Parapertussis - is this why the vaccine seems ineffective?

[Metasequoia]

Don't get me wrong, I don't have much (okay, any) faith in the pertussis vaccine - but I'm wondering if the "outbreak" in California is really parapertussis and not pertussis. It's all over our area as well (we're 4 weeks into it ourselves) and now I wonder if we have pertussis or parapertussis.

Our doctor wrote on Ds's chart that his symptoms appeared to be pertussis or pseudo-pertussis - is that just another name for parapertussis?

We seem to have spread it to quite a few people who have recently come down with symptoms and who have tested positive. One family who has three vaccinated children (who all tested positive and all have symptoms) tested positive for parapertussis, not pertussis.

I'm really curious what we have - it seems more likely that it would be parapertussis since that's what this family has. I'd like to find out what the little boy we babysat has (pertussis vs. parapertussis.)

BUT, ours did NOT seem mild. It started the last week of July for all of the kids and Dd2 is still coughing a lot. That's well over 30 days so far.
Ds had the worst of it after he developed pneumonia from it. He coughed until his lips turned blue, collapsed on the ground after his 2-3 minute long coughing fits, vomited *puddles* of pure, thick mucous, etc. He did a z-pack to try to help with the pneumonia.
I've been coughing for 3 weeks already and still going, though I *think* I'm over the hump.

Here's what I've seen so far:

http://search.wi.gov/query.html?qt=p....gov&style=dhs (There's a PDF here that I couldn't link to):

State of Wisconsin

Department of Health and Family Services

Parapertussis Q and A

What is parapertussis?
Parapertussis is a bacterial illness that is similar to pertussis (whooping cough) but is typically milder than pertussis. Parapertussis is caused by the bacterium Bordetella parapertussis, whereas pertussis is caused by Bordetella pertussis. Only B. pertussis produces the pertussis toxin (PT).

More info:
http://www.health.state.mn.us/divs/i...s.html#vaccine

http://www.cidd.psu.edu/research/syn...-parapertussis

An acellular whooping cough vaccine actually enhances the colonization of Bordetella parapertussis in mice; pointing towards a rise in B. parapertussis incidence resulting from acellular vaccination, which may have contributed to the observed increase in whooping cough over the last decade.

[Angela512]

The pertussis vaccine is ineffective because it does not prevent transmission or infection, only severity of the illness.

[Metasequoia]

Originally Posted by Angela512

The pertussis vaccine is ineffective because it does not prevent transmission or infection, only severity of the illness.

I realize this - but I wonder if some of these cases are in fact B. parapertussis, NOT B. pertussis, kwim? I know that a lot have been diagnosed as pertussis, confirmed by testing, but surely *some* are parapertussis...

[ttcintexas]

Never heard of parapertussis. Interesting.

[Ruthla]

This sounds like medical jargon for "well, it's the same symptoms as pertussis, but since it's not the EXACT strain we vaccinated for, we can still call the vaccine effective."

How long do you think it will be until they make a new vaccine that includes both strains, with more side effects, and then a third strain starts causing illness?

[Metasequoia]

We're into our fifth week of coughing, so I'm going with pertussis vs parapertussis.

Two families who we had close contact with on 8/2 both recently came down with The Cough and both tested positive for pertussis. We never had contact with the family who tested positive for parapertussis, but I believe they played with the people we infected, after we infected them.

Interesting indeed.

It's not a mutation. Bordatella pertusssis, while being nearly identical symptom-wise to Bordatella parapertussis, is a totally different bacteria. It's not a mutated form. B. parapertussis has been around for a very long time.

And the studies that show that B. parapertussis is on the rise directly because of the pertussis vaccine leave me wondering just how directly this works.
If we had pertussis and transmitted it to these two other families and during their contagious stage, they played with this other family (who had the DTaP series), is it possible that they became infected with B. parapertussis because of the vaccine? I didn't think it was that straightforward, kwim?

[japonica]

From what I've read, pertussis is changing...partly in response to the vaccination programs...

http://www.ncbi.nlm.nih.gov/pmc/arti...7/?tool=pubmed

Changes in the genomic content of circulating Bordetella pertussis strains isolated from the Netherlands, Sweden, Japan and Australia: adaptive evolution or drift?
Audrey J King,1 Tamara van Gorkom,1 Han GJ van der Heide,1 Abdolreza Advani,2 and Saskia van der Lee1

CGH data also revealed that the genome size of B. pertussis strains is decreasing progressively over the past 60 years...Our results show that B. pertussis is a dynamic organism that continues to evolve.

It's an interesting read...they noticed that the pertussis bacteria is undergoing gene loss, with a rapid rate of gene deletion that can be seen in many areas of the world. The authors note that with certain bacteria, gene loss can equal an increase in virulence.

They also noted a complete change in strains in the Netherlands, where strains that were circulating six decades ago cannot be found today and it's posited that this is another reason for the increase in the number of reported cases.

Also, the pertussis bacteria have adapted to live in older, previously vaccinated hosts:

Immune pressure may select for certain strains with a particular advantage, and which may be linked to specific gene content. The fact that we see the same or similar strains in different countries during certain time periods suggests that an important advantage for these strains may be their capability to spread throughout the immunized population.