Whooping Cough and Cellphones

On my first day of school, I was sent home by Miss Augustine, my little town’s perennial first grade teacher who had been on the job for 40 years. I hadn’t misbehaved. I’d coughed. My cough was then and still is deep and noisy, reminiscent of a seal barking. Miss Augustine feared whooping cough. Later, my mother reassured Miss Augustine that it was just me.

Whooping cough is a highly infection disease that is, like many infectious diseases, returning after about a 50 year absence. The routine DPT vaccination given to children is credited with that absence. DPT stands for diphtheria, pertussis, and tetanus. Pertussis is whooping cough and is a severe inflammation of the lungs caused by the bacteria Bordetella pertussis. Most cases are among infants, fewer among young children, fewer still among adolescents, and fewest among adults. In the 1920s and 1930s, whooping cough killed a lot of kids. We’re talking thousands in California from among tens of thousands infected. That’s probably why Miss Augustine wanted me out of her class: she started teaching back then. Of course, later on she probably wanted me out of her class for other reasons, but that’s another story.

Last week, the New York Times carried an article by a father concerned about his 11-year old daughter who was recovering from whooping cough. He highlighted the resurgence of the disease and pondered both what could have caused it and what can be done. The title of his article is telling: “Vaccination Is Steady, but Pertussis Is Surging.” In the body of the article he states that among California counties there is no relationship between the incidence of whooping cough cases and vaccination rates. To me, that points to an environmental cause.

In fact, the situation is so bad in California that public health officials have declared a whooping cough epidemic. What’s do the say is causing it? Too few vaccinations. You see, it’s too easy for parents to prevent their children being vaccinated based on the personal beliefs exemption provided by law. Now whooping cough is breaking out all over.

But wait. If vaccination rates don’t seem to have anything to do with the increase in whooping cough cases, why is it that vaccination is the solution? And the only solution?

We saw this kind of thinking last year with regard to the swine flu pandemic that never was. All the evidence suggested that vaccination was irrelevant, yet public health officials insisted that the way to avoid a future outbreak was to vaccinate, vaccinate, vaccinate.

The argument is that vaccinating more children and adults will enable us to reach herd immunity, the level of immunity that prevents the outbreak of whooping cough like we’re experiencing now. With herd immunity, if someone catches whooping cough they aren’t likely to infect someone else. It puts a stick in the wheel. When I’ve done such calculations they end up in the range of 70 to 80 out of 100 people who need to have immunity. In California, over the period 2001 to 2006, the vaccination rate was 95 out of 100 children. But the call has gone out to force vaccination on the remaining 5 in 100 children.

There’s more to this campaign that flies in the face of facts and decency. Among other things, I found it impossible to find actual data and analysis to support the claim that lowered vaccination rates caused the current outbreak. In other words, proponents seem to be making it up. But what I really want to point to is how public health officials and, of course, the mainstream media that relies on these experts, can’t see past the technology of vaccination. The technology makes you safe. If there’s a risk, what you need is more of the technology.

I’m not challenging vaccination as such. What I’m challenging is the fixation on a technology as keeping us safe despite facts to the contrary. What those facts offer is an opportunity to learn something new, to re-examine the problem, maybe even redefine the problem. Perhaps the problem isn’t too few vaccinations but environmental changes that have increased exposures or environmental changes that compromise the immune systems of babies or the failure to use practices that are better than vaccination in conferring immunity. These opportunities should be seized because children are dying.

A few days ago, the New York Times carried an article about how new technologies, particularly wireless technologies, are creating a wide range of problems in National Parks. Rangers describe “visitors who arrive with cellphones or GPS devices and little else—sometimes not even water—and find themselves in trouble. Such visitors often acknowledge that they have pushed themselves too far because they believe that in a bind, the technology can save them.” Accident reports in National Parks include “contributing factors.” The traditional categories are things like animals, weather, and darkness. Rangers have now added “inattention to surroundings.” In a National Park.

Of course, we can say the same thing about a wide variety of technologies, not just vaccinations and cellphones. The fact that people are prone to assume that “the technology can save them” is an opportunity to examine what practices and environmental conditions lead people to that false assumption. Most importantly, we really need to pay attention to our surroundings. The technology should fit into that, not the other way around.