[Script Info] Title: [Events] Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text Dialogue: 0,0:00:09.10,0:00:12.02,Default,,0000,0000,0000,,Hello, Saya Joanne Faryon. Dialogue: 0,0:00:12.02,0:00:15.06,Default,,0000,0000,0000,,Selamat datang di acara khusus malam ini. Ketika Kekebalan Tubuh Gagal: Epidemik Batuk Pertussis. Dialogue: 0,0:00:17.08,0:00:21.06,Default,,0000,0000,0000,,Kita akan mendalami batuk pertussis terparah yang merajalela di California Dialogue: 0,0:00:21.06,0:00:23.05,Default,,0000,0000,0000,,dalam 60 tahun ini. Dialogue: 0,0:00:23.05,0:00:26.09,Default,,0000,0000,0000,,Mengapakah penyakit yang hampir punah 30 tahun yang lalu ini, Dialogue: 0,0:00:26.09,0:00:30.09,Default,,0000,0000,0000,,kini kembali lagi, dan yang lebih parah Dialogue: 0,0:00:30.09,0:00:32.05,Default,,0000,0000,0000,,menyerang ke seluruh negara di dunia? Dialogue: 0,0:00:32.05,0:00:34.08,Default,,0000,0000,0000,,Apa yang kami temukan mungkin akan mengagetkan. Dialogue: 0,0:00:34.08,0:00:37.06,Default,,0000,0000,0000,,Pertanyaan serius tentang seberapa kuatkah vaksin Dialogue: 0,0:00:37.06,0:00:39.09,Default,,0000,0000,0000,,dapat mencegah penyebarluasan penyakit Dialogue: 0,0:00:39.09,0:00:42.03,Default,,0000,0000,0000,,pertanyaan-pertanyaan resmi ke departemen kesehatan Dialogue: 0,0:00:42.03,0:00:44.01,Default,,0000,0000,0000,,yang lamban direspon. Dialogue: 0,0:00:44.01,0:00:47.02,Default,,0000,0000,0000,,KBPS bergabung bersama Watchdog Institute, Dialogue: 0,0:00:47.02,0:00:48.10,Default,,0000,0000,0000,,sebuah pusat investigasi jurnalisme Dialogue: 0,0:00:48.10,0:00:51.02,Default,,0000,0000,0000,,di Universitas San Diego, Dialogue: 0,0:00:51.02,0:00:54.04,Default,,0000,0000,0000,,dan jaringan Radio Netherlands Worldwide untuk mengungkap kisah ini. Dialogue: 0,0:00:54.04,0:00:57.00,Default,,0000,0000,0000,,Kisah yang membawa kita melintasi California Dialogue: 0,0:00:57.00,0:00:59.06,Default,,0000,0000,0000,,hingga ke Amsterdam. Dialogue: 0,0:00:59.06,0:01:02.04,Default,,0000,0000,0000,,But first, we begin in a delivery room Dialogue: 0,0:01:02.04,0:01:06.06,Default,,0000,0000,0000,,in a San Diego hospital, where a mother has just given birth Dialogue: 0,0:01:06.06,0:01:08.03,Default,,0000,0000,0000,,to her third son. Dialogue: 0,0:01:08.03,0:01:15.01,Default,,0000,0000,0000,,[ baby crying ] Dialogue: 0,0:01:15.01,0:01:19.02,Default,,0000,0000,0000,,Matthew Jacob Bryce was born Oct 11, 2010. Dialogue: 0,0:01:19.02,0:01:23.07,Default,,0000,0000,0000,,A healthy baby, the third boy for Cindy and Marlon Bryce. Dialogue: 0,0:01:23.07,0:01:25.08,Default,,0000,0000,0000,,Matthew started showing signs of a cold Dialogue: 0,0:01:25.08,0:01:27.04,Default,,0000,0000,0000,,when he was just two weeks old. Dialogue: 0,0:01:27.04,0:01:29.07,Default,,0000,0000,0000,,The Bryce family knew something was wrong. Dialogue: 0,0:01:29.07,0:01:31.03,Default,,0000,0000,0000,,MARLON BRYCE: It just seemed Dialogue: 0,0:01:31.03,0:01:35.06,Default,,0000,0000,0000,,like this cold it was just affecting his breathing. Dialogue: 0,0:01:35.06,0:01:38.07,Default,,0000,0000,0000,,FARYON: The family was aware of the whooping cough epidemic Dialogue: 0,0:01:38.07,0:01:40.05,Default,,0000,0000,0000,,in California, from news reports REPORTER: Dialogue: 0,0:01:40.05,0:01:43.01,Default,,0000,0000,0000,,State health officials say more than 6,400 cases Dialogue: 0,0:01:43.01,0:01:44.09,Default,,0000,0000,0000,,of whooping cough have been reported this year. Dialogue: 0,0:01:44.09,0:01:46.07,Default,,0000,0000,0000,,FARYON: And their pediatrician. Dialogue: 0,0:01:46.07,0:01:48.03,Default,,0000,0000,0000,,BRYCE: There wasn't any whooping Dialogue: 0,0:01:48.03,0:01:52.05,Default,,0000,0000,0000,,or they always say there is a whooping or a cough, Dialogue: 0,0:01:52.05,0:01:54.05,Default,,0000,0000,0000,,he didn't have a cough or anything it was just Dialogue: 0,0:01:54.05,0:01:55.04,Default,,0000,0000,0000,,that there was a cold. Dialogue: 0,0:01:55.04,0:01:58.06,Default,,0000,0000,0000,,FARYON: Matthew's doctor suspected it could be whooping Dialogue: 0,0:01:58.06,0:02:00.08,Default,,0000,0000,0000,,cough, also known as Pertussis. Dialogue: 0,0:02:00.08,0:02:03.07,Default,,0000,0000,0000,,She took a nasal swab and sent it to the lab. Dialogue: 0,0:02:03.07,0:02:06.05,Default,,0000,0000,0000,,She also started Matthew on antibiotics. Dialogue: 0,0:02:06.05,0:02:09.10,Default,,0000,0000,0000,,Six days later, with Matthew just 23 days old, Dialogue: 0,0:02:09.10,0:02:11.04,Default,,0000,0000,0000,,Cindy Bryce got a phone call Dialogue: 0,0:02:11.04,0:02:13.05,Default,,0000,0000,0000,,from the California Department of Health. Dialogue: 0,0:02:13.05,0:02:15.09,Default,,0000,0000,0000,,The diagnosis was whooping cough. Dialogue: 0,0:02:15.09,0:02:20.09,Default,,0000,0000,0000,,M. BRYCE: The moment I heard it I just immediately started Dialogue: 0,0:02:20.09,0:02:26.00,Default,,0000,0000,0000,,thinking the worst because you have heard the news Dialogue: 0,0:02:26.00,0:02:28.07,Default,,0000,0000,0000,,about the babies that have passed away. Dialogue: 0,0:02:28.07,0:02:31.08,Default,,0000,0000,0000,,FARYON: From January to October this year, Dialogue: 0,0:02:31.08,0:02:35.01,Default,,0000,0000,0000,,10 newborns in California died from whooping cough, Dialogue: 0,0:02:35.01,0:02:37.02,Default,,0000,0000,0000,,two in San Diego County. Dialogue: 0,0:02:37.02,0:02:40.04,Default,,0000,0000,0000,,More than 7,000 children and adults got sick Dialogue: 0,0:02:40.04,0:02:43.04,Default,,0000,0000,0000,,from the disease - the highest number in the state Dialogue: 0,0:02:43.04,0:02:45.02,Default,,0000,0000,0000,,in more than 60 years. Dialogue: 0,0:02:45.02,0:02:48.09,Default,,0000,0000,0000,,Just how did Matthew and so many others come down with a disease Dialogue: 0,0:02:48.09,0:02:51.10,Default,,0000,0000,0000,,that is supposed to be preventable with a vaccine? Dialogue: 0,0:02:51.10,0:02:53.10,Default,,0000,0000,0000,,Tonight we'll raise questions Dialogue: 0,0:02:53.10,0:02:56.09,Default,,0000,0000,0000,,about the effectiveness of that vaccine. Dialogue: 0,0:02:56.09,0:03:01.04,Default,,0000,0000,0000,,A four-month investigation by KPBS and the Watchdog Institute, Dialogue: 0,0:03:01.04,0:03:03.09,Default,,0000,0000,0000,,found many people who have been diagnosed Dialogue: 0,0:03:03.09,0:03:07.01,Default,,0000,0000,0000,,with whooping cough were immunized. Dialogue: 0,0:03:07.01,0:03:09.09,Default,,0000,0000,0000,,We also show how government