DTaP and Transmission

[anewmama]

It has been repeated frequently on this board that DTaP doesn't prevent transmission.

I am wondering where this "fact" comes from. If you have a study or something academic or scientific stating this, please post it. I would really like to see where this is written and how people came to this conclusion in their research.

[rlneub]

Ok lets look at pertussis

http://www.ima.org.il/imaj/ar06may-2.pdf

Pertussis is considered an endemic disease, characterized by an epidemic every 2–5 years. This rate of exacerbations has not changed, even after the introduction of mass vaccination – a fact that indicates the efficacy of the vaccine in preventing the disease but not the transmission of the causative agent (B. pertussis) within the population

http://pediatrics.aappublications.or...act/115/5/1422

Serologic studies suggest that the rate of B pertussis infection in adolescents and adults is 2.0% per year. The rate of cough illnesses (pertussis) caused by B pertussis infection in adolescents and adults is between 370 and 1500 per 100 000 population. These data suggest that there are between 800 000 and 3.3 million cases per year in the United States.

Again evidence that the vaccine does not give herd immunity as it does not prevent transmission of the disease.

http://pediatrics.aappublications.or...ull/104/6/1381

This definition required 21 days of paroxysmal cough plus laboratory confirmation of pertussis in the subject or household contact. There are 2 problems with this definition. The first is that a substantial number of B pertussis infections in unvaccinated children are mild and would not meet the case definition. The second is that all pertussis vaccines tend to modify duration and severity of disease rather than completely preventing illness.18,2326-29,35,36,40 Therefore, the WHO definition has made all vaccines look better than they are and it has tended to obscure differences between vaccines

http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Citation

Since the neurologic picture is not specific for pertussis vaccination, its temporal relationship to the vaccination is the critical variable for determining causation. Although the majority of seizures following pertussis vaccination are associated with fever, it was the consensus of the neurologists attending the workshop, that these do not represent febrile convulsions, but are non-benign convulsions. The incidence of post-vaccine encephalopathy is difficult to ascertain

http://www.immunizationinfo.org/vaccineInfo/vaccine_detail.cfv?id=2...

In rare cases (about 100 children out of 10,000 shots given, or about 1%) children have moderate reactions such as prolonged crying, fever of 105 degrees or higher, seizure, or the child becoming limp, pale, and less alert.

http://www.ncbi.nlm.nih.gov/pubmed/8917236

After 67,000 doses, 153 serious adverse events (0.23%) were reported, 8 considered possibly related, and 5 related to vaccination, including 1 hypotonic-hyporesponsive episode.

----------------------------------

Now my point is, the pertussis vaccine is advocated to protect newborn infants from receiving pertussis, yet the vaccine does not stop transmission. 1% of those vaccinated have moderate adverse reactions and 0.23% have severe reactions.

An issue I find troubling is that since the vaccine lessens the severity of the cough, many people with whooping cough may not know they have it and thus may come into contact with infants and thus pass this on to the infant. The infants getting pertussis will be blamed on the unvaccinated as the issue when in reality it is more likely that an undiagnosed mild case carrier gives the disease to the infant.

[pantufla]

http://www.mothering.com/discussions...d.php?t=806782

[Ophelia]

Originally Posted by rlneub

Now my point is, the pertussis vaccine is advocated to protect newborn infants from receiving pertussis, yet the vaccine does not stop transmission. 1% of those vaccinated have moderate adverse reactions and 0.23% have severe reactions.

An issue I find troubling is that since the vaccine lessens the severity of the cough, many people with whooping cough may not know they have it and thus may come into contact with infants and thus pass this on to the infant. The infants getting pertussis will be blamed on the unvaccinated as the issue when in reality it is more likely that an undiagnosed mild case carrier gives the disease to the infant.

I totally understand this part, but why don't I hear about infants (not vaxed or not fully vaxed) getting pertussis all of the time? You'd think you would hear a lot more of that. Especially since it's worse for that age. Or are they, and it's just getting diagnosed as something else?

