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Local hospital seeing more newborns with Whooping Cough because people aren't vacinnating

(70 Posts)
aufaniae Wed 12-Sep-12 17:17:43

Just had a chat with a nurse friend and she says the numbers of newborns admitted to her hospital as very ill with Whooping Cough is rising, because people aren't vaccinating. sad

I fully understand that there are reasons why some people can't vaccinate, but I am just so fed up with trying to explain why vaccinating is a good idea to some of my friends who don't do it - or delay it - for spurious reasons like "she's so young, I can't bear to put poison in her just yet". angry

Or "it's a conspiracy by the pharma companies" hmm

Or "the diseases aren't that bad, I remember having them when I was little and none of my friends died" hmm hmm

My anti-vac friends seem know all about the risks of vaccines and sod all about the risks of the diseases they're preventing! They also don't seem to have grasped how their actions may affect others.

It's very frustrating, and terribly sad when you hear stories like the ones my nurse friend told me today.

OK, rant over, just had to vent!

bumbleymummy Wed 12-Sep-12 19:52:10

Vaccination rates (5-in-1) here

The uptake for the 5-in-1 (which includes pertussis/whooping cough) is actually quite high. The reason there is an epidemic is because immunity from the vaccine wanes much faster than originally thought so there are lots of older children and adults out there who may have been vaccinated but are no longer immune.

The vaccine is crap wrt efficacy, that's why people are a) getting WC and b) not vaccinating.

AnitaBlake Wed 12-Sep-12 22:22:27

You also have the vast swathe of people of parenting age who weren't ever vaccinated against wc (less than 80% upto the early 90s). So at least 1in 5 (more in the older parent age range) aged between 23 and 38 missed the wc vaccination.

In the US and Aus (where there have been outbreaks) it seems the outbreaks have been caused by either waning vaccine immunity or the strain of whooping cough changing so the vaccine no longer protects as well as it used to (seems particularly true of aP - the vaccination given here now). Or maybe a mixture of both.

The Torygraph is blaming waning vaccine immunity

Adults and teens seem to be good sources for spreading the disease as a) they're less likely to whoop or be ill so it's harder to recognise b) a lot of people assume that as they have been vaccinated they can't get whooping cough and so again don't realise they have it.

ElaineBenes Thu 13-Sep-12 02:31:56

All the more reason to hurry up and introduce a booster.

Effectiveness isn't too bad for the vaccine - about 85% iirc. Unfortunately immunity is waning faster than expected, not helped of course by people not vaccinating without good reason. It's probably a mixture of both factors.

If I had a newborn, I'd ensure that everyone in my household and in close and prolonged contact with the baby had a booster against wc.

ElaineBenes Thu 13-Sep-12 02:34:11

Booster for 11/12 year olds I mean, don't think it's standard in the uk

LeBFG Thu 13-Sep-12 12:06:02

There has been research into the idea that over time in populations where wc transmission rate is lowered (vaccinated populations) the severity of wc is increased. They've also looked at populations across the world and linked outbreaks to vaccine coverage and birth rate. These snippets, in addition to saintly and Elaine's posts, one can easily conclude that the reasons behind wc outbreaks are clearly not well understood.

There is no wc epidemic in the UK. And it is simplifying things boorishly to say the outbreaks we are observing are because the vaccines are imperfect.

For anyone interested in how the incidence of wc is affected by vaccination coverage, here is an abstract of some research where they compared countries with high coverage and others where coverage dropped after a scare (UK incl). I have no access to the full article, but I presume as most wc cases are young children (many unvaccinated) herd immunity is seen to have a striking effect on disease incidence.

My sister and I had whooping cough when v young, it was horrible.

DS is 3 and all his immunisations are up to date with the UK schedule. There is now a confirmed case of whooping cough at his nursery and we have had a letter telling us to have our children vacinated if they are not already. Does anyone know if DS needs further imms, and also if I could get whooping cough for a second time?

And it is simplifying things boorishly to say the outbreaks we are observing are because the vaccines are imperfect.

Well some disagree but whatever. I think most agree that whether it's down to evolution or waning immunity the aP is less effective than the wP which might be relevant if you are concerned about your individual child.

Therin - yes you can have whooping cough again, even after a natural infection. (Especially once whooping cough is out of general circulation when immunity tends to wane more rapidly).