data on the number Dialogue: 0,0:03:09.09,0:03:13.03,Default,,0000,0000,0000,,of people diagnosed with whooping cough lacks timeliness Dialogue: 0,0:03:13.03,0:03:16.07,Default,,0000,0000,0000,,and is often inconsistent, begging the question: Dialogue: 0,0:03:16.07,0:03:19.06,Default,,0000,0000,0000,,just who is keeping track of this epidemic? Dialogue: 0,0:03:19.06,0:03:21.06,Default,,0000,0000,0000,,We'll show you how some of the experts Dialogue: 0,0:03:21.06,0:03:25.02,Default,,0000,0000,0000,,who influence vaccine policy are financially tied Dialogue: 0,0:03:25.02,0:03:27.00,Default,,0000,0000,0000,,to vaccine companies. Dialogue: 0,0:03:27.00,0:03:29.04,Default,,0000,0000,0000,,And, we'll follow the Bryce family as they struggle Dialogue: 0,0:03:29.04,0:03:33.08,Default,,0000,0000,0000,,with their son's diagnosis, and the setbacks in his recovery. Dialogue: 0,0:03:36.09,0:03:40.06,Default,,0000,0000,0000,,Whooping cough, violent cough, the hundred-day cough; Dialogue: 0,0:03:40.06,0:03:42.04,Default,,0000,0000,0000,,all names for Pertussis. Dialogue: 0,0:03:42.04,0:03:44.09,Default,,0000,0000,0000,,DR. JAMES CHERRY: What causes the cough actually we Dialogue: 0,0:03:44.09,0:03:45.07,Default,,0000,0000,0000,,don't know... Dialogue: 0,0:03:45.07,0:03:47.04,Default,,0000,0000,0000,,there's no other cough quite like it. Dialogue: 0,0:03:47.04,0:03:50.08,Default,,0000,0000,0000,,FARYON: Pertussis is a respiratory illness caused Dialogue: 0,0:03:50.08,0:03:53.04,Default,,0000,0000,0000,,by the bacterium Bordetella pertussis. Dialogue: 0,0:03:53.04,0:03:55.05,Default,,0000,0000,0000,,At first, it can mimic a cold. Dialogue: 0,0:03:55.05,0:03:59.01,Default,,0000,0000,0000,,But later produces a violent and persistent cough, Dialogue: 0,0:03:59.01,0:04:02.01,Default,,0000,0000,0000,,a cough that leaves children gasping for air - Dialogue: 0,0:04:02.01,0:04:05.02,Default,,0000,0000,0000,,creating the distinct whooping sound. Dialogue: 0,0:04:05.02,0:04:08.04,Default,,0000,0000,0000,,For adults, whooping cough may only be a nuisance. Dialogue: 0,0:04:08.04,0:04:11.02,Default,,0000,0000,0000,,In fact scientists estimate more than 80 percent Dialogue: 0,0:04:11.02,0:04:14.01,Default,,0000,0000,0000,,of adult cases are never diagnosed Dialogue: 0,0:04:14.01,0:04:17.02,Default,,0000,0000,0000,,because most people assume they just have a bad cold. Dialogue: 0,0:04:17.02,0:04:20.05,Default,,0000,0000,0000,,But to infants whooping cough can be deadly, Dialogue: 0,0:04:20.05,0:04:22.09,Default,,0000,0000,0000,,especially if not diagnosed early. Dialogue: 0,0:04:22.09,0:04:25.04,Default,,0000,0000,0000,,DR. JAMES CHERRY: So with infection Dialogue: 0,0:04:25.04,0:04:29.08,Default,,0000,0000,0000,,that you eventually clear the bacteria and you get better. Dialogue: 0,0:04:29.08,0:04:34.05,Default,,0000,0000,0000,,But it's a prolonged, most cases ... Dialogue: 0,0:04:34.05,0:04:37.04,Default,,0000,0000,0000,,a good percentage of cases in children Dialogue: 0,0:04:37.04,0:04:39.06,Default,,0000,0000,0000,,will last for one or two months. Dialogue: 0,0:04:39.06,0:04:41.07,Default,,0000,0000,0000,,DR. FRITS MOOI: After a pertussis infection Dialogue: 0,0:04:41.07,0:04:45.00,Default,,0000,0000,0000,,you often get super infections, actually that is one Dialogue: 0,0:04:45.00,0:04:47.01,Default,,0000,0000,0000,,of the main complications, pneumonia. Dialogue: 0,0:04:47.01,0:04:50.02,Default,,0000,0000,0000,,FARYON: Young babies aren't able to cough up secretions Dialogue: 0,0:04:50.02,0:04:52.06,Default,,0000,0000,0000,,that collect in their lungs, leading to pneumonia Dialogue: 0,0:04:52.06,0:04:54.09,Default,,0000,0000,0000,,and making it difficult to breathe. Dialogue: 0,0:04:54.09,0:04:59.05,Default,,0000,0000,0000,,Early antibiotic treatment is most critical in this age group. Dialogue: 0,0:04:59.05,0:05:02.06,Default,,0000,0000,0000,,Whooping cough was nearly wiped out by the late 1970's Dialogue: 0,0:05:02.06,0:05:04.09,Default,,0000,0000,0000,,because of mass immunization, Dialogue: 0,0:05:04.09,0:05:07.04,Default,,0000,0000,0000,,but it's somehow found its way back to California Dialogue: 0,0:05:07.04,0:05:11.03,Default,,0000,0000,0000,,and other highly vaccinated communities around the world. Dialogue: 0,0:05:11.03,0:05:14.01,Default,,0000,0000,0000,,Just why it's made such a vengeful comeback has two Dialogue: 0,0:05:14.01,0:05:17.06,Default,,0000,0000,0000,,of the world's leading whooping cough experts in disagreement. Dialogue: 0,0:05:17.06,0:05:20.03,Default,,0000,0000,0000,,Dr. James Cherry of UCLA: CHERRY: Dialogue: 0,0:05:20.03,0:05:22.05,Default,,0000,0000,0000,,The main reason is increased awareness. Dialogue: 0,0:05:22.05,0:05:25.01,Default,,0000,0000,0000,,FARYON: and Dr. Frits Mooi of the Netherlands Centre Dialogue: 0,0:05:25.01,0:05:26.09,Default,,0000,0000,0000,,for Infectious Diseases Control. Dialogue: 0,0:05:26.09,0:05:33.04,Default,,0000,0000,0000,,MOOI: We found really a new mutation in the bug. Dialogue: 0,0:05:33.04,0:05:37.01,Default,,0000,0000,0000,,FARYON: Dr. Mooi and Dr. Cherry both began their research Dialogue: 0,0:05:37.01,0:05:39.08,Default,,0000,0000,0000,,into Whooping Cough about 30 years ago. Dialogue: 0,0:05:39.08,0:05:42.09,Default,,0000,0000,0000,,Cherry in the U.S. and Mooi in The Netherlands. Dialogue: 0,0:05:42.09,0:05:45.06,Default,,0000,0000,0000,,The two scientists know each other's work. Dialogue: 0,0:05:45.06,0:05:49.08,Default,,0000,0000,0000,,CHERRY: First of all, his molecular microbiological science is, Dialogue: 0,0:05:49.08,0:05:54.10,Default,,0000,0000,0000,,he's right at the top of scholars. Dialogue: 0,0:05:54.10,0:05:57.04,Default,,0000,0000,0000,,There's no question about that. Dialogue: 0,0:05:57.04,0:06:02.01,Default,,0000,0000,0000,,I think where some of the things he's published is the clinical Dialogue: 0,0:06:02.01,0:06:04.01,Default,,0000,0000,0000,,data are not very good. Dialogue: 0,0:06:04.01,0:06:07.03,Default,,0000,0000,0000,,MOOI: I don't communicate too much with him but what he wrote Dialogue: 0,0:06:07.03,0:06:11.06,Default,,0000,0000,0000,,in the press is that I screw up epidemiology. Dialogue: 0,0:06:11.06,0:06:13.04,Default,,0000,0000,0000,,That doesn't help me too much. Dialogue: 0,0:06:13.04,0:06:16.05,Default,,0000,0000,0000,,FARYON: To understand why these two experts disagree, Dialogue: 0,0:06:16.05,0:06:18.06,Default,,0000,0000,0000,,you need to know a little about the history Dialogue: 0,0:06:18.06,0:06:19.08,Default,,0000,0000,0000,,of