Please Explain These Pertussis Statistics

[Turquesa]

http://www.who.int/immunization_moni...ntry.cfm?C=USA

Do these variable numbers correlate in any way with vaccination compliance rates? Was DTP, despite the danger of the whole-cell pertussis, more effective than DTaP at keeping the disease at bay? I'm just curious why these trends show pertussis cases on an upswing?

[Deborah]

pertussis stats are really tricky because they are easily influenced by diagnosis.

All it would take is a government bulletin warning doctors that pertussis is going up...and diagnosis will shoot up...but the real rate hasn't change a bit.

My guess is that pertussis is endemic and goes up and down just as it did before the vaccination.

Some of the factors that muddle the situation: vaccination can change the symptoms and make it harder to diagnose, even without the medical assumption that vaccination equals no pertussis cases.

On the other hand, people who get and survive pertussis in childhood, sans vaccination, are also likely to have mild cases in the future: another cause of misdiagnosis.

If doctors are looking out for pertussis, they may diagnose other stuff as pertussis when it isn't, just to make it even more of a muddle.

I suspect that both vaccines are equally ineffective, but DTap may have a slight edge.

[tanyalynn]

I found this study from the journal Pediatrics to be helpful when I was looking at why, really, would it be so hard to diagnose pertussis. It's a prospective study done in West Germany in an area/time with very low pertussis vaccination rates. Even doctors expecting pertussis had a hard time diagnosing it without a test, and the severity of sickness in people who tested positive varied widely (participating doctors tested everyone who came in with > 7 days of cough, regardless of what the doctor thought was going on). And this missed the people who were so mildly sick that they didn't go in to see a doctor.

http://pediatrics.aappublications.or...full/100/6/e10

After reading this, I've lost all hope of actually understanding how much pertussis is circulating.

[miriam]

Doctors do not order lab tests for suspected pertussis cases because they assume everyone is vaxed against it, despite the fact that the vaccine is only 57-78% effective, and the vaccine wears off by adulthood. Who knows how prevalent it really is?

Ever know any one with chronic bronchitis? That is the alternative diagnosis for pertussis when a doctor does order the lab tests for the throat swab that should be done for a correct diagnosis; even then, if the swab is not done at the right time during the progression of the disease, the case may not be diagnosed properly.

We never know. Pertussis appears to be a disease that cannot be conquered, despite generations of vaccinating everyone doctors can get their hands on.

I had pertussis. I am still here.

[HeYunyi]

I was told that in my state (WA) it is rare that a doctor will diagnose pertussis because it means a lot more paperwork than if it was just something like bronchitis. So our state's rates are relatively low, but just across the border in Idaho, where apparently the paperwork is not so burdensome, it is a lot higher.

[mamadelbosque]

When I was doing major research before DS1 was born 3 years ago, I personally came the conclusion that everybody gets pertussis every few years. I ask people occasionally "ever had a 'cold' that just wouldn't go away?" - 'yes' "that was probably pertussis" - to which I get an "oooh, that makes sense!". Really, the vast, vast vast majority of cases are very mild and are just that to the general population - a cold that just would. not. go. away. !!!

[mamakah]

Originally Posted by mamadelbosque

When I was doing major research before DS1 was born 3 years ago, I personally came the conclusion that everybody gets pertussis every few years. I ask people occasionally "ever had a 'cold' that just wouldn't go away?" - 'yes' "that was probably pertussis" - to which I get an "oooh, that makes sense!". Really, the vast, vast vast majority of cases are very mild and are just that to the general population - a cold that just would. not. go. away. !!!

My 2 yr old neice (fully vaxed) had a bad cough for months! It got especially bad at night, where she would cough so hard she would throw up. It had the whoop sound too. I KNOW it was pertussis (I'm sure it lasted at least 60 days). Dr.s diagnosis? Bronchitis. That same Dr. a few months later told my ex sis in law (who went rushing to him because of a cold) that she better get a pertussis booster so "the cold doesn't turn into pertussis"!!!!!!!! Anyway, I think that this little scenario gives a lot of insight into how Dr.s handle possible pertussis cases. There is no way to really know IMO.

[mizznicole]

DS was just diagnosed with RSV. His cough has that whooping sound when it gets bad. But since we have had the swab test done I'm confident that it is RSV.

That said, the papers in town are claiming that pertussis is on the upswing. My SIL said there was a TV news story on a girl that is being hospitalized for it. So she's on a rampage against non-vaxers. That's what brought me here.

We actually did include DTaP in our selective vax schedule.

[Pirogi]

Originally Posted by mamakah

That same Dr. a few months later told my ex sis in law (who went rushing to him because of a cold) that she better get a pertussis booster so "the cold doesn't turn into pertussis"!!!!!!!!

Wow. Just,

[ema-adama]

I was also amazed by my friends doctor who diagnosed her with pertussis as she had been coughing for weeks and when she brought in her fully vaxed baby as he was coughing so badly he was vomting at night and going purple in the face, she was told it couldn't possibily be pertussis. Not a fully vaxed baby, right?

Yeah, mapping/following pertussis is not without it's problems.