The Comeback Killers: Diphtheria, Measles, Whooping Cough, Polio

Diphtheria. Measles. Whooping cough. Polio. If you think these diseases belonged to your parents and grandparents and not to our generation, you may be surprised to hear that they are making a comeback.
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Diphtheria. Measles. Whooping cough. Polio. In the minds of most of Americans, these are killers from a bygone era. If you think these diseases belonged to your parents and grandparents and not to our generation, you may be surprised to hear that these killers are making a comeback. And like comebacks in sports, they are exploiting the weaknesses in our own defenses, at home and abroad.

We don't hear much about diphtheria today in places like the U.S., Europe and Australia. But this disease -- once virtually eliminated in wealthy countries -- showed its comeback ability recently. Just weeks ago, a healthy 22-year-old Australian woman succumbed to the bacterial throat infection, which can lead to difficulty breathing, paralysis, heart failure and, in her case, a tragic death. She is believed to have contracted the disease from a friend who was infected while traveling abroad.

Diphtheria vaccine is the best tool we have for making everyone in a population immune to the disease. Because nearly 90 percent of Australians are vaccinated against diphtheria, the disease, which was once among the most common causes of infectious death in Australia, became virtually non-existent there after the 1950s. Unfortunately, the woman who succumbed to diphtheria was one of the 10 percent that had not been vaccinated.

While sobering, stories like this are becoming increasingly familiar. Infectious killers that were once widespread and have since been beaten back by aggressive immunization efforts are making a comeback in places long thought to be safe havens.

Measles cases are popping up in places long thought to have banished the disease. More than 30 European countries have experienced measles outbreaks this year, and the U.S. is on track to have more measles cases in 2011 than in any year in the last decade. Local media are reporting that misplaced fears about vaccines have likely contributed to it.

Some policymakers believe the threat posed by parents opting out of vaccines is becoming viable enough that compliance needs to be legislated. In California, the state's biggest outbreak of pertussis (a.k.a. whooping cough) in decades has led to more than a thousand illnesses and the tragic deaths of 10 infants. In response, the state enacted a law requiring pertussis vaccination for school-age children.

In the U.S., even with high immunization rates, 85 percent of health care providers will have a parent refuse a vaccine for a child, according to the journal Pediatrics. In his critically-acclaimed book Panic Virus, which the Wall Street Journal says should be "required reading at every medical school in the world," journalist Seth Mnookin explores how misplaced fear has trumped reason among parents faced with the choice to vaccinate their children, and with potentially deadly consequences.

Falling coverage of vaccines means we risk losing the benefit of herd immunity -- or the vaccination of most of a population that helps to protect us all. The consequence could be a resurgence of diseases like mumps and measles that killed millions of people before the invention of vaccines. In wealthy countries, we have access to life-saving vaccines, yet increasingly often refuse to use them. In other countries there is no choice. In order to protect us at home, we need to vaccinate everyone, everywhere.

In my work as an epidemiologist I've seen both the resurgence of previously controlled diseases in the United States and the ongoing transmission of these comeback killers among children living in countries too poor to pay for the vaccines. In 1997, as a CDC epidemiologist, I helped investigate a 400 percent increase in the incidence of Hib meningitis cases among Alaska Natives. In the same year, I worked at a children's hospital in Dominican Republic where they admitted as many cases of Hib meningitis as we got in the entire U.S. over a six-month period, simply because the children of that country lacked access to the vaccine we used in our country.

You can help defend against these diseases by making sure that you and your family are up to date on vaccines so measles, pertussis, and diphtheria can't make a comeback in your home. But you can also help build a breach against these diseases overseas. The GAVI Alliance works to ensure vaccine access for children in the world's poorest countries. In June, world leaders will come together to pledge financial support for the GAVI Alliance. With it, GAVI can vaccinate millions of children, and in the process, save millions of lives while reducing the risks of transmission back to the U.S. But, they can't do it alone. Find out how you can help.