H1N1 Flu Immunization: What are the alternatives? Make an informed choice.

One of my earliest memories is of seeing an iron-lung in a storage room behind the kitchen in a small prairie hospital, when I was a very small child. I was told how a person was put into this cylindrical metal tube, with only their head sticking out, because they had polio and could not breathe on their own. The memory is still very vivid and very clear. The H1N1 Flu virus can move swiftly into the lungs of its victims, leaving medical personnel no alternative but to put them onto respirators to try to save their lives, has brought this to my mind.

Years later, I again saw an iron-lung in a small prairie museum. As an RN myself, I asked my cousin, (also an RN, who was eleven years older and had lived in Saskatchewan all her life,) “Why would the small town of Cereal have had an iron-lung?” She told me that there had been a particularly bad polio epidemic that had spread throughout the prairies in the thirties. The few hospitals available had not been able to hold all the cases. Sometimes the overload of sick had been cared for in the churches or schools. Polio was still a summer scourge in the late forties and early fifties. People were told to stay away from crowds, especially on beaches and in movie theatres, when a polio epidemic was rampant. Polio was a disease that attacked varying muscles and caused paralysis, usually limbs were affected, but in about 10% of cases the respiratory muscles were affected, frequently causing death. People who survived polio were often paralyzed or disabled by their wasted muscles for the rest of their lives. In the USA there were 300,000 cases of polio with 58,000 deaths in 1952. We all knew people who had polio. My closest friend was a polio victim as a baby and was left with a limp then developed post-polio syndrome in her later years; my grade eight teacher was a beautiful young lady with a wasted arm; a teenage friend’s arms were left weakened; a friend of my mother’s had heavy steel braces on her legs, as did my friend’s sister. These were people I personally knew. Franklin Delano Roosevelt was struck down with the disease as a young man. Although he went on to become president of the United States, he never walked again. Then Jonas Salk invented an immunization for this dreaded disease. In 1955 it became generally available to a welcoming public. People did not question whether there might be some problems for a few of the people who were immunized. I gratefully took my year old daughter to be immunized along with my husband and myself. Each person counted in the battle to eradicate the disease. We knew what the alternatives were.

While we grew up red measles, German measles or Rubella, mumps, chicken pox, scarlet fever, whooping cough or pertussis passed through communities regularly. We heard tales of diphtheria that attacked the throat, tetanus that caused lock jaw and small pox that if it didn’t kill you left you terribly scarred. When I first had children of my own, communicable diseases were still regular threats, usually brought home by the first child who went to school. The diseases were usually mild, we all knew how to recognize and treat them. My friends remember being kept in a dark room when they had measles. The Asian flu and the Hong Kong flu went through the world in the mid-fifties. I remember being sicker that I ever have been in my life in the fall of 1957, with the Asian flu.

When one person in a household came down with a contagious disease, we all knew that if we had not already had the disease, we could be the next victim. Quarantines were the only thing we could do to stop the spread of the diseases. We knew about the incubation periods, so would remain watchful while the days counted off. I remember the summer of 1963 I was looking after two young nephews while their mother was in the hospital having another baby. My son and his cousin both woke up sick one morning. One had chicken pox and the other had measles. For the next few weeks the diseases were passed back and forth amongst the children. The second nephew spent a few weeks with us waiting his turn to get the last of the diseases. It was a joyful day for his parents when he could finally return home to meet his new brother.

But then again there were those who were very ill and had serious side-effects from the contagious diseases. Because most of today’s baby boomers and younger adults have not had personal experiences with the serious illnesses that occurred in the pre-immunization days, they fail to comprehend the alternative to immunization. Most of those diseases still exist in the third world, although the World Health Organization works hard to immunize as many people as possible throughout the world, with the hope that one day those diseases be globally eradicated, as has Small Pox.

The Diptheria Tetanus and Pertussis (DTP) combination immunization protects against three very serious diseases. What were the alternatives?

Diphtheria is an infection of the nose, throat, and lungs that produces a thick coating over the air passages, seriously interfering with breathing. The condition can spread to the heart and nervous system, causing permanent heart and brain damage. Between 10 and 15% of those who contract diphtheria die.

Tetanus, or "lock jaw" causes severe muscle spasms that interfere with breathing. The infection is usually contracted from a puncture wound and can cause convulsions and paralysis that are fatal in 50% of cases.

Pertussis or "whooping cough" is an infection of the throat and lungs. It is easily identified by a characteristic noisy "whooping" cough. Pneumonia is a common occurrence with this disease, which may also be complicated by convulsions, brain damage, and death. This illness is particularly deadly in infants less than one year old.

Measles, Mumps, and Rubella (MMR). The MMR vaccine is a combination vaccination that simultaneously produces antibodies against measles, mumps and rubella (German measles).

Mumps, caused by an infection of the salivary glands, produces swollen glands, primarily in the neck, that can lead to deafness, pancreatitis, seizures, and brain disorders. In males the swelling can also occur in the testicles producing sterility and impotence.

Measles (Red) is still a killer outside the United States and is the most serious of the common childhood diseases. One in every 1,000 cases can result in deafness, blindness, brain damage, and seizures. 10% of people who develop brain damage or seizures will die.

Rubella or German Measles is a mild viral disease in the children who catch it, but if it occurs in a pregnant woman, especially in the first trimester, the developing fetus may be affected producing severe birth defects in her infant. Thousands of infants were born with heart disease, deafness, and mental retardation as a result of their mother’s contracting German measles during her pregnancy.

If Canadians and Americans had not stepped up to the plate and gone for polio immunization in the big way, the disease might have continued unabated until this day. Instead it has been virtually eradicated from North America. When the other immunizations became available, we again gladly had our children immunized. We knew what the alternatives were. Because we willingly had our children immunized, there are generations of North Americans who do not have a memory of the tragedies that occurred due to the scourges that blazed a trail throughout this land every year.

Some people became complacent and forgot about the benefits of the immunizations. Many found excuses for not seeking immunizations for their children. As they said, “There might be side effects.” Let me tell you the side effects were nothing compared to the havoc and tragedy that could be created by those diseases. People no longer realized how many serious illnesses, disabilities and deaths were avoided by the immunizations. Many people had not heard about their grandparent’s siblings - the ones who did not reach adulthood, because they died of one disease or another. Efforts are made to try to immunize as much of the global population as possible. As a result, Small Pox has been eradicated. Still many third world countries have pockets of communicable diseases. We have relaxed our vigilance. With speedy travel throughout the world, diseases can reach North American ports of entry within 24 hours. Many of those diseases are rarely seen on this continent – and then some like TB were thought to be controlled in North America. However, there has been a resurgence of a treatment- resistant TB here, believed to have arrived from third world countries. We must be vigilant and work with our public health agencies to keep diseases at bay. It is a battle that we all must fight.

Now those responsible for public health are advising the public to go for H1N1 Flu immunization to stop the spread of a disease that can strike our young people with amazing swiftness and deadliness. This is a new virus that has mutated to move to human hosts. H1N1 was formerly only seen in animals. Children, as young as six month old, students, young adults, especially pregnant women and baby boomers are all at high risk. Some people born before 1957 are thought to have some immunity, gained by exposure to one of the global flu’s that passed through the world in the mid-fifties because that was a similar type of virus. That doesn’t go to say everyone 52 years of age and older is immune to the H1N1 virus. The ball is now in your court. It is up to you to step up to the plate and strike down this new scourge that is threatening people throughout the world.

Make and informed decision. Think about the alternatives!