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Remaining vigilant about vaccine preventable diseases

By Ann Mathew

Rowan County Health Department

Imagine walking through your neighborhood and seeing children using walkers and wheelchairs because of a virus that caused them permanent paralysis. Imagine parents too scared to let their children outside to play for fear that they might catch this virus. Imagine schools, public swimming pools and movie theaters shut down to prevent spread of this virus.

In the 1950s, due to the polio virus, people across the United States did not have to imagine, as this was their reality. Fortunately for us, due to widespread vaccination campaigns, the polio virus was eradicated from the United States in 1979. Furthermore, in 1980 another terrible and deadly disease, smallpox, was declared eradicated from the world. Truly, vaccines have been an enormous success for both national and international public health.
There are currently 17 recommended vaccines for diseases: Chickenpox (varicella), diphtheria, influenza, hepatitis A, hepatitis B, haemophilis influenza type b (Hib), human papilloma virus (HPV), measles, meningococcal, mumps, pneumococcal, polio (poliomyelitis), rotavirus, rubella (German measles), shingles (herpes zoster), tetanus and pertussis (whooping cough).
Since vaccinations have been introduced, significant decreases in the incidence of these diseases and complications from these diseases have been seen. For instance, haemophilis influenza type B is a severe disease and was the leading cause of meningitis in children less than 5 years old. The incidence of this disease declined immensely, by more than 99 percent, after the use of vaccine; this, in turn, decreased the number of cases of deadly meningitis.
Other examples include tetanus, otherwise known as lockjaw, which causes painful muscle tightness and stiffness; the tightness of muscles in the head and neck can lead to difficulty swallowing, difficulty breathing and even death. Diphtheria is a disease that causes a thick coating in the back of the throat that can also lead to difficulty breathing and death. Pertussis causes severe coughing spells that also lead to difficulty breathing, especially among infants. Diphtheria and pertussis are spread through secretions from coughing or sneezing. Tetanus enters the body through cuts, scratches or wounds. After vaccinations were introduced for these diseases, reported cases of tetanus and diphtheria dropped 99 percent and pertussis declined 80 percent. It is even recommended that pregnant women be vaccinated every pregnancy with Tdap to protect the newborn from pertussis.
In spite of these success stories, some vaccine preventable diseases are seeing a resurgence in communities across the United States. In 2015, a large measles outbreak that started from the Disneyland amusement park in California was traced to an infected overseas traveler. In 2014, a large measles outbreak occurred in Ohio, primarily among the Amish communities. According to the Centers for Disease Control and Prevention (CDC), the majority of those that contracted measles were unvaccinated. And, as measles is still common in Europe, Asia, and Africa, travelers from these places can bring measles to the U.S. and it can spread when it reaches a highly unvaccinated community.
Mumps is another disease in which outbreaks have occurred, primarily in crowded areas such as school dormitories or sports teams. In 2015 and 2016, several universities have reported mumps outbreaks, the two largest in Iowa and Illinois. In 2014, there was even an outbreak among teams in the National Hockey League. According the CDC, outbreaks of mumps can still occur even in highly vaccinated communities; however, a highly vaccinated community can limit the size, duration and spread of the outbreak.
We have seen how efficacious vaccines have been over the years, making once fearsome diseases now rare occurrences. However, we must remain vigilant; diseases do not discriminate between classes or race — even former President Franklin D. Roosevelt was left crippled by polio. The Rowan County Health Department provides immunizations for children and adults, and participates in the Vaccine for Children program, which provides free immunizations  to special populations such as Medicaid eligible, uninsured, under insured, American Indian or Alaska Native. As a community, we must continue to educate and promote vaccinations so that diseases can be prevented and millions of lives can be saved.

Ann Mathew is a Family Nurse Practitioner at the Rowan County Health Department.

Sources:
Kinch, M.S. (2016). Drama on I-270 Tech Corridor. A Prescription for change.(pp. 199). Chapel Hill, NC: The University of North Carolina Press.

The College of Physicians of Philadelphia. (2017). Disease Eradication. Retrieved from https://www.historyofvaccines.org/content/articles/disease-eradication

Centers for Disease Control and Prevention. (2016). Vaccines and Preventable Diseases. Retrieved from
https://www.cdc.gov/vaccines/vpd/vaccines-diseases.html

Centers for Disease Control and Prevention. (2015). Vaccine Information Statement Tdap Vaccine. Retrieved from https://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.pdf

Centers for Disease Control and Prevention. (2015). Vaccine Information Statement Hib Vaccine. Retrieved from https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hib.pdf

Centers for Disease Control and Prevention. (2017). Measles Cases and Outbreaks. Retrieved from
https://www.cdc.gov/measles/cases-outbreaks.html

Centers for Disease Control and Prevention. (2017). Mumps Cases and Outbreaks. Retrieved from
https://www.cdc.gov/mumps/outbreaks.html

Berish, A. (2016). FDR and Polio. Retrieved from https://fdrlibrary.org/polio

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