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Published On: Mon, Jun 30th, 2014

Vaccine-preventable diseases and the resurgence in the US

Measles, mumps and pertussis–three vaccine-preventable diseases that are making news in the United States in 2014 with a resurgence in cases being seen locally in some cases, while nationally in others.

As of June 27, the number of measles cases reported in the US, there has been 539 measles cases reported since the beginning of the year, with two-thirds of the cases reported from Ohio (365). A small amount of the cases are linked to travel to countries in the midst of large outbreaks. The Philippines, who as of May reported some 40,000 cases has been the prime culprit at the epicenter of the Ohio outbreak. The Centers for Disease Control and Prevention (CDC) says as of June 27, 23 US travelers who returned from the Philippines have become sick with measles. Most of these cases were among unvaccinated people. 

Photo credit: CDC/ Amanda Mills

Photo credit: CDC/ Amanda Mills

Measles was not to long ago thought to be basically eradicated in the US. In 1950, 319,000 cases were reported in the US. In 1960, the number grew to nearly 442,000. In 1963, the first measles vaccine was licensed for use. Later the MMR and MMRV were approved for use. 

In 1989, the American Academy of Family Physicians, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices changed the recommendation to two doses so that almost all children (99.7%) would be protected.  Immunity is lifelong.

In 1970, the number of measles cases in the US dropped significantly to 47,000….In 2000, only 86 cases were reported–essentially eradicated. Now in 2014 we see over 500 cases with six months left in the year. What happened? Many would lay the blame to the 1998 study by British physician, Andrew Wakefield,  suggesting a link the between the MMR and autism causing a drop in vaccination rates.

Even to this day, 33 percent of parents of children under the age of 18 and 29 percent of all adults continue to believe “vaccinations can cause autism.” 50 percent of parents are aware of the study that linked autism to childhood vaccinations, but only half of these parents are aware that the study has since been discredited and retracted.

Very few realize that numerous epidemiologic studies have been performed that debunk Wakefield’s study.

We are seeing the same situation with mumps and pertussis. Central Ohio has reported more mumps cases in 2014 to date (444) than the whole United States in all of 2013 (438).

The story of mumps and vaccines against it are similar to measles. In 1970, over 100,000 mumps cases were reported in the US; however, Dr. Maurice Hillman’s “Jeryl Lynn” strain of the mumps vaccine was approved in 1967. In 1980, the total mumps tally in the US dropped to 8,500 and in 2000 the case count was only 338.

The combination measles-mumps-rubella (MMR) and measles-mumps-rubella-varicella (MMRV) vaccines are the best way to prevent mumps. The CDC says two doses of mumps vaccine are 88% (range: 66-95%) effective at preventing the disease; one dose is 78% (range: 49%−92%) effective. The first vaccine against mumps was licensed in the United States in 1967, and by 2005, high two-dose childhood vaccination coverage reduced disease rates by 99%.

Pertussis is also resurging this year in California, where  4,558 cases were reported to date, far surpassing the total number of reported cases in 2013, which was 2,532. We’ve seen outbreaks of pertussis in the US about every 3-5 years with the 2012 outbreak, which had 40,000 cases, was the largest outbreak in 50 years.

A couple of things concerning the pertussis vaccine are going on. First, an FDA study last year shows that acellular pertussis vaccines licensed by the FDA are effective in preventing the disease among those vaccinated, but suggests that they may not prevent infection from the bacteria that causes whooping cough in those vaccinated or its spread to other people, including those who may not be vaccinated.

In addition, the CDC reports on a New England Journal of Medicine letter was published on February 7, 2013, noting the first appearance in the United States of pertussis strains that are missing pertactin. More recently a paper evaluating the prevalence of these pertactin-deficient strains in the United States was published in Clinical Vaccine Immunology.

Pertactin is one of several components of all pertussis vaccines. It is a protein that helps pertussis bacteria attach to the lining of the airways. Although pertactin is an important part of the vaccines, current evidence suggests pertussis vaccines continue to prevent disease caused by both pertactin-positive and pertactin-negative pertussis strains since other components of the vaccines provide protection.

Protection from childhood pertussis vaccines still appears to be excellent during the first few years after vaccination, but wears off over time. Outbreaks and epidemics being seen around the country are consistent with what is seen as vaccine protection wears off.

The message is clear, vaccines are pretty effective in the prevention of these diseases, just remember that sometimes the immunity may wear off as in the case of pertussis.  For more infectious disease news and informationvisit and “like” the Infectious Disease News Facebook page

 

About the Author

- Writer, Co-Founder and Executive Editor of The Global Dispatch. Robert has been covering news in the areas of health, world news and politics for a variety of online news sources. He is also the Editor-in-Chief of the website, Outbreak News Today and hosts the podcast, Outbreak News Interviews on iTunes, Stitcher and Spotify Robert is politically Independent and a born again Christian Follow @bactiman63

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