A Mother’s Legacy

25 06 2012

I would like to tell you about my mother and all mothers like her who suffered through the loss of a child from an infectious disease. Raising a family in the hills of Kentucky, where most people were too poor to pay for the little, if any, medical help available, my mother struggled to keep her family healthy.

When one of her babies became seriously ill, my mother and her parents did everything they could to try and help her. Despite their efforts, my mother watched her child, Patsy Lynn, die from whooping cough. While making arrangements for Patsy’s funeral my mother learned that another one of her children was gravely ill. Both children were buried on the same day, in the same casket, in the same grave next to my mother’s church.

After the death of two children, my family was able to relocate to the Cincinnati area where medical attention was more readily available. We all had our vaccines as my mother was determined not to lose another child to unseen viruses and she insisted on washing and boiling everything that we touched.

I lived through the effect the loss had upon my mother’s life. The fear of disease was so real then, but many of us today forget what it was like to live in a time when diseases like measles, polio and smallpox were so much more common and deadly.

I remember the time that I was not allowed to play with a friend because her mother had been sent to the “TB hospital” and I vividly remember the Sunday that we spent standing in the long lines to receive our sugar cubes laced with the polio vaccine.

During the early ’60s, I remember being put to bed in a dark room when it was thought I might have the measles. Most of all, I’ll never forget that several of my teachers wore braces because of the effects of polio.

My mother tried her best to prevent us from succumbing to any disease which may shorten our lives, so I’m thankful that when she died of cancer in 1982 she did not know that I had somehow contracted the hepatitis B virus.

In June 1995, I was diagnosed with hepatitis B about a week before my 25th wedding anniversary. A doctor told my husband that I had a sexually transmitted disease and that he should be tested and vaccinated. What the doctor failed to tell us at the time was that this hepatitis could be spread in many other ways. I had complete trust in my husband and, thank God he had faith and trust in me, so this suggestion of sexually promiscuity did not harm our marriage.

Within the week we were informed that my husband tested negative, as did my children, who have all been vaccinated.

I have tried for years to find out where I got the virus. Could it have been from my mother who died of liver cancer? Did I get it in grade school, or from dental work, surgeries? Did I get it in one of the hospitals or clinics where I have worked as an interpreter? Did I get it from a child who ran into me on the playground, or from the little girl who bit me while I was working in the Cincinnati Public Schools?

The only thing I can be sure of is that I did not get hepatitis B from sexual contact, drug use or tattoos. However, I have now arrived at a place of peace in my life by accepting the fact that I will never know the path of transmission—and I no longer search for that answer.

And this is my mother’s legacy to me: protect your children the best you can.

By Barbra Anne Malapelli Haun





Adults Young and Old Need Vaccines

21 05 2012

Adults know to wash hands and wear condoms to prevent infections. And we try to eat fruits and veggies to stay healthy. Some days, we even exercise.

One thing we don’t do enough of is get vaccinated.

Other than the flu vaccine in the autumn, I seldom think about vaccines for myself. I bet I’m not alone.

But, we should remember to vaccinate.

We make sure our kids wear seatbelts and helmets, cross the street at the light and keep a weather eye on the ocean for sneaker waves, and get all the vaccines they need.

For the most part, we follow the same safety rules, except for that one about vaccines.

I am determined to get myself fully vaccinated and to nag encourage friends to do the same. I don’t want to get sick and think “if only.”

If you’re like-minded, I’ve listed the diseases for which there are vaccines for adults 19 years of age and older. Not every adult will need every vaccine, so print out this post and take it to your provider, find out what vaccines you need, and realize that you may need more vaccines if you’re traveling outside the US:

