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A History of [Un]Vaccinated Diseases
Brian Altonen MS MPH
1/27/2015
A Reminder to Us about the
History of Diseases, before
there was Immunization
diseases covered . . .
Poliomyelitis, Measle...
Sources and References
•Many of the black and white images in this
presentation come from my Second edition copy
of Frankl...
Franklin Henry Top (1903 - )
Portrait source: ihm.nlm.nih.gov
For Biog: http://medicine.yale.edu/publications/Images/M@YV3...
Polio is by far the most devastating infectious disease to have
and then survive. Unlike Small Pox, which kills or leaves ...
More
examples
of
polio’s
impact,
from
recent
Web
News
pages
One of the major deterrents to allowing a child to
have a disease during the 1960s was the fear of
what other illnesses or...
Poliomyelitis
The experience of Polio during the early 1950s
From the AMA Popular medical magazine: Hygieae
Poliomyelitis can result in
muscular atrophy in a small
percentage of its victims. As
many as 75% may recover
from whateve...
Muscle re-education
was performed over
much of the body, but we
tended to focus on
postural muscles and
muscles used to mo...
Exercise had
to be a part of
the daily plan
for recovery as
part of every
muscle
re-education
process.
Hygieia (AMA)
Sternocleido-
mastoid muscle
re-education.
Tendon
stimulation by
the use of hands
and pressure
points over
tendons was
tho...
Stretching and
movement
therapy
may be
performed to
prevent the
tightening and
reduced mobility
of joints,
ligaments and
t...
“Full Packs” were used to treat Poliomyelitis bed-ridden patients.
http://www.minnpost.com/mnopedia/2012/11/sister-kenny-i...
Intercostal Paralysis
due to
Poliomyelitis is the
reason many polio
victims required
respiratory
assistance.
This use of a...
Its common
name:
“IRON LUNG”
Negative
pressure
regulator.
A Barometric
Chamber used
to assist in
respiration.
Hygieia (AMA...
June 1948
Hygieia
Magazine
(AMA)
Treating
the
patient as
a person
in a
typical
1948
“Polio
Center”
This distribution
map for vaccine
refusals based
upon V-codes
depicts a high
likelihood for the
consequences
of these vacc...
http://www.measlesrubellainitiative.org/tag/japan/
Measles
Upon first glance, a disease like the measles
appears mildly obtrusive, and not overly
aggressive. So you decide to just l...
Which leads me to ask . . . if you were a
parent sitting in the waiting room, and saw
the child in this photo sitting acro...
Based on simple clinical observations, Measles, Chicken Pox or both
could be infecting this patient. In fact, according to...
Chicken Pox
http://www.today.com/health/angelina-jolie-has-chickenpox-its-no-joke-1D80370180
http://www.dailymail.co.uk/tv...
Chicken Pox cases
are found across
the U.S. It is
generally
perceived as a safe
and natural
alternative to the
recommended...
The early sign of
Chicken Pox is
very “plain”,
and non-
extraordinary.
“Tear Drop”
vesicles form.
Chicken Pox,
Day 2,
around a
Small Pox
Vaccination Scar
On the second
day we see more
vesicles and
more of a
reaction
ensu...
And like any
“Natural Disease Process”,
Chicken Pox does have its
complications . . .
A “normal”, but several looking
Generalized, Polymorphic Eruption
Chicken Pox with bullous impetigo
Chicken pox with facial cellulitis,
and a secondary lesions formed in
front of the ear.
and worse . . . .
Small Pox
A few days into a Small Pox infection, pustules begin merging
together on adjacent parts of the body, forming a large crus...
https://dittrickmuseumblog.files.wordpress.com/2014/06/image_3.jpg
Small Pox, at its worst
“Polysquamous secondary lesions” . . .
Treating
Small
Pox
From
Inoculations
to Vaccines
timelines.tv
From Benjamin Jesty, of Yetminster in Dorset, England, who inoculated his family
with cowpox in 1774
Inoculat...
