HBsAg. However, since the injected dose is minute, in the range of 10 micrograms, the antigen will not be picked up in an HBsAg ELISA (or another test) of the peripheral blood specimen.
The whooping cough vaccine given to babies and toddlers loses much of its effectiveness after just three years -- a lot faster than doctors believed -- and that could help explain a recent series of U.S. outbreaks among children who were fully vaccinated, a study suggests.
The study is small and preliminary, and its authors said the results need to be confirmed through more research. Nevertheless, the findings are likely to stir debate over whether children should get a booster shot earlier than now recommended.
"I was disturbed to find maybe we had a little more confidence in the vaccine than it might deserve," said the lead researcher, David Witt, chief of infectious disease at the Kaiser Permanente Medical Center in San Rafael, Calif. Dr. Witt presented his findings Monday at a conference in Chicago.
The study was done in California, where whooping cough vaccinations are a hot-button issue. The state had a huge spike in whooping cough cases last year, during which more than 9,100 people fell ill and 10 babies died. California schools have turned away thousands of middle and high school students this fall who haven't gotten their booster shot.
Government health officials recommend that children get vaccinated against whooping cough in five doses, with the first shot at age 2 months and the final one between 4 and 6 years. Then youngsters are supposed to get a booster shot around 11 or 12. That means a gap of five to eight years.
Dr. Witt's study looked at roughly 15,000 children in Marin County, Calif., including 132 who got whooping cough last year. He found that youngsters who had gone three years or more since the last of their five original shots were as much as 20 times more likely to become infected than children who had been more recently vaccinated.
Read more: http://www.post-gazette.com/pg/11263/1176014-114-0.stm#ixzz1dKvC1AXN
We present a unique case of life-threatening pneumococcal meningitis complicated by vasculitis in a fully vaccinated 4-year-old female with the heptavalent conjugate vaccine for Streptococcus pneumoniae (PCV7). Serotype 23F was isolated in both blood and cerebral spinal fluid (CSF) samples. Pulses of methylprednisolone were promptly initiated in addition to antibiotics leading to a good recovery. CSF studies and magnetic resonance imaging (MRI) of the brain were used for diagnosis and monitoring the response to corticoid therapy. We report the investigations of a child with failure of PCV7 vaccine to protect against vaccine-serotype invasive disease. Use of corticosteroids and temporal association with changes in brain imaging are described for the first time in literature.
Source: Neuropediatrics. 2011 Nov 14. http://www.ncbi.nlm.nih.gov/pubmed/22083882
Pneumococcal meningitis is still today a life threatening disease among children under-5 worldwide. Although the heptavalent vaccine has demonstrated its ability to reduce the incidence of pneumococcal disease its efficacy is limited due to the restricted number of serotypes included. We report a case of a child with a Streptococcus pneumoniae meningitis despite the use of heptavalent conjugate vaccine.
Source: New Microbiol. 2009 Jul;32(3):317-8. http://www.ncbi.nlm.nih.gov/pubmed/19845117
Thirteen kids in the Smithtown School District has contracted pertussis, a highly contagious bacterial infection also known as whooping cough, Suffolk County Health Commissioner James L. Tomarken announced Tuesday.
Cases were confirmed in St. James Elementary School, Tackan Elementary School and Nesaquake Middle School, and the health department has advised school officials to begin infection control measures.
According to the health department, all the infected children had been immunized, which explains why they only came down with mild cases of the infection.
Source: SmithtownPatch, 21 June 2011. http://smithtown.patch.com/articles/13-kids-contract-whooping-cough-at-smithtown-schools
Children exposed to chemicals called PFCs — used in some non-stick cookware, stain-resistant coatings, fast-food packaging and microwave popcorn bags — have a reduced response to vaccines, raising the possibility that the compounds could prevent children from being adequately protected against disease, a new study shows.
The study, published today's Journal of the American Medical Association, focused on perfluorinated compounds, hundreds of which are in use, says study author Philippe Grandjean of the Harvard School of Public Health. Children can be exposed prenatally as well as environmentally.
Because the compounds are water- and grease-resistant, they are used as coatings on paper plates, rainwear, upholstery and other uses. They can be absorbed through food, water and the dust from treated textiles. A 2011 report found that six of 10 paper bags and cardboard boxes used for food packaging contained PFCs.
Scientists measured children's exposure by taking blood samples from their mothers during pregnancy, and from the children at ages 5 and 7.
More vaccine coverage:
Continuous coverage by health reporter Liz Szabo on the myths and benefits of vaccines.
Common myths about vaccines
Measles returns as some parents refuse vaccines
Parents describe pain of losing children to vaccine-preventable diseases
Adult vaccines can hold down health costs
More kids skip school shots in 8 states
At age 5, just before receiving a scheduled booster shot, 26% had antibody concentrations too low to protect them from tetanus; 37% had levels too low to protect from diptheria. Researchers gave them booster shots to provide additional protection, Grandjean says.
Children with the highest prenatal PFC exposure had the lowest response to vaccinations, as measured by the antibodies produced after they received the shots, the study says. Doubling a child's PFC exposure cut immune response in half.
"That's a pretty impressive effect, and one that deserves attention," says Peter Hotez, director of the Texas Children's Hospital Center for Vaccine Development, who wasn't involved in the study. It "gives us pause for concern."
Source: USA Today, 24th January 2012. http://yourlife.usatoday.com/health/story/2012-01-24/Chemical-exposure-may-compromise-vaccine-response/52774114/1
Then, about a month ago, doctors at Doernbecher Children's Hospital at OHSU diagnosed it: Sean had Dawson Disease; a rare, neurological condition caused by the measles virus. Less than 10 people in the United States are reported to have it each year.
"He actually had the vaccine itself, the first dose, but it didn't protect him," Alpapara told KOIN. She says when Sean was a baby he got the measles virus in the Philippines, after he had been vaccinated. Alpapara says that often times, vaccines in other countries are not as strong as they are in the United States.
She thought when he had the measles and survived, that would be the worst of it.
"He almost died then. But I never thought there was some kind of disease that just laid dormant in his brain for 10 years," she said.
Source: Koinlocal6, 17th February 2012.
Thursday, the Alamance County Health Department said they now have 82 confirmed cases. The Health Department also said all of those cases had previously received the pertussis vaccine.
The vaccination for whooping cough, also known as pertussis, has changed. Back in 1991, doctors reformulated the vaccine because some children were having severe reactions to the original vaccine.
