Bordetella Pertussis Mutations may Reduce Vaccine Effectiveness

A recent report by the Centers for Disease Control (CDC) has discovered that mutations in a particular gene may be partially responsible for the increase in B. pertussis or whooping cough cases. CIDRAP reports that B. pertussis isolates in some children in the U.S. have been tested and found to have gene mutations in the coding region for Pertactin.

In the US study, researchers looked at pertactin genes from 12 isolates of B pertussis from children hospitalized in Philadelphia in 2011 and 2012. Most of the patients were younger than 2 years old, but the group also included a 9-year-old and 14-year-old.

They analyzed the pertactin genes from the specimens and amplified and sequenced the coding region. They determined the pulsed-field gel electrophoresis (PFGE) patterns and detected pertactin using Western blotting with antiserum and a strain from the World Health Organization (WHO) as the pertactin-positive reference.

Eleven of the 12 pertussis strains they tested were negative for pertactin. The pertactin allele in all isolates was pm2, but the mutations were different than pertactin-negative pm2 isolates from France, according to the report. (Variants in Japan and Finland had insertion sequences in the pm1 allele.)

Pertactin is a virulence factor for B. pertussis which is an adaptation of the organism that enables it to colonise its host.  Pertactin is an adhesin that promotes adhesion of B. pertussis bacteria to the tracheal epithelium of humans.  Pertactin (Prn) is one of the antigens in the acellular vaccine along with inactivated pertussis toxin (PT), filamentous hemagglutinin (FHA) and fimbriae types 2 and 3 (Fim).  The U.S. group, as reported in NEJM, found both insertions and stop codons that prevented the B. pertussis bacterium from expressing pertactin although the virulence of the pertactin negative strains was the same as pertactin positive strains.

Japan and France have also found pertactin negative strains but with different insertions and deletions in a different allele than what has been found in the U.S. although the net result is the same. The current theory is that these mutations have occurred through selective adaptations against the acellular vaccines.  The pertactin negative strains may not be as virulent as the pertactin positive strains although more research would be necessary to confirm this.

The only significant difference (p = 0.29) was that the time between the beginning of the cough and hospitalization was longer for infants infected with a PRN– isolate; this finding might reflect less severe disease in this group.

Note: I believe that the reported p-value of 0.29 is a typo and perhaps should have been 0.029.

The vaccines still remain effective for attenuating disease severity even with fewer than the age-appropriate dosing schedule of three by six months old.

Vaccination was associated with less severe clinical symptoms (Table 2): the proportion of hospitalizations in intensive care units was significantly lower in the vaccinated group (p = 0.001). Clinical symptoms, such as apnea, syncope, cyanosis, and deterioration of general condition, were also less frequent in the vaccinated group (Table 2). This confirms previous findings (12) indicating that infants who receive 1 or 2 doses of pertussis vaccine are protected to some extent.

Pertussis vaccination introduced in the U.S. in the 1940s (as a whole-cell vaccine) and around the world at various times after that have undoubtedly saved millions of lives.  This finding does not negate the necessity of infants receiving the full series and older children and adults remaining current on boosters in order to prevent widespread morbidity and mortality.  What these findings do is highlight the importance of developing more effective pertussis vaccines while maintaining a high safety profile.

Jake Crosby Throws Fellow Anti-Vaxxers Under the Bus

Anyone following anti-vaccine groups like Age of Autism (AoA), Generation Rescue and SafeMinds (they are really comprised of the same group of core members who have set up multiple fronts in order to appear more numerous than they actually are) will know Jake Crosby, wonder boy "cub reporter" for AoA.

Last November (2012) there was a congressional hearing lead up by California Republican representative Darrell Issa.  Autism parent Brian Hooker revealed a series of meetings he had with rep. Issa and other congress critters.  Mr. Hooker was accompanied by Andrew Wakefield who wined and dined members of the oversight committee that would ultimately hear testimonies from anti-vaccine groups on the topic of autism.  The testimonies and speakers at this hearing has made Jake Crosby very angry and has posted his diatribe on none other than the Bolen Report.

