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Whooping Cough

Passive Immunity 101: Will Breast Milk Protect My Baby From Getting Sick?

By January 10, 2016 14 Comments
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As a neonatal nurse specialist, mothers often ask me about the antibodies found in breast milk and how they can work to protect their babies. To explain it to them, and to you, I have to delve into immunology, and those conversations are usually too technical for most readers and mothers I meet in the NICU. Unfortunately, the information that is readily available to mothers that isn’t highly technical is a large body of conflicting information. So I’m here to talk more about this very important topic in a way that makes it straightforward! My goal is to answer very common reader questions like these:

“Why does my infant need any vaccines at all since she’s getting all the antibodies she needs from my breast milk?” and,

“Why does my seven-month old son need to get a flu shot if I received it during my pregnancy?”

Both, excellent questions! Parents, take note – there are 2 ways babies acquire immunity: through passive transfer, and active transfer (also known as acquired immunity).

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Categories: Ages + Stages, Food, Nutrition, + Infant Feeding, Infectious Disease + Vaccines, Newborns + Infants

Two Months After Whooping Cough: An Update from Tara Hills and Her Family

By and June 16, 2015 4 Comments
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We’ve received a lot of questions from our readers about the status of Tara Hills, the formerly anti-vax mother whose 7 children caught whooping cough, just a week before their updated vaccination schedule was supposed to begin. It’s been a couple of months since we’ve posted an update, so we interviewed Tara this week.

Read more about Tara’s story:
Learning the Hard Way: My Journey from #AntiVaxx to Science – April 8, 2015
Whooping Cough is so Rotten, That We Couldn’t Post the Video – April 9, 2015
With 7 Kids in Recovery from Whooping Cough, Tara Hills Answers Your Questions – April 15, 2015

Here’s what she told told us:

So first up, even though it’s more than two months later we still get emails and messages asking about how your kids are doing now. How is everyone doing post whooping cough?

I’m touched that 2 months later people around the world care enough to ask about our family. Really touched. Physically everyone is well. The 7 kids responded to the antibiotic treatment and turned a corner within days. That cough is awful though and has lingered in our youngest. It can linger up to 12 weeks so we’re hoping it goes away soon. Mercifully no one went into respiratory distress so we don’t expect long-term damage.

Emotionally the kids are fine and life is normal again. I’m another story. I still think of this everyday. Painful reminders, what ifs, gratitude, self-consciousness as strangers say they ‘know me’. Many, many lessons learned the hard way.

How about how the medical community in Ottawa responded to you during and after the crisis? Did you feel any judgement from your doctor, the hospital or public health agencies?

They were excellent. We were assigned a nurse from Ottawa Public Health from day 1 when the results came back positive. She was our go-to through and after the crisis. She worked with us (over the phone) step by step, was very calm, helpful, and professional. We were in great hands.

Something which shocked Julia and Leslie was that other parents seemed to be understanding and supportive of you online, but both the pro-science and anti-vaccine communities seemed to have harsh words for you but for different reasons. Have you lost any friends in either camp due to your post?

Our story hitting international news was shocking and surreal. I was willing to ‘speak into the microphone’ even though I felt sick in front of such a huge audience. But we stood by our core message and still do. I stayed away from news comment feeds because I was too involved and overwhelmed with everything. It was all so “out there” so the harsh words didn’t affect me. Closer to home, all our key relationships were fine. Some friendships were strained temporarily and only 1 was lost, mostly due to disagreements with how I handled what was a very difficult situation for our family.

It was hard to hear the harsh judgement from the pro-science community. We thought they’d embrace us with open arms. We had already learned our lesson and booked the catch-up appointments. We expected the anti-vaccine community to react harshly to us, but to have the pro-science community rub our faces in a pile of shame was disgustingly unhelpful in advancing their cause. Some asked “what if it had been polio?” I know! Don’t you think I KNOW? That’s exactly why we shared our story and withstood the firestorm from every angle.

WC TimelineWere there any misconceptions that bothered you?