"What we're finding is that this vaccine is safer. But, the downside is that it's not producing antibodies that are as protective as the old, cellular pertussis vaccine. The answer to everyone is...look, you still get the vaccine," Guilford County Health Department Medical Director Ward Robinson said.
Source: Digtriad.com, 24th February 2012.
Thirty children have been diagnosed with measles at an outbreak connected to the Ysgol Eifionydd School in Porthmadog, North Wales.
Of the 30 children affected by the outbreak, none of them have received more than one dose of the MMR vaccine. Two doses of the vaccine are required to protect against measles, mumps and rubella.
Source: Vaccine News Daily, 2nd March 2012.
Although pertussis has been supposed to be a vaccine-preventable disease ever since the widespread vaccination of children against pertussis was started, since the 1990s, cases of pertussis and related fatalities are on the rise, especially in countries with high vaccination coverage - Quote from
Korean J Pediatr. 2010 May; 53(5): 629–633.
http://www.vaccineriskawareness.com/Skewed-Statistics?r=1335574907 - vaccine reports on dead third world children destroyed.
http://blog.unicef.org.nz/2010/02/04/unicef%E2%80%99s-child-immunization-campaign-in-haiti-kicked-off-today/ - an example of vaccination campaigns in a poor country.
During a whooping cough outbreak in California in 2010, immunized children between eight and 12 years old were more likely to catch the bacterial disease than kids of other ages, suggesting that the childhood vaccine wears off as kids get older, according to new research.
"We have a real belief that the durability (of the vaccine) is not what was imagined," said Dr. David Witt, an infectious disease specialist at Kaiser Permanente Medical Center in San Rafael, California, and senior author of the study.
Whooping cough, or pertussis, is caused by Bordetella pertussis bacteria. The infection produces an intense cough that lasts weeks and can lead to pneumonia, an inability to breathe or death -- although most cases don't reach such extremes.
In early 2010, a spike in cases appeared at Kaiser Permanente in San Rafael, and it was soon determined to be an outbreak of whooping cough -- the largest seen in California in more than 50 years.
Witt had expected to see the illnesses center around unvaccinated kids, knowing they are more vulnerable to the disease.
"We started dissecting the data. What was very surprising was the majority of cases were in fully vaccinated children. That's what started catching our attention," said Witt.
Source: http://www.reuters.com/article/2012/04/03/us-whoopingcough-idUSBRE8320TM20120403
+
Islamabad - Another ‘suspected’ case of polio reported in a Pakistani child who was vaccinated for polio. Perhaps it’s time to raise a very important question.
There was hardly any more appropriate way than to quote verbatim, in the title above, what the latest media report published about a Pakistani child who was vaccinated and still developed what sounds like paralysis. Now what do we call this policy of Pakistani media– subtlety of expression, or reluctance to highlight threats?
As readers may spot in the report, a child from Islamabad was vaccinated for polio, and he never missed a dose as the vaccination program requires. But he has developed a disability which is suspected to be polio. While we should praise this particular paper for at least reporting the case, the reporting has been stripped of all the suspicion that gives a reader a critical glimpse of the situation. We don’t miss noting that the report excludes all details of what actually happened to the child. He is said to have ‘stopped walking’. Sounds like the word ‘paralysis’ is too scary for the masses most of whom still do not know about the life-threatening and life-crippling effects of the orally administered polio vaccine – one that was banned in the US more than 10 years ago, and banned in Europe more than 25 years ago.
The tests of the child have been sent to the NIH lab, which, as the news report notes, is the only
one across the entire country that can medially verify a polio case. A single lab in the entire country of 180 million people for testing a polio case! Does that not sound like a joke? Well, perhaps it is. No wonder that polio cases are ‘on decline’ as some claim in this country. But are they?
Let’s look at some of the news links where Pakistan’s truth-shy media dared to report on cases of paralysis or even death among children vaccinated for polio:
• December 2010: Incidence of polio among children vaccinated under the polio eradication program rises and causes concern for the government.
• June 2011: An infant hardly 2 weeks young died in Naseerabad (Punjab) soon after polio vaccine was administered to her. The parents blamed the vaccine for the death. But, as expected, the local administration declared it as natural death.
• November 2011: A 5-year-old child in Faisalabad (Punjab) died after becoming paralyzed neck-down just a few days after polio drops were sent down her throat. The child started complaining of pain in her limbs immediately after receiving the drops, soon starting to scream out of pain. The bereaved parents protest and blame the polio vaccine for the child’s death; their cries are ignored.
• Of 4 reported polio cases, three children in Pakistan’s Sindh and Punjab provinces were those vaccinated for the disease – Source: Measles Initiative
• February 2012: Two kids in Sindh crippled for life; the children’s father blames the polio vaccine for the calamity and demands for a probe; as usual, the curtains drop over the cases.
A number of other links are there online about disparate cases of polio and DEATH occurring immediately or soon after the administration of the polio drops. In some cases, media create the excuse of ‘expired vaccines’ causing the damage; sometimes it is ‘improper’ or ‘careless’ administration of the drops; and sometimes just ‘suspected’ cases of polio happening after the vaccination. But no one dares ask the question: why a vaccine version that is banned in the developed world given to millions of children in the third world?
Source: Digital Journal, 21st May 2012 - http://www.digitaljournal.com/article/325249
Of the 35 cases enrolled in our study, 23 were male (65.7%) and 12 were female (34.3%). Their ages varied between 2 months and 13 years (mean: 6.5 ± 3.9 years) (Table I). Three of the cases were aged ≤3 months. Four cases were aged <1 year. There were 4 cases in the age group 1-4, 11 cases in the age group 5-8, 11 cases in the age group 9-12, and 5 cases in the age group 13-16 (Table I). Thirty-four of the cases (97.1%) were fully vaccinated according to their ages. One case aged 2 months was not vaccinated.
Because antibody levels were tested qualitatively and semi-quantitatively in our study and 34 of the cases (97.1%) were fully vaccinated according to their ages, a cut-off value to determine whether the positivity in their antibody level was due to vaccination or infection could not be specified.
The fact that our cases did not include any patient with culture-confirmed pertussis may be attributed to the fact that 97.1% of the cases were fully vaccinated according to their ages.
PT is the single antigen that is specific for B. pertussis and it is considered that IgG antibodies developed against PT may be responsible for long-term immunity3,11,15. Although it has been reported that the detection of high levels of IgG antibodies against PT in a single serum sample is diagnostic of recent or acute infection with B. pertussis, when antibody levels according to age groups are known in the society19, the cut-off value indicating prevention has not yet been determined32.