For anyone particularly interested there's a lot on google but although this article isn't particularly about whooping cough, (although the current situation is commented on) - the research group this person belongs to always seems to produce very sensible work and is a good starting point.

insanityscratching Thu 13-Sep-12 14:44:54

Seventeen years ago my six week old son contracted whooping cough, it was a scary time particularly because the GP didn't recognise what it was. Ironically my four other children had been immunised and didn't contract whooping cough but assume ds most likely contracted it when I was taking them to and from school each day. It was never determined where ds picked it up from as he was the only case notified in that area in three months however it took me three visits to the GP and my insistence on a swab before ds was diagnosed so no doubt other cases weren't recognised at the time.

LeBFG Thu 13-Sep-12 14:48:50

What you quoted me saying was in reference to the waning of vaccine-acquired immunity saintly, not evolution of disease resistance which would be a factor another factor causing wc outbreaks (which is why I referred to your post in my post) but not in the UK obviously.

I do find that bm seems so want to simpify things by highlighting waning vaccine immunity at the exclusion of all else. She could equally talk about coverage, but no, she would rather focus on one factor: the vaccination itself, and criticise that instead.

Therein: I would go to your GP and ask about checking immunity/getting some boosters. As saintly said you can get it twice, although your DS's source appears to be restricted to the nursery.

LeBFG Thu 13-Sep-12 14:53:16

insanity, what a scary time for you. Sources of wc are frequently not found. You just reminded me. I've read in several sources that diagnosis of wc is much better nowadays, it's picked up better in adults in particular, which of course will have an effect on statistics.

There is a good website which plays recordings of whooping cough www.whoopingcough.net/welcome.htm I'm sure there's a non-whoop whooping cough file audio file on the site as well (it's more common for adults/teens not to whoop). Helpful if you're wanting to compare sounds.

bumbleymummy Thu 13-Sep-12 18:33:01

To the exclusion of all else? hmm it just happens that these outbreaks are being attributed to waning immunity from the vaccine.

Anyway, I thought this was interesting.

"The substantial majority of the cases are explained by this waning immunity," said Dr. William Schaffner, an infectious-disease specialist at Vanderbilt Univers"

"The proportion of cases involving children ages 7 to 10 -- most of them vaccinated -- rose from less than 10 percent before 2006 to nearly 40 percent this year, according to the CDC."

"The researchers found that the risk of getting whooping cough increases by about 42 percent a year after a child's last dose of vaccine."

"While some parents around the country have taken a stand against childhood vaccines, the outbreak is not being driven by unvaccinated children, according to the CDC. Most of the illnesses are in vaccinated youngsters, officials said."

The problem - in terms of this outbreak - really does seem to be particularly with the aP - whether it's waning immunity or change of strain. Interestingly they don't seem to be suggesting a return to the wP - because the aP is safer.

Well I thought it was interesting anyway grin

bumbleymummy Thu 13-Sep-12 22:03:13

Me too saintly smile

That article mentioned that there is currently an inhalable pertussis vaccine in development. Another inhalable vaccine! They really do seem to be moving that way.

LeBFG Fri 14-Sep-12 10:39:09

I don't see why you are surprised bm that research is continually developing vaccines that are safer and more effective.

Outbreaks of wc have always occurred in vaccinated populations bm. The severity is less and the interval between outbreaks is longer than in the pre-vaccination period. Wc vaccine immunity (wP and aP) had never been lifelong. The outbreaks in the States in your link are talking about the severist outbreak in 50 years (shows you how well the older imperfect vaccine was working). The only thing they mention changing is the vaccine in 1997. This new vaccine induced immunity for a shorter period. So, yes, the newer but less effective vaccine could explain this trend, and indeed they think this to be the case here.

Other factors in this or other populations could include diversity of virulence factors meaning the vaccine is less effective. I can think of other factors in the UK, such as immigrant populations bringing in wc. And although vaccination rates are high in children they are much lower in adults. What I'm saying isn't controversial - there are multiple factors at work. Did you not think my link was interesting too bm?

LeBFG Fri 14-Sep-12 10:54:04

Oops, I also meant to say that although national vaccination rates are high for the 5:1, there are local and regional discrepancies where rates do drop below 90%. Just a thought.

bumbleymummy Fri 14-Sep-12 11:48:16

Where have I said I'm surprised about continuing research? hmm Iwas pointing out that yet another inhalable vaccine is in development. You have been on other threads about that.