Some people have said that whopping cough is no biggie so they “aren’t convinced” or alarmed enough to reconsider examining the vaccine issue much less get their kids or themselves vaccinated. For most of our kids it wasn’t a nightmare, but it was awful for the youngest ones. The two youngest would cough so hard they threw up, none of us slept that week.

Our story was illustrative of a vaccine-preventable illness sweeping through one family. That’s why I shared our story in that context. Some people online dismissed it and acted like the whole thing was one big stay-cation for our family. That truly shocked me. I couldn’t believe that after hearing the sounds of our children struggling to breath through coughing fits they would dismiss the risk to infants. It was beyond shocking.

Waiting to make sure our 5-month-old niece and 2 immune-compromised family members were going to be okay was indescribable. I had so much guilt and fear, there are no words to describe the waiting to hear if our infant niece was hospitalized or worse, all because of us.

For me one of the most shocking things was people alleging there were ‘holes’ in my story and that I was a paid actress. Even more bizarre is that some people alleged that I was covering up a more scandalous truth. Are you kidding me? I would have given anything for our family to not have gone through what we did!

When you changed your minds about vaccines do you think (honestly) there was anything anyone could have said to you to change your mind?

Maybe? How they approached me would have made a huge difference. Respectfully validating and addressing versus sarcastically dismissing my concerns and questions would have made a difference. Building our trust through caring, patient dialogue would have helped. Just talking to me at all like an intelligent caring person would have helped.

If someone had said in a genuinely kind tone. “Tara, you are a great mom who loves her kids dearly. I know there is so much confusion about vaccines. I care about you and want to help you make a informed decision you feel really confident in. Would you be willing to share some of your concerns with me so we could go through them one by one? In the end it’s your decision. I want to make sure you are totally confident in your decision since it’s so important.” I would like to think I would have stepped willingly into that kind of conversation. There was no threat or attack that would trigger defensiveness.

It’s hard to talk to loved ones about vaccines. Hopefully our sharing will help people have those talks in a constructive way, guide them to a starting point they can relate to, and maybe help save some lives.

You said in an earlier post that the Disneyland measles outbreak was part of what contributed to your rethinking of your anti-vaccination stance. When you finally began your new wave of research, can you clarify how that happened, and how did you look for and find your information?

It had been building for some time. Seeing the hatred and fear towards people who didn’t vaccinate (like us) was alarming. I knew if push came to shove, and we lost the freedom to choose, we would have to be rock solid certain of our stance. So in February, I came out of the anti-vax closet by posting on my personal Facebook wall that I was that mom. That I felt caught between a horrible rock and terrible place. That somehow no matter how much I searched for solid answers I’d never really know. That it would boil down to a coin toss with our kids’ health in the balance. So I set out to prove we were right NOT to vaccinate. I had my kids’ health at stake and my pride to defend. So I started reading anti-vaccine books, publications, and popular sites to bolster my position. But I knew a fair trial demanded I listen to both sides. A public health advocate (The Scientific Parent’s Leslie Waghorn) suggested I list my key concerns/questions, and offered to go through them with me one by one. She disarmed my defensive posture by validating that it was okay to ask questions and even better to seek solid answers. Turns out that all my concerns boiled down to only a few key questions, which I addressed in my first Q&A.

Were your older children aware of your decision to stop vaccinating, and if so how did you talk to them about your decision to resume vaccination?

Our oldest (10) and I had discussed it back in February or March when she saw me doing a lot of research and reading about vaccines. So she had the backstory when the pertussis hit our family. I talked to her using an analogy of imaginary kids playing at our park. It went like this: What if after playing Johnny, Suzy came along and whispered “don’t play with Johnny. His family is dirty and will make your family sick!” What should you do? Just believe her words or go check her story to see if it’s true? How could you know for sure? Then I bridged to the vaccine issue, shared our story from when she was little, how all the Suzys were talking and we got scared and confused. We froze when we should have dug deeper for solid answers. A painful life lesson I hope our children will not repeat.

