Dirty Medicine-Mumps, Mudpies, & Myths

Written by Bakersfield Magazine

In late April 2009, news reports began to surface about a new strain of influenza.

A 10-year-old in California tested positive for a virus that was a unique combination of influenza virus genes never previously identified in either animals or people. Two days after this first diagnosis, an 8-year-old, living 130 miles away in California, also tested positive. There was no known connection between these patients.

By the same time the following year, the Center for Disease Control and Prevention (CDC) and the World Health Organization (WHO) would look back on the H1N1 pandemic as not only a success story but also a learning experience. The same goes for the Kern County Department of Public Health.

“It was the first time we tried to prevent a pandemic before it occurred,” said Matt Constantine, Director of Public Health Services.

“The experience represented a culture shift. For the first time, we had the ability to test for something we thought was coming.”

Playing In The Dirt

Culture shift really is the key phrase here. If you’re over the age of 30 (or grew up on a farm), chances are you spent some portion of your childhood playing in the dirt. If you’re over the age of 20, you remember a time before every restaurant had to have a Department of Environmental Health grade posted in its window. You also remember that not every place of business had a giant bottle of hand sanitizer at the front desk.

But it’s not because parents and doctors didn’t care about our health back then—it’s because some of the most common ways we protect against food and airborne pathogens today were not around. Some of the illnesses we contracted were mysteries. Our parents and grandparents grew up without “modern” medical advances and because they grew up fine, it was assumed that the children of that time could simply build up their immune system by playing in the mud...and by being around other sick kids. Hence the popularity of “chickenpox parties.”

However, our understanding of communicable diseases has changed. Our arsenal of knowledge has grown substantially.

“Kids today have grown up with new practices for preventing illnesses. Like coughing or sneezing into the crook of your arm,” Constantine elaborated. “It’s certainly not a practice I grew up with. Parents today are much more aware of infection not because we didn’t have infectious diseases in the decades preceding this one, but because there are more readily available resources for parents to learn about their child’s immune system; to learn what vaccines can keep their children from contracting preventable diseases.” Not to mention the creation of the vaccines themselves.

As Denise Smith, Director of Disease Control for the Department of Public Health, noted, common diseases many of us (over a certain age) associated with childhood are preventable today.

“The MMR [measles, mumps, rubella] vaccine was first created in the late ‘60s,” explained Smith. “But we had epidemics here in Kern County in the late 1980s. One in 1985 and one from 1989 to ‘90. Everyone learned that one dose wasn’t offering longterm protection.” So, the CDC researched the vaccine and the disease and began recommending that children receive two doses: one at 12 months of age and the second around age 4.

In 1995, a vaccine for chickenpox (varicella zoster virus) became available. According to the CDC, after the release of the vaccine, cases of chickenpox in the United States decreased 10-fold from almost four million a year. Today, children are immunized with the MMRV (measles, mumps, rubella, varicella) vaccine. That might make some of us who dealt with chickenpox a bit bitter, but your grandparents probably feel the same way about the measles or polio.

Before leaving office, in the wake of a pertussis (whooping cough) epidemic, Former Governor Schwarzenegger signed AB 354 into law. Beginning July 1, 2011, students entering grades 7-12 must provide proof of having a pertussis booster shot (also known as DTaP) before starting.

DTaP covers diphtheria, tetanus, and pertussis (the “a” stands for acelluar, which means the pertussis component contains only a part of the pertussis organism). Because we have the capability to be looking for these outbreaks, we are more alert when we do see cases.

“With more technology and more awareness, we have to worry about things that our grandparents didn’t have to worry about 50 years ago,” Constantine said. “We have to keep pace with these advances and it’s hard for us to mentally process the full scope of these diseases, their vaccines, and the panics that come when a virus or disease is spreading.

“With H1N1, for example, we didn’t know what to expect. I stood on Stockdale Highway between police officers while traffic had slowed to a standstill and people were lined up for hours to get a vaccine.”

And, as Constantine explained, we’ve become accustomed to the flu. We know when flu season starts—we know what precautions to take. Even though, on average, close to 50,000 people die each year from the common flu, H1N1 scared people because it was something relatively new.

But while the WHO officially declared the outbreak to be a pandemic on June 11, 2009, the pandemic level 6 rating was an indication of spread, not severity. The strain of the virus had a substantially lower mortality rate than a common flu outbreak.

“People were seeing the images before the data was coming out,” explained Mariel Mehdipour, MPH, Director of Health Promotions for the Kern County Department of Public Health. “Production of the vaccine had to catch up to the demand.” It was unlike anything the Department had seen before, and that includes the mass inoculations for polio in the 1950s.

The reason that organizations like the CDC, the WHO, and the Department of Public Health urge parents to get certain vaccines for their children is because they want to prevent large-spread epidemics of what used to be common childhood illnesses.

The truth is, so many advances have come from studying viruses and common infections that scientists and doctors have a much clearer picture of where these diseases come from. And they can see the effects of these diseases on our bodies and our immune systems. Everyday citizens can access these findings—which can have both good and bad outcomes. But the important thing is that people are paying attention; people are wanting to know how these diseases spread and how they can prevent them.

Overly-Sanitized

Still, there is something to be said for overusing antiseptic and antibacterial sanitizers.

Bottles of hand sanitizer are everywhere and because we are always “on the go,” they have become our go-to solution when our hands are dirty (or when we perceive them to be dirty).

“A great use of hand sanitizer stations would be at a place like a petting zoo,” Smith explained. “It’s a location where soap and water is not readily available. That’s the purpose of hand sanitizer—to kill germs on your hands when a washroom is not accessible. But hand sanitizers should not be relied on instead of soap.”

The reason? If you use it too much, hand sanitizer stops working the way it was intended to—the way you want it to.

The active ingredient in hand sanitizer is alcohol—either isopropanol, ethanol, or some other form. That alcohol is what kills the bad germs. However, it also kills the good germs we have on our hands at all times.

It seems contradictory that using hand sanitizer all the time will potentially lead to you coming down with an infection, but think about this: our bodies, especially our hands, are covered with bacteria and germs that are there to protect us. Our bodies rely on these ever-present germs to fight off other bacteria. Should another virus or bacteria come in contact with our hands, after they’ve been doused with hand sanitizer, there will be no natural defenses.

“That’s not to say that hand sanitizer shouldn’t be used during flu seasons,” Smith warned. “It is still a good idea for children to use hand sanitizer at school or on field trips, but only after coming in contact with something that could pass on germs.”

A Happy Medium

Researchers have discovered that no matter how much we play around outside, no matter how long we play around with sickly kids, our immune system will not be “stronger” for it. We do need to develop antibodies (proteins in our immune system) to certain germs (like viruses and bacteria) so that our body can fight off future infections, but simply playing outside in the dirt won’t help us develop those, much to your grandfather’s chagrin. That type of immunity, the kind that John Travolta’s character in The Boy in the Plastic Bubble desired so badly, can only come from being exposed to the specific virus or disease—usually by way of inoculation. We know that now.

It’s important to talk to your family doctor and learn about what vaccines are necessary to keep you and your children healthy, especially because certain vaccines are not necessary for everyone. And some vaccines have ingredients that can cause allergic reactions in small numbers of patients. Of course, just because you get a vaccine for diphtheria doesn’t mean you’re free to play in a swamp or swim in a ditch.

“I give people the same advice moms have been giving for decades,” Constantine quipped. “Wash your hands.”

Article appeared in our 28-2 Issue - June 2011