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-   Diptheria, Pertussis, & Tetanus (http://www.mothering.com/forum/112-diptheria-pertussis-tetanus/)
-   -   Can We Discuss DTaP and Transmission? (http://www.mothering.com/forum/112-diptheria-pertussis-tetanus/998940-can-we-discuss-dtap-transmission.html)

Shelsi 11-14-2008 02:08 PM

I think most of us can agree here that the pertussis vax does not prevent transmission.

However doesn't it prevent some transmission? If you have pertussis but no symptoms you're much less likely to spread germs. You're not coughing all over the place, nose running, etc.

MissRubyandKen 11-14-2008 02:24 PM

I believe it could reduce transmission.

ema-adama 11-14-2008 02:40 PM

I might be wrong here, but the vaccine is against the toxin which causes the 'whoop' in WC and not the bacteria. So, you would still get the runny nose and even a cough, but just not the 'whoop'. You could spread it like a common cold without knowing that *that* particular cold was WC.

Gitti 11-14-2008 03:12 PM

My understanding is that the vaccine helps to build resistance to the toxins from the bacteria.

So, you can of course carry the bacteria. The bacteria does its job of multiplying and in the process cause by-products which are the toxins.

Normally you would show a reaction to the toxins. This buildup of resistance though prevents that. It does not however prevent you from carrying and spreading the bacteria around. And that without symptoms.

See how ineffective the vaccine actually is?

You have whooping cough but don't know it. This prevents you from taking any precautions.

here is a good article - http://insidevaccines.com/wordpress/...s-yo-yo-stats/

tanyalynn 11-14-2008 05:58 PM

I thought much of the problem of transmission is that the pertussis part of the vaccine is supposed to reduce the symptoms from the toxin, but the bacteria's been busily multiplying for a couple weeks, I think, before the coughing gets bad. I thought pertussis presented as a fairly regular cold for a week or two, and then the bad coughing would set in, and I thought that was when the body was really feeling the effects of the toxin. But the person has still been spreading bacteria while they just felt like they had a regular cold, and that part isn't affected by the vaccine. By the time the coughing gets bad, I thought the person was becoming less contagious anyway.

quarteralien 11-14-2008 06:58 PM

I'd understood that the same principle applies to the diphtheria portion as well, that it's a vaccine for the toxin, not the bacteria, so it too wouldn't prevent carriage. Top it off with tetanus not being a communicable disease, and DTaP appears to contribute not one iota to herd immunity.

In answer to your original question, I believe you're right, that if you aren't actively coughing, there is less likelihood of transmission. Whether the subclinical case is because of the vaccine or not is debatable though.

Shelsi 11-14-2008 09:23 PM

Ok that makes sense. I thought you wouldn't feel sick at all, no sneezing, runny nose, etc.

So in the end it's probably about the same: You have DTaP and don't feel very ill so you're out spreading the virus unknowingly, or you don't have DTaP and feel bad but you're coughing is spreading the virus. And that of course doesn't even touch on DTaP's actual effectiveness.

2boyzmama 11-14-2008 10:35 PM

I recently asked this exact question to my son's Infectious Disease doctor (he has a primary immune deficiency with t-cell deficit, so he's followed very closely) He told me that this is incorrect, that the pertussis portion of the DTaP vaccine IS against the bacteria, it's the tetanus and diptheria portions that are against the toxin. So therefore it WILL prevent transmission. I pointed out to him that the CDC's own webpage says (in a foot note, I believe) that "it's not clear that TDaP [the adult version] prevents transmission" even though the market it heavily to parents and grandparents of infants.

I'm still trying to get verification, but this is what he told me, and as an Infectious Disease doctor, this is supposedly his specialty...take that for what it's worth I guess...

lirpasirhc 11-14-2008 10:40 PM

did the infectious disease specialist ever send you those canadian references?

2boyzmama 11-14-2008 10:41 PM

Here is the package insert which in the very first sentence says that it's Diptheria toxoid and Tetanus toxoid, but Pertussis bacteria (acellular because the old whole-cell bacteria was thought to be the cause of the adverse reactions in the DTP vaccine; that's what the "a" in DTaP stands for) It appears that Connor's dr was right, the pertussis portion of the vaccine DOES protect against the bacteria, so in theory SHOULD prevent transmission.

I'm guessing that the issue is the efficacy of the vaccine. PLUS, immunity is wearing off, most adults no long have immunity, and adults tend not to have the classic "whoop", so they are ill with pertussis without knowing it and spreading it around.

It's a very frustrating vaccine...