the pertussis vaccine. Dialogue: 0,0:06:19.08,0:06:23.07,Default,,0000,0000,0000,,ANNOUNCER: Since most serious cases occur before school age, Dialogue: 0,0:06:23.07,0:06:26.01,Default,,0000,0000,0000,,immunization in school may be too late. Dialogue: 0,0:06:26.01,0:06:29.03,Default,,0000,0000,0000,,FARYON: The bacteria that causes whooping cough was first Dialogue: 0,0:06:29.03,0:06:32.01,Default,,0000,0000,0000,,isolated in Belgium in 1906. Dialogue: 0,0:06:32.01,0:06:33.08,Default,,0000,0000,0000,,At the time, the illness was one Dialogue: 0,0:06:33.08,0:06:35.07,Default,,0000,0000,0000,,of the leading causes of infant death. Dialogue: 0,0:06:35.07,0:06:40.07,Default,,0000,0000,0000,,ANNOUNCER: In 1921, whooping cough killed 316 Dialogue: 0,0:06:40.07,0:06:42.06,Default,,0000,0000,0000,,Michigan children. Dialogue: 0,0:06:42.06,0:06:47.03,Default,,0000,0000,0000,,Last year, the number of deaths was reduced to 63. Dialogue: 0,0:06:47.03,0:06:51.03,Default,,0000,0000,0000,,FARYON: The discovery lead to the first attempts at a vaccine. Dialogue: 0,0:06:51.03,0:06:55.02,Default,,0000,0000,0000,,But it wasn't until the late 1940's scientists developed a Dialogue: 0,0:06:55.02,0:06:58.00,Default,,0000,0000,0000,,vaccine effective enough to prevent whooping cough. Dialogue: 0,0:06:58.00,0:06:59.09,Default,,0000,0000,0000,,ANNOUNCER: Unlike the disease however, Dialogue: 0,0:06:59.09,0:07:01.07,Default,,0000,0000,0000,,a vaccine does not endanger life. Dialogue: 0,0:07:01.07,0:07:05.04,Default,,0000,0000,0000,,FARYON: By 1946, mass immunization programs began Dialogue: 0,0:07:05.04,0:07:08.08,Default,,0000,0000,0000,,in the U.S. and the number of cases dropped dramatically. Dialogue: 0,0:07:08.08,0:07:10.08,Default,,0000,0000,0000,,Prior to the vaccine the rate Dialogue: 0,0:07:10.08,0:07:14.08,Default,,0000,0000,0000,,of disease was 157 cases per 100,000. Dialogue: 0,0:07:14.08,0:07:19.08,Default,,0000,0000,0000,,By the 1970's, with large scale immunizations, fewer than one Dialogue: 0,0:07:19.08,0:07:22.07,Default,,0000,0000,0000,,in one hundred thousand people got whooping cough. Dialogue: 0,0:07:22.07,0:07:26.02,Default,,0000,0000,0000,,But the vaccine was not without controversy. Dialogue: 0,0:07:26.02,0:07:29.03,Default,,0000,0000,0000,,The early versions were associated with side effects Dialogue: 0,0:07:29.03,0:07:32.10,Default,,0000,0000,0000,,such as prolonged crying spells and seizures in babies. Dialogue: 0,0:07:32.10,0:07:37.06,Default,,0000,0000,0000,,By 1996, the FDA approved a new whooping cough vaccine. Dialogue: 0,0:07:37.06,0:07:40.02,Default,,0000,0000,0000,,It was called an acellular version. Dialogue: 0,0:07:40.02,0:07:43.03,Default,,0000,0000,0000,,That means the vaccine uses only purified components Dialogue: 0,0:07:43.03,0:07:45.06,Default,,0000,0000,0000,,of the disease-causing organism. Dialogue: 0,0:07:45.06,0:07:49.01,Default,,0000,0000,0000,,That vaccine was considered to be safer and associated Dialogue: 0,0:07:49.01,0:07:51.03,Default,,0000,0000,0000,,with few mild side effects. Dialogue: 0,0:07:51.03,0:07:56.05,Default,,0000,0000,0000,,Today, the U.S. uses only the acellular pertussis vaccine. Dialogue: 0,0:07:59.04,0:08:02.06,Default,,0000,0000,0000,,But as the United States was changing vaccines something else Dialogue: 0,0:08:02.06,0:08:04.04,Default,,0000,0000,0000,,was happening Dialogue: 0,0:08:05.08,0:08:09.07,Default,,0000,0000,0000,,health officials across the country were reporting increasing numbers Dialogue: 0,0:08:09.07,0:08:12.02,Default,,0000,0000,0000,,of positive whooping cough cases. Dialogue: 0,0:08:12.02,0:08:16.01,Default,,0000,0000,0000,,And in a government lab about 30 minutes outside of Amsterdam, Dialogue: 0,0:08:16.01,0:08:19.02,Default,,0000,0000,0000,,a group of scientists had discovered something else - Dialogue: 0,0:08:19.02,0:08:22.03,Default,,0000,0000,0000,,the bacterium that causes whooping cough started Dialogue: 0,0:08:22.03,0:08:23.10,Default,,0000,0000,0000,,to look a little different. Dialogue: 0,0:08:23.10,0:08:28.07,Default,,0000,0000,0000,,MOOI: This new mutation had the effect that the bacteria started Dialogue: 0,0:08:28.07,0:08:30.05,Default,,0000,0000,0000,,to produce more pertussis toxin. Dialogue: 0,0:08:30.05,0:08:32.08,Default,,0000,0000,0000,,FARYON: Just whether that mutation is to blame, Dialogue: 0,0:08:32.08,0:08:35.05,Default,,0000,0000,0000,,at least in part, for the California epidemic Dialogue: 0,0:08:35.05,0:08:38.04,Default,,0000,0000,0000,,and outbreaks elsewhere in the world is at the heart Dialogue: 0,0:08:38.04,0:08:40.02,Default,,0000,0000,0000,,of the whooping cough debate. Dialogue: 0,0:08:40.02,0:08:44.04,Default,,0000,0000,0000,,Dr. Mooi believes this to be the case, but not Dr. Cherry. Dialogue: 0,0:08:44.04,0:08:47.02,Default,,0000,0000,0000,,CHERRY: Even though these changes have occurred there is Dialogue: 0,0:08:47.02,0:08:51.01,Default,,0000,0000,0000,,no evidence that that's lead to increased vaccine failure. Dialogue: 0,0:08:56.02,0:08:59.07,Default,,0000,0000,0000,,FARYON: Here in San Diego County, more than 85 percent Dialogue: 0,0:08:59.07,0:09:01.04,Default,,0000,0000,0000,,of children are immunized. Dialogue: 0,0:09:01.04,0:09:03.02,Default,,0000,0000,0000,,In fact, less than three percent Dialogue: 0,0:09:03.02,0:09:06.09,Default,,0000,0000,0000,,of kids entering kindergarten have not been immunized Dialogue: 0,0:09:06.09,0:09:09.01,Default,,0000,0000,0000,,because of their family's personal beliefs. Dialogue: 0,0:09:09.01,0:09:11.08,Default,,0000,0000,0000,,But despite the high immunization rate, Dialogue: 0,0:09:11.08,0:09:14.05,Default,,0000,0000,0000,,San Diego has the second largest number Dialogue: 0,0:09:14.05,0:09:17.06,Default,,0000,0000,0000,,of positive whooping cough cases in California. Dialogue: 0,0:09:17.06,0:09:20.08,Default,,0000,0000,0000,,Dr. Dean Sidelinger is San Diego's deputy public Dialogue: 0,0:09:20.08,0:09:21.07,Default,,0000,0000,0000,,health officer. Dialogue: 0,0:09:21.07,0:09:22.07,Default,,0000,0000,0000,,DR. DEAN SIDELINGER: This is a disease Dialogue: 0,0:09:22.07,0:09:25.01,Default,,0000,0000,0000,,that if someone has it it's very easily transferred Dialogue: 0,0:09:25.01,0:09:26.08,Default,,0000,0000,0000,,from one person to another. Dialogue: 0,0:09:26.08,0:09:29.01,Default,,0000,0000,0000,,So if you or I sitting here during this interview, Dialogue: 0,0:09:29.01,0:09:32.01,Default,,0000,0000,0000,,one of us