I'm glad we're in agreement about the new vaccine. Yes, other factors may come into play but I putting the blame on 'people not vaccinating' as in the OP is a bit misguided.

ElaineBenes Fri 14-Sep-12 11:58:55

I think we can safely say that people not vaccinating isn't helping the situation much

bumbleymummy Fri 14-Sep-12 12:29:31

From above on the US outbreak:

"Most of the illnesses are in vaccinated youngsters"

bumbleymummy Fri 14-Sep-12 12:35:35

Heaven forbid we should ever just admit that the ineffectiveness of the vaccine may be causing problems hmm

LeBFG Fri 14-Sep-12 12:44:15

At least we are all in agreement: boosters all round while we wait for an improved vaccine

bumbleymummy Fri 14-Sep-12 12:48:59

Not sure how you got that from my last post BFG. hmm I actually think it would make more sense to either vaccinate non-immune pregnant women and/or newborns in order to protect the most vulnerable rather than just continuing to vaccinate the masses with an ineffective vaccine.

LeBFG Fri 14-Sep-12 12:55:14

The vaccine is NOT ineffective!!! That comment just exemplifies why I think your vaccine-dismissing is so wrong. Where's the evidence that we're headed to a pre-vaccine-like era wrt wc?

You say you're worried about waning immunity, then boosters will help this. I think in France they booster young teens now. Perhaps a thing to be doing in the UK? I guess there must be a very good reason not to vaccinate the newborns....or else someone other than bm would have thought of that one!

bruffin Fri 14-Sep-12 13:19:28

The graph that BM proudly linked to on another thread shows just how effective the vaccine has been.
The US went from over 7100 deaths in a 3 year period (late 1930s) prior to vaccination, to under 100 deaths in a the whole of the 1990s.
Most of those deaths were in the age bracket that cant be vaccinated but the 1938-1940 period there were around 2500 deaths in the 2 month and under bracket.
So from2500 deaths in 3 years to 94 deaths in 10 years and they claim the WC vaccine doesnt work hmm

bruffin Fri 14-Sep-12 13:21:13

Just to clarify the 7100 deaths were in children under 1 year of age.

bumbleymummy Fri 14-Sep-12 13:21:31

You know we use a different vaccine now bruffin don't you?

bumbleymummy Fri 14-Sep-12 13:27:53

I suppose it depends on your definition of 'effective'. You could argue that it is effective in protecting the individual for a short period of time but it is ineffective in providing long lasting protection and/or creating protection for the 'herd'.

bruffin Fri 14-Sep-12 13:31:23

That is fairly irrelvent as the vaccine was changed in 1997 during the second period and in the period for 2000-2006 there were only 145 deaths. Even now there will be a fraction of the pre vaccination figures.

bruffin Fri 14-Sep-12 13:32:40

It's effective at what it is meant to do ie prevent death.

MangoLangoTango Fri 14-Sep-12 13:39:17

The ideal vaccine would provide lifelong immunity. But a vaccine that provides protection for even a few years is still effective, you just need more boosters. That's pretty obvious.

Failure to provide herd immunity is not the fault of the vaccine, that lies with poor uptake.

LeBFG Fri 14-Sep-12 13:42:44

Ahh, here we go. Using terms like 'short' and 'long'.

The old vaccine immunity still waned. In fact, waning immunity (i.e. where they test for antibodies years after vaccination) may be very similar in both the old and the new vaccines. The new vaccine may be less effective - perhaps immune system is less well triggered during infection, no idea really.

Bruffin's point is very strong and needs adressing: the graph you posted shows young babies die less now than historically. How can this be explained is the vaccine is 'ineffective'? (on an aside, this graph alse shows how well the herd immunity effect can work, even with a vaccine that wanes - thanks for the link)

Elaine - I'm not sure that people not vaccinating is making much difference to these outbreaks (esp because actually very few people refuse the early jabs, and if you want to protect against tetanus you are forced to have aP as well). It's lazy (and dangerous) to automatically blaming the 'anti-vaccinators'.

Quick google - this was published in the last 13 hours (and there are others like it published around the same time - so not the rag of choice, but bang up to date and I'm sure the original sources can be found. Reasons for the US outbreaks

LeBFG Fri 14-Sep-12 14:53:39

In the States, vaccine coverage is good but not excellent. At three doses most States are around the 95%, but for the full four doses, most States are at about 75-85% (the virgin islands at 61.8!).

