Another fear-based whooping cough article that blames the unvaccinated even while saying the vaccine isn't working

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NEWS.COM.AUFOX SPORTSCAREERONECARSGUIDEREALESTATENEWS NETWORKThe AustralianNEWSOPINIONNATIONAL AFFAIRSBUSINESSAUS ITHIGHER EDMEDIASPORTARTSLIFEMAGAZINESCAREERSVIDEOTHE WEEKEND AUSTRALIAN MAGAZINEWISH MAGAZINETHE DEALREVIEWTHE ARTSLIFETRAVELLOGINSIGN UPView our Top 100 wines interactiveTHE WEEKEND AUSTRALIAN MAGAZINEHow worried should we be about the whooping cough epidemic?BY:MARY-ROSE MACCOLLFrom:The AustralianApril 28, 2012 12:00AMIncrease Text SizeDecrease Text SizePrintDianne Cherrie with her daughter Tori-Rose: both caught a bad case of whooping cough. Source: SuppliedNCIRS director McIntyre: 'We'd be much more worried if we were seeing increased deaths.' Source: SuppliedWHEN my nine-year-old son woke up last month with a low fever and a scratchy throat, I didn't think beyond how to manage work with him at home.The symptoms gave way to a barking cough a few days later, so I rang my GP's office. My son had been exposed to whooping cough at school, I told the nurse, but it can't be that because he's fully vaccinated. I just wanted to check what to do. "Bring him in and tell the girls at the desk," she said. "They'll put him in isolation until the doctor sees him." Thinking she hadn't heard, I said: "But he's vaccinated." "I know," she said. "But he might have whooping cough all the same."As I was to learn, Australia is in the grip of the largest and longest-running epidemic of whooping cough since mass vaccination started more than half a century ago. The numbers have been increasing dramatically - 38,606 cases reported last year, compared with only 4863 in 2007 - and eight babies have died since 2008. This is despite Australia boasting one of the highest vaccination rates in the world. But, as it turns out, even some of those who've been vaccinated are falling sick.Paediatricians say better testing and reporting help to explain the increasing caseload, along with waning immunity in older children and adults who can then become susceptible to the highly contagious disease. But microbiologists insist the bug that causes whooping cough, Bordetella pertussis, is adapting to a vaccinated world, with a new, more toxic strain linked to epidemics in Europe, the US, Canada and Australia. These new strains are now responsible for 84 per cent of cases, compared to 31 per cent before the current epidemic. What's needed, these disease detectives declare, is a better vaccine.While the current vaccine for whooping cough is still the best front-line defence we have, it doesn't provide immunity for as long or as well as it might. While this is no reason to stop vaccinating - every medico and scientist I spoke to was adamant that a fall in vaccination rates will lead to a much more widespread and severe disease - the fact remains that if you've been vaccinated you can still catch whooping cough, which can be debilitating in some people. Worse, you can have a mild dose yourself and unwittingly pass on the disease to a baby. One in 200 babies who catch whooping cough will die. "I THOUGHT I was dying. I coughed so much I wet my pants. I saw stars, literally. In the middle of the night, my son heard me choking and ran into the room. I woke, still choking; I just couldn't get my breath."At 38, just after she had given birth to daughter Tori-Rose in July 2010, Dianne Cherrie caught a bad case of whooping cough. The disease had been brought into the house from school by her nephew Genesis, then 12, who lives with the family. Genesis gave it to Cherrie's son , then 20. Then Cherrie contracted the disease, followed by newborn Tori-Rose.Cherrie, from the Melbourne suburb of St Helena, had been advised not to have a booster shot after she gave birth (now recommended for new mothers) because of a bad sinus infection. By the time she had the booster two weeks later, she'd caught the bug. She'd also been advised that the boys, vaccinated in early childhood, didn't need boosters. Tori-Rose was too young to be vaccinated. Now everyone in the family was sick, except Cherrie's husband, Condon, then 38, who'd had whooping cough as a child.Cherrie took Tori-Rose to her GP because she was coughing "until she was beetroot-red". The GP, however, dismissed it as a dry cough, nothing to worry about. "You doubt yourself," she reflects. "You think the doctors must know." Back to the doctor, back home and then, at 3am, "I heard this gasp, like nothing I'd ever heard before, from Tori. and I shot out of bed." They went to hospital and "this time, we refused to leave until someone told us what was going on." They waited for over an hour to see a doctor, "which was lucky because Tori actually coughed when he was there. When she turned blue, the doctor said it was bronchiolitis."Tori-Rose was transferred to the Royal Children's Hospital in Melbourne and spent the next three days in intensive care. The whooping cough was so bad that Cherrie was told her daughter might need to go on life support. And when she saw on the news that a baby in South Australia had died, she remembers thinking: "God, you gave her to me after 20 years. You can't take her away after six weeks." Tori-Rose spent two weeks in hospital and will most likely suffer asthma as she grows up. Now a fierce advocate for vaccination, Cherrie wants Australia's immunisation program expanded to include whooping cough boosters for adults. "The government is