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About The nugget. (Sisters, Or.) 1994-current | View Entire Issue (Aug. 15, 2018)
Health & Fitness Wednesday, August 15, 2018 The Nugget Newspaper, Sisters, Oregon 18 Commentary... Why are ‘long-gone’ diseases on the comeback? By Diane Nauman, R.Ph. Columnist Ambulance lights flash. Hospital doors fly open. Family members com- fort a mother in tears as her baby is admitted to the hospital. The prognosis is guarded. After two weeks of cold symptoms, fever and cough, the now critically ill child is being treated as a “Pertussis” case, accord- ing to the ER physician. Pertussis? What is pertus- sis? Whooping cough? In Deschutes County? How is this possible? The same scenario hap- pens in Portland, but this is a three-year-old girl with a 104-degree fever and head-to-toe rash. Again, the prognosis is guarded. The initial diagnosis is measles. Measles? In Multnomah County? In 2018? This reality is becoming common in Oregon. Both are vaccine-preventable dis- eases, but Oregon has one of the lowest vaccination rates in the U.S. There aren’t enough vaccinated people to provide “herd immunity” for many contagious dis- eases. Centers for Disease Control (CDC) states that 92–94 percent of a popula- tion must be vaccinated to provide herd immunity for whooping cough and 95 per- cent for measles. Oregon towns fall far below this level. Whooping cough starts with cold-like symptoms with a week- long incubation period, has airborne transmission and is most contagious prior to diagnosis. Measles, also an airborne disease, is conta- gious four days prior to the start of a rash and continues for at least four days after rash onset, making it easy to spread. Whooping cough was reported in Redmond schools this spring and has been in the Bend School District in the past as well. In May and June 2018, Lane and Douglas counties had a large outbreak of whooping cough, with more than 100 cases confirmed at over 18 schools (including North Douglas Elementary School, Monroe Middle School and Sheldon, Springfield and Thurston High Schools. California had a statewide epidemic of whooping cough in 2014 and continues to have cases. Whooping cough can be deadly to babies and toddlers, with over 50% of infants requir- ing hospitalization. It is so dangerous to infants that it is now rec- ommended that pregnant women get a Tdap (tetanus, diphtheria & acellular per- tussis) vaccination in the third trimester between 27 and 36 weeks of pregnancy to provide the newborn with some protection against whooping cough, regard- less of previous Tdap or Td shots, since newborns can’t receive Tdap at birth. Tdap is given to infants at 2, 4 and 6 months, with a booster at 12-18 months and 4-6 years. In addition to childhood doses, individuals above 12 years of age should receive a single dose of Tdap to provide immunity against Tetanus, Diphtheria & Whooping Cough, with additional Td booster every 10 years throughout life. Measles is on the rise in Oregon. A child in Clark County, Washington, con- tracted measles from expo- sure to one of the three chil- dren in Multnomah County with measles in July 2018. The first Portland case had spent significant time at a Gresham childcare center. This led county officials to warn people who had been at the childcare cen- ter, Legacy Salmon Creek Medical office, and three Portland retail locations visited by infected children that they might have been exposed to measles. Less than a month before this, a person who traveled outside the U.S. visited a Portland emergency room and was confirmed to have measles. How quickly measles can spread was demonstrated in December 2014 by the “Disneyland Outbreak” where at least 173 people from seven months of age to 70 years became infected with measles and took it back home to 21 different states, including Oregon. Health officials say 39 cases were traced to direct expo- sure at the park, with 117 infections linked by primary or secondary exposure. In California, San Diego County also reported a vac- cine preventable outbreak of 591 cases of Hepatitis A out- break from July 2017-July 2018. This outbreak resulted in 406 hospitalizations (68 percent) and 20 deaths. Yet 11 percent of Sisters Elementary School students, nine percent of students at Sisters Middle School and four percent of Sisters High School students have non- medical exemptions for school district required vac- cines and are not vaccinated. Why? There are many reasons parents in affluent coun- tries choose not to vacci- nate. Some don’t perceive any risk to their children and think the diseases don’t occur anymore. Some believe “herd immunity” will protect them. This is definitely no longer true in Oregon. Others don’t understand past vaccine preservatives (thimerosal) are no longer used. Today’s vaccines used nationally by physicians, hospitals and pharmacies most commonly come in preservative-free single- dose syringes. Still other parents have concerns about links between autism and vac- cinations. Review stud- ies on the CDC website at https://www.cdc.gov/ vaccinesafety/concerns/ autism.html. Meningitis is a con- cern as well. Six students at Oregon State University with bacterial meningitis were hospitalized in 2017, prompting administra- tors to change vaccination requirements. Meningitis is a serious disease with a 15 percent fatality rate, even with hospitalization and antibiotic treatment. Fifteen percent of survivors suffer long-term consequences like loss of fingers, toes, limbs; and brain damage. Benton County Health Department officials and Corvallis phy- sicians know this well. An infected high school student in Corvallis lost both legs above the knees. University of Oregon’s 2015 meningitis outbreak left multiple students sick and one dead. Again, the University of Oregon expanded its immunization requirements for all incom- ing students to include Meningococcal quadriva- lent (serogroups A, C, Y, and W-135) vaccine and OSU requires meningococ- cal serogroup B vaccina- tion as well. Parents of col- lege-bound students should check with each university’s meningitis immunization requirements, as they vary from campus to campus. Globally, infectious dis- eases are important factors to consider when travel- ing internationally and for immigration into the U.S. Thirty-nine cases of polio have been verified so far in the Congo, Pakistan, Afghanistan, Nigeria, Papua New Guinea and Somalia this year. In 2017, there were more than 30 cases of polio in Syria alone. Many of the cases left these peo- ple, many of them children, paralyzed for life and stress the importance of childhood immunizations. As a parent, I under- stand that parents want to do what is best for their chil- dren but can be confused by misinformation on the Internet and in other places. I raised four daughters here in Oregon. All were immu- nized with childhood vac- cines. All are healthy. All were valedictorians at their Oregon high schools. All have college degrees. Two are graduate students in OSU’s College of Pharmacy and one is finishing a Ph.D at Columbia University in New York City. One was an outstanding Oregon high school athlete and repre- sented the U.S. at the Pan Am Jr. Games in Medellin, Colombia. Our family is only a “sample size” of four kids, but I can confidently say that vaccines harmed none. And as they travel through- out the world, I have peace of mind knowing they won’t contract polio or other vac- cine-preventable diseases common outside of the U.S. People with questions about vaccines are welcome to come talk to me at Sisters Drug. Diane Nauman is the pharmacy manager at Sisters Drug inside Ray’s Food Place and administers vaccinations to Sisters-area residents. 541-588-6232 AT SISTERS DRUG Back to School, College & Travel Vaccinations Meningitis A & B, Tetanus, Whooping Cough, Oral Typhoid, Hepatitis A & B, Rabies, Flu & Pneumonia. CALL TO GET ON THE WAITING LIST FOR SHINGRIX SHINGLES VACCINE! A SHIPMENT IS EXPECTED THIS MONTH! Now located inside Ray’s Food Place Mon-Fri 9 a.m.-6 p.m., Sat 10 a.m.-2 p.m., Closed Sunday 541-549-6221 • 635 N. 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