In December, 2009 my sister Liza died of influenza.
She was previously healthy and only 49 years old. She sought medical care early. She was cared for at a good hospital in a major city. She had no other infections. And she was unvaccinated.
To say I was surprised is an understatement. And yet, I’m a pediatric intensive care physician.
As a clinician, it’s easy for me to trace out the clinical course of Liza’s illness. The physiology of organ failure, mechanical ventilation and critical illness are familiar to me in the same way that your daily work is to you. It’s the human side that I still haven’t come to terms with. The part where you watch your sister die over the course of three long weeks while you stand helpless. The part where you listen to a physician tell your family that they are out of options. The part where you know that they are right and you realize that influenza is sometimes too much to handle, even with all our modern medicine.
That part is much harder to process.
Her symptoms started with fever, but progressed to vomiting after a few days. She went to the urgent care clinic twice over the course of a few days before ending up in the emergency department of the local hospital. She had begun to experience difficulty breathing, and the emergency physician noted that the oxygen saturation in her blood was very low. They put her on oxygen, and an x-ray revealed that both her lungs were filled with fluid. A condition that led to her being diagnosed with pneumonia.
You see, your lungs are supposed to have air in them. They should look like sponges. Pneumonia is just the term we physicians use to describe the situation when fluid, infection, and inflammation fill those little air spaces in the sponge.
Pneumonia can come from viruses or bacteria. If your pneumonia is caused by a bacteria, you can get antibiotics to kill the bacteria. However, if your pneumonia is caused by a virus, like influenza, there is not much we can do but ride it out and wait for your own immune system to clear it. The simple fact is that we just don’t have very good medications for viruses. Tamiflu can be prescribed and it might slow down the virus, but it doesn’t kill it or stop it.
So, they did the only thing they really could do, and started her on IV Tamiflu. She was moved to the intensive care unit downtown, and within the next few hours she struggled to breathe and her oxygen saturations continued to fall. She had to be placed on a ventilator, and the hope was that her lungs would recover after a few days. After all, it was ‘just the flu’.
We never did get to speak with her again.
Every Child By Two’s online platforms have reached over 11 million people with evidence based vaccine messaging in 2016. As we look back at the record number of views and shares there have been on Shot of Prevention blog posts this past year, we’re especially grateful to our blog readers, contributors and subscribers.
Whether you have shared a post, shared your story, or shared your expertise, know that our growth and success would not have been possible without your support. Thanks to you, people are referencing our content before making important immunization decisions for themselves and their families. In these final days of 2016, we hope that you will revisit these top five posts from the past year and share them with others in your social networks. Together, we can continue to engage more people in these important immunization discussions.
In 1949, Judith contracted polio along with 42,000 other people in the U.S. Judith survived five months in the hospital and multiple surgeries, but sadly 2,720 people died from polio that year. As Judith bravely shares her story, she explains that it represents an inconvenient truth to people who are in denial about the risks of polio. She is continually shocked by people who refuse vaccines, who refuse to believe she ever suffered with polio, or who actually believe the polio vaccine is part of a government or “big pharma” conspiracy. By sharing Judith’s story we hope to encourage continued polio vaccination and support of polio eradication worldwide and applaud people like Judith who are courageous enough to speak out in support of vaccines. To read Judith’s story, click here.
Emily Stillman was pronounced brain-dead just 30 hours from the onset of a severe headache. What they though was a migraine turned out to be meningococcal disease. In this post Emily’s mother Alicia explains that although Emily received a meningococcal vaccine, the MCV4 vaccine she received only protected her against meningococcal serogroups A, C, W and Y. It did not protect her against serogroup B, which is what caused Emily’s death. Since Emily’s death, a MenB vaccine has been approved for use. However, most parents still don’t know it exists and therefore, most students are still not protected.
As the Director of The Emily Stillman Foundation, Alicia Stillman helps educate people about the importance of “complete and total” protection against all serogroups of meningococcal disease. This means ensuring that teens and young adults receive both meningococcal vaccines; the MCV4 vaccine that protects against serogroups A,C, W and Y, as well as a MenB vaccine series. To learn more about fully protecting our youth against meningococcal disease, read Alicia’s guest blog here.
