Health: 'Vintage' Bugs Return Mumps? Whooping cough? Rickets? What year is it?
Courtesy of A. Harrison and F.A. Murphy / Reuters A Look Inside: A transmission electron micrograph of the mumps virus
By By Mary Carmichael
Newsweek
May 1, 2006 issue - Growing up in Peoria, Ill., in the 1950s, Lance Rodewald caught "measles and mumps and probably German measles," and though he doesn't remember suffering through any of them, his wife, Patricia, assures him they were all "absolutely miserable" experiences. She knows because she had them, too. Infectious diseases were a midcentury rite of passage. But as Rodewald grew up, he watched those childhood terrors retreat. Doctors started vaccinating widely in the '60s and '70s, and by the time he was old enough to have kids of his own, it seemed the only common illness left for American parents to worry about was chickenpox.
Scientists developed a vaccine for that as well. But even after his kids made it safely to adolescence, Rodewald, 52, didn't assume that the era of infectious disease in kids in the United States was over. As a pediatrician and director of the Centers for Disease Control's National Immunization Program, he had looked at the data-and seen that "all these diseases are just a plane ride away."
Or, in the case of the mumps, which is now tearing through the heartland for the first time in decades, nine plane rides away. That's how many connecting flights it took for just two infected airline passengers, one flying out of Arizona, the other from Iowa, to apparently kick-start a new eight-state epidemic that has so far sickened 1,165 people. The outbreak serves as a grim reminder that vaccines aren't perfect and that despite modern medicine's advances, germs commonly associated with the early 20th century are still very much in the world. Right now several of the mustiest-sounding diseases-whooping cough, anyone?-are spiking again. "When fewer people start getting diagnosed, there's a premature declaration of victory," says Kenneth Castro, of the CDC. "Then we let our guard down, and the diseases come back and bite us."
Public-health officials certainly weren't expecting to get "bitten" by mumps this year. Although the virus has been circulating in British kids since 2000, it hadn't caused much trouble in the United States since an outbreak in Kansas 18 years ago. The Midwest is the epicenter again, but the victims are primarily college students, not children. Once a childhood disease, the virus has now taken hold in university towns. That's partly because crowded dorms and cafeterias are breeding grounds for germs that are spread by sneezing and coughing. But there's also a factor unique to this generation of college students. In the late '80s, the measles/mumps/rubella vaccine was upgraded from one dose to two, and some of the last kids to get the less effective single-dose vaccine are in college now. Others haven't had any doses at all because some parents, fearing a purported link to autism, did not have their kids vaccinated. And even those who've had both doses aren't fully protected: the vaccine is 90, not 100, percent effective.
"Vaccine fatigue," as clinicians call it, may also explain the recent resurgence of another rare disease, whooping cough, or pertussis. Docs introduced a vaccine in the '40s, and by the '70s the disease was practically eradicated, with only a thousand or so cases per year. But as the disease's profile dwindled, parents were less careful about getting their kids the four to five necessary booster shots. Numbers started rising again in the '80s and '90s. In 2004, the most recent year for which there is full data, there were 25,800 cases. Rodewald hopes that a new adolescent booster vaccine introduced in October will put those numbers back on a downward trend.
As if they didn't have their hands full with mumps and whooping cough, doctors are also starting to worry about other blasts from the past. National statistics haven't been collected, but many papers in the medical literature argue that rickets-a vitamin deficiency long thought to be a relic of the 19th century-is increasing among African-American and Hispanic kids, particularly in the North. Doctors blame it on everything from an increase in breast-feeding (breast milk doesn't contain much vitamin D) to the overuse of sunscreen (the body needs ultraviolet light to produce the vitamin). Another vintage ailment, scarlet fever, the scourge of "Little Women" and "The Velveteen Rabbit," though easily treatable with antibiotics now, also endures. It infects hundreds of kids each year, but pediatricians will usually say those kids have "a symptom of strep throat," not scarlet fever, if only so as not to scare the parents. Finally, though tuberculosis is at a record low, a nasty drug-resistant strain has emerged. Seems like old times.