As I said earlier, vaccine coverage is often given for large regions and may not reveal local pockets of poor immunisation levels. These pockets may be just enough to maintain the disease at a level so that when an outbreak occurs (as they do in relatively regular waves) the outbreaks are more serious. Just speculating.

Your article, saintly, talks about the 'main' reason for the outbreaks being the change in vaccine. It would appear there are other reasons too.

My point LeBFG, is that if people say 'oh well it's the anti-vaccinators' and focus efforts there while ignoring the need for more boosters/development of a better vaccination then more babies will die.

It would appear to be more sensible to focus on the 'main' reason if you want to deal with the outbreaks. Rather than say I think we can safely say that people not vaccinating isn't helping the situation much when I'm not sure - in these outbreaks at least - that there is much evidence for that.

If you look at American figures it seems amongst children the rates of vaccination coverage for pertussis is high, whereas the rates for adults are low. more info here Even in the States where presumably babies go into daycare at a much younger age than here (given the lack of maternity leave) they say Indeed, family members are often the source of pertussis exposure in young infants. This is adults infecting babies - that's the problem, this is apparently due to waning immunity, not anti-vaccinators.

Much as it's fun to have a bash at those who don't vaccinate it would make more practical sense to focus on the steps needed to actually stop these outbreaks.

This is interesting

This is a bit odd: In 2006, Tdap was recommended for adults and adolescents, with routine vaccination recommended at age 11–12 years. Although the relative reduction in incidence of pertussis among adolescents aged 11–12 years demonstrates immediate vaccine effectiveness, the increasing number of cases in adolescents aged 13–14 years in both Washington and the United States suggests immunity wanes after Tdap vaccination in those adolescents fully vaccinated with acellular vaccines during childhood (5). In observational studies, Tdap effectiveness was 66%–72% among adolescents who largely received DTwP for some of the childhood doses (5,6). Studies evaluating Tdap effectiveness and duration of protection in adolescents fully vaccinated with DTaP are being conducted in Washington and California.

Would the 13 and 14 year olds in the group have received the 11-12 year old booster? Or did they miss it? They must have had it surely??

Also does anyone know any more about vaccinating pregnant women? I've seen that recommended and must admit it makes me nervous. But asides from that I thought that wild type whooping cough antibodies don't pass easily across the placenta (which I thought was the reason why newborns are so susceptible). Any further explanation regarding that would be welcomed. Is vaccine induced immunity more transferable or something, or are babies born with passive w/c immunity.

numbertaker Fri 14-Sep-12 18:46:56

I have read loads round this, it is a different strain, and in a pub med study I read this morning it shows that the strain of vaccine injected acutally inhibts the clearing of the other strain from the body, showing that people who have had the DTAP are more likely to get the other strain, this is borne out in the california study.

Australia have stoppedc cocooning as it has proven that it has not stopped transmission of the W/C and is not cost effective.

Again there are higher that needed vaccine coverage so you cant blame the non vaxxers on this one.

Tabitha8 Fri 14-Sep-12 18:48:44

www.ncbi.nlm.nih.gov/pmc/articles/PMC1459731/ from 2006.
This is interesting, although it's about pigs, not people.
They vaccinated the mothers and immunity was passed in the milk.

Although, it also says this:
"In pigs, in contrast to humans, immunoglobulins are not transmitted in utero, which makes colostrum and milk the only source of antibodies and therefore limits the use of this model for analyzing passive transfer of immunity"

numbertaker Fri 14-Sep-12 18:50:17

[http://www.ncbi.nlm.nih.gov/pubmed/20200027 study]

numbertaker Fri 14-Sep-12 18:50:40

http://www.ncbi.nlm.nih.gov/pubmed/20200027

This is oldish (1990) but talks about passive immunity in the pre and post vaccine era. You have to squint to read it though. I am slightly struck by how uncertain it all seems.

I remember when 8 week old ds2 was exposed coming to the conclusion that he wasn't likely to have had that much passive immunity from me or breast feeding.

Thanks for the piglet link. That's all a bit uncertain as well isn't it.

