During the last half of 2014, the Ebola virus crisis in West Africa practically consumed the 24×7 cable news airwaves. Fortunately, the epidemic in Guinea, Sierra Leone and Liberia seems to be fading and Ebola is disappearing from news coverage as fast as it first appeared.
In its place, we’re confronted with another deadly public health outbreak — measles — except this time it’s not in far off Western Africa, it’s right here at home.
What’s especially frustrating is that domestic measles infections were practically eliminated back in 2000, but since then the number of cases has risen significantly, particularly in the last nine months. As a result, there has been much discussion about parents deciding to opt-out of vaccinating their children. We disagree with these opt-out decisions — there are only a few exceptional medical cases where children should opt-out of vaccinations for diseases like Measles, Mumps and Rubella.
This past February 10th, the United States Senate conducted a hearing to understand the reason for plummeting vaccination rates in our public health system. They took testimony from Rear Admiral Anne Schuchat, MD, Director, National Center for Immunization and Respiratory Diseases at the Centers for Disease Control (CDC).
Dr. Schuchat is a highly qualified spokesperson with direct experience in public health emergencies. She led the CDC’s Anthrax Emergency Response Team when the congressional office mail was targeted after the 9/11 attacks. She also conducted studies of the meningitis vaccine in West Africa, led emergency public health actions to control the SARS crisis in China and the H1N1 flu virus response in 2009. She also led the federally-funded Vaccines for Children (VFC) Program.
If you’re a movie buff, the fictional character of Erin Mears in the 2011 film Contagion was loosely based on Dr. Schuchat. British actress Kate Winslet reportedly consulted with Dr. Schuchat as she prepared for her portrayal of the character.
In her congressional testimony, Dr. Schuchat spoke about how we may be victims of our own success. According to Schuchat, today’s young parents generally don’t have direct experience with devastating diseases like polio, measles, mumps and rubella. As a consequence parents in some micro-communities have let child MMR vaccination rates (for measles, mumps and rubella) drop as low as 50%.
Such low rates fail to protect young children under the age of one — who cannot be vaccinated — from exposure to these devastating diseases. It’s only when vaccination rates start to reach 90% or more — a phenomenon known as herd immunity — kicks in to protect un-vaccinated infants.
Dr. Schuchat also addressed a Lancet study, which linked vaccines with the onset of autism. She reminded Senators that this study had been thoroughly discredited and the researcher had his medical license due to misrepresentations. Nonetheless, she acknowledged that many young parents continued to avoid vaccinations based on misinformation from this discredited study.
As an aside, Dr. Gary Brewton reminds us that we should always be cautious when reading articles published in the Lancet, as it’s not a peer-reviewed medical journal.
What does Dr. Gary Brewton advise for his Adult Patients?
Dr. Brewton’s practice is adult primary care, so the following applies to adults only. If you had a measles vaccination when you were younger, evidence indicates it will continue to provide you with sufficient protection.
However, adult patients should be particularly concerned about the current outbreak of Pertussis, (more commonly known as Whooping Cough epidemic) which is not getting enough media attention in Dr. Brewton’s view.
In the first eight months of 2014, the CDC reported that there were over 17,000 new cases of Pertussis in all 50 states — an increase of 30% compared with the same period in 2013.
Now is the Time to get your Pertussis Vaccine.
All our adult patients should get what is commonly called the Tdap Vaccine, which covers Tetanus, Diphtheria and Pertussis. There are two available brand names for the vaccine, Boostrix® and Adacel® — either one is OK to use. Tdap Vaccines are widely available area pharmacies like CVS and Walgreens. Rather than come into our office for the Tdap shot, we recommend you go directly to a pharmacy to get the vaccine.
If you don’t follow this advice and end up getting a case of Pertussis (Whooping Cough), you are in for a three-month long ordeal. For the first week or two, the patient will experience what appears to be a common cold — with a cough. In the second stage of Pertussis — which can last from one to six (or even ten) weeks — patients will experience numerous rapid coughs, followed by the characteristic ‘whoop’ sound as patients gasp for air. Patients report being exhausted after these extensive coughing fits.
The third, convalescent stage of Pertussis lasts for about two to three weeks. During the gradual recovery period, patients remain susceptible to secondary respiratory infections.
To learn more about Pertussis, please visit http://www.cdc.gov/pertussis/index.html or contact our office if you suspect you have been exposed.