Yet Another Reason to Immunize Alert
Hello Reader,
Today’s YARTI alert is brought to you by diphtheria. Yes, diphtheria, that disease about which many people have apparently forgotten. In all of this insane yammering about how the pertussis vaccine doesn’t work (it does), we tend to overlook the other diseases against which the DTaP or TDap vaccine protect–diphtheria and tetanus. A recent story from India should remind both of us yet again that a deadly disease such as diphtheria is only a plane ride away.
Before we get to this story, I highly recommend that you subscribe to the ProMED mailing list, which provides daily updates of disease outbreaks around the world. The reporting is sparse and to-the-point, and can be more absorbing than you latest copy of Entertainment Weekly. Yesterday’s issue brought diphtheria to the forefront of my thinking when I read that 5 children–none vaccinated–have died in India from the disease. These children did not have access to healthcare and were not able to receive the lifesaving vaccination, despite Herculean efforts by the Indian government to maintain protective vaccine coverage. Diphtheria rarely rears its hideous head in developed countries these days, but once again, the anti-vaxxers are busily beavering away and putting out the welcome mat for its return.
So why should we be concerned about diphtheria, if the story above is not enough to worry you? The CDC offers an excellent overview, but in short, it is a bacterial illness that can cause airway obstruction, which as you have guessed can result in a terrifying death. The case fatality rate for diphtheria is highest in children under five years of age, where it may reach 20%. In addition to this information, I have an anecdote to share. Yes, reader, an anecdote.
Anti-vaxxers love to go on and on about how their grandparents didn’t get “hardly any” vaccinations and yet they are still alive! How can this be? Well, the answer is that they were damned lucky. All of us alive today had grandparents who were lucky. My maternal grandmother, who is 97 years old, recently shared a story with me about diphtheria, and her incredulity that people wouldn’t run to get a vaccine for it. You may very well read the following story and imagine it in sepia tones, to which I say: don’t. It could happen again, and it will happen again if the anti-science movements continue to spread lies and misinformation.
When my grandmother was a little girl, diphtheria swept through her neighborhood. Children died in the houses on either side of her, but luckily she was spared. It has been 90 years, and like all people who live to their 90s, my grandma has been through a lot, including having a husband who was deployed in the Pacific throughout the majority of WWII. Yet she recalls the loss of her dear friends and schoolmates with both clarity and despair. And she leaves us with a poignant question: Whose grandparents would they have been?
Now go get your dangnabbed vaccination.
I suspect that diphtheria is one of many possible reasons that one or both of my grandmother’s brothers died before the age of seven. The cause of death was not written in the family Bible that was sent to me by my cousin (from which I scanned several pages, and then sent it off to my brother).
Diphtheria is also at the heart of the ,why the Iditarod Trail Sled Dog Race exists.
And yes, it can happen again:
Diphtheria in the former Soviet Union: reemergence of a pandemic disease.
Successful Control of Epidemic Diphtheria in the States of the Former Union of Soviet Socialist Republics: Lessons Learned
Very interesting, Chris! I had no idea of the Iditarod connection. Thanks for sharing.
Skewed: I wrote a more popularized article about the Idatarod and diphtheria, because I had an old pediatrics textbook written by a doctor who started practicing in the days before the antiserum or the vaccine. It’s hair-raising.
http://voices.yahoo.com/diphtheria-iditarods-strangling-2841059.html
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And, if I apply the logic used by the anti-vaccination crowd to WWI or II … no one died in either war. Everyone I knew who had served in either war was alive.
This is fantastic, thank you very much! Excellent writing. Interesting anecdote: after Chris told me about the Iditarod and diphtheria, my kids asked me to read them “the Balto book”. I was so excited to pick it up and see “The Bravest Dog Ever: The True Story of Balto”. I couldn’t believe the coincidence.
For parents who may want to share this story with their kids:
The Bravest Dog Ever: The True Story of Balto (Book and CD)
Another great post, Skewed! Well done!
Growing up in Sri Lanka, I was constantly surrounded by people who had their limbs amputated due to polio. Not only that, but my grandmother developed fulminant liver damage from Hepatitis A and passed away from it. Hepatitis A is considered a self-limited illness, but this was certainly not the case with my grandma. I use this story as an example of why the Hepatitis A vaccine is important for children and adults. It was one of the first vaccines I got in the US after starting Medical School as it was highly recommended for all healthcare professionals. Of course the skeptics tell me that it was the dirt and lack of sanitation in the third world that killed my grandma rather than the actual Hepatitis. At that point, I just politely hand over a vaccine waiver for them to sign, and that conversation is over. Sometimes you just can’t win, when the logic is so flawed.
My mother and I were recently discussing the vaccine aversion that is spreading like a wildfire here in the US. She told me something that I was never aware of: more than half of our extended family passed away from Typhoid Fever since it was an epidemic in Sri Lanka when my mother was a child. My grandfather who was also a doctor got his family immunized at the earliest opportunity, which is why my mom is alive to tell the tale today.