Type IgM and IgG antibodies are produced after vaccination; however, the type IgA antibodies that develop after vaccination are in very low concentrations8,11. Although pertussis vaccines have been in use for a long time, reliable antibody levels that determine immunity have not yet been identified11.
Because antibody levels were tested qualitatively and semi-quantitatively in our study and 34 of the 35 cases (97.1%) were fully vaccinated according to their ages, a cutoff value to determine whether the positivity in their antibody level was due to vaccination or infection could not be specified.
Source:
| Comparison of Nasopharyngeal Culture, Polymerase Chain Reaction (PCR) and Serological Test for Diagnosis of Pertussis |
| Ali Bülent Cengiz1, İnci Yıldırım1, Mehmet Ceyhan1, Gülten Seçmeer1 Deniz Gür2, Ateş Kara1 |
| 1Infectious Disease Unit, Department of Pediatrics, and 2Pediatric Microbiology Laboratory, Hacettepe University Faculty of Medicine, Ankara, Turkey http://www.turkishjournalpediatrics.org/?fullTextId=673&lang=eng |
India’s health ministry, celebrating a year of freedom from wild polio, now faces a dilemma that public health experts had predicted years ago: the very vaccine it is using to fight polio is causing more polio paralysis than the wild poliovirus.
India observed last Thursday as a milestone, marking a full year without polio caused by a wild poliovirus.
But surveillance data show that last year, seven children in India developed polio from vaccine-derived poliovirus (VDPV), the medical term for a virus from the oral polio vaccine (OPV) that has regained the ability to cause disease.
Such infections occur when virus from the OPV, after being excreted by vaccinated children, regains neuro-virulence and the ability to circulate in the environment and strikes other vulnerable children.
Public health experts also estimate that between 100 and 180 children in India develop vaccine-associated polio paralysis (VAPP) each year, a rare but serious side effect of the OPV they had received to protect them from the wild poliovirus. As opposed to VDPV infection, VAPP affects the vaccinated children themselves.
Source: The Telegraph, India. 15th January 2012. http://www.telegraphindia.com/1120116/jsp/frontpage/story_15011108.jsp#.T9pjWFJ9xD0
It was hoped that following polio eradication, immunisation could be stopped. However the synthesis of polio virus in 2002, made eradication impossible. It is argued that getting poor countries to expend their scarce resources on an impossible dream over the last 10 years was unethical. Furthermore, while India has been polio-free for a year, there has been a huge increase in non-polio acute flaccid paralysis (NPAFP). In 2011, there were an extra 47,500 new cases of NPAFP. Clinically indistinguishable from polio paralysis but twice as deadly, the incidence of NPAFP was directly proportional to doses of oral polio received. Though this data was collected within the polio surveillance system, it was not investigated. The principle of primum-non-nocere was violated. The authors suggest that the huge bill of US$ 8 billion spent on the programme, is a small sum to pay if the world learns to be wary of such vertical programmes in the future.
Source: Indian J Med Ethics. 2012 Apr-Jun;9(2):114-7. http://www.ncbi.nlm.nih.gov/pubmed/22591873
Global health leaders have committed to making 2010-19 the decade of vaccines, with the aim of ensuring that lifesaving vaccines are available globally. The Bill and Melinda Gates Foundation pledged $10bn (£6.5bn; €8bn) to the new decade,1 which was established in recognition of the astonishing technological progress in developing new vaccines and our ethical obligation to make these vaccines available to all children in the poorest countries of the world.1 2 w1-8 The ultimate goal is to save lives, and vaccination programmes measure potential impact in terms of the lives saved.1 2 w1
A WHOOPING cough epidemic is sweeping Australia and according to one Ipswich doctor the current vaccine is the reason why.
Ipswich Medical Centre GP Paul Curson said many of the people he had treated during this epidemic were fully immunised, suggesting the vaccine was failing to protect people.
So far this year 490 cases of Pertussis (whooping cough) have been reported in the West Moreton Health Services District, up from 436 last year but far in excess of the 50 cases in 2007.
Dr Carson, a veteran of 30 years as a GP, said the current vaccine was simply not doing its job.
"The vaccine is no good, we're seeing whooping cough in people that shouldn't really have it," Dr Curson said.
"It is showing up in kids that have been vaccinated."
Dr Heidi Carroll, a public health physician with Queensland Health's Communicative Diseases Control Service said Dr Curson's claim was baseless.
"No vaccine is 100% effective, the Pertussis vaccine is about 80-90% effective," she said.
"What it is really good at is preventing death and serious illness. People can still pick up the illness (but) it is often a lot milder than it otherwise would have been.
"It's true we are getting more young people coming through but that is because of the epidemic."
Dr Curson blamed a change from a cellular vaccine to an A- cellular version in the late 1990's for its reduced effectiveness.
According to officials in the Hamburg School District, they have an outbreak of pertussis, better known as whooping cough, on their hands.
A letter to parents from Hamburg superintendent Stephen Keifer warns parents there have been "several confirmed cases of pertussis in the school district."
Keifer told 69 News there have been five cases, four of which were students at the elementary schools.
"That's not unique," said Dr. Kenneth De Benedictis, the head of Reading Hospital's infection control and prevention. "That's happened before in that population."
De Benedictis said most children have been vaccinated against pertussis.
"Either it's worn off or there's something defective in the vaccine, but it is an effective vaccine basically," De Benedictis explained.
Source: 69 News, 17th August 2011 - http://www.wfmz.com/news/District-Dealing-With-Outbreak-Of-Whooping-Cough-In-Schools/-/121458/220568/-/141ssff/-/index.html
Three children in the same Grand Island elementary school have been diagnosed with pertussis, more commonly called whooping cough, since last Thursday.
The Central District Health Department issued a whooping cough outbreak advisory this morning.
All three children were current on vaccines, Vap said.
"They all have five doses (of pertussis vaccine), so we are not exactly sure why they contracted the disease," Vap said.
Source: The Independent, 2nd March 2011 -
http://www.theindependent.com/news/local/grand-island-has-whooping-cough-outbreak/article_762d224e-2877-51b1-a5b7-8d0e91f1f51f.html
Two more Women's and Children's Hospital doctors have been confirmed with whooping cough in Adelaide.
There have now been three cases in recent weeks.
Nine adults and 41 babies who were patients at the hospital have been offered antibiotics as a preventative measure.
