Pertussis (Whooping Cough)
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Routine vaccination of infants and young children has resulted in a marked decline of pertussis in every country with a vaccination program. A booster is now recommended for adolescents and adults, combined with the tetanus and diphtheria vaccines.
Canadian Immunization Guide. Evergreen edition. http://www.phac-aspc.gc.ca/publicat/cig-gci/index-eng.php (external link)
Canadian Paediatric Society http://www.caringforkids.cps.ca/handouts/immunization-index (external link)
Capsule HistoryEarly 1900s – Pertussis killed 5 out of every 1000 children born in the United States before their fifth birthday. Most deaths involved infants less than 12 months of age.
1900–1940 – Infant deaths from pertussis decreased by over 70% due to better nutrition, less overcrowding and smaller families. However, while deaths decreased, the number of reported cases stayed the same.
1930s – The first "whole-cell" vaccine is developed. However, it causes more adverse reactions in children than any other vaccine: fever, irritability, crying, drowsiness and vomiting. On rare occasions, children have trouble breathing or have an allergic reaction such as anaphylaxis (which can lead to shock or obstruction of the respiratory tract).
1940s to 1990s – A new whole-cell vaccine is developed which eliminates the risk of anaphylaxis. Acetaminophen (like Tylenol) reduces the other symptoms such as fever and crying.
1995–1996 – Pertussis decreased across Canada, but the incidence varied from province to province. Between 1995 and 1996, pertussis incidence decreased between 30% to 75% in Newfoundland, Nova Scotia, New Brunswick, Quebec and Ontario. During the same period, it increased between twofold and tenfold in Prince Edward Island, Saskatchewan, British Columbia and Northwest Territories.
1997 – "Acellular vaccine" (a vaccine composed of purified proteins) was introduced into Canadian vaccination programs. It causes fewer reactions and is just as effective as whole cell vaccine. In the future, the new vaccine may be used to boost adolescents and adults.
Case Study #1 — JapanBefore 1950 – 100,000 cases of pertussis per year
1974 – 200–400 cases of pertussis per year; 2-3 deaths
1975 – Use of pertussis vaccine halted following the death of two infants after receiving the vaccine. Two months later, the ban was lifted when the deaths were found to be unrelated to the vaccine. However, due to unfavourable publicity, many parents chose not to have their children vaccinated.
1976–79 – The vaccination rate fell, resulting in an epidemic of pertussis; 13,000 reported cases and more than 100 deaths.
Case Study # 2 — England and Wales1975 – Following news reports of the alleged dangers of pertussis vaccine, vaccination rates declined from 75% to 25%.
1977–79 – Lower vaccination rates led to an epidemic affecting more than 100,000 people, including 100 deaths.