Before vaccinations, there were inoculations.
For inoculations, you took some material from the
diseased part and exposed ...
www.historyofvaccines.org
“Courtesy Wellcome Library, London.
Francisco Javier de Balmis shows smallpox vaccination scars....
The cowpox or kine pox was brought to the U.S. by
Benjamin Waterhouse, of Harvard University, 1802.
Due to proximity, its ...
Small Pox
reaction,
reduced by
Vaccination
rather than
Inoculation.
[F.H. Top, 1947]
Vaccine Scar Fresh Vaccine
Telltale
Signs
of
your
history
MUMPS
Pittsburgh Penguins Captain Sidney Crosby
December 12, 2014
Kevin Allen and Nancy Armour, USA
TODAY Sports.
“ NHL mu...
The Mumps is produced
by a viral infection of the
parotid (salivary) gland.
http://www.immunize.org/photos/mumps-photos.as...
Those who had the mumps in the 1960s may
remember this question from your family
doctor:
‘Do you remember what side it was...
Long Term Side Effects of the Mumps
•Deafness
•Meningoencephalitis and complications
•Seizures
•Paralysis
•Hydrocephaly . ...
SCARLET FEVER
wiki wiki
Streptococcus pyogenes
www.healthofchildren.com
http://www.tamworthinformed.co.uk/scarlet-fever-on-the-rise-in-midlands/
A Scarlet Fever
patient’...
Stages for the “Strawberry
Tongue” of Scarlet Fever
(Strep A)
The Ophthalmic Emergency: Orbital Abscess in Scarlet Fever
For more: http://www.patient.co.uk/doctor/orbital-and-preseptal...
Complication 2
Nephritis (Kidney
inflammation) with
subsequent edema (kidney
failure)
(also note swelling around the
neck ...
Nonsuppurative
Arthritis,
with a swollen
left hand and
wrist
(right side is not
impacted,
and appears
normal)
Complication...
The
Consequences
of
Acute
Mastoiditis and
Nephritis,
associated with
Scarlet Fever
Complication 4
Ethmoiditis
This child experienced
infection of the
ethmoid sinus cavity
by the streptococcus
also responsible for
the sca...
Toxins produced by the organism can
lead to renal failure and other organ
system damage.
The continued growth of the organ...
This case demonstrates the results of
the Schultz-Charlton Phenomenon or
Blanching Test for diagnosis and
treatment (note ...
Septic Scarlet Fever, with severe thrombosis and gangrenous nose
The streptococci responsible for Scarlet Fever may develo...
Also linked to the onset
of a gangrenous state in
Scarlet Fever patients:
Swelling of the Eyelids
Discharge of the Nose
Fo...
DIPHTHERIA
1930s, Ohio http://flickrhivemind.net/Tags/diphtheria/Interesting
Pierre Bretonneau (1778-1862), coined
the nam...
In 1735, a major Diphtheria
Epidemic spread across the
Colonies in North America. This
was one of the first epidemics to
h...
http://dittrickmuseumblog.com/category/online-exhibits/
Examples of the Presentation of “Distemper”/Diphtheria to a Physic...
More Modern Illustrations
This is the
Pseudomembrane
or “False Membrane”,
that is visible in the Throat of a
diphtheria patient.
This sample is a ne...
An Important Diphtheria Lesson: Animals were/are
very important to the development of vaccines.
Edward Jennings documented...
Horses were the primary means for producing
Diphtheria vaccines throughout the late 1800s.
Aside from Horses, Sheep were t...
Diphtheria, Croup, and Pertussis
In contrast with Diphtheria, kids can also catch the
Croup and Whooping Cough.
Bacterial ...
Whereas Croup and Whooping Cough did
not completely close off air passages,
diphtheria did. The laryngotomy process
was us...
In 1885, Joseph P. O'Dwyer
invented an intubation
process that could be used to
treat the obstruction of the
larynx for a ...