  • Flu is a respiratory illness. It can cause fever, chills, sore throat, cough, muscle or body aches, headaches, tiredness, and a runny or stuffy nose. You get over it after several miserable days, unless you develop complications, some of which can be life-threatening.
  • Tetanus, diphtheria, and pertussis vaccines are combined for adults. Tetanus is caused by certain bacteria entering the body through a break in the skin. It’s the one that causes lockjaw, and can cause spasms and seizures. It has a surprisingly high death rate of 10 – 20% of cases. Diphtheria is caused by bacteria spread person-to-person and can damage the heart, kidneys and nerves. Pertussis, also called whooping cough, is a very contagious disease caused by bacteria. In some parts of the world, it’s called the 100-day cough. The “whoop” is most often heard from babies, for whom it can be a lethal infection.
  • Varicella, also called chickenpox, is a virus that spreads easily and causes a blistery rash, itching and fever. For some, it can cause severe complications including pneumonia or sepsis.
  • Human papillomavirus (HPV) is a sexually transmitted infection that is very common in the population. Most people get it and get over it, but some will develop genital warts or cervical or other types of cancers.
  • Zoster or shingles is caused by once having had chickenpox. The virus stays in the body after the chickenpox clears up and goes away, and years later can reactivate, causing pain and itching, followed by a rash.
  • Measles, mumps, rubella vaccines are also combined for adults. Measles is caused by a virus that makes you feel like you have a bad cold, along with a rash on the body and white spots in the mouth. It can develop into pneumonia or ear infections, sometimes requiring hospitalization. Rubella is also caused by a virus and brings with it a rash and fever. This infection can be devastating to the fetus if a woman is pregnant when infected. Mumps is caused by a virus with symptoms of fever, fatigue and muscle aches followed by the swelling of the salivary glands. Rarely it will cause fertility problems in men, meningitis or deafness.
  • Pneumococcal disease is caused by bacteria and can appear as pneumonia, meningitis, or a bloodstream infection, all of which can be dangerous.
  • Meningococcal disease is caused by various bacteria, and the available vaccines prevent many of these infections. The symptoms are varied and include nausea, vomiting, sensitivity to light and mental confusion. This disease can lead to brain damage, hearing loss, or learning disabilities.
  • Hepatitis A is caused by a virus. It’s generally a mild liver disease, but can rarely severely damage the liver.
  • Hepatitis B is also caused by a virus that damages the liver. Most adults are infected for a short time, but some become chronically infected. The infection can cause jaundice, cirrhosis or even liver cancer.

More information on these infections can be found on the CDC website.

Talk to your provider about these vaccines. Who can afford to get sick these days?

By Trish Parnell

Image courtesy of Lancaster Homes





Annie’s Dad

17 10 2011

(This testimony was given on behalf of PKIDs to a U.S. House of Representatives’ committee a few years ago. It is so compelling—and, unfortunately, still relevant—that we wanted to share it with you now.)

My name is Dr. Keith Van Zandt, and as a practicing family physician, I appreciate the opportunity to address this committee regarding hepatitis B vaccines. I have degrees from Princeton and Wake Forest Universities, and completed residency training in family medicine here in Washington at Andrews AFB.

Today, however, I am here as a dad. I have five children, two of whom my wife Dede and I adopted from Romania. Our youngest, Adrianna, was nearly four years old when we adopted her from the orphanage, and was found to have chronic active hepatitis B when we performed blood work prior to bringing her home.

She had contracted this from her mother, who died when Annie was nine months old, from the effects of her liver disease as well as tuberculosis. We have been very fortunate to have had some excellent medical care for Annie, but her first year with us was an endless procession of liver biopsies, blood draws and over 150 painful interferon injections I gave to my new daughter at home. Interferon is a form of chemotherapy for hepatitis B that has many side effects and only a 25 to 40% success rate.

We know first-hand the pain and family disruption this completely preventable disease can bring.

You have already heard testimony from some of the world’s leading experts on hepatitis B and its vaccine, and I can add little new information to that. As a family doctor, though, I see patients every day whose lives have been significantly improved by the immunizations we now have available. My forebears in family medicine struggled in the pre-vaccination era with the ravages of horrible diseases that are now of only historical interest.

Preventive immunizations have so changed our world that I am afraid that we no longer remember how horrible some of these diseases were. My family and I have made multiple trips to Romania to work in the orphanages, and unfortunately I have seen the effects of many of these diseases there.

I am certainly aware of the potential for adverse reactions to our current vaccines, but we must maintain the perspective that these reactions are extremely rare. My partners and I in Winston-Salem care for over 40,000 patients, and I can honestly say that in over 20 years of practice we have never seen a serious adverse reaction to any vaccine. I believe that the vast majority of family physicians around the country can say the same. Certainly, I do not wish to minimize the suffering and losses of families who have experienced these problems, but we must remember that immunizations remain the most powerful and cost-effective means of preventing disease in the modern era.