doing nothing about this," she complains. "It's disgusting."University of Sydney paediatric infectious diseases specialist Professor Isaacs says whooping cough remains a serious illness for young babies who are more susceptible until they complete the first course of three vaccinations, normally given at two, four and six months of age. Babies may suffer 20 to 30 coughing fits a day, all ending with the trademark sharp intake of breath that gives whooping cough its name, he explains. But not all babies produce the whoop, and some don't even cough; "the first presentation is apnoea - they just stop breathing," he says. Isaacs maintains that eight deaths since 2008 is a lot "from an infectious disease we think we can prevent with immunisation". Babies die because of nastier pneumonia; there can also be brain inflammation (encephalitis). "This is just a nasty disease at a very vulnerable age."University of Melbourne population health epidemiologist Associate Professor Jodie McVernon says that while vaccine refusal is often blamed for the current epidemic of whooping cough, the causes are likely to be much more complex. Other countries witnessing the same disturbing increases in whooping cough, particularly among younger age brackets, show that "if this was an easy one to solve, you can be pretty sure it would have been solved by now".THE National Centre for Immunisation Research and Surveillance is the closest thing we have in Australia to the US Centers for Disease Control - rendered so well dramatically in Soderbergh's film Contagion. But if you expect to find clean labs, military-style uniforms and vats of SARS going into cryogenic freezers, you'll be let down. Instead, the NCIRS, housed in a modern glass and metal building on the campus of Sydney's Westmead Hospital, is like any office. People in cardigans and slacks sit in partitioned cubby-holes or gather around the kettle in the kitchen. Their job? To keep Australia's children safe from vaccine-preventable disease and vaccine injury.Vaccines work by introducing disease antigens - the things in a virus or bacterium our immune system learns to recognise as dangerous - without introducing the disease itself, so that we produce antibodies, proteins tailor-made to fight the particular disease. The idea is that, when it comes across the "wild" disease, our immune system already knows what to do and fights back before we develop serious infection. The majority of scientists and medicos are in favour of vaccines on the grounds that any risks - and there are risks - are much smaller than the risks associated with the diseases they prevent. The most successful vaccines - those against smallpox, polio, diphtheria, measles and mumps - have eradicated these diseases altogether or stopped them circulating in well-vaccinated populations. But whooping cough has continued in the same cycling epidemics seen before vaccination, getting smaller with each cycle. Until now.NCIRS director McIntyre explains that a dose of whooping cough might confer 20-plus years of immunity, "but you have to put up with the disease". The current vaccine may provide immunity for as little as four years - although it should still provide protection against severe or fatal disease. Not everyone who is vaccinated develops immunity, though. Based on clinical trials, after the initial three doses provided to babies by six months of age only 84-89 per cent are protected against disease - and the vaccine's effectiveness in the real world may be even lower. Also, some children suffering autoimmune disorders aren't vaccinated because it's too risky; and then there are those who aren't vaccinated because of parental objections.McIntyre insists that in terms of severity of disease - measured by hospitalisations and deaths - the current epidemic is no worse than one in 1995-98, although there are many more reported cases. "That doesn't mean to say we haven't got a problem. But we'd be much more worried if we were seeing increased deaths."NCIRS clinical research director Booy, who contracted whooping cough as a baby when he was too young to be fully vaccinated, describes it as one of the most highly transmissible diseases of all. He explains it this way: "In the course of me having pertussis ... and coughing for the next month to three months, I would infect more than 10 people ... Flu, you infect 1.5 or 2." This means you need "high levels of immunity in the population". ONE of the most highly publicised recent cases of whooping cough involved and Toni McCaffery, who lost their four-week-old daughter Dana to the disease in 2009. Neither the parents nor their two other children had any symptoms, and they still don't know how Dana contracted the disease. However, the McCafferys live in a pocket of coastal northern NSW in which nearly 10 per cent of children are not vaccinated - more than three times the national average.Unlike Dianne Cherrie, Toni McCaffery wasn't given advice about a booster shot during pregnancy or immediately following Dana's birth. "You can't protect your child from something you don't know about," she says. When Dana became sick, Toni took her to see the GP but, like Cherrie, was sent home. "It's not just parents who need to know," she says. "Whooping cough is very deceiving. Dana was fine during the day. She didn't even cough, just tried to clear her throat and gagged on mucus." Dana was airlifted from Lismore Base Hospital to the Mater Children's Hospital in Brisbane, where intensive care included multiple