had pertussis chances are we could transmit Dialogue: 0,0:09:32.01,0:09:33.05,Default,,0000,0000,0000,,that to the other person. Dialogue: 0,0:09:33.05,0:09:34.10,Default,,0000,0000,0000,,Sidelinger says in the past, Dialogue: 0,0:09:34.10,0:09:37.10,Default,,0000,0000,0000,,the number of whooping cough cases peaked in summer Dialogue: 0,0:09:37.10,0:09:41.07,Default,,0000,0000,0000,,and slowed by fall, but this year, that didn't happen. Dialogue: 0,0:09:41.07,0:09:45.04,Default,,0000,0000,0000,,SIDELINGER: So as time goes on we're seeing more cases. Dialogue: 0,0:09:45.04,0:09:48.10,Default,,0000,0000,0000,,We know that public awareness plays into that as we talk Dialogue: 0,0:09:48.10,0:09:51.05,Default,,0000,0000,0000,,about Pertussis more people are asking their doctors Dialogue: 0,0:09:51.05,0:09:53.02,Default,,0000,0000,0000,,and doctors are asking their patients we're going Dialogue: 0,0:09:53.02,0:09:55.04,Default,,0000,0000,0000,,to see more, but that trend continued. Dialogue: 0,0:09:55.04,0:09:59.05,Default,,0000,0000,0000,,FARYON: By the end of November 2010, nearly 1000 infants, Dialogue: 0,0:09:59.05,0:10:02.08,Default,,0000,0000,0000,,children and adults in San Diego County tested positive Dialogue: 0,0:10:02.08,0:10:04.00,Default,,0000,0000,0000,,for whooping cough. Dialogue: 0,0:10:04.00,0:10:06.08,Default,,0000,0000,0000,,More than half of them had been immunized. Dialogue: 0,0:10:06.08,0:10:08.01,Default,,0000,0000,0000,,Our investigation shows Dialogue: 0,0:10:08.01,0:10:10.09,Default,,0000,0000,0000,,that trend continues throughout California. Dialogue: 0,0:10:10.09,0:10:14.02,Default,,0000,0000,0000,,KPBS and The Watchdog Institute collected data Dialogue: 0,0:10:14.02,0:10:16.10,Default,,0000,0000,0000,,from 9 California counties that report some Dialogue: 0,0:10:16.10,0:10:19.00,Default,,0000,0000,0000,,of the highest infection rates. Dialogue: 0,0:10:19.00,0:10:22.06,Default,,0000,0000,0000,,Our research shows that where immunization history is known, Dialogue: 0,0:10:22.06,0:10:26.02,Default,,0000,0000,0000,,between 44 and 83 percent of people diagnosed Dialogue: 0,0:10:26.02,0:10:28.06,Default,,0000,0000,0000,,with whooping cough were vaccinated. Dialogue: 0,0:10:28.06,0:10:30.04,Default,,0000,0000,0000,,We looked at California Department Dialogue: 0,0:10:30.04,0:10:32.04,Default,,0000,0000,0000,,of Public Health records too. Dialogue: 0,0:10:32.04,0:10:35.05,Default,,0000,0000,0000,,In cases where vaccination history was recorded, Dialogue: 0,0:10:35.05,0:10:39.01,Default,,0000,0000,0000,,more than 80 percent of infected people had been immunized. Dialogue: 0,0:10:39.01,0:10:41.00,Default,,0000,0000,0000,,DR. MARK HORTON: From the epidemiology experts Dialogue: 0,0:10:41.00,0:10:45.08,Default,,0000,0000,0000,,and the experts in vaccine this is absolutely expected. Dialogue: 0,0:10:45.08,0:10:48.02,Default,,0000,0000,0000,,FARYON: Dr. Mark Horton is the director Dialogue: 0,0:10:48.02,0:10:50.07,Default,,0000,0000,0000,,of the California Department of Public Health. Dialogue: 0,0:10:50.07,0:10:52.06,Default,,0000,0000,0000,,HORTON: If you've got a percentage Dialogue: 0,0:10:52.06,0:10:56.03,Default,,0000,0000,0000,,of the population vaccinated and a percentage of those vaccinated Dialogue: 0,0:10:56.03,0:10:57.04,Default,,0000,0000,0000,,that are still susceptible Dialogue: 0,0:10:57.04,0:11:00.08,Default,,0000,0000,0000,,because the vaccine isn't perfectly effective or effective Dialogue: 0,0:11:00.08,0:11:02.08,Default,,0000,0000,0000,,in all individuals, when you work Dialogue: 0,0:11:02.08,0:11:05.00,Default,,0000,0000,0000,,out the arithmetic you'll see that even Dialogue: 0,0:11:05.00,0:11:06.10,Default,,0000,0000,0000,,with a very effective vaccine, Dialogue: 0,0:11:06.10,0:11:08.04,Default,,0000,0000,0000,,and even if you have the majority Dialogue: 0,0:11:08.04,0:11:10.03,Default,,0000,0000,0000,,of the population vaccinated, Dialogue: 0,0:11:10.03,0:11:14.01,Default,,0000,0000,0000,,the pool of susceptibles will include a number of individuals Dialogue: 0,0:11:14.01,0:11:15.04,Default,,0000,0000,0000,,that have never been vaccinated Dialogue: 0,0:11:15.04,0:11:19.04,Default,,0000,0000,0000,,but will also include quite a few and in some cases greater Dialogue: 0,0:11:19.04,0:11:20.02,Default,,0000,0000,0000,,than 50 percent Dialogue: 0,0:11:20.02,0:11:22.04,Default,,0000,0000,0000,,of the individuals have been previously vaccinated. Dialogue: 0,0:11:22.04,0:11:24.07,Default,,0000,0000,0000,,FARYON: In other words, if you do the math, Dialogue: 0,0:11:24.07,0:11:26.07,Default,,0000,0000,0000,,you will always find a certain number Dialogue: 0,0:11:26.07,0:11:28.06,Default,,0000,0000,0000,,of immunized people getting sick Dialogue: 0,0:11:28.06,0:11:31.06,Default,,0000,0000,0000,,if a vaccine is not 100 percent effective. Dialogue: 0,0:11:31.06,0:11:34.09,Default,,0000,0000,0000,,HORTON: So that's no surprise to us nor is it a reflection Dialogue: 0,0:11:34.09,0:11:36.05,Default,,0000,0000,0000,,on the efficacy of the vaccine. Dialogue: 0,0:11:36.05,0:11:37.09,Default,,0000,0000,0000,,REPORTER KEVIN CROWE: It's not a reflection Dialogue: 0,0:11:37.09,0:11:39.01,Default,,0000,0000,0000,,on the efficacy of the vaccine? Dialogue: 0,0:11:39.01,0:11:39.07,Default,,0000,0000,0000,,HORTON: Correct, correct. Dialogue: 0,0:11:39.07,0:11:42.06,Default,,0000,0000,0000,,FARYON: But 20 years ago, the reverse was true. Dialogue: 0,0:11:42.06,0:11:44.10,Default,,0000,0000,0000,,According to a report by the Centers for Disease Control, Dialogue: 0,0:11:44.10,0:11:48.04,Default,,0000,0000,0000,,more than half of the children between 3 months and 4 years old Dialogue: 0,0:11:48.04,0:11:51.04,Default,,0000,0000,0000,,who got whooping cough nationwide between 1990 Dialogue: 0,0:11:51.04,0:11:53.09,Default,,0000,0000,0000,,and 1996 were not immunized. Dialogue: 0,0:11:53.09,0:11:56.05,Default,,0000,0000,0000,,The rate of whooping cough has also been increasing Dialogue: 0,0:11:56.05,0:11:58.00,Default,,0000,0000,0000,,for the past 20 years. Dialogue: 0,0:11:58.00,0:12:00.09,Default,,0000,0000,0000,,From less than one in 100,000 Dialogue: 0,0:12:00.09,0:12:04.02,Default,,0000,0000,0000,,to 18 per 100,000 here in California. Dialogue: 0,0:12:04.02,0:12:08.06,Default,,0000,0000,0000,,And in some California counties such as San Luis Obispo, Dialogue: 0,0:12:08.06,0:12:12.09,Default,,0000,0000,0000,,rates are nearly as high as before vaccines were developed. Dialogue: 