Do you have any advice for parents who are skeptical about vaccines or have questions?

That I commend them for taking the time and effort to focus on this vital part of parenting! To make sure to consider their biases and check their sources carefully and to not cherry-pick the information they like best. They should also talk to their doctors before making any decisions about vaccines. Our doctor was very understanding when we said we wanted to catch the kids up on their vaccines. We didn’t consult him before we stopped vaccinating because we were afraid of being judged or worse. I now wish I’d talked to him because he was very understanding.

 

– Edited by Leslie Waghorn and Julia Bennett

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Categories: Infectious Disease + Vaccines

With 7 Kids in Recovery from Whooping Cough, Tara Hills Answers Your Questions

By and April 15, 2015 12 Comments
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Tara Hills Luke

Tara cuddling with her recovering 10 month old.

When I wrote our story last week, I had no idea our story would go ‘viral’ (no pun intended).  We are a private family, as most homeschooling families are, so we thought that maybe a few people in our community would see it.  We never imagined that our story would travel around the globe.  As encouraged as we are to hear about the positive impact our decision to share it has had on many others, it has also been hard handling a real medical crisis in the face of intense global media and public scrutiny. Last Tuesday, when the positive test results came in 4 days late, the waves of chaos hit us with a fury that we can’t possibly describe. Everything that day was a blur, from me editing my original post to include our diagnosis, to the reality of dealing with 7 active cases of pertussis.  

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Categories: Infectious Disease + Vaccines, Policy, Politics, + Pop Health

Whooping Cough is so Rotten, That We Couldn’t Post the Video

By and April 9, 2015 9 Comments
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We posted this video to our Facebook page, an interview on CBC of Tara Hills, the mother of seven children in quarantine with whooping cough. She spoke to the CBC Ottawa news affiliate shortly after her story on our page went viral.

Later on Wednesday evening, Tara followed up with us by sending us several videos of her children suffering from the classic “whoop” that pertussis is so infamous for, and we have to admit, readers, it was a tough (if not horrifying) watch. We appreciate Tara’s raw and open approach to sharing the perils of not vaccinating children against deadly illnesses and her desire to help parents in her community recognize the symptoms.

However, we decided it was too much to show in the best interest of the children involved. Their health outcomes are unknown at this time, but we’re hoping for the best for them and we know they’re getting the best care possible.

So instead, we’d like to bring you an edited audio file of the sounds of some, but not all of her children, so you can get a better understanding of the impact of this type of illness  – and why vaccinations are so very important to prevent suffering.

For more information on whooping cough, visit http://www.cdc.gov/Pertussis or talk to your health care provider.

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Categories: Infectious Disease + Vaccines, Policy, Politics, + Pop Health

Learning the Hard Way: My Journey from #AntiVaxx to Science

By April 8, 2015 158 Comments
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I’m writing this from quarantine, the irony of which isn’t lost on me.

Emotionally I’m a bit raw. Mentally a bit taxed. Physically I’m fine.  All seven of my unvaccinated children have whooping cough, and the kicker is that they may have given it to my five month old niece, too young to be fully vaccinated.

We’d had a games night at our house in March, my brother-in-law had a full-blown cold, so when the kids started with a dry cough a few days later I didn’t think much of it.  But a week after the symptoms started the kids weren’t improving, in fact they were getting worse.  And the cough. No one had a runny nose or sneezing but they all had the same unproductive cough.  Between coughing fits they were fine.

Then a few days later at midnight I snapped. My youngest three children were coughing so hard they would gag or vomit. I’d never seen anything like this before.  Watching our youngest struggle with this choking cough, bringing up clear, stringy mucus – I had heard of this before somewhere.  My mom said I had it when I was a kid. I snapped into ‘something is WRONG’ mode.

I jumped on Google to type in “child cough.” My kids had all but one symptom of pertussis, none of them had the characteristic “whoop.” But they had everything else.