Although the HPV vaccine is one of the most effective ways we have to prevent numerous types of cancer, it is still being grossly underutilized. As a result of persistent but inaccurate myths circulating on the internet, some parents are more fearful of the HPV vaccine than the human papillomavirus itself. This is causing them to refuse or delay HPV vaccination for their children.
In this popular blog post, we highlight ten critical facts that address the most common misconceptions about HPV infection and the vaccine that can help prevent this very common infection. To learn more, be sure to read the post here.
There are many misconceptions about hepatitis B and how the infection is transmitted. Because of this, many parents don’t consider their children to be at risk of infection and so they question the need for a hepatitis B vaccine at birth. In this post, the Prevent Cancer Foundation explains the connection between hepatitis B and liver cancer and discusses ways in which infants and children can unknowingly contract hepatitis B. Their Think About the Link™ education campaign suggests that vaccinating infants before they leave the hospital is a critical first step in protecting your newborn from a virus that can lead to cancer later in life. To learn more about Hepatitis B and the vaccine to prevent it, click here.
Back in the 1980’s, Barbara Loe Fisher claimed that the whole cell pertussis vaccine (DTP) was dangerous and causing too many adverse events. Her complaints prompted the development of the more purified (acellular) pertussis vaccines that we use today; DTaP for infants, and Tdap for adolescents and adults. While studies have shown that these newer vaccines are not as effective as the old whole cell pertussis vaccine, they are the best protections we have against the dangers of pertussis.
Unfortunately, those who need protection the most are those who are too young to be vaccinated. Infants are at high risk of severe complications from pertussis, to include hospitalization and death, but babies don’t begin receiving pertussis vaccine until two months of age. After newborn Calle Van Tornhout contracted pertussis from a hospital nurse at birth, she died at just 37 days of age. Callie’s death has had her home state of Indiana considering a bill that would mandate pertussis vaccination among health care workers. But Barbara Loe Fisher is opposed to that as well. To read more about the history of pertussis vaccines, click here.
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Parents often go to great lengths to help their children succeed in college. What they may not realize is that their children often arrive on campus unprotected from a life threatening, yet preventable disease known as meningococcal serogroup B.
Four women, known as the ‘MenB Strong Moms’, became united on a mission to save others after their teen children died from meningococcal serogroup B before a vaccine was available to prevent the disease. Through a special partnership between The Kimberly Coffey Foundation and The Emily Stillman Foundation, they produced the following Meningitis B Shatters Dreams PSA to educate young adults and their parents about the availability of the MenB vaccine and to encourage college kids to get vaccinated while home for winter break.
“Our kids have brought us together and their message is loud and clear in this PSA.” says Alicia Stillman, Director of The Emily Stillman Foundation. “We don’t want parents to have to bury their children like we have, and we want kids to take it upon themselves to get protected and ask for the MenB vaccine.”
In the past few years, there have been outbreaks of meningococcal serogroup B on several U.S. college campuses. This isn’t surprising considering that one out of ten people have the bacterium that causes meningococcal disease in the back of their nose and throat with no signs or symptoms of disease. Additionally, typical teen behaviors, such as living in close quarters, hanging out in large groups, sharing drinks or utensils, and kissing, all increase the risk of meningococcal disease.
And when meningococcal disease strikes, it strikes quickly. In fact, one in ten teens and young adults who develop meningococcal disease will die from it, sometimes within 24 hours. Those lucky enough to survive will often suffer significant physical and mental disabilities, ranging from deafness, nervous system problems, brain damage, or loss of limbs.
While most teens receive the recommended meningococcal vaccine known as MenACWY at age 16, or prior to attending college, the MenACWY vaccine does not prevent the serogroup B strain. Since this B strain accounts for approximately half of all meningococcal cases in the U.S. among those age 17-22, the MenB Strong Moms believe it is imperative that young adults and their parents understand the options for prevention. Unfortunately, although the MenB vaccine has been licensed for over a year, many doctors are still not mentioning it to their patients and therefore, most parents and young adults don’t realize the vaccine exists. Read more…
This guest post by Serese Marotta, Chief Operating Officer of Families Fighting Flu, is part of the CDC Flu Blog-A-Thon held in honor of National Influenza Vaccination Week.
As parents, we do everything we can to protect our children. We buckle them into their car seats, make them wear their bike helmets, hold their hand while crossing the street, and even get them their recommended childhood vaccinations. But what about getting our kids the flu vaccine?