transfusions to rid her body of the pertussis toxin, but after three days she succumbed.The McCafferys have honoured Dana's memory by helping the NCIRS's Booy develop his website chainofprotection.org, aimed at providing evidence-based information about diseases, vaccines and risks. When her daughter was born in January last year, Toni McCaffery said there was just as much whooping cough around and "the information wasn't any better". The McCafferys have successfully lobbied governments to provide better information to families and a national information campaign finally rolled out in November last year. At the same time the then federal minister of health, Nicola Roxon, announced that from this year children must be up-to-date with the immunisation schedule to receive the $726 per child Family Tax Benefit Part A supplement. Parents can register a conscientious objection and still be eligible for the benefit and around 3 per cent do. Dianne Cherrie says she believes vaccination should be compulsory. "If they don't vaccinate, they risk my child's life."Sally Newham, 38, lives in the same pocket of northern NSW as the McCafferys. Her 13-year-old son Tarn, who wasn't vaccinated, caught a mild dose of whooping cough three years ago. "I was so young," Newham says of her decision not to vaccinate. "It was a big enough thing just thinking about my own kid. It didn't even occur to me that we could make someone else's baby sick." Newham, who gave birth at home, said her midwife told her that "from her understanding the diseases had diminished more from better hygiene and sanitation in the modern world." She claims some people now leave the area with their newborn babies to prevent their kids from being exposed to the disease. "The stories floating around when Tarn was a baby were all about what vaccines do. We didn't hear about babies dying of the diseases." THE only time NCIRS director McIntyre becomes agitated during our interview is when I ask him about the role of clean water and less overcrowding, as opposed to vaccines, in reducing levels of whooping cough. "There are a lot of reasons that's rubbish," he says. "No one would deny that better sanitation and diet is all good. But if you look at the records going back with these diseases, it's obvious to blind Freddie that vaccines made the difference."McIntyre says whooping cough was second only to diphtheria as the biggest infectious disease killer in Australia in the 1930s. In the decade from 1926, it killed 2808 people, more than measles, tetanus and polio combined. In the decade from 1956, when vaccination rates had reached around 80 per cent and Australia's population had nearly doubled, 58 people died of whooping cough. Isaacs says a scare in England in the 1970s, when it was claimed that the whooping cough vaccine caused brain injury - later discredited by research evidence - caused immunisation levels to drop to 30 per cent in some places. "There were huge outbreaks of disease," says Isaacs. "We know at least 36 babies died who wouldn't have died otherwise because of fear about a vaccine."The first mass vaccination for whooping cough in Australia began in the 1940s, with a vaccine made from a whole cell of B pertussis. These whole-cell vaccines had hundreds of antigens to which people could develop an immune response but they were thought to be associated with side-effects - high fevers leading to febrile convulsions in babies. It's sometimes the case, Isaacs says, that vaccines which cause more fever and problems also give better immunity. Many countries, including Australia in 1996, moved to an acellular vaccine, which used only part of the cell. It was believed to have fewer side-effects, less fever, but only three to five antigens to which we might develop an immune response.University of NSW medical microbiologist Associate Professor Ruiting Lan has identified new strains of B pertussis that he believes have emerged in response to the change in vaccine. Lan says the new strains may be evading the acellular vaccine, leading to increased disease. The latest research by Lan's team, published last month, shows that from 2008, when the current epidemic began, the new strains were in 84 per cent of disease samples taken from whooping cough sufferers compared with only 31 per cent between 2000 and 2007.Molecular microbiologist Professor Frits Mooi, from the Centre for Infectious Diseases Control in the Netherlands, has been studying B pertussis since a Netherlands epidemic in the 1990s. Mooi agrees the bug is changing but says it's been mutating in response to both acellular and whole-cell vaccines. He says there were good and bad whole-cell vaccines anyway, with some countries using vaccines that were not very effective.Mooi first identified a B pertussis strain that produces more of the deadly pertussis toxin in 2004. He later showed that this strain was associated with epidemics in the Netherlands and Finland. Mooi says Lan is now identifying the same strain, or group of strains, in Australia's epidemic. Pertussis toxin suppresses our defence against infection, he says. "It advantages the pathogen in every way. We vaccinate, the bacteria produces more toxin, and vaccination becomes less effective." Lan and Mooi agree the current vaccine is the best defence against disease but both believe better vaccines are needed.Mooi says people in vaccine research, including himself, are nervous about criticising existing regimes because if people stop vaccinating, worse epidemics will inevitably