Personally, it still sickens me to know that the disease my daughter has was completely preventable if hepatitis B vaccines had been available to Annie and her mother.

Whereas 90% of adults who contract hepatitis B get better, 90% of children under the age of one go on to have chronic disease, and 15 to 20% of them die prematurely of cirrhosis or liver cancer.

I know first-hand the gut-wrenching feeling of being told your child has a chronic disease that could shorter their life. I know first-hand the worry parents feel when their hepatitis B child falls on the playground, and you don’t know if her bleeding knee or bloody nose will infect her playmates or teachers. I know first-hand the concern for my other children’s health, with a 1 in 20 chance of household spread of hepatitis, and the thankfulness I feel that they have had the availability of successful vaccines. I know first-hand the pain a parent feels for their child as they undergo painful shots and procedures for their chronic disease with no guarantee of cure.

I am not the world’s leading expert on hepatitis B or the hep B vaccine, but I am an expert on delivering the best medical care I can to my patients in Winston-Salem, NC. I am also not the world’s leading expert on parenting children with chronic diseases, but I am the world’s best expert on parenting my five children.

I know professionally that immunizations in general have hugely improved the lives of those patients who have entrusted their medical care to me. I know personally that had the hepatitis B vaccine been available to my daughter, her life and mine would have been drastically different. I am also thankful that my other children have been spared Annie’s suffering by being successfully vaccinated.

Anecdotes of vaccine reactions are very moving, but they are no substitute for good science. Please allow me to continue to provide the best medical care I can with the best system of vaccinations in the world, and allow me to keep my own family safe.

Thank you very much for your time.

Keith Van Zandt, M.D.





Does Vaccination Prevent Cancer?

7 03 2011

The history of anxiety about possible negative effects of vaccines is long, tracing back at least as far as Benjamin Franklin. Countering these worries is the fact that vaccines are one of the greatest public health successes of our time, saving millions of lives worldwide.

Now we know that vaccine benefits may extend beyond prevention of the target childhood disease.

An already recognized extra benefit comes with the vaccines for varicella. A varicella vaccine not only can prevent chickenpox in young people, but may also stop the occurrence of shingles in older folks.

Shingles, a neurological attack by the chickenpox virus decades after an infection, can cause a rash that leaves behind chronic, unbearable pain. Vaccination in childhood may protect against shingles, and according to a new study from a Texas group, published in The Journal of Pediatrics, childhood vaccines may offer reduced odds of childhood cancer.

The researchers, going on hints from earlier studies, looked at vaccine rates in specific areas and compared those numbers to childhood cancer rates in the same region. While childhood cancers are rare, they are, of course, devastating. The most common cancers in children are leukemia and brain and spinal cord cancers. According to previous studies, some common childhood infections might increase a child’s risk of leukemia, while vaccinations might reduce that risk. It’s not a nutty idea that some infections—especially viral infections—might be associated with cancer. Indeed, a few viral infections have an established association, including human papillomavirus (HPV, associated with cervical and anal cancers), hepatitis B (associated with liver cancer), and Epstein-Barr (the “mono” virus, linked to a type of lymphoma).

The researchers looked at the 2800 cases of childhood cancer diagnosed in Texas from 1995 to 2006, focusing only on cases diagnosed in children two years or older. For every child diagnosed with cancer, the team identified four more children who had not had cancer, matched for age and sex. As a final step, they then mapped how many children from each group had been born in Texas counties with high vaccination rates.

Their results showed that where hepatitis B vaccination rates were high, odds of all childhood cancers fell by almost 20%. Where rates of inactivated polio virus, hepatitis B, or a specific mix of childhood vaccinations were high, odds of finding cases of a common childhood leukemia, acute lymphoblastic leukemia (ALL), dropped by as much as 38%. The biggest dip in odds came with higher rates of Hib (Haemophilus influenzae type b) vaccine and ALL, with a 42% decrease in ALL odds where Hib vaccination rates were high.

