Very Basic Question - Page 2 - Mothering Forums
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#31 of 38 Old 07-19-2007, 11:21 PM
 
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It's not saying much to me in terms of when the illness is transmissible. It is saying that the case definition misses people who are infected & therefore the efficacy studies that use that case definition may be inaccurate.

Don't know anything juicy about ACT except that it isn't a vaccine component. Honestly I haven't read anything about pertussis immunity in many years.
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#32 of 38 Old 07-19-2007, 11:32 PM
 
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Quote:
It's not saying much to me in terms of when the illness is transmissible. It is saying that the case definition misses people who are infected & therefore the efficacy studies that use that case definition may be inaccurate.
But it means we have no way of knowing if the vaccine does anything to alleviate symptoms in the first few weeks, when pertussis is the most contagious.

Quote:
Don't know anything juicy about ACT except that it isn't a vaccine component. Honestly I haven't read anything about pertussis immunity in many years.
I'll find it again. It's bizarre.
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#33 of 38 Old 07-19-2007, 11:44 PM
 
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I think that's exactly why Sanofi includes their little disclaimer - because they don't know how it really impacts that time period. What makes you say that's when it's most contagious?
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#34 of 38 Old 07-20-2007, 12:59 AM
 
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Here's the stuff about ACT...

First...what it is and what it does:

http://iai.asm.org/cgi/content/abstr...e2=tf_ipsecsha


Quote:
Proliferation of Bordetella pertussis in the lungs of infant mice challenged by the intranasal route was examined. The bacteria rapidly proliferated in the lungs of mice challenged with a sublethal dose of a wild-type strain (BP338) or a filamentous hemagglutinin mutant (BPM409) from 500 at day 0 to 10(7) at day 15. The infection cleared in about 40 days. Pertussis toxin-deficient mutant BP357 gave a similar profile; however, the number of bacteria recovered was slightly reduced, suggesting that pertussis toxin is not essential for bacterial growth in the lungs. In contrast, adenylate cyclase toxin mutant BP348 was rapidly cleared from the lungs, with no viable bacteria remaining 10 days postchallenge, suggesting that the adenylate cyclase toxin is a colonization factor required for the bacteria to initiate infection.
Now some weirdo vax immunity stuff...

http://www.journals.uchicago.edu/CID...997378209Guest

Quote:
The ELISA values of antibody to ACT in convalescent-phase
serum samples from previously vaccinated or unvaccinated
children with pertussis due to B. pertussis or B. parapertussis
infections are presented in table 2. In unvaccinated children,
the serum GMTs after pertussis due to B. pertussis or B. parapertussis
infections were elevated
: 872 EU/mL and 512 EU/
mL, respectively (48- and 28-fold greater than the GMTs in
unvaccinated infants). Only 1 of the subjects, an 8-month-old
infant, had a low titer in the convalescent-phase blood sample
(titer, 16 EU/mL). In contrast, the GMTs in convalescent-phase
serum samples obtained from subjects in whom vaccination
had failed were only slightly elevated.
The GMT in the serum
samples obtained from subjects for whom DTP () vaccine failed
was 92 EU/mL, and it was 49 EU/mL in the serum samples of
subjects for whom DTaP (Lederle/Takeda) vaccine failed (5-
and 3-fold greater than the GMT in serum samples obtained
from unvaccinated infants).
~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Quote:
Of particular
interest is the lack of a significant ACT antibody response
in children for whom the DTP or DTaP vaccines failed. This
induced tolerance is intriguing and may be due to the phenomenon
called “original antigenic sin
” [22]. In this phenomenon,
a child responds at initial exposure to all presented epitopes
of the infecting agent or vaccine. With repeated exposure
when older, the child responds preferentially to those epitopes
shared with the original infecting agent or vaccine and can be
expected to have responses to new epitopes of the infecting
agent that are less marked than normal.
Because both vaccines
contained multiple antigens (i.e., PT, FHA, PRN, and fimbriae),
the patients who had been vaccinated responded to the antigens
that they had been primed with and did not respond to the
new antigen (i.e., ACT) associated with infection
.
Strange, huh?

Have you read about phagocytosis (or lack thereof) in vax sera? Something about vaccine immunity inhibits phagocytosis as often as it helps it.
I'll find you that, too, if you want...
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#35 of 38 Old 07-20-2007, 01:02 AM
 
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About the infectious period...



http://www.drlera.com/bacterial_dise...ping_cough.htm
Quote:
Whooping Cough (Pertussis)

Information from CDC


Quote:

Infectious period

Highly infectious when the ‘cold-like’ symptoms occur in the early stages. Without treatment, a person is infectious for the first three weeks of coughing. With appropriate antibiotic therapy, the person is no longer infectious to others five days after starting antibiotics.
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#36 of 38 Old 07-20-2007, 01:54 AM
 
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But there's no citation for that statement. When we do investigations the period of communicability isn't counted until the onset of cough, which is why I'm curious.
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#37 of 38 Old 07-20-2007, 02:05 AM
 
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Here's an australian gov site that says the same thing. (word for word)
http://www.dh.sa.gov.au/pehs/Immunis...acts-oct04.pdf

Quote:
Infectious period
(time during which an infected person can infect others)
Pertussis is highly infectious when the “cold-like”
symptoms occur in the early stages.
Without
treatment, a person is infectious for the first three
weeks of coughing.
Here's what the pink book says:

http://www.cdc.gov/vaccines/pubs/pin...loads/pert.pdf

Quote:
The first stage, the catarrhal stage, is characterized by the
insidious onset of coryza (runny nose), sneezing, low-grade
fever, and a mild, occasional cough, similar to the common
cold.
Quote:
Communicability
Pertussis is highly communicable, as evidenced by secondary
attack rates of 80% among susceptible household contacts.
Persons with pertussis are most infectious during the
catarrhal period and the first 2 weeks after cough onset
(i.e.,
approximately 21 days).
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#38 of 38 Old 07-20-2007, 10:48 AM
 
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So pretty much anytime they're oozing or spraying they're contagious. I don't think any real basis exists to distinguish relative contagiousness of each of those 2 phases.
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