Other Lessons from the Past
Rotary International
. . . on Pinterest
Brian Altonen . . .
on Pinterest
National Institutes o...
Lesson 1
Why immunize?
Lesson 2: What about Quarantine?
• A public health, professional, and personal responsibility
• Can people abide by this P...
Cattle for Pox,
1880s-early 1900s
(no longer practiced)
The entire body was shaved and
sterilized. The skin was infected.
...
Lesson 4: Horses
for Diphtheria
1898
Lesson 5: Once upon a time . . .
Lymph + Antitoxin = Vaccine
This original Antitoxin-Lymph
approach is of course no longer...
Lesson 6: The “Old” and “New” in vaccines, 19th to early 20th century
19th C
20th C
21st C
Signs of change!
Recent History - Present Status
(On this poster are the years
we initiated vaccines for . . . . )
Here is What we’ve
Accomplished . . .
“the Vaccine Years...
During the 1960s:
Sabin’s Oral Poliovaccine was developed
We saw reductions in the number of Polio children
Rubella pathog...
Will we go back to:
• the 90s
• the 80s
• the 70s
• the 60s
• Or earlier?
These
recent
outbreaks,
from
2012-15,
are like
going back
in time . . .
May 31, 1803 Poughkeepsie JournalSmall Pox
Eradication
began
about 1800
(some argue
earlier)
It finally
became
a Success i...
1984 & 2012 Hudson Valley, NY 2014
In recent years we’ve regressed, back to the 80’s perhaps.
Example
www.cdc.gov
http://www.cdc.gov/measles/cases-outbreaks.html
Most of the
2014 cases are
linked to
the
Disneyland
outbreak i...
Signs of reverting back to . . .
• The 80s – Measles outbreaks, Mumps and Whooping Cough;
numbers and events increase. [Cu...
Vaccinate? The Sooner, the Better
(but remain on schedule)
• The “Too Many Vaccines for my child” argument can be
eliminat...
The End
A History of [Un]Immunized Diseases
A History of [Un]Immunized Diseases
A History of [Un]Immunized Diseases
A History of [Un]Immunized Diseases
A History of [Un]Immunized Diseases
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A History of [Un]Immunized Diseases

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Review of the history of Vaccination and Inoculation, and the diseases that have been reduced due to the immunization program. An epidemiological transition approach is taken to evaluating the decline in the current preventive care system that exists for infections diseases. Asks the question--"Will Polio ever return?"

Published in: Health & Medicine
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A History of [Un]Immunized Diseases

  1. 1. A History of [Un]Vaccinated Diseases Brian Altonen MS MPH 1/27/2015
  2. 2. A Reminder to Us about the History of Diseases, before there was Immunization diseases covered . . . Poliomyelitis, Measles, Chicken Pox, Small Pox, Mumps, Scarlet Fever, Diphtheria
  3. 3. Sources and References •Many of the black and white images in this presentation come from my Second edition copy of Franklin H. Top’s Communicable Diseases, 1947. •Images and materials obtained from other resources are so noted on the page and/or beneath the picture.
  4. 4. Franklin Henry Top (1903 - ) Portrait source: ihm.nlm.nih.gov For Biog: http://medicine.yale.edu/publications/Images/M@YV3I4.pdf
  5. 5. Polio is by far the most devastating infectious disease to have and then survive. Unlike Small Pox, which kills or leaves a scarred survivor capable of performing daily functions . . . Polio may leave it survivors debilitated or disabled. Major limbs experience loss of motor function and often a paralytic like state occurs from mid-body down. << Polio victim in Bangladesh www.demotix.com
  6. 6. More examples of polio’s impact, from recent Web News pages
  7. 7. One of the major deterrents to allowing a child to have a disease during the 1960s was the fear of what other illnesses or debilitating conditions could be suffered by that child due to this experience. With polio, for example, we sat and watched as kids went through this and demonstrated its impact on their activities. The same could be true for the whooping cough, mumps, measles, rabies, tetanus, flu and pneumonia, depending on how bad the case was. All of us knew a family that had a bad outcome from their child becoming ill—such as deafness, the inability to attend a parochial school, the need for a wheel chair, regular PT, a reduced physical education class performance.