We had vaccinated our first three children on an alternative schedule and our youngest four weren’t vaccinated at all.  We stopped because we were scared and didn’t know who to trust.  Was the medical community just paid off puppets of a Big Pharma-Government-Media conspiracy?  Were these vaccines even necessary in this day and age? Were we unwittingly doing greater harm than help to our beloved children? So much smoke must mean a fire so we defaulted to the ‘do nothing and hope nothing bad happens’ position.

Symptoms and timeline of pertussis (whooping cough)

Learn the signs of pertussis (whooping cough). Click to enlarge.

For years relatives tried to persuade us to reconsider through emails and links, but this only irritated us and made us defensive.  Secretly, I hoped I would find the proof I needed to hold the course, but deep down I was resigned to only find endless conflicting arguments that never resolved anything.  No matter if we vaccinated or not, I thought, it would be nothing more than a coin toss with horrible risks either way.

When the Disneyland measles outbreak happened my husband and I agreed to take a new look and weigh the evidence on both sides. A friend suggested I write out my questions so we could tackle them one by one.  Just getting it out on paper helped so much. I only ended up with a handful of questions. But more potent than my questions were my biases.

I just didn’t trust civic government, the medical community, the pharmaceutical industry, and people in general.  By default, I had excluded all research available from any major, reputable organization.  Could all the in-house, independent, peer-reviewed clinical trials, research papers and studies across the globe ALL be flawed, corrupt and untrustworthy?

The final shift came when I connected the dots between a small, but real measles outbreak in my personal circles this time last year.  But for the grace of God, our family was one step from contracting measles in our mostly under-or-unvaccinated 7 kids.  Maybe we could have weathered that storm unscathed in personal quarantine.  But in the 4 highly contagious days before any symptoms show we easily could have passed on our infection to my sister’s toddlers or her 34-week-old son in the NICU.

When I connected the dates for everyone involved it chilled me to the bone.  I looked again at the science and evidence for community immunity and found myself gripped with a very real sense of personal and social responsibility before God and man.  The time had come to make a more fully informed decision than we did 6 years ago.  I sat down with our family doctor and we put together a catch-up vaccination schedule for our children.

That schedule that was supposed to start the week after I found myself in the waiting room of the Children’s Hospital of Eastern Ontario (CHEO) with my 10-month-old son, waiting to confirm if he had whooping cough.

I said before that the irony isn’t lost on me that I’m writing this from quarantine.  For six years we were frozen in fear from vaccines, and now we are frozen because of the disease.  My oldest two are getting better, the youngest four are getting worse and fast.  Ottawa Public Health has been so helpful and communicative, trying to get us the help we need while keeping the community safe.  We are under quarantine and starting antibiotics.  Tonight, the baby started ‘whooping’.  I did the right thing going to the hospital when I did.  I can only hope this painfully honest sharing will help others.

I am not looking forward to any gloating or shame as this ‘defection’ from the antivaxx camp goes public, but, this isn’t a popularity contest.  Right now my family is living the consequences of misinformation and fear.  I understand that families in our community may be mad at us for putting their kids at risk.  I want them to know that we tried our best to protect our kids when we were afraid of vaccination and we are doing our best now, for everyone’s sake, by getting them up to date.  We can’t take it back … but we can learn from this and help others the same way we have been helped.

Vaccination is a serious decision about our personal and public health that can’t be made out of fear, capitulation or following any crowd.  No one was more surprised than us to find solid answers that actually laid our fears to rest.  I am confident that anyone with questions can find answers.  I would only advise them to check your biases, sources and calendar: Time waits for no parent.

Read more about Tara’s story:
Whooping Cough is so Rotten, That We Couldn’t Post the Video – April 9, 2015
With 7 Kids in Recovery from Whooping Cough, Tara Hills Answers Your Questions – April 15, 2015
Two Months After Whooping Cough: An Update from Tara Hills and Her Family – June 16, 2015

 

Editor’s Note: Comments on this post are being moderated per The Scientific Parent comment policy.