Sadly, only about 42% of adults and 60% of children received their annual flu vaccine last season.
These statistics may not mean much to you, unless you or a loved one have had a personal experience with the flu. But they haunt me every day. As a mother who lost her healthy, five-year-old son, Joseph, during the H1N1 flu pandemic in 2009, I want to do everything I can to ensure no other child dies from flu.
Despite what many people may believe, influenza is not like the common cold. Influenza is a very serious and highly contagious disease that tends to develop quickly, especially in children. Influenza can also lead to hospitalization or death, even in otherwise healthy individuals. Every year in the U.S., approximately 20,000 children under the age of five are hospitalized, and on average, 100 children die each year from flu infection and its complications. According to the CDC, 80 to 90 percent of pediatric flu deaths over the past few years have been in unvaccinated children, many of whom were otherwise healthy.
This is why I am writing this article and telling Joseph’s story again, in hopes that it will save someone else from losing a loved one to flu.
As a mother, I have always tried my best to protect my kids, including getting them vaccinated against the flu every year. When my son Joseph was in kindergarten, he received his annual flu vaccine on September 26, 2009. Unfortunately, the H1N1 flu strain was just developing, and it was not included in the seasonal vaccine that year. On October 9th he threw up a few times and became increasingly lethargic. Our pediatrician suggested we take him to the local urgent care and upon arrival, they found his blood oxygen level to be very low. They immediately transported him to the local children’s hospital where a rapid flu test came back negative and he was eventually diagnosed with pneumonia.
Several days into his hospital stay, the doctors informed us that Joseph’s culture was growing influenza, which was likely H1N1, but not to worry—it was “just the flu”.
Losing your 20 year old healthy child to flu is something no parent ever expects to happen.
by Franki Andersen
Seven months ago, I lost my beautiful daughter, Brittany Danielle Andersen, at the age of 20. I’m sharing her story so that parents and young adults will know that the flu doesn’t just take young kids and old people. It takes whomever it wants at any age.
As a mother, there is nothing worse than seeing your child sick and hospitalized. When Britt was young she loved to sing, dance, play on her swing set and dress up. But we had a few medical scares in those early years. In fact, she was on life support four times between the ages of 18 months and 6 years due to repeated bouts of strep throat that would effect her lungs. But then, after a surgery to remove her tonsils and adnoids, she never got sick again, and I was grateful that those hospital days were behind us.
That was, until she fell ill with influenza A earlier this year.
It was a Thursday, March 24th and she said her throat was itchy so she picked up some TheraFlu before I dropped her at her dads’ house. I talked to her later that evening to see how she was feeling, and I could hear how the sore throat had altered her voice. But she said that she was fine.
The next day, her father dropped her off before work. She stood in the doorway for a minute and when I asked her if she was coming in, her reply was “I don’t quite feel like myself”.
I asked her if she had breakfast and she said no, so she had some toast and juice before going to lie down. I propped her up with some pillows so she was sitting upright on her bed and about fifteen minutes later I checked in on her and asked how she was. Her reply was simply “Ok” but that obviously wasn’t true because those were the last words she ever said to me.
Around 11:45, I heard a weird rattle coming from her room. I went in and found her lying on her back. When I tried to wake her, I noticed white saliva coming out of her mouth. I called 911, and when they got there, they could not get a pulse. They worked on her for what seemed like eternity and then put her in the ambulance. I followed the ambulance to the hospital and at 2pm they told us they got a pulse back.
What a relief, I thought and collapsed into a chair.
They then life-flighted her to Sioux Falls, SD. When I arrived there the head nurse and lung doctor told me that she was not stabilizing. They had maxed out all the blood pressure meds they could give, and nothing was working. They said the word septis, which I was unfamiliar with at the time, and they told me I would need to “make a decision”.
At 6:30 am on Saturday, March 26th, 2016 I made that decision and my daughter was taken off of life support.
This guest post was written by Carolyn who works as a Home Health Community Nurse and who originally shared her son’s story on the Nurses Who Vaccinate blog to help raise awareness of the symptoms and dangers of pertussis.
