Saturday, February 28, 2015

Childhood Illnesses, a memoir

One of my oldest memories is the Christmas of 1959.

Christmas, 1959, was the Christmas I had measles.  I still remember seeing pictures of me at Christmas in my pyjamas with a blanket wrapped around me which was, then and now, all you could really do for measles.  I didn't suffer any ill effects and it wasn't until 20 years later in Medical School that I learned about all the bad things that could have happened to me.

As an aside, I have actually seen cases of measles in Canada.  One year, an entire cohort of children got vaccinated with a bum batch of vaccine which meant about 5 years later we had teenagers all the same age presenting with fevers and rashes and I finally got to see Koplik's spots.  All of the cases I saw were mild suggesting there was partial immunity.

By that time vaccination existed for polio, diphtheria and tetanus all very nasty diseases.  We were not that far removed from the polio epidemics of the early and mid 1950s.  We were constantly reminded of it by the kids in wheelchairs and the kids with leg braces some of whom attended school with us.  

Diphtheria is of course a really nasty disease, thankfully as a physician primarily working in the developed world, I have never seen a case.  I do remember reading in Kipling's autobiographical
"Stalky and Co." how the headmaster saved a child with diphtheria's life by doing some sort of 19th century intubation or tracheostomy.  Not sure whether this was based on a real incident or just something Kipling thought up.  Tetanus I have seen, usually in older adults some ending up on ventillators some not, at least one dying from it.

I remember going for my vaccinations as a toddler.  My mother would take me to the public health unit where a nurse would paint a rabbit on my arm with mercurochrome and stab the rabbit with a needle.  It still hurt although the ice cream cone afterwards almost made  it worthwhile.  Later, I get the Sabin vaccine which came on a sugar cube.

Vaccinations took place in the schools in Grades 5 and 10.  I believe it was possible to get a note from your parents exempting you but I don't think anybody did.  Why would they?  As I mentioned, we still had reminders of the polio epidemics all around us plus a lot of our parents had had a sibling, friend or classmate die of an infectious disease.

Along with vaccinations for diphtheria tetanus and polio, we were vaccinated for smallpox.  I was re-vaccinated for smallpox just before medical school in 1978, making me one of the last people vaccinated for it.

Vaccines for measles, mumps, rubella didn't exist when I was a child so I got to have them all along with chickenpox.

I got mumps at 3 or 4 which I remember as not all that bad, again treated by wearing pyjamas during the day.  I do remember my older brothers who got it the same time as I did were a little sicker.  Mumps has a lot of adverse consequences although more in adults.

Pertussis or whooping cough I got at age 6.  I don't know if I even missed school.  I did have to miss the swimming pool part of a friend's birthday party but not the dinner and ice cream after.

Chickenpox came at age 7, keeping my out of school for a few days (although this time I didn't have to wear pyjamas) and postponing my father's home made haircuts which I hated.  Chickenpox as I found it in medical school is highly contagious, one of my classmates who had never had it spent less than a minute in the door of the room of a child with chickenpox contracted it which means he wasn't allowed on the wards until the infectious disease department deemed him fit to do so.

Rubella I didn't get until age 17.  It was again a mild disease, fever and myalgias and I stayed away from school for a week or so.  Rubella of course can cause congenital malformations and I could potentially have infected somebody something I still wonder about.  Rubella was still fairly common when I was in medical school.

While living in university residence in 1976, I came down with a very severe flu, which years later I figure was probably the H1N1 strain, then called swine flu.  I missed a couple of days of classes and basically crawled to classes for another few days.  I have not ever been so sick.  I never sought medical attention, some people with the same thing who did, were promptly hospitalized.  

If it appears I am making light of all the vaccine-preventable diseases I had as a child, I am not.  I was shocked when in medical school I learned what could have happened to me as a child.  I often wonder how my mother who had been a nurse and who knew of the awful consequences of these diseases kept calm with sometimes 3 children sick with something.  As I have pointed out, this was still in the early antibiotic and vaccine era and many adults then had had somebody close to them die from an infectious disease so there may have been a fatalism that helped them get through. That same experience of premature death was why the parents of my generation embraced vaccines so enthusiastically.

We of course did a lot of things in the 1960s which we would never do now, like not wearing seatbelts and I like to think that as a society we have evolved. I continue to be disappointed.

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