  8. 8. Poliomyelitis The experience of Polio during the early 1950s From the AMA Popular medical magazine: Hygieae
  9. 9. Poliomyelitis can result in muscular atrophy in a small percentage of its victims. As many as 75% may recover from whatever paralysis it produces. A common treatment for these patients was to improve quality of life through “muscle re-education”, in which a physical therapist or nurse encourages and assists the patient in making the appendages move. Hygieia (AMA) The “hamstring” muscle is being re-educated in this patient
  10. 10. Muscle re-education was performed over much of the body, but we tended to focus on postural muscles and muscles used to move about with an ambulatory device. The nurse or PT in this case is stretching the back muscles of a patient, tightened due to lack of use. Hygieia (AMA)
  11. 11. Exercise had to be a part of the daily plan for recovery as part of every muscle re-education process. Hygieia (AMA)
  12. 12. Sternocleido- mastoid muscle re-education. Tendon stimulation by the use of hands and pressure points over tendons was thought to assist in this process. Hygieia (AMA)
  13. 13. Stretching and movement therapy may be performed to prevent the tightening and reduced mobility of joints, ligaments and tendons. Hygieia (AMA)
  14. 14. “Full Packs” were used to treat Poliomyelitis bed-ridden patients. http://www.minnpost.com/mnopedia/2012/11/sister-kenny-institute-revolutionized-treatment-polio-patients Sister Kenny Institute revolutionized treatment of polio patients By R.L. Cartwright | 11/27/12 Sister Elizabeth Kenny, ca. 1911, Australia The Sister Kenny Institute revolutionized the treatment of paralyzed children with polio by adding hot packs to their regimens, with the goal of calm and soothing paralyzed muscles. Hygieia (AMA) (An offshoot of an early 1800s water cure practice) Australiandoctor.com.au
  15. 15. Intercostal Paralysis due to Poliomyelitis is the reason many polio victims required respiratory assistance. This use of an artificial respirator to assist in breathing was mostly employed in the 1940s and 1950s. Relate this to the following two Public Health questions . . . What would the cost for such a device be today? Could we afford it for dozens or hundreds of new cases?Hygieia (AMA), c. 1952
  16. 16. Its common name: “IRON LUNG” Negative pressure regulator. A Barometric Chamber used to assist in respiration. Hygieia (AMA), 1948 The Iron Lung was first called “Drinker Respirator”, invented 1928, by Philip A Drinker Portrait is from: http://www.polioplace.org/people/philip-drinker-phd
  17. 17. June 1948 Hygieia Magazine (AMA) Treating the patient as a person in a typical 1948 “Polio Center”
  18. 18. This distribution map for vaccine refusals based upon V-codes depicts a high likelihood for the consequences of these vaccine refusal behaviors now developing, with a clear peak noted in the Pacific Northwest.
  19. 19. http://www.measlesrubellainitiative.org/tag/japan/ Measles
  20. 20. Upon first glance, a disease like the measles appears mildly obtrusive, and not overly aggressive. So you decide to just lock the kid away in his or her room, in order to prevent others from making contact. This is exactly what my parents did when I caught the measles in the early 1960s. (FYI: that is not me in this picture) Then, my physician “Dr. D” came to our house, making “quarantine” less a problem back then than the same practice can be today. Today, with both parents working and the need for a patient to be seen by his/her physician in the office setting, we set the stage for clusters of more cases to develop.