My son is a healthy 16-year-old, middle linebacker for his Varsity football team. He jet skis, is an avid boater, plays lacrosse, and enjoys working out, eating healthy and exercising. I never suspected he would suffer with a vaccine preventable disease.
His cough was mild at first. Not a nagging cough, not a wet cough, just a mild cough. I asked my son if he was feeling well and although he said he was fine, I gave him cough syrup and took his temperature. It was normal (hint #1) and we both went to sleep, although I did hear him cough occasionally through the night.
This marked the beginning of the longest 7 weeks of our lives.
The occasional cough continued for a week, but then I noticed it was worsening, and it was making him very short of breath. One day he called me from school and asked me to pick him up. I took him to urgent care, where they diagnosed him with bronchitis, gave him amoxicillin, put him on a five-day dose of prednisone and gave him an inhaler.
That night was the beginning of the nightmare. He coughed so violently that he became short of breath. He was gasping and choking and even began vomiting (hint #2). This continued through the next day and night. He was exhausted. I was exhausted. And even though I am a nurse, I felt helpless.
I took him to the local Emergency Department where the pediatric physician prescribed an albuterol nebulizer and a chest X-ray. The chest x-ray came back crystal clear (hint #3). When I questioned the doctor about the vomiting, they suspected it was due to a gag reflex, but they decided to give him saline for dehydration and take blood and urine samples.
All of his blood work came back fine except for his neutrophils and his monocytes which were only slightly elevated (hint #4). They treated him as a case of atypical pneumonia and put him on a five-day dose of Zithromax and advised us to continue the prednisone until finished.
During the next 10 days, as he completed the medications, my son continued to have these bouts of uncontrollable violent coughing, always resulting in vomiting, choking on phlegm and gasping. He was eating, but also losing weight, and he was in and out of school, often due to being up all night coughing.
One evening he vomited in the basin where I noticed black stringy flecks. I immediately thought it was blood, but he assured me it was something he had eaten. The next morning he vomited again, and this time it was phlegm with blackened red strings (hint #5). I put the vomit in a baggie, put him in the car and took him back to the emergency room.
His sample tested positive for blood and so they gave him several nebulizer treatments, upped his prednisone, repeated the chest x-ray (which again came back clear), prescribed the inhaler every four hours and released him. With the increased prednisone, the cough did slow down a bit, but he still was vomiting phlegm and gasping, so I made a follow-up appointment with his physician where they did a thorough exam and diagnosed him with pertussis.
Pertussis? Really? How did my healthy kid get whooping cough? I was diligent in getting him vaccinated. How did three different doctors miss this?
A flu vaccine is recommended for every one age 6 months and older because preventing the flu is better than suffering with it. The real danger of flu is not just in the fever, cough, congestion, extreme fatigue and muscle aches that can cause people to be ill for a week or more, it’s the fact that influenza causes thousands of hospitalizations and deaths each year.
Getting a flu shot not only helps to protect us from getting the flu ourselves, but it means we are less likely to spread the virus to those who are more vulnerable to complications from the flu. This includes young children, pregnant women, infants too young to be vaccinated, older individuals, and people with weakened immune systems. In fact, children account for about 20,000 hospitalizations and roughly 100 deaths from influenza each year.
Unfortunately, this year we are hearing that some parents are opting to skip the flu vaccine for their children simply because the nasal flu mist – also known as the live attenuated influenza vaccine (LAIV) – is no longer recommended or available this season.
As a mother, I know it can be difficult to deal with children who have anxiety over shots and needles, and no parent likes to see their children in pain. However, when parents skip shots for their children, they are more likely to have to watch their children suffer with the flu, which is much more dangerous than any short-lived anxiety over getting a needle in the arm. In some cases, the flu can be devastating and even fatal, especially for young children.
Consider Gianna’s story.
Her mother, father and brother were all vaccinated in 2015. But by January, they still hadn’t gotten around to getting two and a half-year old Gianna vaccinated. She fell sick on January 8th, and by January 10th she had died from influenza.
With Gianna, like we see with many children, everything happened so fast. She started feeling ill at daycare. The next morning her pediatrician confirmed that she had the H3N2 influenza virus and prescribed antivirals. But the infection spread quickly and the antivirals didn’t even have time to kick in.
Later that evening, Gianna called out to her mother as she lay beside her in bed. It would be the last time she would hear Gianna’ voice. Read more…