0,0:12:12.09,0:12:14.09,Default,,0000,0000,0000,,Two days after our interview Dialogue: 0,0:12:14.09,0:12:18.06,Default,,0000,0000,0000,,with the Bryce family, Matthew got a fever. Dialogue: 0,0:12:18.06,0:12:21.05,Default,,0000,0000,0000,,He was hospitalized at Rady's Children's Hospital Dialogue: 0,0:12:21.05,0:12:24.00,Default,,0000,0000,0000,,in San Diego. Dialogue: 0,0:12:24.00,0:12:26.08,Default,,0000,0000,0000,,Matthew was not immunized against whooping cough. Dialogue: 0,0:12:26.08,0:12:28.00,Default,,0000,0000,0000,,He's too young. Dialogue: 0,0:12:28.00,0:12:31.09,Default,,0000,0000,0000,,Babies can't be immunized until they're two months old. Dialogue: 0,0:12:31.09,0:12:34.09,Default,,0000,0000,0000,,But everyone else in the Bryce family was vaccinated - Dialogue: 0,0:12:34.09,0:12:37.02,Default,,0000,0000,0000,,even his parents got booster shots. Dialogue: 0,0:12:37.02,0:12:39.04,Default,,0000,0000,0000,,The practice of immunizing everyone Dialogue: 0,0:12:39.04,0:12:42.00,Default,,0000,0000,0000,,around a newborn baby is called cocooning. Dialogue: 0,0:12:42.00,0:12:46.09,Default,,0000,0000,0000,,CINDY BRYCE: When I called the doctor they asked me who has it Dialogue: 0,0:12:46.09,0:12:50.04,Default,,0000,0000,0000,,and I couldn't give them an answer because I don't know Dialogue: 0,0:12:50.04,0:12:53.05,Default,,0000,0000,0000,,where he got it from because everyone's been vaccinated. Dialogue: 0,0:12:53.05,0:12:56.05,Default,,0000,0000,0000,,FARYON: Myron and one of his sons were also tested Dialogue: 0,0:12:56.05,0:12:58.04,Default,,0000,0000,0000,,for whooping cough - both were negative. Dialogue: 0,0:12:58.04,0:13:00.10,Default,,0000,0000,0000,,M. BRYCE: The one thing I would want Dialogue: 0,0:13:00.10,0:13:05.07,Default,,0000,0000,0000,,to know is the vaccine working? Dialogue: 0,0:13:05.07,0:13:11.03,Default,,0000,0000,0000,,Is it as effective because before this I thought the Dialogue: 0,0:13:11.03,0:13:18.07,Default,,0000,0000,0000,,vaccine was working and I thought that if I did everything Dialogue: 0,0:13:18.07,0:13:27.02,Default,,0000,0000,0000,,that I was told to do that our sons would be protected. Dialogue: 0,0:13:27.02,0:13:30.01,Default,,0000,0000,0000,,FARYON: Just how effective is the vaccine? Dialogue: 0,0:13:30.01,0:13:32.07,Default,,0000,0000,0000,,That all depends on who you talk to. Dialogue: 0,0:13:32.07,0:13:34.02,Default,,0000,0000,0000,,Drug information included Dialogue: 0,0:13:34.02,0:13:37.01,Default,,0000,0000,0000,,with the two most commonly used whooping cough vaccines Dialogue: 0,0:13:37.01,0:13:40.04,Default,,0000,0000,0000,,in the US say the vaccine is 85 percent effective. Dialogue: 0,0:13:40.04,0:13:44.01,Default,,0000,0000,0000,,MOOI: This new strain has completely invaded the Dialogue: 0,0:13:44.01,0:13:46.05,Default,,0000,0000,0000,,Netherlands and also other countries and pushed Dialogue: 0,0:13:46.05,0:13:48.03,Default,,0000,0000,0000,,out all the other strains. Dialogue: 0,0:13:48.03,0:13:49.01,Default,,0000,0000,0000,,It's quite unique. Dialogue: 0,0:13:49.01,0:13:51.06,Default,,0000,0000,0000,,FARYON: Dr. Mooi believes there's no way Dialogue: 0,0:13:51.06,0:13:54.05,Default,,0000,0000,0000,,to determine how effective the vaccines are Dialogue: 0,0:13:54.05,0:13:56.01,Default,,0000,0000,0000,,because they have not been tested Dialogue: 0,0:13:56.01,0:13:58.04,Default,,0000,0000,0000,,against the new strain of whooping cough. Dialogue: 0,0:13:58.04,0:13:59.07,Default,,0000,0000,0000,,MOOI: We call it the p3 strain. Dialogue: 0,0:13:59.07,0:14:02.05,Default,,0000,0000,0000,,FARYON: A strain he believes is more virulent Dialogue: 0,0:14:02.05,0:14:04.00,Default,,0000,0000,0000,,and can make people sicker. Dialogue: 0,0:14:04.00,0:14:07.05,Default,,0000,0000,0000,,This strain emerged while the new acellular vaccines were Dialogue: 0,0:14:07.05,0:14:08.04,Default,,0000,0000,0000,,being developed. Dialogue: 0,0:14:08.04,0:14:09.05,Default,,0000,0000,0000,,MOOI: I can tell you one Dialogue: 0,0:14:09.05,0:14:14.03,Default,,0000,0000,0000,,of the reasons the vaccine companies are not too happy Dialogue: 0,0:14:14.03,0:14:20.08,Default,,0000,0000,0000,,with me is because if what I say is true they selected the wrong Dialogue: 0,0:14:20.08,0:14:22.10,Default,,0000,0000,0000,,strains in the 1980's. Dialogue: 0,0:14:22.10,0:14:25.04,Default,,0000,0000,0000,,FARYON: Mooi's lab was studying the new strain Dialogue: 0,0:14:25.04,0:14:28.06,Default,,0000,0000,0000,,when The Netherlands experienced an unexpected whooping cough Dialogue: 0,0:14:28.06,0:14:30.03,Default,,0000,0000,0000,,epidemic in 1996. Dialogue: 0,0:14:31.00,0:14:33.01,Default,,0000,0000,0000,,MOOI: There was a very direct relationship Dialogue: 0,0:14:33.01,0:14:37.07,Default,,0000,0000,0000,,between the emergence of these strains, we call them p3 strains Dialogue: 0,0:14:37.07,0:14:40.06,Default,,0000,0000,0000,,and the increase in pertussis notifications. Dialogue: 0,0:14:40.06,0:14:44.08,Default,,0000,0000,0000,,CHERRY: There's absolutely no evidence that either Dialogue: 0,0:14:44.08,0:14:48.09,Default,,0000,0000,0000,,of the two vaccines that are most common today used Dialogue: 0,0:14:48.09,0:14:54.03,Default,,0000,0000,0000,,in the U.S. that there is increased vaccine failure Dialogue: 0,0:14:54.03,0:14:56.00,Default,,0000,0000,0000,,with either of those vaccines. Dialogue: 0,0:14:56.00,0:15:01.01,Default,,0000,0000,0000,,FARYON: So if you had to explain why we're seeing this epidemic Dialogue: 0,0:15:01.01,0:15:03.01,Default,,0000,0000,0000,,the highest number of cases in 60 years, Dialogue: 0,0:15:03.01,0:15:04.07,Default,,0000,0000,0000,,what would you tell people? Dialogue: 0,0:15:04.07,0:15:07.06,Default,,0000,0000,0000,,CHERRY: The main reason is increased awareness. Dialogue: 0,0:15:07.06,0:15:12.05,Default,,0000,0000,0000,,People, particularly public health people are much more Dialogue: 0,0:15:12.05,0:15:14.09,Default,,0000,0000,0000,,aware and that trickles down. Dialogue: 0,0:15:14.09,0:15:17.06,Default,,0000,0000,0000,,FARYON: Cherry says the increase is also due in part Dialogue: 0,0:15:17.06,0:15:19.09,Default,,0000,0000,0000,,because of something called waning immunity. Dialogue: 0,0:15:19.09,0:15:23.05,Default,,0000,0000,0000,,Immunity to whooping cough does not last a lifetime, Dialogue: 0,0:15:23.05,0:15:26.04,Default,,0000,0000,0000,,whether you are vaccinated or develop natural immunity Dialogue: 0,0:15:26.04,0:15:27.10,Default,,0000,0000,0000,,from