The hospital says the doctors have contracted the infection despite keeping their vaccinations up to date.
One of the doctors diagnosed over the weekend also worked at North Eastern Community Hospital in Adelaide.
Another 46 patients there have been offered antibiotics.
There has also been a recent infant death in Adelaide from whooping cough.
Source: ABC News, 18th October 2010 - http://www.abc.net.au/news/2010-10-18/more-kids-hospital-doctors-get-whooping-cough/2301942
Those fully vaccinated for whooping cough can still get the disease, says an epidemiologist with the Indiana State Department of Health.
“We do see cases of kids appropriately vaccinated who still get the disease,” said Angie Cierzniewski, a state vaccine preventable disease epidemiologist.
“Some vaccines we think of as rockstars — they work exceptionally well and it’s almost unheard of to get the disease once a person is vaccinated,” she said, giving the example of the vaccine for measles.
The pertussis vaccine “is not a rockstar,” she said. It’s possible to be fully vaccinated and get the disease, she said. Typically, the disease would be less severe if the person is fully vaccinated.
A Clay County woman knows first-hand that a pertussis vaccination doesn’t eliminate the possibility of someone getting pertussis, also known as whooping cough.
The woman, who did not want her name used, said four children in her family became infected with the disease, and the child that first developed it — her 4-year-old — did have the required doses for her age.
She said two of her children had the required number of doses, a 2-year-old was not vaccinated because of low immunity and other reasons and the oldest, an 8-year-old, was lacking one of the required doses of the vaccination.
The primary series of whooping cough vaccinations calls for five doses, recommended at two months, four months, six months, 15 through 18 months and the last one before kindergarten (four to six years of age), Cierzniewski said.
The Clay County woman said health authorities had incorrect information that her children contracted the disease because they were not immunized. She wants people to realize they can contract the disease even if they are immunized. “I feel the public may have a false sense of security,” she said.
None of her children required hospitalization, and the entire family has been treated with antibiotics, she said.
Source: The Tribune Star, 4 December 2010 - http://tribstar.com/news/x1199045212/Even-those-fully-vaccinated-can-still-get-whooping-cough-health-official-says
Bass called the outbreak “an extraordinary situation” that began in December and has grown to include more than 103 cases that are either confirmed or probable, with an almost equal number falling into each category.
“It certainly has been a learning curve,” he said. But he and Shapley-Quinn praised the school system, and in particular public information officer Jenny Faulkner, for effectively working with the health department. The school system has worked with the health department to identity “close contacts” of students with confirmed or reportable cases in order to notify families.
Pertussis, or whooping cough, is a bacterial infection of the respiratory tract that can last for many weeks. Symptoms include a runny nose, low fevers, coughing fits and vomiting.
Bass said the system has a “really good vaccination rate,” which “raises questions about the vaccine itself” and its effectiveness in preventing the disease. He and Shapley-Quinn said it’s likely the Centers for Disease Control will study the situation to examine those questions.
SHAPLEY-QUINN SAID there’s no instance of a child who had not been vaccinated getting pertussis, though the health department is waiting to receive paperwork to confirm for certain one student was up to date on the shots.
After pertussis was found at B. Everett Jordan Elementary School, Shapley-Quinn said, “We gave out 700 courses of preventive antibiotics in that school alone.”
With approval from the CDC, the health department began shifting its approach in an effort to balance disease prevention and overuse of antibiotics, which can weaken resistance of the body’s immune system. Now, families of students considered close contacts of those with confirmed or probable cases of pertussis get a letter that says “If you have a cough, see your doctor” instead of automatically being offered the antibiotics.
Source: The Times News, 14th March 2012. http://www.thetimesnews.com/news/school-53424-department-health.html
A Bunbury mother has put out a call for other parents to not ignore children coughing after her two vaccinated children were diagnosed with whooping cough.
Whooping cough cases have doubled across the South West with 91 cases reported in the first three months of this year.
In Bunbury there have been 14 cases reported, doubling from seven last year.
Stacey Baskerville’s son Finn, 6, and daughter Ruby, 8, were both vaccinated against the illness when they were 18 months old.
But 10 days ago she got a call from a doctor telling her they had both contracted the contagious disease.
‘‘I was just in shock—I couldn’t believe them when they said it was whooping cough,’’ Ms Baskerville said.
‘‘To think that even if you do vaccinate against it you can still get it is scary.’’
Source: The South Western Times, 5th April 2012 - http://au.news.yahoo.com/thewest/regional/southwest/a/-/community/13354759/whooping-cough-outbreak-in-bunbury/
PARENTS across Australia will no longer receive free whooping cough vaccinations because it is not effective in protecting newborns from the potentially deadly illness, a parliamentary committee has heard.
Since 2009 all states and territories except Tasmania have at some stage introduced the free parental vaccination program in an effort to shield infants from the illness.
Whooping cough, a highly infectious airborne bacterial disease, can kill if complications cause lack of oxygen to the brain.
It is most serious in babies under a year old, with newborns susceptible as they are unable to be vaccinated until they are at least four months old.
But at a Victorian Parliamentary Accounts and Estimates Committee hearing on Tuesday, Department of Health divisional executive director Chris Brook said states were abandoning the "cocooning" program from June 30.
He said the national Pharmaceutical Benefits Advisory Committee (PBAC) had determined vaccinating parents was not effective in protecting newborns, after two pharmaceutical manufacturers made submissions to the PBAC.
The PBAC, which is totally independent and very expert, has determined that there is no clinical effectiveness of this strategy," Professor Brook said.
He said this had made it clear the cocooning strategy should not be continued.
"So all jurisdictions who have been in this program will be effectively ceasing the cocooning strategy as of the end of June this year."
Source: The Telegraph, 8th May 2012 - http://www.dailytelegraph.com.au/news/breaking-news/states-ending-free-parent-whooping-vaccine/story-e6freuyi-1226350174856
“In 2011, there were an extra 47500 new cases of NPAFP [in India]. Clinically indistinguishable from polio paralysis but twice as deadly, the incidence of NPAFP was directly proportional to doses of oral polio received.”
“In the states of Uttar Pradesh (UP) and Bihar, which have pulse polio rounds nearly every month, the non-polio AFP rate is 25- and 35-fold higher than the international norms. The relationship of the non-polio AFP rate is curvilinear with a more steep increase beyond six doses of OPV in one year.”