Northernlurkerisbackatwork Fri 14-Sep-12 19:04:48

Oh dear. I am really worried about this. I am convinced dd1 had whooping cough earlier this year. I took her to the GP a month after symptoms started and GP dismissed WC. I know now that was a pretty typical reaction. She did give her erithromycin though which improved things a bit.
All my dcs have been vacconated and dd1 had a booster only a year or so ago I think. However neither of the other girls seem to have contracted it from dd1, nor have dh and I (vaccinated in the 70s). Thankfully neither did our newborn niece who we visited the week after dd1 had been a bit feverish but appeared perfectly ok except for a cough. I thought it was just a cough as a tail end of a bug. Niece has a toddler brother and cousin and dd1 was well so it never occurred to me not to go. I am furious with myself about that now and have warned my best friend to be cautious. She is expecting dc2 next month. I know it worried her when I told her about it but I think this is risk parents should be aware of. In my local paper this year there has been one story of a newborn dying from whooping cough sad

Tabitha8 Fri 14-Sep-12 19:13:20

www.netdoctor.co.uk/diseases/facts/whoopingcough.htm
This says no immunity is passed in breastmilk.
"Although infants who are breastfed are usually protected against most common childhood infections, they receive no protection against whooping cough. This is why early vaccination is recommended. "

I can't even find anything about this in the "crankosphere". Most odd.

LeBFG Fri 14-Sep-12 20:10:09

That's quite a interesting study numbertaker. How sad that the aP vaccine was rolled out as it was a safer vaccine only to see these sorts of possible, weirdly unpredictable side-effects. Makes one wonder if we should have stuck with the wP.

I'm actually very surprised that no-one is suggesting reintroducing the wP. Particularly as it sounds as if an improved aP is a long way from development. Wonder why that is.

numbertaker Fri 14-Sep-12 22:43:18

they cant reintroduce the whole cell because they withdrew it because of too many side effects.

as for vaccinating new borns the vaccine insert says that it is not to be given under 6 weeks old, and if they suddenly say its ok, i want to see the studies.

numbertaker Fri 14-Sep-12 22:45:18

I am sure its a crock about it not passing in the breastmilk, everything else does, there is some other agenda here.

Borisismyhousespider Fri 14-Sep-12 22:49:54

Interestingly enough I work in an area with a high higher education population and the infectious disease people have been around to see us this week as several of our adult customers have tested positive for whooping cough, barely any contact with the younger generation, so it's looking likely that the disease is entering the country one way, through the inbound 'foreign' student population. FYI.

ElaineBenes Sat 15-Sep-12 01:31:45

Hmmm, so yet another conspiracy theory, numbertaker? Wasn't that with the mmr? Now those nasty big pharma folk are burying evidence showing that immunity to whooping cough passes in breastmilk! Goodness me! Yes, there must be a hidden agenda hmm

LeBFG Sat 15-Sep-12 07:18:36

This was one thing I speculated about Boris...either here or the other thread, about immigrant pockets enhancing outbreaks. There must be a heterogenous landscape of immunity across the country.

Yeah, I don't really believe they're hiding anything number. Normally they like to go on about how wonderful everything is about bf, probably a bit too much. Immunity against wc (not a virus) is a bit complicated which is why immunity wanes with time I think. So I can believe it's not easily transmitted mother to baby.

Booboostoo Sat 15-Sep-12 08:34:17

I'm in France and everyone gets recalled for whooping cough here every 10 years, I take it that's not the case in the UK? I don't know if incidences of the diseases are lower here though, the GP specifically advised us to check all adults around newborn DD had been vaccinated for whooping cough as there were outbreaks.

I had wc at 4 months old. I almost died.

sashh Sat 15-Sep-12 10:06:50

I have te full article * LeBFG* linked to - not sure why I was able to get to it, possibly because I have access to some articles through my research.

It compares outbreak with vaccination rates in a number of countries. Some give 4 doses, some 5 doses etc.

I think the most interesting is the East/West Germany.

bumbleymummy Sat 15-Sep-12 10:32:12

Oh dear 'blame it on the immigrants'. hmm
Perhaps the reason you're seeing it more in adults, boris, is because their immunity to it has waned, as shown in the articles linked to.

bumbleymummy Sat 15-Sep-12 10:38:26

Maternal antibodies to WC don't seem to last beyond 8 weeks.

sashh Sun 16-Sep-12 07:09:39

Was the 'blame it on the immigrants' aimed at me?

I wasn't. It's just interesting to see the differences between vaccination rates and wc in populations that are virtually identical.

