Sunday, August 30, 2015

Why the Fuss About Pertussis?

Today, on a lovely Sunday just hours before local children return to their schools after a wonderful season of warm weather and fun, I was going to write about some events coming to our community - a film festival and a carnival, to be exact, fun things headed our way as the season turns from summer to autumn. Those topics will need to wait for a day, though, as today I knew I needed to write about something just as timely, just as pertinent and, although far less fun, far more likely to save lives: vaccination.

The news of a recent outbreak of pertussis - know colloquially as "whooping cough" - in northern Alberta stopped me dead in my tracks, particularly when medical experts suggested the reason for the outbreak is that we are under-vaccinating our population, creating a situation where enough remain unvaccinated (or under-vaccinated) to allow the spread of diseases like whooping cough. And while whooping cough on its own is enough of a worry, the fact is that the vaccine for pertussis is usually part of the series known as "DPTP" - Diphtheria, Pertussis, Tetanus and Polio, and if we are under-vaccinated against pertussis odds are very high we are also under-vaccinated against some very other very frightening diseases, like polio.

If you are my age chances are you have never known anyone with polio. If you are part of my parent's generation, however, chances are good you know someone who was maimed or killed by polio. In their era polio was a known, real and terrifying affliction that paralyzed, led to years (or even a lifetime) spent in contraptions known as "iron lungs" and in some cases outright killed. During outbreaks parents kept their children away from schools and swimming pools, playgrounds and libraries in an attempt to quell the disease, often to no avail. Polio is an insidious disease which is still found around the world, and it still kills - and there is absolutely no guarantee it could not infect North Americans again.

The one thing standing between us and diseases such as polio is vaccination. In recent years there has been an outbreak of another kind, a form of near-hysteria that blamed vaccines for the rise in conditions such as autism, but the truth is that vaccines have never been proven to cause autism. The one definitive thing vaccines HAVE been proven to do, though, is prevent disease.

I wonder if in the face of a disease like Ebola, which has an incredibly high fatality rate, anyone would refuse a vaccine that would prevent it? The news of the development of a possible vaccine against Ebola is reason to rejoice in the countries this disease has struck, as they have clearly seen the devastation such a disease can bring, and they know their only hope is a vaccine that will prevent it from ever gaining ground again. Should Ebola ever truly land on the shores of North America - not as a random positive case brought back from overseas but as part of a continental epidemic - would we refuse to vaccinate because we fear some unproven side-effect in the face of a disease that is virtually always fatal?

And yet we seem to believe the completely unproven allegations about routine childhood vaccinations causing developmental conditions, perhaps because we have been fortunate enough to never actually see the diseases these vaccines prevent. We have become complacent because we have never had a sibling die of polio, or watched our neighbourhoods quiver in terror as a case was confirmed and we feared for our families. The anti-vaccine groups have done a damn fine job in scaring us about vaccines, but it seems we have forgotten the real terror is the diseases we are vaccinating against.

Maybe the truth is that we need to be frightened. Maybe it takes an epidemic to make us think clearly and to realize that our best strategy is to prevent these diseases that maim and kill. It is sobering to think that perhaps the outbreak of whooping cough is just the canary in the coal mine, warning us that just as pertussis can return so can all the other diseases we have worked over decades to prevent and even eradicate.

What I know is this: my parents, who saw polio and pertussis, measles and mumps, diphtheria and tetanus, would have thought the idea of not vaccinating against these diseases completely insane. They had witnessed them first hand, seen family and friends suffer and even die. They had the first hand knowledge we lack, and from it they knew the value of vaccines because they knew they would do anything to protect their children from insidious diseases that had already stolen from them during their lives.

This outbreak of pertussis is a siren call to action. Check to make sure your children's vaccines are up to date - and while at it check to make sure your own are, too, as adults still require vaccination to ensure they cannot contract and spread these diseases (as they are often far more serious in the young, the elderly and the immunocompromised). Stop listening to what "celebrities" who have never studied epidemiology (the study of disease) say and listen instead to those who have devoted their lives and careers to saving lives. And if you are reluctant to do that then find someone who lived through the early years of the previous century and ask them about polio and the other diseases they saw as both children and parents. If you need to be scared straight about vaccines, that should be enough to do it. The fuss about an outbreak of pertussis is that it signals we have a problem - and one that if not addressed could grow in magnitude and cost us far more than we have ever imagined.

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