getting the disease. Dialogue: 0,0:15:27.10,0:15:31.06,Default,,0000,0000,0000,,Almost all experts agree waning immunity is contributing Dialogue: 0,0:15:31.06,0:15:34.04,Default,,0000,0000,0000,,to whooping cough outbreaks worldwide. Dialogue: 0,0:15:34.04,0:15:38.06,Default,,0000,0000,0000,,Where they disagree: when does immunity fail? Dialogue: 0,0:15:41.01,0:15:45.03,Default,,0000,0000,0000,,Dr. Mooi believes the new strain of Pertussis causes immunity Dialogue: 0,0:15:45.03,0:15:47.04,Default,,0000,0000,0000,,to fail sooner than in the past. Dialogue: 0,0:15:47.04,0:15:49.02,Default,,0000,0000,0000,,And he's published his findings Dialogue: 0,0:15:49.02,0:15:52.05,Default,,0000,0000,0000,,in several peer reviewed journals including the CDC's Dialogue: 0,0:15:52.05,0:15:54.00,Default,,0000,0000,0000,,Infectious Diseases. Dialogue: 0,0:15:54.00,0:15:59.03,Default,,0000,0000,0000,,MOOI: When the immunity is sub-optimal what will happen the Dialogue: 0,0:15:59.03,0:16:04.03,Default,,0000,0000,0000,,bacteria will not be recognized very well by the immune system Dialogue: 0,0:16:04.03,0:16:08.03,Default,,0000,0000,0000,,because of the mismatch and second of all even Dialogue: 0,0:16:08.03,0:16:10.07,Default,,0000,0000,0000,,if immune response is started Dialogue: 0,0:16:10.07,0:16:14.07,Default,,0000,0000,0000,,in the body the toxin will be able to delay it. Dialogue: 0,0:16:14.07,0:16:19.09,Default,,0000,0000,0000,,You could say these two changes work together Dialogue: 0,0:16:19.09,0:16:22.05,Default,,0000,0000,0000,,by decreasing the period Dialogue: 0,0:16:22.05,0:16:25.08,Default,,0000,0000,0000,,of which the vaccine is protective further. Dialogue: 0,0:16:25.08,0:16:27.09,Default,,0000,0000,0000,,FARYON: The Netherlands learned something else Dialogue: 0,0:16:27.09,0:16:30.04,Default,,0000,0000,0000,,after its 1996 epidemic. Dialogue: 0,0:16:30.04,0:16:33.03,Default,,0000,0000,0000,,At the time, it had very few samples of the bacteria Dialogue: 0,0:16:33.03,0:16:35.08,Default,,0000,0000,0000,,that was causing people to get sick. Dialogue: 0,0:16:35.08,0:16:38.08,Default,,0000,0000,0000,,So Mooi's lab began asking doctors and their labs Dialogue: 0,0:16:38.08,0:16:41.05,Default,,0000,0000,0000,,to send him positive Pertussis swabs. Dialogue: 0,0:16:41.05,0:16:44.07,Default,,0000,0000,0000,,His lab now has 3,000 samples. Dialogue: 0,0:16:44.07,0:16:47.09,Default,,0000,0000,0000,,California has collected just 29 samples from the more Dialogue: 0,0:16:47.09,0:16:51.05,Default,,0000,0000,0000,,than 7,000 whooping cough cases in the state. Dialogue: 0,0:16:51.05,0:16:55.01,Default,,0000,0000,0000,,During the KPBS/Watchdog four month investigation, Dialogue: 0,0:16:55.01,0:16:57.02,Default,,0000,0000,0000,,we also learned data kept by the state Dialogue: 0,0:16:57.02,0:17:00.09,Default,,0000,0000,0000,,and the CDC was often lagging behind county data Dialogue: 0,0:17:00.09,0:17:02.07,Default,,0000,0000,0000,,and was inconsistent. Dialogue: 0,0:17:02.07,0:17:05.08,Default,,0000,0000,0000,,While counties like San Diego knew the immunization status Dialogue: 0,0:17:05.08,0:17:08.05,Default,,0000,0000,0000,,of the vast majority of people with whooping cough, Dialogue: 0,0:17:08.05,0:17:11.08,Default,,0000,0000,0000,,the state's data listed the information as unknown. Dialogue: 0,0:17:11.08,0:17:15.02,Default,,0000,0000,0000,,Despite statewide protocols for reporting pertussis, Dialogue: 0,0:17:15.02,0:17:19.02,Default,,0000,0000,0000,,a KPBS/Watchdog survey found some counties don't follow them Dialogue: 0,0:17:19.02,0:17:22.01,Default,,0000,0000,0000,,or are slow to report the information HORTON: Dialogue: 0,0:17:22.01,0:17:24.09,Default,,0000,0000,0000,,There's a perception that the more numbers the better, Dialogue: 0,0:17:24.09,0:17:30.05,Default,,0000,0000,0000,,but let me be very clear we in no way need reports Dialogue: 0,0:17:30.05,0:17:33.00,Default,,0000,0000,0000,,on every single case of pertussis for us Dialogue: 0,0:17:33.00,0:17:37.00,Default,,0000,0000,0000,,to make important judgments and decisions Dialogue: 0,0:17:37.00,0:17:38.03,Default,,0000,0000,0000,,about what's happening. Dialogue: 0,0:17:38.03,0:17:41.05,Default,,0000,0000,0000,,FARYON: The CDC in Atlanta declined our requests Dialogue: 0,0:17:41.05,0:17:42.06,Default,,0000,0000,0000,,for an interview. Dialogue: 0,0:17:42.06,0:17:45.05,Default,,0000,0000,0000,,In an email response they said it is "difficult Dialogue: 0,0:17:45.05,0:17:49.04,Default,,0000,0000,0000,,to disentangle all the factors" contributing to increases Dialogue: 0,0:17:49.04,0:17:52.09,Default,,0000,0000,0000,,in pertussis, but listed "increasing transmission, Dialogue: 0,0:17:52.09,0:17:54.04,Default,,0000,0000,0000,,better recognition, Dialogue: 0,0:17:54.04,0:17:57.03,Default,,0000,0000,0000,,and increased laboratory confirmation." Dialogue: 0,0:17:57.03,0:18:00.03,Default,,0000,0000,0000,,We also asked whether a new more virulent strain could be Dialogue: 0,0:18:00.03,0:18:02.00,Default,,0000,0000,0000,,contributing to the outbreak. Dialogue: 0,0:18:02.00,0:18:05.08,Default,,0000,0000,0000,,The CDC's response: "Available data do not suggest Dialogue: 0,0:18:05.08,0:18:08.03,Default,,0000,0000,0000,,that ptxP3 is more virulent, Dialogue: 0,0:18:08.03,0:18:11.04,Default,,0000,0000,0000,,or that increasing reports are attributable only Dialogue: 0,0:18:11.04,0:18:14.03,Default,,0000,0000,0000,,to the emergence of ptxP3. Dialogue: 0,0:18:14.03,0:18:18.04,Default,,0000,0000,0000,,We continue to work on this and other potential explanations Dialogue: 0,0:18:18.04,0:18:20.05,Default,,0000,0000,0000,,for the increase in pertussis Dialogue: 0,0:18:20.05,0:18:23.08,Default,,0000,0000,0000,,that has occurred since the 1980s." Dialogue: 0,0:18:23.08,0:18:26.09,Default,,0000,0000,0000,,The CDC sent us this study by their own investigators. Dialogue: 0,0:18:26.09,0:18:28.02,Default,,0000,0000,0000,,The study looked at children Dialogue: 0,0:18:28.02,0:18:30.10,Default,,0000,0000,0000,,between 6 months and five years old. Dialogue: 0,0:18:30.10,0:18:33.01,Default,,0000,0000,0000,,It found pertussis vaccines to be more Dialogue: 0,0:18:33.01,0:18:35.02,Default,,0000,0000,0000,,than 90 percent effective. Dialogue: 0,0:18:35.02,0:18:39.06,Default,,0000,0000,0000,,The study looked at data between 1998 and 2001. Dialogue: 0,0:18:39.06,0:18:42.07,Default,,0000,0000,0000,,It did not collect pertussis strain information. Dialogue: 