nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Saturday, December 18, 2010

California Whooping Cough Outbreak: Cases In The Previously Immunized?

A poorly done news article on California whooping cough cases occurring in people who allegedly* have already been immunized.

This piece from the Orange County Register Watchdog blog (Dec 16) implies that either the vaccine is no good or that there's a new strain of whooping cough that's causing concern during the outbreak in California.
Thing is, a whole lot of people who have been immunized for whooping cough are still getting whooping cough, according to an interesting piece by The Watchdog Institute and KPBS in San Diego.  For whooping cough cases where vaccination histories were known, between 44 percent and 83 percent of the sick had been immunized, the report found.
Actually, it's probably neither of those two explanations (vaccine no good, new strain).

In the old days, we said that there were several vaccines that provided lifelong immunity.  We now know that's not true.  Even those people who had the disease itself--chickenpox, for instance--can break out again later in life.  With chickenpox, the recurrence is called "shingles" (it's the same virus).  We never completely rid the body of the virus in childhood and a minority of patients lose their immunity, usually after the fifth decade, and can develop shingles.

It's no wonder then, that as we have 50 or more years of experience with vaccines like smallpox, mumps, and measles that we find the duration of immunity is just "very" long, not lifelong.  On the order of 1-2 decades from some people, longer for others.

Then there are vaccines that we've always known the immunity they conferred was short-lived:  tetanus needs to be given every ten years, the flu shot every year.

Back to whooping cough.  It's likely that, since we first began giving whooping cough vaccination, some individuals did not develop a long-lasting immunity.

But, here's the key.  There was little whooping cough disease around, so they never got exposed again.  No exposure, no illness.  Then...when an outbreak occurs, as in California, the virus is circulating widely, and more of the those vulnerable folks win the Fickle Finger of Fate Award...and get whooping cough.

No need to postulate ineffective vaccine or a new viral strain.  Occam's razor.

The writers at the OC Register didn't do their homework:  they went with the hype over the more plausible science.

None of this "disproves" a new strain, but why make up a theory for which there's no evidence, when there's a good explanation at hand?

Digression:  I worked as a volunteer in the ER when I was in high school. I once asked a doctor, "We give the DPT shot (or DTP, as some call it).  It's for diphtheria, whooping cough, and tetanus.  D stands for diphtheria, T stands for tetanus, but where does P come from?"  He said, "Whoo-*P*ing cough."  The real answer is "pertussis," the medical term for whooping cough.  Ha ha.

Doc D
*I say allegedly, because records get lost and memories are notoriously inaccurate.

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