[wallacesmum]

Breastfeeding could be a factor.

[mamakay]

Originally Posted by Ophelia

I totally understand this part, but why don't I hear about infants (not vaxed or not fully vaxed) getting pertussis all of the time? You'd think you would hear a lot more of that. Especially since it's worse for that age. Or are they, and it's just getting diagnosed as something else?

The average age of infection is aroung age 4 or 5, and most people are infected with pertussis every 4 or 5 years, so it'll be "sorta" rare for a newborn to be unlucky enough to catch it so young. But it does happen.
I'd guess that it is probably usually misdiagnosed as asthma or bronchitis even in infants as young as 4 months. Also, nobody knows how well the first shot or two works, so there's a chance it's pretty effective at reducing the symptoms enough to guarantee that most vaxed babies who catch it won't be diagnosed.
I've heard pedis say stuff like "All the infants under one I've seen with pertussis need to be hospitalized"...but, all that tells you is what those docs expect pertussis to look like, and that they always misdiagnose the milder cases.

[berkeleyp]

so there's a chance it's pretty effective at reducing the symptoms enough to guarantee that most vaxed babies who catch it won't be diagnosed.

If they don't have enough symptoms to be diagnosed, doesn't that also mean they aren't likely to be hospitalized - so isn't that a good thing?

[wallacesmum]

Sure, a less severe case is a good thing. That's why I think it is critical to know how to care for pertussis, in order to lessen the symptoms.

[anewmama]

Wallacesmum,

This comes up, but there is very little that can be done to care for someone with a case of pertussis. Beyond making them more comfortable, but there isn't any care that is available to lessen or hasten the diseases progress. SA is often mentioned here but I haven't ever seen a whole lot of research on SA as a treatment, or how many people here have actually had to use this treatment on a very young infant/toddler who might refuse to drink a solution of SA. What other treatments are you referencing? Antibiotics? I hear that is only somewhat effective right in the beginning.


Mamakay, what do you think? Do you think the Pertussis vax doesn't prevent transmission?

[wallacesmum]

Well, there is plenty of older clinical evidence for the efficacy of vit. C in neutralizing toxins. Pertussis does its stuff using toxins. So one could conclude that the anecdotal experience of folks, alongside the biological activity of an antioxidant as powerful as vit. C, is sufficient evidence that there might be something to it.

Edit: I missed part of your post. As to what I would recommend with a very young child: well, in a truly severe situation I would probably look for a practitioner who uses IV vit. c, but for more mild situations I would just dose up mom and nurse heavily - that's what we did anytime ds was sick.

[anewmama]

Right, but no solid evidence or information from current studies. I just think that is really important for people to hear. That studies are old and evidence frequently anecdotal. Particularly for mom's no longer nursing or who can't. And even dosing mom and nursing, without evidence of how much C is being transmitted and used by the child, it's sort of a shot in the dark (no pun intended), don't you think?

Certainly none of this is concrete enough to call a definite treatment. Most illness respond to antibiotics. That is an example of a definite treatment in my book.

[mamakay]

Mamakay, what do you think? Do you think the Pertussis vax doesn't prevent transmission?

I've never been able to find any evidence that it does, and there's loads of epidemiological evidence that it doesn't, and according to the cell biology, it can't.

http://pediatrics.aappublications.or...ull/104/6/1381

Case definition has been particularly problematic in all of the recent DTaP vaccine efficacy trials. For uniform comparative purposes a case definition was suggested by a WHO expert committee.39 This definition required 21 days of paroxysmal cough plus laboratory confirmation of pertussis in the subject or household contact. There are 2 problems with this definition. The first is that a substantial number of B pertussis infections in unvaccinated children are mild and would not meet the case definition. The second is that all pertussis vaccines tend to modify duration and severity of disease rather than completely preventing illness.18,2326-29,35,36,40 Therefore, the WHO definition has made all vaccines look better than they are and it has tended to obscure differences between vaccines

http://whqlibdoc.who.int/hq/1999/WHO_V&B_99.03.pdf

In discussion, Dr Cherry pointed out that in Japan also the reported pertussis incidence in children under three months of age has not declined substantially with return to a high vaccination coverage.