  21. 21. Which leads me to ask . . . if you were a parent sitting in the waiting room, and saw the child in this photo sitting across the room, what medical condition would you suspect he has? How might we distinguish Measles from Hives? Or even Poison Ivy? Or an allergic reaction to soap or detergent? Or a photosensitivity to the last medication he was prescribed, or some over the counter product? Would you consider this a risk to your own health? The health of your child (children?
  22. 22. Based on simple clinical observations, Measles, Chicken Pox or both could be infecting this patient. In fact, according to the source of this photograph (Top, 1947), both were infecting this child.
  23. 23. Chicken Pox http://www.today.com/health/angelina-jolie-has-chickenpox-its-no-joke-1D80370180 http://www.dailymail.co.uk/tvshowbiz/article-2872257/Angelina-Jolie-reveals-s-got-chicken-pox-won-t- able-attend-Unbroken-premiere.html?ito=social-facebook https://www.facebook.com/DailyMail/posts/836142159778867 Thirty-nine year old Angelina Jolie came down with Chicken Pox in early December, 2014.
  24. 24. Chicken Pox cases are found across the U.S. It is generally perceived as a safe and natural alternative to the recommended immunization process.
  25. 25. The early sign of Chicken Pox is very “plain”, and non- extraordinary. “Tear Drop” vesicles form.
  26. 26. Chicken Pox, Day 2, around a Small Pox Vaccination Scar On the second day we see more vesicles and more of a reaction ensuing, as well as new signs and symptoms.
  27. 27. And like any “Natural Disease Process”, Chicken Pox does have its complications . . .
  28. 28. A “normal”, but several looking Generalized, Polymorphic Eruption
  29. 29. Chicken Pox with bullous impetigo Chicken pox with facial cellulitis, and a secondary lesions formed in front of the ear.
  30. 30. and worse . . . .
  31. 31. Small Pox
  32. 32. A few days into a Small Pox infection, pustules begin merging together on adjacent parts of the body, forming a large crusty material that with time sloughs off. Pustules tend to aggregate the most on the face, head and appendages.
  33. 33. https://dittrickmuseumblog.files.wordpress.com/2014/06/image_3.jpg Small Pox, at its worst
  34. 34. “Polysquamous secondary lesions” . . .
  35. 35. Treating Small Pox From Inoculations to Vaccines
  36. 36. timelines.tv From Benjamin Jesty, of Yetminster in Dorset, England, who inoculated his family with cowpox in 1774 Inoculation . . .
  37. 37. Before vaccinations, there were inoculations. For inoculations, you took some material from the diseased part and exposed a previously uninfected person to it. The disease would then erupt. Sometimes a full fledged disease. Sometimes a simpler version of it. The goal of course was the latter. Inoculations were part of the Revolutionary War soldier’s experience, and were required of nearly all troops starting in 1777 (in 1776, they were still uncertain). As a result of infection, an inoculation forms and then naturally reduces, leaving the patient with a scar as evidence of the experience. In the Hudson valley of New York, inoculation was practiced up until about April 1803. Source: Poughkeepsie Journal, Microfilm at Adriance Library, Poughkeepsie, NYThe replacement of inoculation with vaccines.