It’s important to remember that the authors didn’t establish a cause–effect link here. This study is based on the numbers, and the take-home message here is a simple one. The authors put it best in their abstract: “Some common childhood vaccines appear to be protective against ALL at the population level.”





HB FOUNDATION!

25 10 2010

We love the Hepatitis B Foundation and all the folks connected to the organization.  Here’s why: The Hepatitis B Foundation (HBF) has been working for years to find a cure for those infected with HBV and to improve their quality of life. 

To help reach their goals, Joan and Tim Block and their partners at HBF established the Institute for Hepatitis and Virus Research a few years ago. It’s a stunning achievement that continues to give hope to all families affected by HBV. 

The website provides many resources, such as an up-to-date listing of hepatitis B drugs, making it easy for parents and professionals to see what’s been approved by the FDA and what’s happening in clinical trials.

And, a few years ago, HBF received funding from the National Library of Medicine to provide a tutorial on searching for information on the Internet.  It’s a painless way to get an introduction to Medline, PubMed and other sites. Every parent we know wants to find out as much as possible about the virus that’s infected their child.

HBF holds three one-day patient workshops every year, each in a different city.  Workshop goals include increasing liver cancer screenings, informing patients about treatment options, and providing support to those affected by hepatitis b.

The foundation provides copious amounts of information on hepatitis B in English, as well as helpful “chapters” in other languages. 

If you or someone in your life is affected by hepatitis B, you should bookmark this website.  It might come in handy one day.





Itching to Get a Tattoo?

17 05 2010
A collection of tattoos.

Credit: Skype user "SwanDiamondRose"

Humans have adorned their bodies with tattoos for thousands of years. Even the Iceman, whose remains are about 5,200 years old, was so marked.

Why, then, is tattooing viewed with raised eyebrows by parents and secret longing by our youth?

As parents, we’ll put aside the whole “It’s a lifelong commitment and that cute butterfly on your arm is going to go all funhouse mirror on you when you’re old!” thing, and concentrate on questions of health.

We can’t speak for the secret longing of youth because those years have evaporated into the ether for us.

So, the health of it…

Those tattoos aren’t painted on. Your skin is punctured and the ink injected underneath. Because of this, you may end up with severe and long-lasting itching, skin infections, or even HIV, hepatitis, or other bloodborne diseases.

Tattoo regulations vary by state, and sometimes within a county or city.  Some are governed by the health department, while others are regulated by the department of cosmetology.

While there are regulations, not all tattoo parlors are diligent in following safe, accepted precautions.

A professional tattoo artist takes pride in his artistry and safety habits, and will encourage you to ask questions. If you’re determined to get a tattoo, do yourself a favor and follow these suggestions:

  • Ask if you can observe a tattoo in process.
  • Look around and note the following about your tattooist and the parlor:
    • What are the qualifications of your tattoo artist?  Ask to see certificates and credentials.
    • Is the tattoo shop neat and clean?  Ask to see the autoclave. Does it work?
    • Does the artist wash his hands and use and dispose of sterile gloves appropriately?
    • Latex gloves can be used only with water based ointments.
    • All equipment including needles, tubes, pigments (ink), ointments and water must be single use only, and come out of sterile, sealed, dated packages, or disposed of after use.
    • Ensure that all non-disposable equipment is autoclaved.
    • Watch for cross-contamination.
    • Be sure that the area is completely disinfected after each client with a commercial disinfectant or bleach solution.
    • Tell your tattooist if you’re pregnant or nursing, have a heart condition, severe eczema, or problems with keyloids. Your tattoo might have to wait, or may not be recommended.

This is not the time to look for a bargain!  If you want a tattoo, seek out a professional tattooist who is experienced, and follows strict safety practices in his tattoo shop.

And finally, please think twice about getting a tat where cellulite may form. It’s just, we can’t, it’s too…gah! (You’ll thank us later.)

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NVHR

9 06 2009

The National Viral Hepatitis Roundtable (NVHR) is a coalition working to eliminate viral hepatitis in the U.S.

nvhr-logo09

They have a Call to Action that, when implemented, will save lives by preventing infection.

Hepatitis B and C can cause cancer or even death in children and adults.

Join with the NVHR in asking that funds be put toward the elimination of these deadly diseases.

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