(aka...no herd immunity with mass vaccination. The newborns are the "canaries in the colemine" for detecting how much pertussis is "out there" circulating.)

From an Adacel ad:

http://www.adacel-locator.com/index....E&P=HowS_pread

“It is unknown whether immunizing adolescents and adults against pertussis will reduce the risk of transmission to infants.”

A bunch of studies going into the why's and how's of the vaccine not actually preventing infection:

http://scholar.google.com/scholar?q=...r=&btnG=Search

[mamakay]

Originally Posted by berkeleyp

If they don't have enough symptoms to be diagnosed, doesn't that also mean they aren't likely to be hospitalized - so isn't that a good thing?

Oh, definitely. If the first few doses actually do anything. I suspect that they probably do, but nobody really knows for sure.

[runes]

Originally Posted by anewmama

Right, but no solid evidence or information from current studies. I just think that is really important for people to hear. That studies are old and evidence frequently anecdotal. Particularly for mom's no longer nursing or who can't. And even dosing mom and nursing, without evidence of how much C is being transmitted and used by the child, it's sort of a shot in the dark (no pun intended), don't you think?

Certainly none of this is concrete enough to call a definite treatment. Most illness respond to antibiotics. That is an example of a definite treatment in my book.

But you can't just put that out there without delving into WHY recent research and evidence isn't there about Vitamin C and it's role in health and healing. Care to venture to guess why it's not being looked into? Just saying the evidence is "old" is deceptive. Why do you need evidence on the amounts of Vitamin C? Do you know how it works? The dosage needed for each person is highly variable on the individual as well as their health status, but luckily, our bodies are pretty clear on telling us when we've reached a threshold level of Vitamin C. Just because "science" looked into it before but isn't currently looking at it doesn't mean that it's not a safe/effective treatment.

By the way, you wanna talk about old? Go look up the package insert of the MMR, and look at the dates of some of the studies that are cited on it. Then we can address the double standard.

[Deborah]

funny incident on old research

I was attending a public forum to discuss water fluoridation. The pro-F people had a very standard line of attack: all the research against water F was old. I brought up a study by a highly respected science explaining that F destroys enzymes. One of the pro-F people said: "But that article is from 1982." I replied: "If F destroyed enzymes in 1982, it stills destroys enzymes in 2006. That sort of science doesn't expire." They didn't have an answer.

So, if the evidence that vitamin C is effective against certain types of toxins is 70 or 80 years old, it doesn't really matter. Once an effect has been demonstrated, it stands until someone shows that there was an error in the original research.

We need to learn how to spot some of the standard strategies used to convince people that they can't figure stuff out for themselves. Learned helplessness is the goal, I think.

[mamakay]

On vit C and pertussis...here's the old research...

http://www.seanet.com/~alexs/ascorba...37-n2-p134.htm

http://www.seanet.com/~alexs/ascorba...-p1884-eng.htm

There's a lot more recent research on ascorbate treating other toxin mediated bacterial diseases.

(like this)
http://mrw.interscience.wiley.com/co...665/frame.html

So, I think it's quite possible the old research on VitC and pertussis was right...but it's not completely a "fact", IMO, without more followup.

[wallacesmum]

I'd love to see new research, and I hope that it will start to happen as vit. c is re-entering the spotlight as a cancer treatment.

But, yeah, it doesn't bother me that the research is old, if it is valid. I don't know why people are so scared to think vit. c might work, and there is very little risk in trying. Compared to the risks of antibiotics, (and how current is that research?), I'll take SA anytime.