Patients have also accused me of wanting to push ALL the vaccines that were ever invented on the kids. I politely tell them that this is not the case. If it were, I would be pushing the BCG vaccine on them as well as the one for Typhoid. As it is, miliary TB is not an issue here, so the BCG is useless, and the same goes for Typhoid fever. The vaccines that we DO recommend however, are because they effectively provide protection from diseases that are still found in the US. Some will understand this logic, and appreciate my taking the time to explain stuff to them, while others… well… they are the reason why my supervisor is seriously considering closing the practice to vaccine naysayers.
I would say you could be shocked at my vaccine record, but you might actually understand it. I was an Army brat who was born overseas, and ended up spending about a third of my youth in South and Central America. I had a total of seven smallpox vaccines (the first at birth did not take, and I got my last one in 1974 as a teenager at an Army clinic in Panama). I have been vaccinated for typhus, typhoid and yellow fever, plus tested several times for TB.
And I am still alive.
In 1976 I was in a college dorm where they were recruiting students to try the new swine flu vaccines. So I brought down my Department of Defense shot record and stood in line. The young student doctor was surprised at my shot record (his jaw dropped). But he dutifully filled in that I had both the “Influenza A/NJ” and “Influenza B/HK” (which I assume are the swine flu from New Jersey and one from the 1968 Hong Kong flu).
Your vaccination record is probably pretty similar to mine, Chris!
I still have the scars on my left upper arm from the BCG vaccine. So do the rest of my family who were born in Sri Lanka. I find myself constantly having to educate my own medical assistants on what BCG is, when we have to interpret vaccination records from overseas. Sometimes, as in the case of Iraqi refugees, they have already been to the county clinics for vaccines before they come to me, so I have very really translations if any, left to do. Others, when they come to me with records from the middle east and what not, have me spending a lot of time trying to unravel what was given and when. I also have to remember that they write the dates with day/month/year so that adds to the confusion, lol. But it’s all good, since the extra time taken to unravel the vaccination records prevents my patients from getting vaccines that they already received elsewhere.
I am so glad to find a blog like this. It is refreshing! I never knew, until I had my daughter, what a hot topic vaccinations were. In fact, I hadn’t even given birth to her and a co-worker was already judging me by my actions, such as getting a flu shot while pregnant. I haven’t seen this co-worker since having my child (who is now 3) and I’m sure they’d be terribly surprised to see that she’s a thriving, healthy and normal toddler.
I get a feeling that many people think “why keep vaccinating? these diseases existed soooo long ago, they surely must be gone?” (another good one: a lady actually told me once, “I don’t need to get my daughter vaccinated because everyone else vaccinated their children!”)
Anyway, I want to share my story. I am 30 years old. I’m what many people call young, right? My aunt – just one generation above me – laid on her deathbed as a child in the 1940′s, thanks to Polio. Her parents (my grandparents) watched as she lay there dying, the doctors telling them these words exactly (I don’t think these are words you would ever forget as a parent): “Your daughter will not make it through the night. Say goodbye to her now.” Before I had my daughter, I could not fully understand the impact and absolute horror of these words. By some miracle, my Aunt survived through the night and went on to live a life filled with many health complications. To this day when I see her, I still see the effects that Polio had on her. Who knows the life she could have led without such debilitating consequences of this disease? My grandparents have since both passed, however I cannot even imagine how they would have felt being given the opportunity to offer a vaccination to their child to prevent her suffering…or how they would feel now seeing people run screaming the opposite direction from vaccinations.
When my daughter received her vaccination rounds which included the polio vaccination, all I could think of was the image of my grandparents standing over their daughter’s bed, thinking that was the last time they were going to see her alive…and how grateful I am that as a 30 year old today, between my aunt’s generation any my generation, we now have these amazing masterpieces of medicine keeping my family safe.
I don’t know why I felt compelled to share this story, I guess it just felt like a safe place to do so. And now with baby #2 on the way, if anyone makes a comment to me about flu vaccinations while pregnant…oh boy…mama bear will make an appearance!
Thank you for this blog, keep up the good work! I will definitely keep reading!!
Have fun with baby #2.
And it does not matter what worked with baby #1, because they are all different. Each kid will find her/his own special way to drive you crazy.
My daughter is a freshman in college. She told me yesterday that one of her professors remarked that she had shingles in college due to stress, with all of the gory details about the pain. This made me wince since my daughter had chicken pox when she was only six months old a year before the varicella vaccine was available.
There is a higher chance of getting shingles for those who had chicken pox before their first birthday (like my daughter). It often happens during period of great stress like at finals,especially those who worry about their performance (like my daughter).
I am seriously thinking of asking our family doctor if my daughter could get a shingles vaccine because she does stress about academics. She has a night guard for her teeth because she was wearing them down in her sleep due to academic stress. Seriously, I did not push her into becoming a high achiever!
Yet another reason to get the varicella vaccine.
Thanks for the kind words and for sharing your story, Anne. A lot of anti-vaxxers are now making the bizarre claim that polio really wasn’t that serious of a disease. It is hard to wrap my head around that.