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Friday, September 17, 2010

Reported Pertussis Cases on the Rise: What Parents Need to Know

Back to school time has begun all across the nation, meaning that children will soon be in the ideal environment for spreading disease. Being in such close quarters around other kid’s has them sharing more than just toys. In some cases, kids share lunches, the same drinks, or even the things that another kid puts in their mouth.

There are sets of standard state vaccination requirements that must be met before enrolling children in school or day care. Parents can check the resources below for Arizona's back to school information about the vaccines required for child care and school attendance for the 2010-2011 school year. Despite these protective and proactive state requirements, cases of pertussis have been on the rise.

Many Americans don’t realize the most important role that immunization plays in our society because of the fact it’s so successful. Parents often rationalize not getting their child vaccinated, or delaying the vaccine, simply because of a lack in recent outbreaks. But, the notions that a lack of outbreaks is a direct result of more parents getting their children vaccinated, is a concept that is often neglected. Many people, even educated ones, are not only placing their children at risk, but the entire community they live in.

Only believing in what you can see is just as irrational as only believing in things you can't. But, even bad logic is still logic. For example, a great deal of naturopathy practitioners and homeopathy proponents claim that they prefer a more natural method of protecting their children from illness and disease. The notion is that the chemicals in the vaccine are not "natural", therefore they are deemed as being “toxic” and foreign, which is dangerous because they are unnatural to the body. This is either a good example of a complete absence of scientific knowledge or an obvious perversion of science that can potentially endanger an entire community.

Currently, there are some troubling signs of this growing fear of vaccinations showing up in society and through various forms of data capture.

A rise in vaccination exemption requests
The Arizona Department of Health Services collects Immunization Data Reports from schools and child care centers. In Arizona, parents have the right to request an exemption for their children from certain vaccine requirements, based on religious or personal beliefs. This “right” shows a complete disregard for the real issue of public health risks. People are opting out of vaccinations, increasing the risk to vaccine-preventable diseases. The greater the number of un-vaccinated children increases, the greater the risk of being infected by disease increases for all children.

The ADHS reports the rates that these “rights” are being requested have more than doubled since 2001, showing a potentially dangerous trend. The more unimmunized people in a community, the greater the risk is for outbreaks of vaccine-preventable diseases.

Twenty-one states allow for what are called, “philosophical” exemptions, which includes personal beliefs and something along the lines of borderline superstition. A number of state courts have dealt with this issue, citing that mandatory vaccinations do not violate 1st Amendment rights to religious freedom. In the United States Supreme Court case, Employment Division, Department of Human Resources of Oregon v. Smith, 494 U.S. 872 (1990), Justice Antonin Scalia, writes on behalf of the majority on this case,

"We have never held that an individual's religious beliefs
excuse him from compliance with an otherwise valid law
prohibiting conduct that the State is free to regulate."



Pertussis outbreak

At one point, the pertussis vaccine reduced the annual number of deaths to less than 30, but in the last few recent years, the number of cases has started to rise. According to the California Department of Public Health, from January to September 7, 2010, more than 3,800 cases of pertussis were reported. The number of reported cases this year is seven times greater than during the same time period in 2009. Pertussis seems to make a reoccurring appearance in the United States that spikes every 3-5 years. But, if the current trends shown in early reports continue on to the end of the year, California will have the highest annual rate of pertussis reported in over 50 years and earn the highest rate of disease in 47 years. The CDPH is attempting to combat this state epidemic by providing the general public with various forms of guidance, educational materials, and free vaccination clinics. But, the issues surrounding vaccination denial and the people who fear or distrust doctors, hospitals, modern medicine, or science in general, are often left unaddressed. Visit the California Department of Public Health website for the most recent information.

Pertussis, also known as “whooping cough”, is highly contagious and most serious for infants because they are most vulnerable to transmission. Infants are too young to receive inoculation so they rely on the benefits of herd immunity. Quite often, the young children who get pertussis must be hospitalized. The disease is caused by a bacterium called, bordetella pertussis, which is a respiratory tract infection that is very serious in babies and can often lead to an infant’s inability to breathe.

A severe coughing spell can result from pertussis and a child can develop a “whooping” sound when breathing in. Watch this video of a Public Service Announcement with Jennifer Lopez promoting immunization against pertussis and providing audio of a child with whooping cough.

The best method to fight whooping cough is through vaccination
Adults and other older children can spread pertussis to babies, so the best way for parents to protect themselves and their newborn is to make sure that everybody in the family is immunized against whooping cough. Children should be up to date with their immunizations, infants and toddlers should have four shots against pertussis, and a booster before kindergarten. Parents can ask their doctors about the new Tdap vaccine for the kids 10 years of age and older, which protects them against pertussis and includes a tetanus and diphtheria booster.

Multiple vaccines are safe in infants
Some parents are concerned about the number of recommended vaccines in early childhood. Here is a new article in the June 2010 issue of Pediatrics, documenting that vaccinating infants on the recommended schedule has no adverse effect on a child’s neuropsychological outcomes, 7 to 10 years later.


VACCINE RESOURCES FOR PARENTS:


10 Things Parents Need to Know

Addressing Common Concerns

Arizona vaccine requirements for 2010-2011 school year
Back to school information about vaccines required for child care and school attendance for the 2010-2011 school year in Arizona from the ADHS website.

CDC Pink Book Site Map for Where to Give Vaccines
Documents showing photographs of infants, a toddler, and an adolescent with recommended locations for vaccinations can be found on pages D-18 to D-22 of the 11th edition of the CDC Pink book.

**Catch-up Immunization Scheduler
The CDC website has an interactive, web based adult immunization scheduler for people 19 years of age and older. Users of the adult scheduler can sign up for “email updates” to ensure they are notified when there are changes to the adult recommended immunization schedule.

**Childhood Immunization Scheduler
There is also an interactive, web based childhood Immunization scheduler for children 6 years old and younger

**Both schedulers can be downloaded onto a personal computer. When immunization recommendations change, the CDC will update both immunization schedulers.



Additional resources of pertussis outbreaks going back to 2004-2005:


Notes from the Field: Pertussis –- California, January—June 2010
MMWR June 9, 2010; 59(26):817

Use of Mass Tdap Vaccination to Control an Outbreak of Pertussis in a High School--Cook County, Illinois, September 2006-January 2007
MMWR July 25, 2008;57(29):796-9

Outbreaks of Respiratory Illness Mistakenly Attributed to Pertussis --- New Hampshire, Massachusetts, and Tennessee, 2004--2006
MMWR August 24, 2007; 56(33):837-842

Pertussis Outbreak in an Amish Community–Kent County, Delaware, September 2004–February 2005
MMWR August 4, 2006;55(30):817-21