0,0:18:42.07,0:18:46.08,Default,,0000,0000,0000,,SINGING: Do you happen to know what a T-dap is? Dialogue: 0,0:18:46.08,0:18:51.08,Default,,0000,0000,0000,,It's a special vaccine but it's not just for kids. Dialogue: 0,0:18:53.02,0:18:55.09,Default,,0000,0000,0000,,FARYON: Sanofi Pastuer, one of two companies Dialogue: 0,0:18:55.09,0:18:59.04,Default,,0000,0000,0000,,that make the vaccine widely used in the U.S., Dialogue: 0,0:18:59.04,0:19:02.03,Default,,0000,0000,0000,,sponsored this singing competition earlier this year. Dialogue: 0,0:19:02.03,0:19:07.01,Default,,0000,0000,0000,,SINGING: Pertussis is the reason why you should call your Dialogue: 0,0:19:07.01,0:19:09.00,Default,,0000,0000,0000,,doctor today. Dialogue: 0,0:19:09.00,0:19:11.04,Default,,0000,0000,0000,,FARYON: It was a public relations exercise Dialogue: 0,0:19:11.04,0:19:15.00,Default,,0000,0000,0000,,to get the word out about whooping cough and immunization. Dialogue: 0,0:19:15.00,0:19:18.03,Default,,0000,0000,0000,,But just where is the line between good PR and trying Dialogue: 0,0:19:18.03,0:19:20.08,Default,,0000,0000,0000,,to influence public health policy? Dialogue: 0,0:19:20.08,0:19:23.10,Default,,0000,0000,0000,,SINGING: Take a shot and give pertussis a whooping. Dialogue: 0,0:19:23.10,0:19:28.07,Default,,0000,0000,0000,,FARYON: Especially when public health policy can increase Dialogue: 0,0:19:28.07,0:19:30.01,Default,,0000,0000,0000,,vaccine sales. Dialogue: 0,0:19:30.01,0:19:33.00,Default,,0000,0000,0000,,Since 2007, the California department Dialogue: 0,0:19:33.00,0:19:36.00,Default,,0000,0000,0000,,of health has spent more than $200 million Dialogue: 0,0:19:36.00,0:19:39.04,Default,,0000,0000,0000,,on pertussis vaccines for children on medical Dialogue: 0,0:19:39.04,0:19:41.00,Default,,0000,0000,0000,,or who are under-insured. Dialogue: 0,0:19:41.00,0:19:43.05,Default,,0000,0000,0000,,And it's sure to rise. Dialogue: 0,0:19:43.05,0:19:47.08,Default,,0000,0000,0000,,In September, the California state legislature passed a law Dialogue: 0,0:19:47.08,0:19:50.08,Default,,0000,0000,0000,,requiring all students to receive another dose, Dialogue: 0,0:19:50.08,0:19:54.02,Default,,0000,0000,0000,,a sixth dose of the pertussis vaccine before entering Dialogue: 0,0:19:54.02,0:19:55.04,Default,,0000,0000,0000,,middle school. Dialogue: 0,0:19:55.04,0:19:57.01,Default,,0000,0000,0000,,It may be a case of what's good Dialogue: 0,0:19:57.01,0:19:59.08,Default,,0000,0000,0000,,for business is also good for public health. Dialogue: 0,0:19:59.08,0:20:02.03,Default,,0000,0000,0000,,But how much influence does industry have Dialogue: 0,0:20:02.03,0:20:04.02,Default,,0000,0000,0000,,over public health policy? Dialogue: 0,0:20:04.02,0:20:06.05,Default,,0000,0000,0000,,Sanofi Pasteur also established Dialogue: 0,0:20:06.05,0:20:09.04,Default,,0000,0000,0000,,and funds The Global Pertussis Initiative. Dialogue: 0,0:20:09.04,0:20:13.03,Default,,0000,0000,0000,,A group made up of medical experts from around the world. Dialogue: 0,0:20:13.03,0:20:15.07,Default,,0000,0000,0000,,The GPI was established 10 years ago Dialogue: 0,0:20:15.07,0:20:19.10,Default,,0000,0000,0000,,to study why pertussis was making a comeback and find ways Dialogue: 0,0:20:19.10,0:20:21.05,Default,,0000,0000,0000,,to control the disease. Dialogue: 0,0:20:21.05,0:20:23.03,Default,,0000,0000,0000,,More than half its members are employees Dialogue: 0,0:20:23.03,0:20:25.00,Default,,0000,0000,0000,,of the pharmaceutical company Dialogue: 0,0:20:25.00,0:20:28.02,Default,,0000,0000,0000,,or receive research money or consulting fees. Dialogue: 0,0:20:28.02,0:20:31.05,Default,,0000,0000,0000,,Public officials from across the country, including California Dialogue: 0,0:20:31.05,0:20:34.09,Default,,0000,0000,0000,,and the CDC, site the Global Pertussis Initiative Dialogue: 0,0:20:34.09,0:20:37.02,Default,,0000,0000,0000,,when making vaccine policy. Dialogue: 0,0:20:37.02,0:20:40.01,Default,,0000,0000,0000,,Dr. James Cherry is a member of the initiative. Dialogue: 0,0:20:40.01,0:20:43.02,Default,,0000,0000,0000,,He's also received speaking fees and research funds Dialogue: 0,0:20:43.02,0:20:45.03,Default,,0000,0000,0000,,from vaccine manufacturers. Dialogue: 0,0:20:45.03,0:20:48.01,Default,,0000,0000,0000,,At the same time, he sat on government committees Dialogue: 0,0:20:48.01,0:20:51.04,Default,,0000,0000,0000,,to help determine vaccine policy and efficacy. Dialogue: 0,0:20:51.04,0:20:56.04,Default,,0000,0000,0000,,FARYON: A cynic might say that if you have a community Dialogue: 0,0:20:56.04,0:21:01.02,Default,,0000,0000,0000,,of experts in pertussis as in the Global Pertussis Initiative, Dialogue: 0,0:21:01.02,0:21:03.09,Default,,0000,0000,0000,,who primarily their work in terms Dialogue: 0,0:21:03.09,0:21:06.04,Default,,0000,0000,0000,,of this endeavor is being funded by the drug company Dialogue: 0,0:21:06.04,0:21:10.01,Default,,0000,0000,0000,,that makes the vaccine, there might be less incentive Dialogue: 0,0:21:10.01,0:21:13.08,Default,,0000,0000,0000,,to say make a new vaccine and more incentive Dialogue: 0,0:21:13.08,0:21:16.04,Default,,0000,0000,0000,,to say just use the old one more often. Dialogue: 0,0:21:16.04,0:21:17.08,Default,,0000,0000,0000,,What do you say to them? Dialogue: 0,0:21:17.08,0:21:19.09,Default,,0000,0000,0000,,CHERRY: I don't think that's true. Dialogue: 0,0:21:19.09,0:21:25.05,Default,,0000,0000,0000,,I think that we've been talking about new vaccines. Dialogue: 0,0:21:25.05,0:21:32.05,Default,,0000,0000,0000,,It think the difficulty with the new vaccine lies in the expense Dialogue: 0,0:21:32.05,0:21:39.04,Default,,0000,0000,0000,,that it would cost to make a new vaccine and the difficulty Dialogue: 0,0:21:39.04,0:21:46.00,Default,,0000,0000,0000,,in testing it because of FDA requirements for it and I think Dialogue: 0,0:21:46.00,0:21:48.09,Default,,0000,0000,0000,,if the climate was right for either of two Dialogue: 0,0:21:48.09,0:21:52.03,Default,,0000,0000,0000,,of the major manufacturers they would do it. Dialogue: 0,0:21:52.03,0:21:55.05,Default,,0000,0000,0000,,MOOI: And these are three different pertussis strains. Dialogue: 0,0:21:55.05,0:21:59.02,Default,,0000,0000,0000,,FARYON: Dr. Mooi is a critic of the Pertussis Initiative. Dialogue: 0,0:21:59.02,0:22:04.06,Default,,0000,0000,0000,,MOOI: My big disappointment is they have totally Dialogue: 0,0:22:04.06,0:22:09.01,Default,,0000,0000,0000,,and I think willfully ignored pathogen adaptation. Dialogue: 