California Cough

A new epidemic has been sweeping across the pacific coast, and it's not a new disease. More than 800 new cases of Bordetella pertussis, or "whooping cough" have been reported in the last two weeks, and as of June 10th, there have been 3458 cases of pertussis reported to California Department of Public Health in 2014, more than in all of 2013. (Source: CDPH)

Gram-stained photomicrograph of
Bordetella pertussis bacteria
Image courtesy of CDC

Bordetella pertussis is a respiratory illness that starts with cold-like symptoms including a runny nose and possible mild cough or fever. After 1-2 weeks, severe and distinct coughing fits develop and can last for more than 10 weeks, causing vomiting and fatigue.  In infants, the disease can manifest in apnea, or a pause in breathing pattern.  It's also particularly dangerous for babies, with about half of infected infants needing hospitalization. The pertussis bacterium attaches to small hair-like extnesions called celia which line the upper respiratory symptoms.  It releases toxins that damage the cilia and cause inflammation.  It is a very contagious human disease that is spread by droplet transmission.  No vaccine is 100% effective, so during community circulation the infected should be avoided.

The epidemic isn't all due to an anti-vaccination movement.  Pertussis is actually cyclical, with peaks every 3-5 years.  Over the past 20-30 years. peaks have been getting higher and overall case counts rising, due to a viaretiy of factors including increased awareness, improved diagnostic tests, better reporting, more circulation of hte bacteria, and waning immunity. Also, the vaccine used in the US, the acellular pertussis vaccine (DTaP), which has fewer possible side effects, does not protect as long as the whole cell vaccine (DTP).

Even though this epidemic is not directly caused by anti-vaccination tendencies, vaccines are absolutely critical not only to protect against several dangerous and potentially fatal diseases but to protect those that are unable to receive them, such as those that are allergic to components in the vaccine delivery system, the immunocompromised, infants below vaccination age, and the elderly whose vaccines may have worn off with time.