The Cliff Notes version is that Jake has decided to slam his comrades-in-arms, particularly SafeMinds, because they chose to try and appear sane and rational (as sane and rational as one can be given that they believe vaccines cause autism) in front of the congressional committee by refusing to let Jake present his contorted conspiracy theories and instead letting Mark Blaxill speak and trimming Brian Hooker's screed down.  Jake's little hissy fit is a thing of beauty to read as it illustrates the mindset of anti-vaxxers and their slimy tactics to weasel their way onto a platform of legitimacy.

ETA: Since Liz Ditz was so kind to take screen shots of Jake's exposition, I'm including the link to her page here.   Jake recently "spoke" at the IACC public comment session (for a limited value of "spoke" since he launched into a predictably atrocious tirade) so to see him in action, the video is available here (138 minute mark).

Another Family has Changed their Opinion About Vaccination

unfortunately, it took three of them coming down with measles for mum and dad to change their minds: Karl Daw and his 3 and 4 year olds sons were so sick that they had to be admitted to the hospital, the 6 month old baby has been given a measles vaccine now.

Go get your MMRs - there is no reasonable alternative.

Tetanus in an Unvaccinated Boy in NZ

It happens - unvaccinated children do contract tetanus (as we had reported before). It doesn't happen very often, but when it does, it is incredibly cruel. Alijah, a 7 year old Auckland (NZ) boy cut his foot (as children will do) and developed tetanus. The NZ Herald provides a harrowing description of what that means:

Within 36 hours, the 7-year-old Auckland boy was crippled by body spasms, unable to swallow and racked with pain.

"He was screaming in agony," mother Linda Williams said.

.../...

"It was hideous. He was spasming every three minutes. He was biting his tongue and bleeding. His arms were spasming and he was arching his back and his whole face and jaw was completely locked."

Alijah was admitted to a ward but 24 hours later he was moved to intensive care, put into an induced coma and paralysed by drugs to prevent the spasms and relieve the pain.

His breathing had to be monitored because the muscle contractions could close the airway, and later a tracheotomy tube was inserted in Alijah's throat to help him breathe.

Luckily, Alijah survived and could leave the hospital after 26 days, although he now faces a year of rehabilitation to relearn how to eat and walk. The parents are blaming themselves for their son's horrific ordeal and have since vaccinated their other children and asked other parents of unvaccinated children at their son's school to reconsider. Although both hold degrees in the science/health field, they had fallen for the anti-vaccine misinformation. Alijah's dad says:

Parents like us make the decision to not vaccinate on very little factual information about the actual consequences of the diseases - massive pain, disability and death - and a lot of non-factual, emotive information from the internet stating inflated figures on the frequency and severity of adverse reactions and conspiracy theories about 'evil' doctors, governments and drug companies.

.../...

Believing myths about vaccines is not the same as getting the facts. And that is the core problem.

We hear from more and more parents who are regretting their non-vaccine decision (e.g. against pertussis) and maybe it is about time more parents spoke about vaccinating. Currently, the discussion seems to be dominated by a very vocal minority, which, despite being on the very fringe manage to endanger children's lives.

ETA: a bit more info and renewed self awareness here.

When The Truth Calls....

Hollie from Motherhood: The Truth is a great mom - all natcheral - she used cannabis during pregnancy and birth and she is NOT poisoning her pweshous snow flakes with evil vaccines, instead, she was looking for pox and whooping cough parties. Unfortunately, Hollie seems to suffer from really low self-esteem, because, faced with a little criticism, she called one random pro-vaccine minded Facebooker at her workplace (a law school, cough) and since nobody answered, Hollie left her threats on her target's voicemail (which I guess does answer the question what cannabis does to your IQ).

Classy:

MMR-Encephalitis NVICP Decision

The United States Court of Federal Claims (USCFC) has recently compensated petitioners Saeid B. Mojabi, Parivash Vahabi and their minor son, Ryan B. Mojabi for a table injury of encephalitis as a result of MMR vaccination.  Naturally the usual suspect is exploiting this for his own validation.  Dr. Bob Sears states:

Vaccines don't cause autism . . . except when they do. Here is another case of MMR-induced encephalitis that resulted in autism.