[anewmama]

Originally Posted by kidspiration

But you can't just put that out there without delving into WHY recent research and evidence isn't there about Vitamin C and it's role in health and healing. Care to venture to guess why it's not being looked into? Just saying the evidence is "old" is deceptive. Why do you need evidence on the amounts of Vitamin C? Do you know how it works? The dosage needed for each person is highly variable on the individual as well as their health status, but luckily, our bodies are pretty clear on telling us when we've reached a threshold level of Vitamin C. Just because "science" looked into it before but isn't currently looking at it doesn't mean that it's not a safe/effective treatment.

By the way, you wanna talk about old? Go look up the package insert of the MMR, and look at the dates of some of the studies that are cited on it. Then we can address the double standard.

I am guessing you will say that the reason for no research into it is money and the powers that be not wanting us to know about it.

This is not my point. My point is that there is SOME research and it's old.. There is a VERY high chance your infant or young toddler will NOT be willing to drink SA. THIS IS WHAT HAPPENED TO ME. When my daughter was very sick with pre-pneumonia and straph (diagnosed tentatively after 4 days), she would NOT drink or eat anything and barely wanted to nurse. And when I took stuff, it did not work. In the end, antibiotics were the only thing that worked. Whether SA would have worked for this particular illness is not the point: the point was there was no way to get it into her. And it might have worked for these illnesses as they really were never confirmed by a lab test or x-ray, but the fact is what little I could get to her via breastmilk did not work.

I just get burned with the somewhat flippant recommendations that exist on this forum for how to treat illnesses when they do NOT come with any sort of caveats. The recommendations come with tones of certainty and proven effectiveness.

Yes, maybe maybe SA has been helpful. Yes, maybe some kids will drink it. Maybe some breastfeeding mom's can pass on some Vit C in whatever form through breastfeeding.

But to throw out SA and some of the treatments recommended here as if they work 100% and have been SHOWN to do so is just as bad as vaccine makers throwing out their vaccines and telling you they work without enough science and study and research. You just can't have it both ways.

So back to what sparked this.... yes, SA might help. There may be some treatments. But to be so empirical in stating that these are treatments to many of these VPD is wrong IMHO. It gives people the illusion that they will have effective options for treating their child and therefore, there is no need to vaccinate. This is just not presenting an accurate picture. If you want to present all the buggy information on vaccines, you must do the same for SA (and CLO) for their to be true balance and for anyone to really make a good decision.

And for the record, I have not vaccinated my daughter yet except for one DTaP. I am not advocating vaccines or anything. It's an individual choice. But when I read mom's here saying the know how to treat diseases so they are well armed for not vaccinating, I honestly cringe. How many diseases have they REALLY had to treat? Is this based on experience or just reading some book? Have they had to try to treat the full range of a diseases potential course? For instance, the worst case of measles or just a mild case? The worst case of pertussis or just a mild, diagnosed at home case. Have they really had a case of polio start to go haywire? To say it doesn't exist isn't the point. The point is do they really know how to treat these diseases and all the directions they can take when complications start to arise.

Do you understand what I am trying to say?

[anewmama]

Originally Posted by wallacesmum

Compared to the risks of antibiotics, (and how current is that research?), I'll take SA anytime.

Sure, I would take it too. But at some point, if nothing is improving, I will resort to antibiotics, no question. And for my own history of illnesses, there is nothing that I didn't have that in the end didn't get cured by antibiotics without any near term side effects. Who knows what will happen to me in 30 years and if it is a result of antibiotics.

[anewmama]

Originally Posted by mamakay

So, I think it's quite possible the old research on VitC and pertussis was right...but it's not completely a "fact", IMO, without more followup.

This is what I believe. It needs much more follow up and people being advised by other moms on this board need to be aware of this. It's "malpractice" to not state this when SA is recommended. IMHO. It is being presented much too empirically.