0,0:22:09.01,0:22:15.05,Default,,0000,0000,0000,,I think a few years ago we had the year Dialogue: 0,0:22:15.05,0:22:21.01,Default,,0000,0000,0000,,that Darwin died 100 year ago, it was not so long ago, Dialogue: 0,0:22:21.01,0:22:25.05,Default,,0000,0000,0000,,I think it's very strange that evolution Dialogue: 0,0:22:25.05,0:22:29.02,Default,,0000,0000,0000,,and pathogen adaptation is completely ignored Dialogue: 0,0:22:29.02,0:22:30.02,Default,,0000,0000,0000,,by such a group. Dialogue: 0,0:22:30.02,0:22:35.00,Default,,0000,0000,0000,,I find that bad for science and bad for public health. Dialogue: 0,0:22:35.00,0:22:38.01,Default,,0000,0000,0000,,FARYON: Sanofi Pasteur released this statement to KPBS Dialogue: 0,0:22:38.01,0:22:40.03,Default,,0000,0000,0000,,and the Watchdog Institute. Dialogue: 0,0:22:40.03,0:22:44.02,Default,,0000,0000,0000,,It says its grant to the GPI brings the world's authorities Dialogue: 0,0:22:44.02,0:22:48.05,Default,,0000,0000,0000,,on pertussis together and that benefits society as a whole. Dialogue: 0,0:22:48.05,0:22:50.09,Default,,0000,0000,0000,,The company also says "at the present time, Dialogue: 0,0:22:50.09,0:22:54.08,Default,,0000,0000,0000,,there is no evidence to suggest current pertussis vaccines Dialogue: 0,0:22:54.08,0:22:56.08,Default,,0000,0000,0000,,lack effectiveness." Dialogue: 0,0:22:56.08,0:23:00.06,Default,,0000,0000,0000,,Dr. Dean Sidelinger was one of the first health officials Dialogue: 0,0:23:00.06,0:23:03.08,Default,,0000,0000,0000,,to learn immunized people were getting sick in his county. Dialogue: 0,0:23:03.08,0:23:06.08,Default,,0000,0000,0000,,He said he was surprised, but in the end, Dialogue: 0,0:23:06.08,0:23:10.08,Default,,0000,0000,0000,,he says the current vaccine is still the best thing he's got Dialogue: 0,0:23:10.08,0:23:12.03,Default,,0000,0000,0000,,to protect his community. Dialogue: 0,0:23:12.03,0:23:14.01,Default,,0000,0000,0000,,SIDELINGER: It does significantly decrease the Dialogue: 0,0:23:14.01,0:23:17.00,Default,,0000,0000,0000,,pertussis we see a significantly lower number Dialogue: 0,0:23:17.00,0:23:20.02,Default,,0000,0000,0000,,of pertussis cases now then we saw before we started using Dialogue: 0,0:23:20.02,0:23:21.03,Default,,0000,0000,0000,,the vaccine. Dialogue: 0,0:23:21.03,0:23:25.00,Default,,0000,0000,0000,,So we don't want people to feel complacent or to say I don't want Dialogue: 0,0:23:25.00,0:23:27.03,Default,,0000,0000,0000,,that vaccine because I've seen many of the cases Dialogue: 0,0:23:27.03,0:23:29.08,Default,,0000,0000,0000,,that have been reported were fully vaccinated. Dialogue: 0,0:23:29.08,0:23:32.04,Default,,0000,0000,0000,,FARYON: Sidelinger says there would be many more cases Dialogue: 0,0:23:32.04,0:23:34.07,Default,,0000,0000,0000,,if there was no vaccine at all. Dialogue: 0,0:23:34.07,0:23:36.00,Default,,0000,0000,0000,,Dr. Mooi agrees. Dialogue: 0,0:23:36.00,0:23:38.10,Default,,0000,0000,0000,,He believes public health officials should be encouraging Dialogue: 0,0:23:38.10,0:23:43.05,Default,,0000,0000,0000,,cocooning, immunizing all those around newborn babies. Dialogue: 0,0:23:43.05,0:23:48.09,Default,,0000,0000,0000,,But in the long run he says, we need better vaccines. Dialogue: 0,0:23:48.09,0:23:51.08,Default,,0000,0000,0000,,Baby Matthew spent four days in the hospital Dialogue: 0,0:23:51.08,0:23:54.02,Default,,0000,0000,0000,,and was eventually discharged. Dialogue: 0,0:23:54.02,0:23:57.04,Default,,0000,0000,0000,,Today, he's getting his two-month routine check-up. Dialogue: 0,0:23:57.04,0:24:00.01,Default,,0000,0000,0000,,DOCTOR: I think it was just bad luck he's had two illnesses Dialogue: 0,0:24:00.01,0:24:04.05,Default,,0000,0000,0000,,in a row and now the cold he's building up his immunity. Dialogue: 0,0:24:04.05,0:24:08.02,Default,,0000,0000,0000,,FARYON: Despite a stuffy nose, Matthew is doing well today. Dialogue: 0,0:24:08.02,0:24:11.03,Default,,0000,0000,0000,,DCOTOR: As you might know the vaccine is not Dialogue: 0,0:24:11.03,0:24:13.02,Default,,0000,0000,0000,,as effective as we want it to be. Dialogue: 0,0:24:13.02,0:24:17.02,Default,,0000,0000,0000,,And that's one reason why there've been a lot of cases going around. Dialogue: 0,0:24:17.02,0:24:21.05,Default,,0000,0000,0000,,But with Matthew in particular, his own immunity has kicked in Dialogue: 0,0:24:21.05,0:24:24.07,Default,,0000,0000,0000,,from having the illness, that is, in effect a sort Dialogue: 0,0:24:24.07,0:24:27.05,Default,,0000,0000,0000,,of a booster that will protect him going forward. Dialogue: 0,0:24:27.05,0:24:31.03,Default,,0000,0000,0000,,And how long that immunity lasts is still a question. Dialogue: 0,0:24:31.07,0:24:34.09,Default,,0000,0000,0000,,MARLON: The one thing I would want to say to parents is just ... Dialogue: 0,0:24:36.06,0:24:39.03,Default,,0000,0000,0000,,is just watch your kids ... Dialogue: 0,0:24:39.04,0:24:40.08,Default,,0000,0000,0000,,just be ... Dialogue: 0,0:24:45.00,0:24:47.04,Default,,0000,0000,0000,,just be concerned. Dialogue: 0,0:24:47.04,0:24:50.07,Default,,0000,0000,0000,,Because at first we thought we were being over protective. Dialogue: 0,0:24:51.06,0:24:57.04,Default,,0000,0000,0000,,But I'm glad we were just a little bit over-concerned. Dialogue: 0,0:24:57.04,0:25:00.09,Default,,0000,0000,0000,,FARYON: Since KPBS and the Watchdog Institute began its Dialogue: 0,0:25:00.09,0:25:04.05,Default,,0000,0000,0000,,investigation, state health officials, the CDC Dialogue: 0,0:25:04.05,0:25:08.02,Default,,0000,0000,0000,,and scientists from UCLA, including Dr. James Cherry, Dialogue: 0,0:25:08.02,0:25:11.06,Default,,0000,0000,0000,,began a new study to determine whether the new strain Dialogue: 0,0:25:11.06,0:25:13.04,Default,,0000,0000,0000,,of pertussis is contributing Dialogue: 0,0:25:13.04,0:25:15.10,Default,,0000,0000,0000,,to the current whooping cough outbreak. Dialogue: 0,0:25:15.10,0:25:18.06,Default,,0000,0000,0000,,For more on this story, and to see more of the data collected Dialogue: 0,0:25:18.06,0:25:24.04,Default,,0000,0000,0000,,in our investigation, go to kpbs.org/whoopingcough Dialogue: 0,0:25:24.04,0:25:27.08,Default,,0000,0000,0000,,and watchdoginstitute.org. Dialogue: 0,0:25:27.08,0:25:30.02,Default,,0000,0000,0000,,For KPBS, the Watchdog Institute Dialogue: 0,0:25:30.02,0:25:33.04,Default,,0000,0000,0000,,and Radio Netherlands Worldwide, I'm Joanne Faryon. Dialogue: 0,0:25:33.04,0:25:35.09,Default,,0000,0000,0000,,Thanks for watching.