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Posted by on Dec 22, 2010 in Epidemiology, Ethics, Infectious diseases, Pediatrics

Top 10 for ’10: No. 10

Top 10 for ’10: No. 10


They seemed like good, though not particularly original, ideas at the time: Initiate a med-pharma blog and inaugurate the coming new year with the top 10 stories from the waning year.

Seemingly good ideas can become millstones with time; nevertheless, these 2 particular self-inflicted burdens have been carried for at least another 365 daysto make a grand total of 3 years. Happy freekin’ birthday, Pathophilia. Here’s what really plagued, worried, or otherwise elevated our royal-we blog spirits in 2010.


No. 10: A Record-Busting Pertussis Outbreak in California.

Way to go, California parents who eschew routine childhood vaccinations.* Nice erosion of herd immunity. You’ve contributed to the worst statewide outbreak of pertussis (aka whooping cough) in the last 63 years. The last 63 years. Meaning since Truman was President. Meaning since Jackie Robinson broke the MLB color line.

Here’s the latest from the California Department of Public Health while I/we simply stew in my/our juices of frustration: 

  • There have been 7824 confirmed, probable, or suspect cases of pertussis reported between January 1st and December 15th. (There were 9394 reported cases in 1947.)
  • This year’s pertussis incidence rate in California is 20.0 per 100,000, which is the highest rate in 52 years. (The rate was 26.0 cases per 100,000 in 1958.)
  • There have been 10 deaths, 9 of which were Hispanic infants (who were too young to be immunized)
  • Children younger than 6 months of age have been particularly vulnerable to disease.
  • The California outbreak peaked in late July-early August, but “relatively high numbers of cases continue to be reported each week.”
  • Because a high level of herd (aka community) immunity is needed to reduce the incidence and spread of pertussis and the fact that vaccine-induced immunity wanes with time, a campaign to urge booster shots among adolescents and adults is ongoing. 
  • According to the CDPH, mothers or other close contacts are the most likely sources of pertussis for at-risk infants. The agency advises,

Thus vaccinating household contacts, health care personnel, and child care workers against pertussis is recommended at least 2 weeks before their contact with young infants. Increasing community immunity through widespread immunization will also decrease the chances that vulnerable infants will be exposed to pertussis. Immunization will also prevent debilitating cases of pertussis in older children, adolescents, and adults.

Unlike the historic California outbreak, which appears to be subsiding, a pertussis epidemic in upstate New York is gaining steam. It’s now at the point at which the Public Health Agency of Canada is advising its citizens “to be on guard against” the disease in the United States. Yes, Canadian officials are now warning about infectious travel risks…south of the 49th parallel.

* Because of, largely, the disproven fears of vaccine-related autism.

Photo of symptomatic child with pertussis from

bmartin (1082 Posts)

A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on and Twitter.