LMCG Sun 23-Sep-12 09:43:51

I will never understand why people think it's ok to pump tiny babies with poisons that don't work. It's too late when the damage is done. There is plenty of info out there to make an INFORMED decision about vaccinations. You will only get a one sided argument from anyone in the health? service they are trained and conditioned to give scripted information and at the end of the day it's their job.There's plenty of information in libraries and on line about how vaccines DON'T WORK and are dangerous, causing untold health problems for babies that last throughout their lives. Vaccination is a multi billion pound industry that is protected and covered up by governments with no interest what damage is being caused. They pay out to vaccine damaged children when they have to but it is all kept quiet and they can always rely on the 'sheep' instinct of people not wanting to stray from the `norm` and have their children vaccinated for fear of being seen as making a fuss. In ALL the outbreaks of whooping cough most of the children were vaccinated!!!!! sad

bruffin Sun 23-Sep-12 09:55:40

Yes there is plenty of informed information out there. You obviously havent read a word of it.

LMCG Sun 23-Sep-12 11:13:29

bruffin you should work for the government ;) I`m going to look for some informed information- So far I've found a lot more `informed information` about how these figures were improving BEFORE any introduction of vaccines. The government just hijacked the information and turned it to their advantage. Your last post hasn't really addressed anything I said ???

Asmywhimsytakesme Sun 23-Sep-12 11:22:19

Lmcg do you not accept that vax have dramatically reduced child deaths in the last century?

I am not a blindly accepting vaxer - we have a number of auto immune illnesses as a family so my dc is not having mmr but will have the measles jab at 18 months, followed by mmr later - maybe at 3.

LMCG Sun 23-Sep-12 12:03:08

no I don't agree. why not the mmr for your dc if you don't see anything wrong with it?? why mention the auto-immune problems if it's not relevant?

MangoLangoTango Sun 23-Sep-12 12:45:37

Again with the conspiracy theories. Vaccines really aren't that profitable compared to say a long term antihypertensive drug or diabetes medication. Just in the same way how antibiotics don't make much money, hence why the development of both these type of drugs are slow because pharmaceutical companies just aren't that interested.

Vaccines aren't perfect because immunity for things like whooping cough can wane, but immunity for whooping cough can also wane following natural disease. And the whooping cough disease in an infant can cause long term lung damage, brain damage and at worse death. So considering there is A LOT of whooping cough going around at present, those who choose not to vaccinate are taking a risk and should their babies fall ill, it will be the same healthcare services left picking up the pieces.

ElaineBenes Mon 24-Sep-12 03:55:50

'The government'? You mean just the UK government? Or is this an international conspiracy of every government of every developed country in the world? Oh, and I guess the WHO is on this big conspiracy as well. LMCG - you don't realise how ridiculous you sound.

You do realise, LMCG, that the reason that most children in whooping cough outbreaks were vaccinated is that most children ARE vaccinated. What's important is the relative risk and it's far far more likely that an unvaccinated child will get whooping cough. Importantly for the individual (rather than the community for herd immunity) the whooping cough vaccine is actually VERY effective in preventing severe whooping cough and long term morbidity and mortality. The problem is that it's not so great in conferring herd immunity because even vaccinated children with less severe whooping cough can still transmit the disease (although are less contagious than unvaccinated) which will therefore reduce the protection to infants who too young to be vaccinated.

I have also done many hours of research into vaccines (just not on the crankosphere) and, as a result, made sure my kids were also vaccinated against chicken-pox as well as the regular UK schedule. I also get them vaccinated against the flu when possible.

AnitaBlake Mon 24-Sep-12 05:00:01

I love the implication that the cost of vaccinating child generates more profit for pharamcetical companies than it would cost to treat the actual diseases, plus potential lifelong side effects. Yes there is profit to be made, but not as much as in treating the disease, surely?

ElaineBenes Mon 24-Sep-12 05:33:05

And especially because if you eradicate the disease you totally wipe out the profits!

Borisismyhousespider Sat 20-Oct-12 22:56:14

Bumblemummy, It's not me blaming it on the immigrants, I was explaining (badly obviously) that the HPA had been in touch, as the adult (not immune to due vaccinations not having been boosted) population has been hit, BUT the source in our area does indeed appear to be indicative of the local university immigrant population, who are un vaccinated/boostered adults (I know quite a few people who have had it recently!)

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