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Categories: Infectious Disease + Vaccines, Policy, Politics, + Pop Health

The Measles Drives Immunization Rates Up, but Whooping Cough Doesn’t Have the Same Effect in Washington State

By April 2, 2015 1 Comment
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On March 31, a prisoner escaped from a hospital about two miles from our house. He fired off a shot at police while he made his escape, and carjacked two individuals causing one car crash. The words, “armed and dangerous” and “area lock down” are not words that generally make the public feel safe, even after evidence suggested the prisoner had moved out of our immediate area.

It was this threat that made me realize how generally lax I am about safety in my own home. I had to confirm that the doors and windows were locked and as usual, I would have been lucky to find my phone to call 911 if I needed to. Theft and dangerous offenders aren’t something I worry about in our area because the crime rate is so low. It took an emergency for me to realize, “it might be a good idea if I knew how to lock our windows.”

Humans are terrible at judging risk. We’re categorically awful at it, and we don’t tend to act on slow-moving risks until the crisis is upon us. Reactively, rather than proactively. It looks like the same pattern is playing out in Washington State, where immunization

Image c/o The Seattle Times. Original can be found: http://static.seattletimes.com/wp-content/uploads/2015/03/dfbde78e-d7fb-11e4-8dd6-4df606469ca8-300x730.jpg

Image c/o The Seattle Times. via: SeattleTimes.com

rates have surged 27% higher than this time last year in the wake of the Disney measles outbreak.

This is remarkable news as immunization rates in Washington State have lagged behind the national average and in the past Washingtonians haven’t always responded to the resurgence of a deadly early childhood disease with the same gusto. A 2011/2012 whooping cough epidemic caused no increase in immunization rates, despite sickening 2,520 residents.

So what’s changed this time?

There are a few potential hypotheses, which include:

  1. The perceived severity of the illnesses, with whooping cough being viewed, not necessarily accurately, as “less severe” than the measles;
  2. Media coverage of the outbreak has been extensive and may have had an educational and awareness impact on parents;
  3. Parents that vaccinate have become much more vocal since the Disneyland outbreak, which may have helped change social norms in certain areas;
  4. A bill was introduced to the Washington State House (and was defeated) that would have removed the personal belief exemptions many parents use to not vaccinate, and this may have prompted parents to vaccinate before its potential passage.

So the short answer is: we don’t know what changed this time. My guess is that it’s a combination of the factors above, and I can’t wait to read the studies once they’re published!

If you’d like to learn more about immunization rates in Washington State, you can read the article from the Seattle Times: Measles vaccinations jump after scare, public dialogue.


 

Resources:

Resources:

JoNel Aleccia. Measles vaccinations jump after scare, public dialogue. The Seattle Times. March 31, 2014. Retrieved 4.2.15.

Rachel La Corte. Lawmaker aims to limit reasons for vaccine exemptions. The Seattle Times. February 4, 2015. Retrieved 4.2.15

Washington State Department of Health. News Release: State vaccination rates for children lag behind national average. September 12, 2013. Retrieved 4.2.15.

Wolf, E., Opel, D., DeHart, M. et al. Impact of a Pertussis Epidemic on Infant Vaccination in Washington State. Pediatrics. pp 456-464, September 2014. Retrieved 4.2.15

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Categories: Infectious Disease + Vaccines, Policy, Politics, + Pop Health

The Consequences of Whooping Cough: How I Developed Cerebral Palsy

By March 16, 2015 No Comments
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I have cerebral palsy, and it’s something I’ve been hesitant to talk about my entire life. Cerebral palsy (CP) “is caused by injuries or abnormalities of the brain. Most of these problems occur as the baby grows in the womb. But they can happen at any time during the first 2 years of life.” As humbling as it is to accept, I have brain damage.

Except for the arrival of their favorite son, my parents have told me there was nothing remarkable about my birth in the mid-70s. Everything went according to plan, but when I was nearly three months old, too young for the vaccine, I contracted pertussis, more commonly known as whooping cough. This is likely how I came to develop CP.