"Though this data was collected within the polio surveillance system, it was not investigated… It is sad that, even after meticulous surveillance, this large excess in the incidence of paralysis was not investigated as a possible signal, nor was any effort made to try and study the mechanism for this spurt in non-polio AFP.”
"From 1980 through 1999, there were 162 confirmed cases of paralytic polio reported. Of the 162 cases, eight cases were acquired outside the United States and imported... The remaining 154 cases were vaccine-associated paralytic polio (VAPP) caused by live oral poliovirus vaccine (OPV).”
About 10 percent of babies born to mothers with the hepatitis B e antigen (HBeAg) will become HB carriers, even with vaccination, a pediatrician said Saturday.
Since the HB vaccine does not guarantee full protection against infection, it is important to keep track of high risk children, said Chen Hui-ling, a pediatrician at National Taiwan University Hospital.
Citing a study of some 2,000 some children, Chen said that infants born to HBeAg mothers have a higher chance of becoming carriers, even if a rigorous vaccination scheme is implemented 24 hours after birth.
Source: Focus Taiwan News Channel, 21st July 2012.
The Zimbabwe government has begun an investigation into reports of severe adverse effects - including deaths - from an immunization program against polio and measles it conducted last month.
Zimbabwean Health Minister Henry Madzorera attributed the negative physical reactions some children have to vaccinations to malnutrition, among other factors. He also said the children may already have other diseases when they get vaccinated.
"Zimbabwe has among the highest maternal and child death rates in the world," said Madzorera. "So some events are coincidental due to the high frequency of child deaths, but also child morbidity. However, vaccination remains a key intervention in giving a child a chance of life. But the frequency and magnitude of adverse events becomes higher on these children who are already sick."
In Zimbabwe, vaccination of children has in the past met with resistance from some parents, who say their children became ill after getting the shots.
The June vaccination program sponsored by the United Nations children's agency (UNICEF) and Japan drew attention when a child died in Masvingo, about 300 kilometers south of Harare.
Deputy Health Minister Douglas Mombeshora confirmed the death and suggested other factors, not just the vaccination, may have caused the death.
“The child was severely malnourished," said Mombeshora. "We also discovered that the parents were on ART [AIDS] therapy. The parents had not come to say they are on treatment. That they are on treatment and the low weight on the child [was] mostly likely [because] the child was HIV positive.”
Source: The Journal of Turkish Weekly, 21st July 2012.
Since mid-2011, a substantial rise in pertussis cases has been reported in the state of Washington. In response to this increase, the Washington State Secretary of Health declared a pertussis epidemic on April 3, 2012. By June 16, the reported number of cases in Washington in 2012 had reached 2,520 (37.5 cases per 100,000 residents), a 1,300% increase compared with the same period in 2011 and the highest number of cases reported in any year since 1942. To assess clinical, epidemiologic, and laboratory factors associated with this increase, all pertussis cases reported during January 1–June 16, 2012, were reviewed. Consistent with national trends, high rates of pertussis were observed among infants aged <1 year and children aged 10 years. However, the incidence in adolescents aged 13–14 years also was increased, despite high rates of vaccination with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine, suggesting early waning of immunity. The focus of prevention and control efforts is the protection of infants and others at greatest risk for severe disease and improving vaccination coverage in adolescents and adults, especially those who are pregnant. Pertussis vaccination remains the single most effective strategy for prevention of infection.
The vaccination status of patients was determined by review of medical records and by patient or parent report. Vaccination was considered up-to-date if the minimum number of doses by age had been received, as recommended by the Advisory Committee on Immunization Practices (2). Patients with invalid dose dates (e.g., date of dose preceding date of birth) were excluded from the vaccination status analysis. Individual doses were excluded if administered <14 days before symptom onset.
Valid vaccination history was available for 1,829 of 2,006 (91.2%) patients aged 3 months–19 years. Overall, 758 of 1,000 (75.8%) patients aged 3 months–10 years were up-to-date with the childhood diphtheria and tetanus toxoids and acellular pertussis (DTaP) doses. Receipt of Tdap was documented in 97 of 225 (43.1%) patients aged 11–12 years and in 466 of 604 (77.2%) patients aged 13–19 years. Estimated DTaP coverage in Washington among children aged 19–35 months was 93.2% for ≥3 doses and 81.9% for ≥4 doses in 2010; Tdap coverage in adolescents aged 13–17 years was estimated at 70.6% (3).
Source: MMWR, July 20, 2012 / 61(28);517-522. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6128a1.htm
Providence Hospital officials say one of their own workers may have exposed hundreds of people to whooping cough, and now they're notifying employees and patients to get help immediately.
Providence Regional Medical Center has been ground zero for the treatment of pertussis, or whooping cough. But this week it became ground zero for a new potential outbreak.
Doctor Ahmet Tural is the head of infectious disease at the hospital. He said a hospital employee went to the staff clinic last week complaining of a nasty cough. He was sent home as a precaution, and on Monday his test results came back positive for whooping cough.
"He probably had it for about two weeks or slightly more, perhaps," Tural said.
That means the employee had two weeks of direct contact with patients and fellow employees at the hospital. Officials believe at least 53 employees have been exposed to the illness, but that number could end up being more than 300 after factoring in patients and visitors.
The hospital has been proactive.
"If they had direct exposure, then we automatically require them to be put on antibiotics," said Providence official Teresa Wenta.
The worker in question thought he had been proactive, too. He was vaccinated against pertussis, but it wasn't effective.
Tural said sometimes the vaccination just doesn't work.
"In 20, 25, 30 percent of the cases it may not be fully protective," he said.
Source: Komo News, 4th July 2012. http://www.komonews.com/news/local/161381365.html
The protection provided by acellular pertussis vaccines (DTaP) as a first dose may fall short of that provided by first-dose whole-cell pertussis vaccines (DTwP), which were phased out in the 1990s because of higher rates of adverse events, an Australian study showed.
Among children born in 1998, rates of pertussis were higher among those who received an acellular vaccine instead of a whole-cell vaccine for the first three doses in the primary series, according to Sarah Sheridan, BMed, of Queensland Children's Medical Research Institute in Brisbane, Australia, and colleagues.
The difference was evident during a pre-epidemic period from 1999 to 2008 and during a period of elevated pertussis rates from 2009 to 2011, they reported in a research letter in the Aug. 1 issue of the Journal of the American Medical Association.
Of 58,233 children born in 1998, 69.5% received at least three doses of any pertussis vaccine during the first 6 months of life. Among the vaccinated children, there were 267 first pertussis cases reported through 2011.