  38. 38. www.historyofvaccines.org “Courtesy Wellcome Library, London. Francisco Javier de Balmis shows smallpox vaccination scars.” . . . versus Vaccination Map of de Balmis’s trips
  39. 39. The cowpox or kine pox was brought to the U.S. by Benjamin Waterhouse, of Harvard University, 1802. Due to proximity, its first promoters in 1802/3, included a Quaker doctor and close friend of the Shakers residing in the Hudson Valley, and some New York and Philadelphia Medical School physicians. See The Vaccination Inquirer and Health Review, Vol. 3 at https://books.google.com/books?id=xgUDAAAAYAAJ Benjamin Waterhouse
  40. 40. Small Pox reaction, reduced by Vaccination rather than Inoculation. [F.H. Top, 1947]
  41. 41. Vaccine Scar Fresh Vaccine Telltale Signs of your history
  42. 42. MUMPS Pittsburgh Penguins Captain Sidney Crosby December 12, 2014 Kevin Allen and Nancy Armour, USA TODAY Sports. “ NHL mumps outbreak rare, but 'could happen anywhere‘ ” Dec. 17, 2014. Accessed at http://www.usatoday.com/story/sports/nhl/2014/1 2/17/nhl-mumps-outbreak-could-happen- anywhere/20562733/
  43. 43. The Mumps is produced by a viral infection of the parotid (salivary) gland. http://www.immunize.org/photos/mumps-photos.asp FH Top, 1947
  44. 44. Those who had the mumps in the 1960s may remember this question from your family doctor: ‘Do you remember what side it was on?’* It can spread from one side to the next, making it last for several weeks. The mumps virus can enter the body and then impact kidneys, sexual organs, thyroid gland and pancreas. Cases infecting the nervous system can led to meningitis. *I am not sure if the answer here really made much of a difference, like could it return if it infected just one side?
  45. 45. Long Term Side Effects of the Mumps •Deafness •Meningoencephalitis and complications •Seizures •Paralysis •Hydrocephaly . . . http://www.cdc.gov/mumps/clinical/qa-disease.html http://www.livestrong.com/article/40876-longterm-side-effects-mumps/
  46. 46. SCARLET FEVER wiki wiki Streptococcus pyogenes
  47. 47. www.healthofchildren.com http://www.tamworthinformed.co.uk/scarlet-fever-on-the-rise-in-midlands/ A Scarlet Fever patient’s presentation – Chief Signs and Symptoms
  48. 48. Stages for the “Strawberry Tongue” of Scarlet Fever (Strep A)
  49. 49. The Ophthalmic Emergency: Orbital Abscess in Scarlet Fever For more: http://www.patient.co.uk/doctor/orbital-and-preseptal-cellulitis • Can lead to severe long term complications. • Offers the streptococcus pathogen a more direct connection to the nervous system.
  50. 50. Complication 2 Nephritis (Kidney inflammation) with subsequent edema (kidney failure) (also note swelling around the neck due to adenitis)
  51. 51. Nonsuppurative Arthritis, with a swollen left hand and wrist (right side is not impacted, and appears normal) Complication 3
  52. 52. The Consequences of Acute Mastoiditis and Nephritis, associated with Scarlet Fever Complication 4
  53. 53. Ethmoiditis This child experienced infection of the ethmoid sinus cavity by the streptococcus also responsible for the scarlet fever. Complication 5
  54. 54. Toxins produced by the organism can lead to renal failure and other organ system damage. The continued growth of the organism throughout the body leads to the development of pustulence (pus), especially in the neck and tonsils area. This can be followed by abscessing. Nearby tissues may then die and slough off, including blood vessels. This subsequent break down of blood vessels can result in severe hemorrhaging and untimely death.
  55. 55. This case demonstrates the results of the Schultz-Charlton Phenomenon or Blanching Test for diagnosis and treatment (note arrows on the belly). This result is produced by the application of an antitoxin for the Streptococcal pathogen on the skin. See https://books.google.com/books?id=CQIWAQAAIAAJ&pg=RA1- PA15 https://books.google.com/books?id=b7rtAAAAMAAJ&pg=PA62 Pityriasis rosea of the skin
  56. 56. Septic Scarlet Fever, with severe thrombosis and gangrenous nose The streptococci responsible for Scarlet Fever may develop into a hemolytic form, which is assessed clinically by placing a tight (but not perfect) tourniquet on an appendage if it displays a significant scarlatina rash. This results in the formation of petechiae in just 10-20 minutes.