Over the years my parents have told me how terrifying it was to hear me coughing and gasping for air. If they weren’t in the room with me and I got quiet they would have to check to see if I was sleeping or if I’d stopped breathing. Once I started walking my parents noticed my left foot was always on its toes and turned inwards. On the advice of a family friend, my parents took me to get evaluated, where I was eventually diagnosed with CP.

It wasn’t until my mid-20s that I truly understood what that experience must have been like for my parents. They had just witnessed their baby struggle through whooping cough and then learned their baby had cerebral palsy. I had just started walking, too young to talk, there was no telling the extent of my injury at that stage. Can you imagine their concern?

The years that followed involved frequent trips to the Children’s Hospital of Eastern Ontario (CHEO) for physiotherapy and testing, more than 10 years with a brace on my left leg, a decade of at-home exercises and casts on both legs for a period of time (which made for an awesome Hallowe’en costume that year – most candy EVER).

Having CP doesn’t mean you cannot succeed in life. My university Sociology professor informed the class that he had CP. He was the first person with CP I had come across that, like me, was only affected physically and not mentally. He suffered from slurred speech and tremors in his arms and hands, but obviously was able to flourish in academia.

I have had more than 35 years to come to terms with the long-term impacts of CP. IWorldCPDayCP-Infographic walk with a slight limp, my balance is a bit of an issue and my left calf is noticeably smaller than my right. I’m at a disadvantage in most sports (which is a shame since of the 3 children in family I was the only one that expressed any interest in sports). Despite my brothers’ claims, I haven’t suffered any mental impairment. I graduated with honors from high school and received a degree in Computer Science at the University of Waterloo.

I mentioned earlier that I’m hesitant to discuss my cerebral palsy, not because I am embarrassed by it, but due to the extent of my injury. I have the most minor case I have personally encountered. Every time I publicly mention that I have CP, I think of all the others with the same affliction. The trials in my life due to CP pale in comparison to theirs. I do not take for granted that I have been extremely lucky.

CP has a wide spectrum of injuries that can result in mental impairment, physical impairment, or both. Growing up, the son of the family that lived next door also had CP, his was the result of an avoidable birth injury. While Stephen was able-bodied, he was a man in his 30s with the intellect of a 6 year old and needed special care throughout his life. I cannot stress enough how lucky I am.

Just like my neighbor’s CP, mine was also avoidable. I was too young for the pertussis vaccine when I contracted the virus, however I caught it from someone. That person was likely either unvaccinated or were under-vaccinated. Recently there has been a movement against vaccinations in general and it frightens me that parents may not have their children vaccinated against pertussis and other illnesses. Measles, mumps, pertussis and others are seen as minor afflictions to some, but I see myself as an example of what can happen as a result of contracting one of these illnesses.

I’m sharing my story and the story of others in the hopes that it will sway at least one doubtful parent to vaccinate. While I’ve been extremely lucky, I was likely seconds away from being severely impaired. A parent should take advantage of any protection they can offer their child, and that includes vaccination.


 

References:
National Institutes of Health. Cerebral Palsy. Updated August 22, 2014. Retrieved March 15, 2015.

Centers for Disease Control and Prevention. Pertussis (Whooping Cough). Last updated December 1, 2014. Retrieved March 15, 2015.

Mayo Clinic. Whooping Cough. Last updated January 15, 2015. Retrieved March 15, 2015.

Children’s Hospital of Eastern Ontario (CHEO). Resources – Cerebral Palsy. Last updated May 2014. Retrieved March 15, 2015.

Mayo Clinic YouTube. Infant Girl with Whooping Cough. Published October 7, 2013. Retrieved March 15, 2015.

World Cerebral Palsy Day. What is Cerebral Palsy Infographic. September 2013. Retrieved March 15, 2015.

Booth, Michael. Nearly Half of All U.S. Children Undervaccinated, A New Study Shows. The Denver Post. January 21, 2013. Retrieved March 15, 2015.

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Categories: Accidents, Injuries, + Abuse, Chronic Illnesses + Conditions, Disability + Disability Advocacy, Infectious Disease + Vaccines