While the child clearly suffers from neurological deficits there is no diagnosis of autism, only an allegation by the parents (petitioners).

Petitioners allege that the MMR vaccination that Ryan received on December 19, 2003 (the first MMR vaccination), resulted in a Vaccine Table Injury, specifically an encephalopathy that produced “a severe and debilitating injury to his brain, described as Autism Spectrum Disorder (‘ASD’).” Id. Alternatively, petitioners argue that “as a cumulative result of [Ryan’s] receipt of each and every vaccination between March 25, 2003, and February 22, 2005, Ryan has suffered, and continues to suffer, neuroimmunologically-mediated dysfunction[] in the form of asthma and ASD, [conditions] which were ‘caused-in-fact’ by the vaccinations.” Id. at 1-2.

The child did not have any ASD behaviours from two CHAT screenings:

On May 10, 2004, at Ryan’s sixteen month well-child visit, Dr. Armstrong completed a Checklist for Autism in Toddlers (CHAT) screen. Ps’ Ex. 4 At 25. That CHAT screen indicated that Ryan was interested in other children, pretend play, peek-a-boo, points with index finger, makes eye contact, and brings object for show. Id. On January 25, 2005, Dr. Armstrong examined Ryan for his twenty-four month well-baby check. Ps’ Ex. 4 at 31. During the visit, Dr. Armstrong conducted another CHAT screen, and again Ryan postively performed each of the listed behaviors.

Although, again the child exhibited neurological deficits affecting language and behaviour:

A month later, on October 27, 2005, Ryan was examined by the intake team at the Early Start Program. Id. at 55. The notes from this assessment reflect that Ryan’s parents “are concerned that Ryan’s development of speech and language appears to be delayed.” Id. The notes go on to state that “[Ryan] does not say very many words. Father relates that Ryan seems to have about 10 words that he will sometimes use. [Ryan] no longer uses words that he has previously learned. He is shy with other children and he is not able to adapt to new situations easily. He does not like to have other people come over to visit.” Id. On November 7, 2005, Dr. Armstrong examined Ryan again and observed that Ryan had “some aggressive interactions with vocalizations and hitting outbursts.” Ps’ Ex. 4 at 57.

Fewer than one child per million doses of MMR develops encephalitis but as many as 1,000 children will develop encephalitis per million cases of natural measles.  This is what we would observe in less than a generation if people like Dr. Bob get their way and stop vaccinating.  It's easy for people like him to criticise vaccines but do nothing to offer a viable alternative.  Single measles vaccines are no different in terms of serious reactions.

The Mojabi-Vahabi family has my utmost sympathy and I am glad that the NVICP system worked for them as it should.  But this decision, in no way, represents the thousands of OAP petitioners who claim some compilation of vaccines caused autism.  Dr. Bob would do well to report the facts instead of continuing to whip parents into a frenzy with histrionics but then again, if he did, he wouldn't be able to sell books, products and "services".

Organic Food Causes Autism (r=9971; p=0.0001)

not found by me, but by jasonp55 - it is impressive, it is unambiguous, it is clearer than the fact that storks deliver babies (p=0.008)

I think respondent Doorsofperceptron has a point when s/he says:

I think they're related.

Both diagnosing autism and buying organic food indicate movement to a society rich enough to concern itself with secondary health issues.

No one believes that autism or eating inorganic food will kill you, but diagnosing autism and developing coping strategies or eating organic food, are seen as good ways to improve people's lifestyle.

Not only have you found a real correlation in American history, but I think if you checked countries all around the world, the percentage of food sold labelled as organic should strongly correlation with the proportion of the population diagnosed as autistic.

Basically, autism testing and organic food are proxies that measure how rich people are.

In any case, this little graph shows impressively that correlation ≠ causation. An important thing to keep in mind when the usual anti-vaccine activists make vaccines responsible for autism and infant deaths.

sources: http://www.ota.com/pics/documents/2011OrganicIndustrySurvey.pdf
http://penndata.hbg.psu.edu/documents/ADR/Idea06.pdf