follow. He also believes that many who deny the effect of strain variation were involved in the clinical trials and saw the new vaccines as the solution to the problem. Mooi insists there's no incentive for pharmaceutical companies to develop a better vaccine. "They say the answer is to vaccinate more often. But how many vaccinations will people tolerate?"Australia's national immunisation program includes an acellular pertussis vaccine manufactured by GlaxoKline in Belgium. It is provided in combination with diphtheria and tetanus vaccines in four doses in early childhood, at a cost of $70 million a year. A fifth dose adolescent booster, produced by GlaxoKline and Sanofi, is offered free in all states during high school but adult boosters, produced by both companies, are not currently part of the national immunisation program. They cost about $35 on prescription. McIntyre agrees the current whooping cough vaccine is not perfect but says it's "the best we've got". He's not sure of the best way to protect babies in the current epidemic. "Maybe we should immunise mothers while still pregnant, or if what we're really worried about is deaths and severe hospital cases, we should protect those who'll die or get sick." He says the best hope for vaccination is a group in France who are working on a nasal spray that might also be an effective booster for adults. Isaacs says part of the problem may be that in the past almost everybody got whooping cough and so they were immune for longer, but now adults and older children, whose vaccine immunity has waned, are carrying the disease and passing it on to babies. For a baby to get sick it has to be coughed on by someone with whooping cough, "although there are people who are not coughing much who can transmit pertussis". Isaacs says maternal antibodies don't appear to help. "Most babies don't get measles under six months and yet babies can get whooping cough."He says the strategy adopted during the current epidemic of "cocooning" infants - offering free immunisation to new parents - doesn't have a strong evidence base "but it should give them some added protection." Is it cost-effective? "Nowhere near. You have to immunise thousands and thousands of parents to protect a very small number of babies." Cocooning hasn't been approved as part of the pharmaceutical benefits assistance scheme and there's no guarantee of continued state funding. "It just works out an expensive strategy given the current cost of the vaccine," says Isaacs.Jodie McVernon says she's heard of some nervous parents who keep their babies housebound to prevent exposure to the disease. "But that's not healthy either," she says, adding that babies need to be introduced to the world and "you don't want new mothers feeling isolated and afraid." As it turned out, my own son didn't have whooping cough, but a nasty virus that made him sick for weeks. Like so many people I interviewed for this story, I had no idea that someone who has been vaccinated can get whooping cough and pass it on to a baby, who could get seriously ill. But if nothing else, it made me aware of the risks of a disease that hasn't been beaten, and whose numbers are on the up.Share on emailShare on linkedinAds By GoogleNIKKI GEMMELL'Distraction will kill the moment as swiftly as a power cut in a nightclub. 'PHILLIP ADAMS'To restate the bleeding obvious: seizures of imports mean nothing. 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Meryl Dorey,SpokespersonThe Australian Vaccination Network, Inc.Investigate before you vaccinateEditor,Living Wisdom MagazineFamily, Health, EnvironmentPO Box 177BANGALOW NSW 2479AUSTRALIAhttp://www.avn.org.auhttp://www.living-wisdom.comPhone: 02 6687 1699 FAX 02 6687 2032skype: ivmmagFreedom is not merely the opportunity to do as one pleases; neither is it merely the opportunity to choose between set alternatives. Freedom is, first of all, the chance to formulate the available choices, to argue over them -- and then, the opportunity to choose. - C. MillsThe authority of any governing institution must stop at its citizen's skin. - Gloria SteinemWe rely on the help and support of our members and subscribers to continue offering our services freely and without prejudice.Please consider helping us by joining the AVN as a member. Go to http://www.avn.org.au to become a member or donate to support our work.We also sell books, videos and DVDs on vaccination and other health issues. Go to http://shop.avn.org.au/ for more details.

Meryl Dorey,SpokespersonThe Australian Vaccination Network, Inc.Investigate before you vaccinateEditor,Living Wisdom MagazineFamily, Health, EnvironmentPO Box 177BANGALOW NSW 2479AUSTRALIAhttp://www.avn.org.auhttp://www.living-wisdom.comPhone: 02 6687 1699 FAX 02 6687 2032skype: ivmmagFreedom is not merely the opportunity to do as one pleases; neither is it merely the opportunity to choose between set alternatives. Freedom is, first of all, the chance to formulate the available choices, to argue over them -- and then, the opportunity to choose. - C. MillsThe authority of any governing institution must stop at its citizen's skin. - Gloria SteinemWe rely on the help and support of our members and subscribers to continue offering our services freely and without prejudice.Please consider helping us by joining the AVN as a member. Go to http://www.avn.org.au to become a member or donate to support our work.We also sell books, videos and DVDs on vaccination and other health issues. Go to http://shop.avn.org.au/ for more details.