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  1. Kathryn Prior
  1. Correspondence to Dr Kathryn Prior, Heart and Lung Unit, Torbay Hospital, Lawes Bridge, Torquay, Devon TQ2 7AA, UK; kathrynbrain{at}doctors.net.uk

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Why is whooping cough on the rise? Is it due to the vaccine or uptake?

The highest number of cases in whooping cough in the USA since 1955 was seen in 2012. The age group affected was those aged 7–11. Five causes for this have been postulated: (1) an evolution in the bacteria away from the vaccine antigen; (2) a decline in vaccine coverage levels; (3) a change in vaccine efficacy and/or duration of protection due to the shift to the acellular vaccine, or a vaccine with lower efficacy; (4) the decline of natural boosting, through reduced exposure to naturally circulating pertussis bacteria; and (5) an increase in disease reporting rates. The team modelled each possibility (doi: 10.1371/journal.pcbi.1004138). The best match was that the efficacy and duration of the cellular pertussis vaccine was lower than the whole cellular pertussis vaccination (this was phased out by 1992 due to concerns about reactogenicity). The model produced allows further testing to be carried out for optimal dosing and timing.

TB treatment with moxifloxacin

New drugs are needed for the treatment of TB. This trial looked at …

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