Post a Comment On: China Matters

Apologies for the paucity of new material on the site in recent weeks.  For the last month I have been wrestling with an acute and fatiguing case of whooping cough (pertussis) caused by the bacterium Bordetella pertussis.

I would like to tell readers that immunization will protect them from this disease...but I can't.

Pertussis vaccine simply doesn't work very well.  The acknowledged failure rate for pertussis vaccine is about 20%.  However, misdiagnosis and under-reporting of pertussis cases is a major problem, especially for adults.  In my state of California, currently in the midst of a declared whooping cough epidemic, it is estimated that cases are underreported by 10:1.  In Poland at one time, it was estimated that cases were underreported by a factor of 167.  One Canadian study reported a mind-boggling finding that there were over 33,000 unreported cases of varying severity for each reported case in the adult cohort.  Taking the number of undiagnosed cases into account, the failure rate for the vaccine, therefore, is probably 30%, or perhaps even more. 

There are no effective treatments for pertussis (identified patients are giving antibiotics to prevent contagion only), and the only sufferers who usually enter the medical system are infants who need breathing assistance.  So it seems that, as an untreatable condition for adults, pertussis isn't really on the radar of the medical profession.

Speaking from personal experience, when I visited the doctor, my practitioner concentrated on making sure I didn't have pneumonia.  My lungs were clear, so he assumed (perhaps also influenced by the fact that I had a current pertussis booster shot) that I probably had a viral bronchial infection. He gave me an antibiotic course "against potential complications", but the p-word or whoop-word were never mentioned.  By the time that my classic pertussis symptoms (paroxysmal coughing, whooping, the pleasure of listening to mucus gurgle up my bronchi, the added pleasure of desperately and violently expelling same upon awaking in the middle of the night, etc.) had presented, it was too late for the standard diagnostic (nose swabs), but I'm quite sure I got it.

I believe I got it from my offspring, who seems to have had a milder, asymptomatic case.  It looks like he, in turn, got it from an adult who was misdiagnosed.

In more good news, today the effectiveness of the Dtap booster is probably significantly less the 7-10 year rule of thumb and, if one has the misfortune of getting whooping cough, one doesn't even get lifetime immunity. 

The medical profession is working on developing a more effective vaccine.  Even with the shortcomings of the current vaccine,I recommend making sure one's pertussis vaccine is up to date.  Complete protection would be nice; even partial protection is preferable to the alternative.

I am working on some pieces for China Matters, but sloooooooooooooowly, in fact in ten-minute increments. If my case lives up to the Chinese description for whooping cough, the "hundred-day cough 百日咳", this situation might persist for a while.   I thank readers in advance for their patience and understanding.