Children who received the three-dose primary series with DTaP only had higher rates of pertussis compared with those who received the primary with DTwP only, both during the pre-epidemic period (13.2 versus 5.2 per 100,000 per year) and the outbreak period (373.1 versus 113.3 per 100,000 per year).
For children who received a mix of both types of vaccine, rates of pertussis were higher during the outbreak period for those who received DTaP as the first dose (409.0 versus 113.3 per 100,000 per year).
It is possible, they noted, that the higher rates of disease with the acellular vaccine could be related to changes in the circulating Bordetella pertussis strains or differences in the immune responses induced by the two types of vaccine.
Source: Medpage Today, 31st July 2012 - http://www.medpagetoday.com/InfectiousDisease/URItheFlu/33998
For infectious diseases where immunization can offer lifelong protection, a variety of simple models can be used to explain the utility of vaccination as a control method. However, for many diseases, immunity wanes over time and is subsequently enhanced (boosted) by asymptomatic encounters with the infection. The study of this type of epidemiological process requires a model formulation that can capture both the within-host dynamics of the pathogen and immune system as well as the associated population-level transmission dynamics. Here, we parametrize such a model for measles and show how vaccination can have a range of unexpected consequences as it reduces the natural boosting of immunity as well as reducing the number of naive susceptibles. In particular, we show that moderate waning times (40-80 years) and high levels of vaccination (greater than 70%) can induce large-scale oscillations with substantial numbers of symptomatic cases being generated at the peak. In addition, we predict that, after a long disease-free period, the introduction of infection will lead to far larger epidemics than that predicted by standard models. These results have clear implications for the long-term success of any vaccination campaign and highlight the need for a sound understanding of the immunological mechanisms of immunity and vaccination.
Source: Proc Biol Sci. 2009 Jun 7;276(1664):2071-80. Epub 2009 Mar 4. http://www.ncbi.nlm.nih.gov/pubmed/19324753
Background: Despite widespread vaccination against Bordetella pertussis, disease remains prevalent. Acellular Pertussis vaccine may be less effective or durable than previously believed. Its clinical efficacy has yet to be evaluated in North America. At the epicenter of the largest outbreak in decades, we examined pertussis incidence and vaccine efficacy in a well-defined, vaccinated community. Methods: We reviewed 171 patients with a positive PCR for B. pertussis from March 1 to October 31, 2010 for demographics and vaccination status. Results: We found 132 cases of clinical pertussis in patients age <19, with peak incidence in ages 8-14. Testing rate peaked in infants, but remained nearly constant in other ages. The case rate markedly increased after age 7, peaking at age 12 and appeared to correlate to an increased interval since vaccination. Unvaccinated children accounted for very few cases. Conclusions: The 2010 pertussis outbreak was an excellent natural experiment to assess the American acellular pertussis vaccine. In a well-defined population with excellent ascertainment, minimized selection bias and known vaccination status, acellular boosters appear to be ineffective after 3 years. The sustaining population of the outbreak was fully immunized by national guidelines but more than 2.5 years since their last booster. Acellular pertussis boosters are effective but less durable than previously thought. Vaccine guidelines and pertussis control measures need to be reconsidered.
Source: M. A. Witt - Res. Assistant, P. H. Katz, MD, MPH - Senior Pediatrician, D. J. Witt, MD - Chief, Infectious Diseases;
Kaiser Permanente Med. Ctr., San Rafael, CA. http://www.abstractsonline.com/Plan/ViewAbstract.aspx?mID=2789&cKey=223c57e0-0217-4327-aa94-9677ed5ea4c4&sKey=4451459e-9f2b-4cb4-af74-27104aa3d756
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Two Hunter region facilities for the disabled are in lock-down after a flu-outbreak and the deaths of three residents who had suffered flu-like symptoms.
In the past week, two men in their 60s and a woman aged in her 40s died at the Stockton and Kanangra Centres.
51 residents are now being treated for the flu and strict infection control measures have been introduced at the centres which house 450 people.
The Opposition Health spokesman, Doctor Andrew McDonald says he is concerned that it may be a new strain of flu.
"This is a great concern because most of these people had been vaccinated against the flu," he said.
"This means that the vaccination is either ineffective or it's a new virus.
"If there's 450 people at these centres, it's highly likely this virus will spread to other facilities in the area and elderly people will be at risk from this virus."
Doctor McDonald says it is very concerning development this late in the flu season.
"This is a great worry because we know that July is the busiest month for influenza, so if we're just having an epidemic now, there is always potential for it to get bigger," he said.
"The great worry about these infections is that the vaccination is ineffective, it will come down to very careful infection control measures."
Disability Services Minister Andrew Constance says strict control practices are now in place.
"Some residents are contained to their units in which they reside," he said.
"We're ensuring that cleanlieness and hygiene procedures at both centres have been intensified and staff at both centres are wearing protective equipment."
Source: ABC News, 3rd August 2012 - http://www.abc.net.au/news/2012-08-03/deadly-flu-outbreak-shuts-centres-for-disabled/4174152
When Pennsylvania State University biologist Andrew Read injected mice with a component of several promising malaria vaccines, he got a disquieting result: The malaria parasites spread through the immunized mice and evolved to become more virulent.
Unvaccinated mice infected with these super-parasites got much sicker than those infected with ordinary malaria.
The findings, Read said, should not discourage research on malaria vaccines - the disease kills hundreds of thousands of African children every year, and the parasites tend to develop resistance to drugs. Between 15 and 20 vaccines are currently in clinical trials around the world, mostly in Africa. Read, who is trained as an evolutionary biologist, said he hopes his result will prompt vaccine researchers to consider how vaccines may affect the evolution of the parasites.
Read has also worked on the evolution of bacteria that resist antibiotics. In a provocative paper published last year, he suggested that typically prescribed doses of antibiotics can sometimes favor resistant strains. Smaller doses, which allow the immune system to kill resistant bacteria, could prove a better long-term approach.
In infectious disease, individual bugs compete within a host, as do individuals in any population of organisms. If a drug or vaccine doesn't completely wipe out or prevent infection, the intervention can tip the evolutionary playing field and possibly favor not only bugs that resist that particular drug, but ones that spread faster, or cause more severe symptoms, Read said.
The malaria findings, published in last week's issue of the journal PLoS Biology, are being taken seriously by vaccine researchers. "If there is an effect like this we need to be mindful of it and take steps to minimize this kind of impact," said Patrick Duffy, chief of the laboratory of malaria immunology and vaccination at the National Institutes of Health.
