Tag: polio

Alternative Names for Vaccine Preventable Diseases

You know all of the names – measles, mumps, rubella, diphtheria, whooping cough, etc.

But do you know why they used to call 10-day measles?

And which disease causes a 100-day cough?

Alternative Names for Vaccine Preventable Diseases

Back in the day, when these diseases were more common, they used much more descriptive terms and nicknames, in addition to their official names.

Why was measles known as 10-day measles?

Because there was also a 3-day measles!

MeaslesRubella
10-day measles3-day measles
red measlesGerman measles
rubeola

Unfortunately, 10-day measles made you feel miserable for 10 days!

Although a vaccine was available, it took a little more time to get measles under better control.

Can you guess which disease was known to cause a 100-day cough?

That’s right, it’s whooping cough or pertussis.

“I honestly felt like it was never going to go away. The doctor told me it was 100 day cough, so I was counting the days while Googling to see if there was anything that could help. I tried everything, you name it, I tried it, and nothing worked. It came to 120 days and I couldn’t understand why it wasn’t gone. I then researched and found that babies take longer to get over whooping cough.”

Fern’s Story – Whooping Cough

Fortunately, the cough doesn’t typically last that long if you are vaccinated and still get pertussis.

What do they call rabies?

Mad dog disease.

But that’s an easy one.

Which disease was known as “the Strangling Angel?”

“The breathing became much more difficult, with a kind of rattling stertor, as if the patient was actually strangling, the voice being exceeding hoarse and hollow, exactly resembling that from venereal ulcers in the fauces. This noise, in speaking and breathing, was so peculiar, that any person in the least conversant with the disease might easily know it by this odd noise; from whence, indeed, the Spanish physicians gave it the name of garrotillo, expressing the noise such make as are strangling with a rope.”

Edward Headlam Greenhow on Diphtheria

How about “The Crippler?”

Fight Polio Poster
Polio, also known as infantile paralysis, was known as “The Crippler.”

The “Speckled Monster?”

Even mild smallpox, as depicted on this WHO Smallpox Recognition Card, included flu like symptoms, a few weeks of pustules, and then waiting for the lesions to scab over...
Even mild smallpox, as depicted on this WHO Smallpox Recognition Card, included flu like symptoms, a few weeks of pustules, and then waiting for the lesions to scab over…

We forget these names, because we don’t see these diseases anymore.

“…for those trained in pediatrics in the 1970s, Hib (Haemophilus influenzae type b) was a horror.”

Walter Orenstein

Do you remember that measles was called a “harmless killer?”

Be sure to think about how these now vaccine-preventable diseases got their nicknames before you think about skipping or delaying your child’s vaccines.

More on Alternative Names for Vaccine Preventable Diseases

Have Normal Childhood Diseases Become More Deadly?

Weren’t measles and chicken pox once a rite of passage for kids?

Yes, in the pre-vaccine era, almost all kids got measles, chicken pox, and other now vaccine-preventable diseases in early childhood.

It was considered a rite of passage.

That she doesn't understand survivorship bias doesn't mean that you shouldn't vaccinate your kids.
That she doesn’t understand survivorship bias doesn’t mean that you shouldn’t vaccinate your kids.

But these diseases were never benign.

They were considered a rite of passage only because we all had to endure them. They weren’t something anyone looked forward to.

Benign diseases don't kill kids.
Benign diseases don’t kill kids.

After all, you don’t typically die from a benign disease.

Have Normal Childhood Diseases Become More Deadly?

But what about the idea that folks never used to worry about these diseases, at least not until vaccines were developed? Or that we only fear diseases that are vaccine-preventable?

It’s easy to say that no one worried about measles in the pre-vaccine era when you are just trying to scare folks away from getting vaccinated.

That’s one of the more ridiculous arguments anti-vaccine folks make.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951 and made headlines in the New York Times. That’s not surprising, as there were 683 measles deaths in the United States that year.

And also one of the easiest to refute.

When was the last time that you saw a headline warning about congenital rubella syndrome?
When was the last time that you saw a headline warning about congenital rubella syndrome?

These diseases that are now vaccine-preventable routinely made headlines in the pre-vaccine era.

Even the schools were closed in San Antonio when polio came to Texas in 1946.
Even the schools were closed in San Antonio when polio came to Texas in 1946.

And it was surviving these diseases that was considered a rite of passage, at least for those who were fortunate enough to survive.

So no, childhood diseases have not become deadlier.

They have always been serious and life-threatening!

Of course, not everyone died who got them, but they were rarely a walk in the park. Remember, even a mild case of measles includes a high fever for 4 to 7 days. That’s why folks often end up seeking medical attention multiple times, even if they don’t end up having any complications and don’t need to get admitted to the hospital

Lassie got shot, but ended up saving the day, getting help for Timmy, after they ran out of gas taking a short cut rushing home.
The Lassie episode about measles, in 1958, was called ‘The Crisis.” There were 552 measles deaths in the United States that year.

But what about the Brady Bunch measles episode, Is There a Doctor in the House? Is that really why you think vaccine-preventable diseases are mild?

In 1969, when that episode first aired, there were 25,826 reported cases and 41 deaths from measles in the United States.

Why don’t we see that many deaths now?

That’s easy.

We don’t see as much measles now. Most folks are vaccinated and protected.

If more people skip or delay their vaccines though, we will see more and more outbreaks, with greater chances that people will die.

Believe it or not, we still don’t have cures for measles, chicken pox, congenital rubella syndrome, and hepatitis B, etc. So while these diseases haven’t become any more deadly, they haven’t become any less deadly either, even with all of the advances of modern medicine.

