Memories of an Epidemic - An Article Written by Ruben J. Rucoba, MD

Memories of an Epidemic - An Article Written by Ruben J. Rucoba, MD


Memories of an Epidemic



May 30, 2013



By Ruben J. Rucoba, MD



You may have heard about the recent outbreaks of measles in Brooklyn and North Carolina, with over 57 cases from those two areas so far, all of which occurred in unvaccinated adults and children. The cases have resulted in pneumonia, hospitalization and one miscarriage. There have been other outbreaks in other states this year, as well. When I hear about outbreaks like these, it brings back nightmarish memories.



In the summer of 1989, I was in my first month of pediatric internship at the old Children’s Memorial Hospital (now Ann & Robert H. Lurie Children’s Hospital of Chicago). I was assigned to the seventh floor, which was the infectious disease (ID) unit. It was a long, hot summer for me, and my month on ID still haunts me. Chicago was in the middle of a measles epidemic, and every day, our team would admit at least one horribly ill child with measles. Even though an effective measles vaccine had been around for decades, many stopped getting the vaccine due to complacency about a disease that few parents had ever seen at that time.



These children would come in with pneumonia, dehydration, high fevers and worse. We had no medicine to treat the measles, but we could give IV fluids and oxygen until they recovered. My colleague took care of one little girl that I’ll call Desiree, a 3-year-old who was a normal, healthy girl before she contracted measles encephalitis, an inflammation of the brain. Afterwards, she couldn’t talk or walk and never communicated with her mother ever again. I’d see her over the years when she came into the hospital with some complication or another, a sad reminder of the horrors of that epidemic.



The child I remember the most was a thin African-American child that I’ll call James. James was an active school-age boy who should have been outside running through a sprinkler or eating an ice cream cone. Instead, he was lying in a hospital bed, breathing with extreme difficulty due to pneumonia, and unable to talk much due to shortness of breath. He gradually got worse over the night, and had to be transferred to the ICU and put on a ventilator. I followed his course over the next few weeks, as he gradually worsened and then died.



Vaccine preventable deaths and disability are a shame to us as a civilization. We know the science: vaccines save lives and they don’t cause autism. But one of the keys to success in preventing these diseases is that everyone needs to get them. I’ve heard parents who refuse vaccines for their kids tells me that if everyone else got them, then their children would be safe. The reality is that no vaccine is 100 percent effective, but if everyone got the vaccines recommend, we could wipe out the targeted disease. We’ve already accomplished this. We saw it with smallpox, and we’re making great strides in accomplishing this with polio.



During the first part of my residency, the ID floor was filled with children with meningitis caused by Haemophilus influenza type B, or HIB. It caused deafness, permanent brain damage and death. At the time, the vaccine was only given to children over 15 months, and most children got the illness at much younger ages. During my residency, a newer vaccine came out that could be given as early as 2 months of age, and since then, I can’t remember the last time I saw a case of HIB meningitis. It’s a devastating disease that’s been wiped out just in my two decades of being a pediatrician. That’s the power of vaccination.



So when I hear about outbreaks of vaccine-preventable illnesses, I’m sad, but also ashamed. As a society, we know better. No child should ever get these diseases. We should never fail another Desiree or James. Please, I beg of you: make sure your children are fully vaccinated on time.



 



Dr. Ruben J. Rucoba is a general pediatrician in Wheaton, Illinois. A member of the medical staff at Ann & Robert H. Lurie Children’s Hospital of Chicago and Central DuPage Hospital, he is especially interested in the care of special needs children. Dr. Rucoba is also a medical writer and the father of four children.