  57. 57. Also linked to the onset of a gangrenous state in Scarlet Fever patients: Swelling of the Eyelids Discharge of the Nose Forchheimer Spots (red dots) on the soft palate and tongue (the “strawberry tongue”) See: http://www.cdc.gov/features/scarletfever/
  58. 58. DIPHTHERIA 1930s, Ohio http://flickrhivemind.net/Tags/diphtheria/Interesting Pierre Bretonneau (1778-1862), coined the name diphtérite for this disease
  59. 59. In 1735, a major Diphtheria Epidemic spread across the Colonies in North America. This was one of the first epidemics to have corroborative evidence for the same event shared by several colonies.
  60. 60. http://dittrickmuseumblog.com/category/online-exhibits/ Examples of the Presentation of “Distemper”/Diphtheria to a Physician
  61. 61. More Modern Illustrations
  62. 62. This is the Pseudomembrane or “False Membrane”, that is visible in the Throat of a diphtheria patient. This sample is a near perfect casting of the inner surface of the respiratory passages. It consists of waste material, dead cells and debris left over by organisms growing within the air passage.
  63. 63. An Important Diphtheria Lesson: Animals were/are very important to the development of vaccines. Edward Jennings documented the value of kine pox vaccine as a preventive agent, due to the exposure ladies had while they were milking cows. Whereas cows were the primary source for producing large amounts of vaccine for the pox, horses were preferred for diphtheria. In 1811, Isaac I. Van Voorhis of Fishkill, NY, studied the use of horses to develop a better understanding of vaccines. He used much the same technique as Edward Jennings. After receiving his MD in 1812, he removed to Fort Dearborn, Chicago, where he served as a Surgeon. (He died in the Chicago Massacre one year later; and so, this story got lost.) http://history.amedd.army.mil/booksdocs/rev/gillett1/ch8.htmlhttp://wp.me/Puh6r-6u0 AforgottenpieceofAmericanMedicalhistory!!!
  64. 64. Horses were the primary means for producing Diphtheria vaccines throughout the late 1800s. Aside from Horses, Sheep were tried for the same purpose, and a few small businesses even tried producing vaccines using this method. When vaccines were required of kids by law by the mid-19th century, this technique of manufacturing was essential for pharmaceutical industries to meet the growing demand. In 1876, New York City became the first public health agency to establish a “Vaccine Farm” using cattle raised in Lakeview, New Jersey. These vaccines required the lymph of a living animal and an antitoxin to lessen the reaction patients had to the vaccine itself. A specific ratio of the two was required for all products, and became the standard for defining potency and efficacy of a vaccine. Whereas Cattle were the staple for producing pox vaccines, horses were required to produce diphtheria vaccines.
  65. 65. Diphtheria, Croup, and Pertussis In contrast with Diphtheria, kids can also catch the Croup and Whooping Cough. Bacterial croup in its worst form mimicked the diphtheria. Caused by Staphylococcus aureus, Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis, it could produce symptoms ranging from laryngeal diphtheria, to bacterial tracheitis, to laryngotracheobronchitis, and to laryngotracheobronchopneumonitis. Depicted here is a very early example of a vaporizer used to treat these cases (later made famous by Vick’s). Many early attempts to use this method for treating diphtheria were to no avail.
  66. 66. Whereas Croup and Whooping Cough did not completely close off air passages, diphtheria did. The laryngotomy process was used to treat countless diphtheria victims up until about 1885, when an intubation process was developed. For the 1874 argument on this, in the Richmond and Lousiville Medical Jl, , go to: https://books.google.com/books?id=bXYCAAAAYAAJ&pg=PA354 From: medical-dictionary.thefreedictionary.com Emergency Laryngotomy
  67. 67. In 1885, Joseph P. O'Dwyer invented an intubation process that could be used to treat the obstruction of the larynx for a diphtheria patient. By the early 1900s, this process, demonstrated in this photo, became an essential part of treating diphtheria patients to increase their survival rates. A “Life-saver”: From Tracheotomy to Intubation
  68. 68. Other Lessons from the Past Rotary International . . . on Pinterest Brian Altonen . . . on Pinterest National Institutes of Health
  69. 69. Lesson 1 Why immunize?