The findings don't apply to most existing vaccines, such as those used against smallpox, measles, and mumps. Those prevent people from ever getting infected, so there's no opportunity for the viruses to evolve in immunized people, Read said. But the malaria parasite is a more complex organism and no vaccine being tested now can wipe it out.
Source: Planet of the Apes, 6th August 2012 - http://www.philly.com/philly/blogs/evolution/165163476.html
Researchers from the British Columbia Centre for Disease Control observed suboptimal vaccine effectiveness against the influenza A/H3N2 virus during the 2010-2011 winter season and also detected genetic variants to the virus using a sentinel surveillance platform.
During this time frame, there were many outbreaks related to influenza A/H3N2 at long-term care facilities in Canada. The outbreaks also affected vaccinated staff. Interim data from the sentinel surveillance system, which incorporated genotypic, phenotypic and epidemiologic indicators, identified genetic variants and suboptimal vaccine effectiveness.
“Unlike other vaccines, the influenza vaccine must be reformulated and re-administered each year to keep pace with ongoing changes in circulating virus strains,” Danuta Skowronski, MD, epidemiology lead of Influenza & Emerging Respiratory Pathogens at BC Centre for Disease Control, told Infectious Disease News. “For this reason, real-time monitoring of circulating strains, their relatedness to chosen vaccine components and their impact on vaccine protection are important. To do this requires the efficient harnessing of molecular, individual and population-level information.”
The researchers analyzed nasal/nasopharyngeal swabs and epidemiologic data from 1,718 participants who presented with influenza-like illness. Among these participants, 93 tested positive with A(H1N1)pdm09, 408 had A/H3N2 and 199 had influenza B. Patients who tested negative for influenza were considered controls. Among the cases, 16% received the influenza vaccine and among the controls, 24% received the vaccine.
The vaccine efficacy for adults aged 20 to 49 years was 65% for A(H1N1)pdm09 and 66% for influenza B. For A/H3N2, however, the vaccine efficacy was only 39%.
Two hundred thirty-three specimens were isolated for hemagglutination inhibition characterization. This process showed that all of the A(H1N1)pdm09 isolates were A/California/7/2009-like and all of the A/H3N2 isolates were A/Perth/16/2009-like, demonstrating that all of the isolates were well matched to the vaccine. However, on phylogenetic analysis, only two of the A/H3N2 isolates belonged to the A/Perth/16/2009 vaccine clade. Most belonged to the A/HongKong/2121/2010 variant, and the remainder belonged to the A/Victoria/208/2009 variant, both of which were not matched to the vaccine.
Source: Infectious Disease News, 3rd August 2012 - http://www.healio.com/infectious-disease/vaccine-preventable-diseases/news/online/%7B90A188FA-50CB-4206-A557-FFE927905EDE%7D/Suboptimal-vaccine-effectiveness-against-influenza-AH3N2-identified
Johnson Crossing Academic Center is undergoing a thorough cleaning this weekend after one student was diagnosed with pertussis, also known as whooping cough.
We had a student that, unfortunately, didn’t stay out of the school,” said Brandi Tumbleson, executive director of Three Rivers District Health Department. “Normally it’s a recommendation that if they test positive for pertussis, they’re out of school until they’ve been on antibiotics for five days. He was in school previous to being tested (last) weekend, and he’s been in school all week.”
The odd thing about this case, she said, is the student had been vaccinated in 2006 and was current on his vaccination schedule.
“That’s what’s frustrating with this,” she said. “I don’t know if the vaccine just wore off; some public experts have been saying it does wear off, but what’s frustrating is we know it can work and that’s why we want people to be vaccinated. However, certain states have had big rushes of it and we’re seeing a rush here in this area.”
Source: Fremont Tribune, 24 August 2012 - http://fremonttribune.com/news/local/johnson-crossing-student-diagnosed-with-whooping-cough/article_580f8724-ee48-11e1-b11a-0019bb2963f4.html?comment_form=true
A detailed look at California children during the state's large pertussis outbreak in 2010 revealed that protection from the diphtheria, tetanus, and pertussis (DTaP) vaccine wanes 5 years after kids receive their last dose, which could be fueling outbreaks.
The findings come on the heels of a warning earlier this summer from the US Centers for Disease Control and Prevention (CDC). The agency, along with state health department partners, found an unusual illness spike in Washington state 13- and 14-year-olds, which also raised the possibility of waning pertussis (whooping cough) vaccine protection.
The United States is headed toward its worst pertussis year in decades, CDC officials said in July, and two states—Washington and Colorado—have declared epidemics.
The new study on pertussis in California children, published today in the New England Journal of Medicine (NEJM), is the first to focus on the cohort of children who have received only the DTaP since birth.
In the late 1990s the United States transitioned from a whole-cell pertussis vaccine to an acellular version, due to a fairly high rate of minor side effects with the older vaccine.
The large size of California's pertussis outbreak allowed researchers at Kaiser Permanente Vaccine Study Center (KPVSC) to examine the relationship between the time since pertussis vaccination and how likely children were to test positive for the disease. The CDC recommends five DTaP doses for children, given at 2, 4, and 6 months; at 15 to 18 months; and when the youngster enters school, between 4 and 6 years of age.
The study focused on Kaiser Permanente's northern California population, which includes 3.3 million members in a system that has electronic medical records and a central laboratory. It compared 277 children between ages 4 and 12 years who tested positive for pertussis with 3,318 kids who tested negative, with a separate comparison involving 6,086 matched controls.
The researchers analyzed the risk of pertussis in California children from 2006 to 2011 in relation to the time since their last dose of DTaP vaccine, finding that protection wanes 42% each year after the fifth dose (odds ratio of 1.42 [95% confidence interval, 1.21 to 1.66]).
The amount of protection that remained after 5 years depended on the initial effectiveness of the vaccine, according to the study. For example, if the initial effectiveness was 90%, it would drop to 42% after 5 years.
Pertussis incidence was highest in kids ages 8 to 11 years, suggesting that the drop-off in efficacy after the fifth dose in schoolchildren played a role in fueling and sustaining California's pertussis outbreak. Investigators wrote that this observation was surprising, because teenagers are typically considered a pertussis reservoir and have been disproportionately affected in previous outbreaks.
They noted that the sharp increase in 8- to 11-year-olds, followed by a sharp pertussis drop in 12- to 15-year-olds, hasn't been seen in the epidemiology of unvaccinated people in previous outbreaks.
