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.
Being a mom to Molly and Frankie is, without a doubt, the most rewarding role I’ve ever had. As we prepared to welcome another baby into our home this fall, I was reminded of just how fragile and precious a newborn can be.
In recent interviews with Fox News and CNN, I shared my concerns over the growing number of unvaccinated children in the area where we live. It frightens me to think that my baby may possibly be exposed to a dangerous and life-threatening disease before he is old enough to be vaccinated himself. It seems unfair that while I do everything in my power to protect this delicate new life, others are making a choice that puts my child at serious risk.
I have real reason to worry. When my second daughter Molly was just 10 months old she contracted whooping cough (also known as pertussis). As any parent can relate, it’s scary when your child gets sick, but it’s especially upsetting when you realize that your child is part of the largest outbreak of whooping cough in over fifty years. As an advocate for Every Child By Two’s Vaccinate Your Baby initiative, I was all too aware of the fact that whooping cough can be deadly for infants, and yet here we were facing that terrible diagnosis. We were incredibly fortunate that Molly fully recovered, but I’ll admit that I was completely rattled by the experience.
Fortunately, since that time, scientists have been closely examining the possible causes for the large number of whooping cough cases over the past few years and have made recommendations aimed at curbing the outbreaks. Part of the problem is that the immunity against the disease is wearing off so that people throughout the U.S. are less immune to whooping cough. Therefore, it’s more important than ever for infants to receive all five recommended doses of the DTaP (diphtheria, tetanus and pertussis) vaccine, followed by the booster shot of the adult version of the pertussis vaccine (Tdap) at 11 or 12 years old. It’s staggering to note that 83% of infants who are diagnosed with whooping cough got it from a family member, most often their own parents. Therefore, adults need to make sure they get a Tdap booster before a new baby arrives to protect themselves and to stop the spread of the disease to infants, who are most likely to become seriously ill from the disease.
Most important for newborns, the CDC’s Advisory Committee on Immunization Practices took a good hard look at the pertussis research and concluded that we can best protect newborns by ensuring that pregnant women receive an adult Tdap booster in their last trimester of each pregnancy. By getting vaccinated during pregnancy, not only was I protected, but antibodies were transferred to my baby through the placenta, providing my baby with protection against pertussis before he could start getting DTaP vaccine at two months of age. So I followed my doctor’s advice and not only received the Tdap vaccine during my last trimester, but I also got a flu shot.
Just as I have the ability to protect my newborn from pertussis, I also have the ability to protect him and other members of my family from influenza. I’ve learned that due to changes in a pregnant woman’s immune system, heart and lungs, I was more prone to serious complications from the flu such as pre-term labor and delivery, hospitalization and even death. And, since children can’t be vaccinated against the flu before six months of age, everyone in our family must do all we can to protect our baby boy. With my child being born in the midst of flu season, I wanted to do everything I could to protect him from a disease that causes more than 20,000 children under the age of five to be hospitalized each year. I find it upsetting to learn that with all the medical resources available to us here in the U.S., last year’s flu season claimed the lives of 109 precious children.
I’ll admit that as a parent I’m concerned about the threat of vaccine-preventable diseases, especially as a result of people choosing not to vaccinate. But I refuse to stand by and watch as others put my children’s health at risk. By getting the flu and pertussis vaccines during my pregnancy, I felt empowered that I could do something positive to protect my child. And you can too.
Talk to your doctor if you have questions about vaccines. In addition, encourage your friends and family to utilize the resources provided by reputable organizations, such as Every Child By Two and the American College of Obstetricians and Gynecologists. And be sure to immunize yourself and your entire family.
By Joe Lastinger, Board Member, Families Fighting Flu
My daughter, Emily, should have started high school this year full of excitement and potential. Her teachers would ask her, “Are you Chris’s little sister?” or “Are you Andrew’s little sister?” In my head I imagine her earning high marks in advanced classes, joining student council, playing volleyball and basketball and having a great group of close friends. Now I realize that it might not have turned out that way. It’s quite possible that Emily would have entered high school at the peak of her teenage rebellion and might not even be on speaking terms with her mom and me. We will never know, because she died suddenly and tragically from influenza when she was only 3½-years-old.
Emily died from influenza in 2004. She died in our bed, in her pajamas, watching cartoons – just hours before we were scheduled to take her back to her pediatrician to have her looked at again. Doctors have terms to describe how children like Emily can be so sick and not necessarily appear so…it’s called “compensation”. Children, we learned, can sometimes compensate for illness…until they can’t anymore.
If I had to describe how my wife and I thought about influenza – “the flu” – before Emily died from it, I would compare it to lice. I know that seems like a silly comparison, but chances are most parents at one time or another have had the unpleasant experience of dealing with lice. It’s a nuisance, cleaning hair, searching for nits, laundering, etc. You hope that the rest of the family doesn’t get it. You are kind of mad that it happened at all. It messes up your family’s busy schedule. You worry that other parents aren’t being diligent and will end up re-infecting your kids (well, at least we did). Maybe you wonder who started this whole mess to begin with.
But, we couldn’t have been more wrong. Influenza kills tens of thousands of people in the U.S. every year. You don’t have to be old, sick or immune compromised. Influenza kills healthy adults and children (like Emily) every year. We’ve spent the last decade working to reduce the number of kids that die every year from the flu. Much of this work has been through Families Fighting Flu, a non-profit advocacy organization we played a small role in getting started, and some of it has been on our own through state and regional efforts in Texas.
The year 2015 will mark a decade that my wife and I have been working to reduce (eliminate, really) the number of childhood deaths attributed to influenza. Ten years without Emily in our lives. Ten years working to make sure that what happened to us doesn’t happen to other parents. There have been successes (universal vaccine recommendations) and failures along the way (people still aren’t taking advantage of vaccinations that are widely available). Recently, I’ve been reflecting on what I have learned over that time and thought I would share a few insights. Read more…