Whooping cough and measles are back, thanks to anti-vaccination truthers

In recent years there have been outbreaks of diseases once thought to have been eradicated, or at least well controlled.

One example is whooping cough (pertussis).

Pertussis / Whooping cough

Pertussis is a disease caused by a bacterium, and it is highly contagious. It can be spread when an infected patient coughs or sneezes and others in the immediate area inhale the bacteria. It can spread throughout a family, spread in a classroom, church, nursery school or other sites.

In older children and adults, pertussis starts off like a cold. Runny nose, possibly cough and similar symptoms. Over the course of a week or two, a prolonged cough develops. The patient coughs in paroxysms, unable to stop until finally he manages to draw in a long, raspy breath (the “whoop” in whooping cough.) Then the coughing starts again.

whooping cough

Child with whooping cough, courtesy of the CDC.

You can hear the whoop here, courtesy of the CDC, as a child gasps for breath at the end of the paroxysm.

Older children and adults usually manage to get through pertussis after a prolonged convalescence, while the cough continues to persist. In babies, however, the disease can be much more severe, even fatal.

About 50% of babies who have whooping cough will need admitted to a hospital. They can develop pneumonia from the bacterium. And while they may not cough as much as older children, they may stop breathing (apnea) and can die.

The good news is that whooping cough can be prevented by vaccination. Both babies and adults need vaccinated.

In the 1930s, there were hundreds of thousands of cases of pertussis in the US yearly. After the vaccine got into widespread use in the 1950s the cases dropped dramatically.  There were still cases occurring, though. Primarily in people who refused vaccinations for themselves and for their children for religious reasons. Outbreaks tended to occur in these populations.

Anti-vaccination advocates have created a resurgence of pertussis

However as anti-vaccination advocates convinced more people to stop vaccinating in recent year, the number of cases of whooping cough has begun to climb again.  (One of America’s most high-profile anti-vaccinate advocates is Jenny McCarthy of ABC’s “The View.”) There have been recent outbreaks in various areas of the country. Recently, there have been upwards of 50,000 cases of whooping cough per year in the US. In 2012 there were 20 deaths caused by pertussis.

From the CDC.

From the CDC.

Measles are back too

Unfortunately, pertussis isn’t the only disease that was almost eradicated, and now is reemerging. Measles, a virus-caused disease, is making a reappearance.

For years, measles was a rarity in the US. In the prevaccination era, measles was common. It spreads easily. School classmates transmitted it, it spread in families. Before vaccination, almost anyone could recognize a case of measles based on the distinctive rash and associated symptoms. Measles can also be a killer, especially in younger children. They can develop pneumonia, and may develop an encephalitis (an infection of the brain). Either can be fatal.

About 1 or 2 children die from measles for every thousand children who get the disease. Worldwide, tens of thousands of children will die from measles.

In the past few years, the US has averaged about 50-60 cases of measles/year. In 2014, there were already that many cases in just the first two months of the year.  And about 20 cases have been reported in NYC alone this year.


Possible reasons for the resurgence include the fact that more people are unvaccinated, and that healthcare workers aren’t used to seeing or thinking about measles, since it’s been relatively rare.

Often measles starts with a fever. Then the child gets a runny nose with a cough, and the whites of the eyes get reddened. These all start before the rash that helps make the diagnosis. Without the rash, the symptoms sound like a lot of other illnesses that young children get: the usual colds, allergies and other diseases. If the doctor or nurse isn’t thinking about measles, because it seems to be rare, the diagnosis can get missed. And the patient can continue to spread the infection to others in the waiting room, school bus or other places before ever being diagnosed himself.

Children and adults need to be vaccinated

These are just two diseases that are reappearing with gradually increasing frequency. The shame is that we have the ability to eradicate them so that they no longer cause illness or death. We haven’t because of people’s failure to be vaccinated, and have their children vaccinated. Smallpox has been eradicated worldwide. Polio has been eradicated in the US. We can do the same for these diseases: pertussis, measles, rubella, mumps and others.

The take-home message is that children and adults need to be vaccinated against these diseases. Not only for their own protection, but to prevent the spread of these diseases to those who may not be able to be vaccinated. Those who are immunocompromised or newborns, for example. If someone in one of those groups gets ill with one of these diseases, it could mean death.

Find out what vaccines adults need here.
And find out what vaccinations children need here.
My previous article about the flu, and why you shouldn’t believe the flu vaccine naysayers.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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