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Pediatrician Remembers a Measles Outbreak Among the Amish

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By: Kathleen Braico, MD, FAAP

Starting our pediatric practice in the 1978, my husband and I joked we ran an infectious disease practice. Our days and nights seemed filled with patients with very serious conditions, including epiglottitis, meningitis, and chickenpox among others—which have now largely disappeared from pediatric practices due to the success of immunizations.

Some of our most difficult patients were those infected with a bacterium commonly known as Hib (short for Haemophilus influenzae type B). When we saw a child infected with Haemophilus influenzae, it was always an emergency. The child could experience a number of conditions and all of them could be lethal. All these children were hospitalized, and in the case of epiglottitis, which is a common complication of Hib, they went directly to the operating room.

Epiglottitis is the swelling of the epiglottis, which can close the airway and, of course, kill a child quickly. Antibiotics to treat the infection don't work fast enough, so treatment moves quickly toward tracheostomy or intubation, which were hard to do on such small patients with severe swelling of the airway and traumatic for the child.

These cases were very scary; they literally kept me up at night. I feared the late-night calls from parents who told me their children were suffering with croup, because it might really be epiglottitis. More than once, I escorted a parent and toddler from my waiting room to my car to personally drive them to the ER to perform the spinal tap for meningitis.

I saw kids die of measles encephalitis and pneumonia from a local Amish community. It was one of the hardest nights I had as a pediatrician, sitting next to a bed of a 1-year-old Amish child. I worked for hours administering a medication to reduce swelling of the brain, but after a while, the child stopped responding to the treatments and passed away. At the time there was a large measles outbreak in the Amish community, because there were a great number of unimmunized people living in close proximity there. It was sad, because it didn't have to happen!

When I was a kid, my mother ran to get us the polio vaccine. My mother had seen polio as a young woman. In fact, my mother-in-law had polio when my husband was a small child. When new vaccines became available when I was a parent, my kids were the first to get vaccinated! My husband and I saw first-hand how deadly these diseases could be; we saw children literally go from healthy to dead in hours.

Vaccines really transformed the practice that my husband and I had together, and they continue to really impress me. The concept of being able to prevent cancer with a vaccine against viral causes of cancer—hepatitis B and HPV vaccines—just blows my mind.

About Dr. Braico:

Kathleen Braico, MD, FAAP is a retired general pediatrician from upstate New York and the medical director of Double H Ranch, a Serious Fun Children's Network camp for children with serious illnesses in Lake Luzerne N.Y. She has been active in international child health since 1998, with a special interest in malnutrition and stunting. She also teaches medical students in a variety of primary care settings.


Medicine Before Vaccines

This article is part of a series of first-person accounts from senior pediatricians about what it was like to practice pediatric medicine before vaccines for diseases like meningitis, measles, and the flu were available. These articles are being published in recognition of National Immunization Awareness Month, which is held in August every year.

Author
Kathleen Braico, MD, FAAP
Last Updated
11/21/2015
Source
American Academy of Pediatrics (Copyright © 2015)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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