Nicola Klein, MD, PhD, who led the study and co-directs the KPVSC, said in a Kaiser Permanente press release that the findings suggest that pertussis control measures may need to be reconsidered.
"Prevention of future outbreaks may be best achieved by developing new pertussis-containing vaccines or reformulating current vaccines to provide long-lasting immunity," she said. However, Klein emphasized that the DTaP is effective and is still an important tool for protecting children and communities. "Following current CDC recommendations remains important," She said.
Tom Clark, MD, MPH, a medical epidemiologist with the CDC's Meningitis and Vaccine Preventable Diseases Branch, told CIDRAP News that researchers have already illustrated the waning protection from an epidemiologic perspective, and now this study and others soon to be published are measuring the degree of risk from the reduced vaccine effectiveness.
Clark coauthored a July report in Morbidity and Mortality Weekly Report (MMWR) that highlighted the illness spike in 13- and 14-year-olds in Washington's recent outbreak
Health officials are also seeing waning protecting with the tetanus, diphtheria, and pertussis (Tdap) booster recommended for 11-year-old children, he said, adding that protection gaps from both vaccines appear to be fueling the current epidemic.
The nation's number of pertussis cases reported so far this year—27,726—has surpassed the final number of 27,550 reported for 2010, making 2012 the hardest-hit year in decades, Clark said. The updated pertussis total appears in today's issue of MMWR.
Scientists don't have a clear understanding of why the vaccine doesn't protect very well, and developing a better vaccine could be a long way off, because there's not much in the pipeline, Clark said. "A lot of us are saying 'start now,' " he added.
In the meanwhile, pertussis vaccination is still the best way to fight the disease and is still a very important tool, especially since there is a lot of ongoing pertussis activity, he said.
Michele Roberts, MPH, with the Washington State Department of Health immunization program, has been involved with the state's epidemiologic investigations of pertussis activity and took note of the new NEJM findings. She said the vaccine protection drop-off the Kaiser team found is another piece of the puzzle that will help experts better understand how to use the vaccine to control outbreaks.
She said the next step is to evaluate the duration of protection from the Tdap vaccine, adding that studies are already under way to shed light on that issue. Pertussis is a difficult disease to understand, Roberts said, because natural infection doesn't provide long-term immunity, and there are still several unanswered scientific questions.
Roberts echoed the point that health officials are still embracing use of the vaccine. She said its short-term protection is good and it is useful for helping prevent the spread of the disease, especially in outbreak settings, and to mitigate the severity of infections.
Klein NP, Bartlett J, Rowhani-Rahbar A, et al. Waning protection after fifth dose of acellular pertussis vaccine in children. N Engl J Med 2012 (published online Sep 13) [Abstract]
Source: CIDRAP, 13th September 2012. http://www.cidrap.umn.edu/cidrap/content/other/news/sep1312pertussis.html
All four children sickened last month by whooping cough in Mahomet had been vaccinated for the disease, a public health official said.
The four children, two at Lincoln Trail Elementary School and two at Mahomet Junior High School, got sick in November, with the latest case lab-confirmed Tuesday, said Rachella Thompson, communicable disease investigator for the Champaign-Urbana Public Health District.
One of the Mahomet youths had severe symptoms, but didn't require hospitalization, she said. For the others, the symptoms were mild.
The disease starts out like a cold with a runny nose, but gradually progresses to violent coughing spasms and sometimes comes with a low-grade fever, Thompson said.
The treatment is being confined at home for five days on antibiotics, she said.
Source: The News Gazette, 6th December 2012 - http://www.news-gazette.com/news/health/health-care/2012-12-06/mahomet-children-whooping-cough-had-been-vaccinated-booster-urged
Hepatitis B virus (HBV) infection is a global health issue. Universal infantile hepatitis B (HB) vaccination is very efficacious. However, HBV infections among those immunized subjects have been reported. The long-term efficacy of postnatal passive-active HB vaccination in high-risk subjects is not well explored. A total of 8,733 senior high school students who were born after July 1987 were assayed for hepatitis B surface antigen (HBsAg) and antibodies to HBsAg (anti-HBs). The overall HBsAg and anti-HBs-positive rates were 1.9% and 48.3%, respectively. The HBsAg-positive rate was 15% in HB immunoglobulin (HBIG) recipients (adjusted odds ratio [OR]: 15.63; 95% confidence interval [CI]: 10.99-22.22). Among students who did not receive HBIG, there was a significantly negative association between HB vaccination dosage and HBsAg-positive rate (P for trend = 0.011). Adjusted ORs for those who received 4, 3, and 1 to 2 doses were 1.00, 1.52 (95% CI: 0.91-2.53), and 2.85 (95% CI: 1.39-5.81), respectively. Among HBIG recipients, the HBsAg-positive rate was significantly higher in subjects with maternal hepatitis B e antigen (HBeAg) positivity and who received HBIG off-schedule. A booster dose of HB vaccination was administered to 1974 HBsAg- and anti-HBs-negative subjects. Prebooster and a postbooster blood samples were drawn for anti-HBs quantification. The proportions of postbooster anti-HBs titer <10 mIU/mL was 27.9%. Subjects with prebooster anti-HBs titers of 1.0-9.9 mIU/mL had significantly higher postbooster anti-HBs titers than those with prebooster anti-HBs titers of <1.0 mIU/mL (P < 0.0001). Conclusion: Having maternal HBeAg positivity is the most important determinant for HBsAg positivity in adolescents who received postnatal passive-active HB vaccination 15 years before. A significant proportion of complete vaccinees may have lost their immunological memories against HBsAg. (HEPATOLOGY 2013)
Source:
Volume 57, Issue 1, pages 37–45, January 2013 - http://onlinelibrary.wiley.com/doi/10.1002/hep.25988/abstract
The Orange County Health Department believes people attending two Hillsborough Youth Athletic Associate baseball games last week may have been exposed to measles.
Health Department officials are asking anyone who attended either of the games to be on the alert for symptoms of measles such as fever, cough, runny nose, red eyes and a rash that begins on the head and moves down.
A person who attended the game developed measles on Sunday, which means he or she may have been contagious while attending the game on Friday and the one on Saturday.
The person who came down with measles had been fully vaccinated and had no reason not to be in public, officials said in a news release.
Source: The Times News, 10th May 2013. http://www.thetimesnews.com/news/region-state/another-case-of-measles-discovered-in-orange-county-1.140457
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