  70. 70. Lesson 2: What about Quarantine? • A public health, professional, and personal responsibility • Can people abide by this Public Health concept today? [recall recent Ebola incidents]
  71. 71. Cattle for Pox, 1880s-early 1900s (no longer practiced) The entire body was shaved and sterilized. The skin was infected. The pustules that formed had their lymph collected. Animal aights activists currently are against the use of animals for producing or testing medications and cosmetics. Ca. 1900 Pharmacognosy course text, Columbia University Lesson 3: Respect our past . . . be grateful for new technology.
  72. 72. Lesson 4: Horses for Diphtheria 1898
  73. 73. Lesson 5: Once upon a time . . . Lymph + Antitoxin = Vaccine This original Antitoxin-Lymph approach is of course no longer used
  74. 74. Lesson 6: The “Old” and “New” in vaccines, 19th to early 20th century
  75. 75. 19th C 20th C 21st C Signs of change!
  76. 76. Recent History - Present Status
  77. 77. (On this poster are the years we initiated vaccines for . . . . ) Here is What we’ve Accomplished . . . “the Vaccine Years” The 1960s was a transitional period in the U.S. immunization program. Much momentum was developed following the successful development of an oral polio vaccine, and according to this poster, the rapidly decreasing measles epidemic problem for the 1960s and early 1970s.
  78. 78. During the 1960s: Sabin’s Oral Poliovaccine was developed We saw reductions in the number of Polio children Rubella pathogen was isolated DTaP and MMR combos were being developed Measles was the focus Here is what has happened:
  79. 79. Will we go back to: • the 90s • the 80s • the 70s • the 60s • Or earlier?
  80. 80. These recent outbreaks, from 2012-15, are like going back in time . . .
  81. 81. May 31, 1803 Poughkeepsie JournalSmall Pox Eradication began about 1800 (some argue earlier) It finally became a Success in 1980 Vaccine manufacturing ceased 1990
  82. 82. 1984 & 2012 Hudson Valley, NY 2014 In recent years we’ve regressed, back to the 80’s perhaps. Example
  83. 83. www.cdc.gov http://www.cdc.gov/measles/cases-outbreaks.html Most of the 2014 cases are linked to the Disneyland outbreak in California The most recent Measles outbreak confirms this.
  84. 84. Signs of reverting back to . . . • The 80s – Measles outbreaks, Mumps and Whooping Cough; numbers and events increase. [Current status? as of 1/2015] • The 70s -- 2 or 3 of Measles, Whooping Cough, Mumps, with trace numbers of Rubella/Scarlet Fever, a Diphtheria “spike”. • Partial decreases (10%-25%) in DTaP and MMR combinations • The 60s – 3 of 4 of Measles, Whooping Cough, Mumps, Tetanus, Hib, with spikes for Scarlet Fever/Diphtheria • Major decreases, esp. for DTaP and MMR combinations • The 50s -- Measles, Whooping Cough, Mumps, and Tetanus; Scarlet Fever, Diphtheria, Hib; Polio especially a concern. • The 40s – Scarlet Fever and Diphtheria are the indicators of severity; Polio is a major concern, if not already present. theatlantic.com www.huffingtonpost.com healthymamas.com National Institutes for Health
  85. 85. Vaccinate? The Sooner, the Better (but remain on schedule) • The “Too Many Vaccines for my child” argument can be eliminated through the use of new technology. • But “Too many vaccines” is not the only excuse mothers use for not vaccinating their children. • Today’s parents have no memories of experiencing measles or having a neighbor who child was disabled or deceased due to experiencing a disease “the way nature planned it.” • This argument for avoiding vaccinations is based mostly on personal philosophy. Who wouldn’t regret learning he/she did not grow up to their fullest life potential due to vaccine their parents “missed” or ignored? • Vaccines improve quality of life, and in the long run greatly reduce the cost for care we will need as we grow older.
  86. 86. The End

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