Medical officials are saying that there have been 37 cases of pertussis — whooping cough — reported in my hometown of Boulder so far this year.
We’re not even 100 days into 2012 yet. [Note: Washington State is in the midst of an actual epidemic of pertussis.]
How serious is this? 30 of those Boulder cases are in children under the age of 18… and it almost took the life of six week old Natalie Schultz. The local news reported on this:
Anti-vaxxers and those opting out of vaccines are a problem, especially as they reduce the herd effect making it more likely unprotected members of the community become sick.
But things may be a little more complex than just blaming anti-vaxxers. Not enough to let them off the hook at the front lines of these problems but maybe enough to see that everyone may have a role here.
Whooping cough is highly infectious – one person can pass it on to 12-17 and requires vaccination rates of over 90% for herd immunity to work.
But it can be more complex than that. Pertussis is a sneaky disease. Even natural infection does not provide lifelong immunity. Vaccination provides perhaps 10 years of protection and booster shots are needed, even in adults.
Few adults get booster shots yet may not be protected, especially with spreading the disease.
Also, some of the newer vaccines while having fewer side effects and adverse reactions, may not even be providing as many years of immunity as the older vaccine. So boosters every 5 years may be recommended.
In fact, it has been recommended that all adults be vaccinated against whooping cough. So some of the loss of herd immunity may come from waning immunity is previously vaccinated adults, who then help spread the disease. Because whooping cough in adults may be underreported as it seems much more like a normal cough.
Influenza virus evolves rapidly to evade our immune system, meaning that we have to get new vaccines every year. While the bacteria that causes whooping cough may never become that revolutionary, there are indications that some strains are evolving ways to evade the immune system.
So while the major problems with whooping cough are social in nature and can be dealt with – no opting out and adult vaccination – there needs to be some recognition that even that might not eradicate the disease if we are also applying Darwinian pressure for the bacteria to evolve.
We will just have to be ‘smarter’.