2boyzmama 11-14-2008 10:42 PM

Quote:
Originally Posted by lirpasirhc View Post
did the infectious disease specialist ever send you those canadian references?
Not yet, I"ll probably get them in the mail when I get his records from that appt. That takes up to two weeks. THe Canadian studies were supposed to show that the vaccine actually is effective against transmission...supposedly...we'll see.

quarteralien 11-14-2008 11:11 PM

I think I'm going mad. I could have sworn I read in the Pink Book chapter on pertussis that the vax doesn't prevent transmission and now I can't find that passage. Did they rewrite it in the last couple of months or am I really going nuts? : I'll read it more carefully, but this is strange.

Gitti 11-14-2008 11:31 PM

WEll, here are a couple of studies quoted -

http://insidevaccines.com/wordpress/...-transmission/

So, who is right?

alegna 11-14-2008 11:32 PM

Hmmm... it may have to do with how it works then. I know that the IPV doesn't prevent transmission either (virus instead of bacteria of course, so whole different creature...)

-Angela

chelsmm 11-15-2008 06:03 AM

Quote:
Hmmm... it may have to do with how it works then. I know that the IPV doesn't prevent transmission either (virus instead of bacteria of course, so whole different creature...)
Angela,
Do you have info about this? I'd be interested to learn more about this. I thought all vaccines were suppose to prevent transmission... Thanks!

Sileree 11-15-2008 08:01 AM

Yeah, some studies do report that the vaccine prevents transmission. And theoretically it could work if protects against the bacteria.

I guess to me the proof that it doesn't work is the prevalence of the disease. If it did prevent tranmission then would the disease be endemic among recently vaccinated children? I don't think so.

quarteralien 11-15-2008 11:59 AM

Quote:
Originally Posted by chelsmm View Post
Angela,
Do you have info about this? I'd be interested to learn more about this. I thought all vaccines were suppose to prevent transmission... Thanks!
Not Angela, but I asked this question several months ago and got this answer:

Quote:
Inactivated polio vaccine (IPV) needs to be injected and works by producing protective antibodies in the blood (serum immunity) - thus preventing the spread of poliovirus to the central nervous system. However, it induces only very low levels of immunity to polivirus locally, inside the gut. As a result, it provides individual protection against polio paralysis but, unlike OPV, cannot prevent the spread of wild polio virus.
http://www.polioeradication.org/vaccines.asp

Proverbs31 11-15-2008 12:45 PM

Quote:
Originally Posted by 2boyzmama View Post
Here is the package insert which in the very first sentence says that it's Diptheria toxoid and Tetanus toxoid, but Pertussis bacteria (acellular because the old whole-cell bacteria was thought to be the cause of the adverse reactions in the DTP vaccine; that's what the "a" in DTaP stands for) It appears that Connor's dr was right, the pertussis portion of the vaccine DOES protect against the bacteria, so in theory SHOULD prevent transmission.
The first sentence says it contains antigens for the pertussis toxin, not the bacteria:

INFANRIX (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) is a noninfectious, sterile combination of diphtheria and tetanus toxoids and 3 pertussis antigens [inactivated pertussis toxin (PT)

MissRubyandKen 11-15-2008 02:21 PM

insert

Quote:
INFANRIX (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) is a noninfectious, sterile combination of diphtheria and tetanus toxoids and 3 pertussis antigens [inactivated pertussis toxin (PT) and formaldehyde-treated filamentous hemagglutinin (FHA) and pertactin (69 kiloDalton outer membrane protein)] adsorbed onto aluminum hydroxide. INFANRIX is intended for intramuscular injection only.

Proverbs31 11-15-2008 04:20 PM

Sorry, my bad

quarteralien 11-15-2008 04:31 PM

So, in English, what are FHA and pertractin?

kriket 11-15-2008 05:22 PM

Quote:
Originally Posted by quarteralien View Post
So, in English, what are FHA and pertractin?
they are pieces of Pertussis.
Pertractin is the "house" or outer membrane protein that sticks to epithelial cells. FHA is the tendril that grabs on. "it is a fimbrial-like structure on the bacterial surface, and cell-bound pertussis toxin (PTx). Short range effects of soluble toxins play a role as well in invasion during the colonization stage."

http://www.textbookofbacteriology.net/pertussis.html for FHA Pertractin, just google for a refrence

2boyzmama 11-15-2008 08:51 PM

Quote:
Originally Posted by quarteralien View Post
So, in English, what are FHA and pertractin?
Quote:
Originally Posted by kriket View Post
they are pieces of Pertussis.
Pertractin is the "house" or outer membrane protein that sticks to epithelial cells. FHA is the tendril that grabs on. "it is a fimbrial-like structure on the bacterial surface, and cell-bound pertussis toxin (PTx). Short range effects of soluble toxins play a role as well in invasion during the colonization stage."