More on Childhood Diseases as a Rite of Passage

What Is the Morbidity/Mortality Rate of the Polio Vaccine vs the Wild Virus?

Some anti-vaccine folks still think that the risks of vaccines are far greater than the risks of the vaccine-preventable diseases they keep you from getting.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

They aren’t, but you can kind of understand why they might think that with a disease like polio, when they might never actually have known anyone to have the disease.

What Is the Morbidity/Mortality Rate of the Polio Vaccine vs the Wild Virus?

Still, even though polio is under good control and close to being eradicated, the risk/benefit ratio clearly favors getting vaccinated and protected.

That’s because the polio vaccines are very safe and if we stopped vaccinating, polio could come back.

In fact, morbidity/mortality from polio vaccines are decreasing, as we are using much less oral polio vaccine (OPV) in the transition (OPV cessation) to just using inactivated polio vaccine (IPV).

“Over the past ten years, more than 10 billion doses of OPV have been given to nearly three billion children worldwide. More than 16 million cases of polio have been prevented, and the disease has been reduced by more than 99%. It is the appropriate vaccine through which to achieve global polio eradication.”

OPV Cessation

And while most developed countries already use IPV, those that are still using OPV recently switched from a trivalent (tOPV) to a bivalent (bOPV) form of OPV. We could do this because type 2 poliovirus has already been eradicated (2015)!

Of course, the issue with the OPV vaccines is that they rarely cause vaccine-associated paralytic polio (VAPP) and circulating vaccine-derived polioviruses (cVDPV).

Fortunately, this is even less common with bOPV.

As this chart from the WHO shows, polio vaccines are very safe.
As this chart from the WHO shows, polio vaccines are very safe.

So morbidity (getting sick)/mortality (dying) from polio vaccines is low.

There were only 31 cases of wild polio in 2018, in Afghanistan and Pakistan, and an additional 102 cases of cVDPV in 7 countries.

What about morbidity/mortality from polio?

“As recently as 30 years ago, wild poliovirus paralysed more than 350 000 children in more than 125 countries every year. In 2018 there were fewer than 30 reported cases in just two countries – Afghanistan and Pakistan.”

“Zero polio transmission and health for all”, WHO Director-General gives new year’s wish to the people of Afghanistan and Pakistan

With a 99.9% drop in polio cases since 1998, your risk of getting polio in most parts of the world is very low, but you still have to consider both the morbidity/mortality of polio in the pre-vaccine era and the risk of polio returning if we stop vaccinating before it is eradicated.

What about the idea that you don’t have to worry about polio because only 1% of kids with polio developed paralysis?

“The mortality rate for acute paralytic polio ranges from 5–15%.”

Disease factsheet about poliomyelitis

Well, when everyone gets polio, even 1% is a lot.

With such a safe vaccine, why put your kids at risk of getting polio?

Do you even understand what the risks are?

No, it isn’t just the risk of wild polio in Afghanistan and Pakistan.

Since the oral polio vaccines shed, if you are unvaccinated, in addition to the risk of wild polio, there is a small risk of getting circulating vaccine-derived polioviruses (cVDPV) if you are not vaccinated and protected. No, it is not a big risk, as there were only 102 cases of cVDPV in 7 countries in 2018, but it isn’t zero either.

And the other big risk is that if enough folks stop getting vaccinated, taking their chances hiding in the herd, polio will come back and our chance to eradicate another vaccine-preventable disease will fail.

More on the Morbidity and Mortality Rates of Polio

Why Do We Still Vaccinate If Polio Has Been Eliminated?

It’s true, polio has been eliminated in the United States.

Are these folks serious with this anti-vaccine nonsense?
Are these folks serious with this anti-vaccine nonsense?

But that doesn’t mean that we can stop vaccinating kids against polio yet.

Why Do We Still Vaccinate If Polio Has Been Eliminated?

For one thing, the last polio case in the United States was a lot more recent than 40 years ago.

What happened 40 years ago?

That was when we had the last endemic case of polio in the United States, in 1979. After that, in addition to cases of VAPP, there were at least 6 cases of imported paralytic poliomyelitis. In fact, the last case of wild polio in the United States was in 1993, just 26 years ago.

And just ten years ago, in 2009, was the very last case of VAPP, a patient with a long-standing combined immunodeficiency who was probably infected in the late 1990s, even though she didn’t develop paralysis until years later.

But still, why couldn’t we stop vaccinating against polio in the United States, even though polio isn’t eradicated yet? After all, we stopped using the smallpox vaccine in 1972, before smallpox was declared eradicated (1980).

While that is true, smallpox isn’t as contagious as polio and there hadn’t been a case of smallpox in the United States for over 30 years when we stopped using the vaccine.

Until wild polio is eradicated and the oral polio vaccine isn’t used anymore (OPV switch), we must continue to vaccinate against polio to prevent new outbreaks.

That is the polio eradication and endgame strategic plan.

Over the next few years, the world will hopefully switch to using just the injectable form of the polio vaccines, which eliminates the risk of VAPP.

But if we are so close, why not just stop vaccinating in those parts of the world that don’t have polio?

Because we are so close to eradicating polio.

Why take the risk of polio spreading from one of the remaining endemic countries, paralyzing kids, and putting eradication efforts further behind?

Should we stop vaccinating kids because anti-vaccine folks are pushing misinformation about DDT, renamed diseases, or vaccine induced diseases?

Of course not!

Vaccines are safe, effective, and necessary.

Let’s continue the work and eradicate polio, once and for all!

And for the record – we don’t pump “kids full of polio” when we give them a polio vaccine. The polio shot is an inactivated vaccine, so doesn’t contain live polio virus.

More on Why Do We Still Vaccinate If Polio Has Been Eliminated?