This headline to a book review in yesterday's NYT made me think of a sideline conversation I had with Robert Lee Hotz last week. It was after the Amy Wallace talk at NYU, which Hotz, a science columnist for the WSJ, moderated. We were chatting about the rise of the anti-vaccine movement. Hotz speculated that the phenomena may owe, in part, to people not remembering (or being cognizant of) the everyday fears and tragedies once commonly associated with childhood infectious diseases fifty years ago--which modern medicine has since largely eradicated. I think he's on to something, so I figured I'd take a stroll down memory lane with this doctor who was on the infectious disease frontlines in New York City, circa 1948:
Most of the patients treated were quite ill and required around-the-clock care. Children with laryngeal diphtheria needed to have membranes removed from their vocal cords by laryngoscopy two or three times a day. A half teaspoon of good whiskey on a lump of sugar in a tablespoon of warm water served as an excellent sedative for these patients and seemed to relax their respiratory distress. Some of the patients with pharyngeal diphtheria progressed to diphtheritic paralysis or myocarditis, and required special care. We treated all types of polio cases (ie, nonparalytic, paralytic, bulbar and encephalitis) using modern respirators for individuals with intercostal weakness and breathing difficulties.
Despite the anti-vaccine movement's staying power, childhood immunization rates are currently over 90 percent in the U.S., so I don't think we'll be returning to those days. Still there are legitimate concerns of outbreaks, which perhaps may shake some sense into parents who buy into the anti-vaccine claptrap that emanates from people who you think would know better. What will it take for reason to win over irrational fear? Unfortunately, I think this haunting quote from pediatrician and vaccine advocate Paul Offit (via Wallace's terrific Wired piece) will prove prescient:
"I used to say that the tide would turn when children started to die. Well, children have started to die," Offit says, frowning as he ticks off recent fatal cases of meningitis in unvaccinated children in Pennsylvania and Minnesota. "So now I've changed it to "˜when enough children start to die.' Because obviously, we're not there yet."