http://www.textbookofbacteriology.net/pertussis.html for FHA Pertractin, just google for a refrence
See, this is the exact problem with this!!! Part of it IS the toxin, however do you notice how they use the word "toxoid" for D and T, but "toxin" for a portion of P? Why? And the other two portions are the acellular part of the pertussis bacteria, as I understand it. So the *idea* is that the vaccine is created to protect against the toxoid AND the bacteria, but because there were such severe effects from the old whole-cell vaccine, they switched to acellular and it isn't as effective.

It's all mumbo jumbo, and drives me crazy!!! With my son's particular special needs, I really *want* to give him protection from pertussis, even just partial protection, but not until I understand this vaccine more!!!

It is clear, though, that the argument of "it doesn't prevent transmission because it protects against the toxin" isn't quite accurate or complete. Does someone want to call the CDC vaccine information line and ask this question??? I might do it, actually.

quarteralien 11-15-2008 09:00 PM

In my rereading of the pertussis chapter of the Pink Book, I found a passage that said the acellular version was more effective than the old whole cell version. : But everywhere you hear about it, you hear that it's safer, but less effective. I don't think anyone has the straight scoop on this vax.

Proverbs31 11-16-2008 12:14 AM

^^Reminds me of Dr. Mendelsohn's saying: you only hear about the downsides of a drug when a replacement drug is introduced...

tanyalynn 11-16-2008 01:28 AM

Quote:
Originally Posted by 2boyzmama View Post
Does someone want to call the CDC vaccine information line and ask this question??? I might do it, actually.
Wow, I didn't realize there was a number you could call to ask technical questions.

If you call, can you share the results with us? Pretty please?

MissRubyandKen 11-16-2008 08:16 PM

I've been trying to find the paper I read that stated this but haven't yet. I remember reading that anything short of universal vaccination with DTaP and Tdap wouldn't see a reduction overall in cases of pertussis at this point.

mamakay 11-16-2008 08:54 PM

They do put actual bacterial antigens in there, but they just don't seem to do what they're supposed to do.

Look through some of these...

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


Especially this one (this is something to send to that infectious disease doc)

http://iai.asm.org/cgi/content/abstract/68/12/7175

Quote:
Characterization of Bactericidal Immune Responses following Vaccination with Acellular Pertussis Vaccines in Adults
Quote:
Similarly, opsonization with the postimmunization sera failed to enhance attachment or phagocytosis of bacteria by neutrophils, and one postimmunization sample with a strong response to filamentous hemagglutinin caused an inhibition of phagocytosis that was statistically significant compared to that observed for the no-serum control. In summary, booster immunization of adults with acellular pertussis vaccines was not found to increase bactericidal activity over preimmunization levels. Identifying ways to promote bactericidal immune responses might improve the efficacy of acellular pertussis vaccines.
What they're saying is that the antigens in the vax that are supposed to teach your immune system how to combat the actual bacteria, don't. It should, and it's supposed to....but it doesn't work.

Which is almost certainly why the 5 component acellular vaccine isn't much more effective than the monocomponent "pertussis toxoid only" vaccine.

The antigen they need to have in there is probably this one:

http://iai.asm.org/cgi/content/abstract/68/12/7152

Quote:
Neutralizing Antibodies to Adenylate Cyclase Toxin Promote Phagocytosis of Bordetella pertussis by Human Neutrophils
But the current pertussis vaccine doesn't have that toxin in there.
Adenylate Cyclase Toxin is sort of like a "forcefield" for the pertussis bacteria.Pertussis excretes that toxin to hide from your immune system. That's probably why the pertussis vax doesn't work to help you clear pertussis more quickly.

mamakay 11-16-2008 09:00 PM

Quote:
Originally Posted by Shelsi View Post
I think most of us can agree here that the pertussis vax does not prevent transmission.

However doesn't it prevent some transmission? If you have pertussis but no symptoms you're much less likely to spread germs. You're not coughing all over the place, nose running, etc.
Pertussis is most contagious in the first couple of weeks, when you think you just have a cold.
There's no evidence that the vaccine does anything at all to prevent that phase. All we know is that it shortens "the cough"...but by the time you have "the pertussis cough"...you're basically mostly done with the contagious phase.

mamakay 11-16-2008 09:09 PM

http://www.mothering.com/discussions...d.php?t=555012


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