Teh One Who Knocks
11-12-2013, 12:14 PM
BY JULIA IOFFE - New Republic
http://i.imgur.com/6L0Z5bKl.jpg
At this writing, I have been coughing for 72 days. Not on and off coughing, but continuously, every day and every night, for two and a half months. And not just coughing, but whooping: doubled over, body clenched, sucking violently for air, my face reddening and my eyes watering. Sometimes, I cough so hard, I vomit. Other times, I pee myself. Both of these symptoms have become blessedly less frequent, and I have yet to break a rib coughing—also a common side effect. Nor do I still have the fatigue that felled me, often, at my desk and made me sleep for 16 hours a night on the weekends. Now I rarely choke on things like water, though it turns out laughing, which I do a lot of, is an easy trigger for a violent, paralyzing cough that doctors refer to not as a cough, but a paroxysm.
Since I came down with pertussis, more commonly known as whooping cough, waking up on Saturday, August 31, with what felt like a light fever and a tightness in my chest, I’ve celebrated the Jewish high holidays, covered Washington's response to the crisis in Syria, hosted several out of town friends and a dinner party or two, attended the funeral of a close relative and the wedding celebration of a close friend, given a lighter strain of the whoop to my mother, and, somewhere in there, managed to turn 31, whooping all the while. I even spent a long weekend on a beach in north Florida, where a friend commented on my now killer abs—odd since, because of my illness, I had not been to the gym at that point for 35 days. “The coughing,” she said cheerfully, “must’ve helped!”
My friends have gotten used to the whoop, and so, it seems, have my colleagues. When they hear it waft across the cubicle walls, that hacking cough melting into a high-pitched, desperate gasping, they now just say, “There’s the whoop!” Which is good because, given that pertussis’s other name is the “100 day cough,” they have a good month of my hackery left to joke about.
It’s funny having the whooping cough at 31 in 2013. Sometimes, you’re at the kind of nice restaurant you can now afford at 31, when the audacity of saying “Mm-hmm” as you chew ends with your choking—actually choking—on a shred of grilled scallion. Sometimes, you’re waiting to go on television to comment on world events, and the producers, having seen how hard make-up was because of your constant, violent coughing, keep you in the hallway until the very last minute so that you don’t interrupt the show with your paroxysms. And sometimes, you’ll start coughing so hard in that hallway that sound engineers peek out and flaccidly offer you some useless cough drops.
Sometimes, you’re interviewing a source and the whoop gets you. When it lets go, you look up and see your source staring at you with eyes squared by horror, and you, still catching your breath, have to soothe and reassure them that you are, after two Z-packs, no longer contagious. Sometimes, you find yourself explaining a sudden paroxysm on a date, and, at first, the guy might think your sense of humor is particularly edgy, with the occasional Victorian flourish. When you explain that, no, I am actually recovering from whooping cough, it can make, after that first stunned and quiet “Oh,” for a nice discussion of public health that ends, inevitably, with a profanity-laced rant about “Park Slope parents” not vaccinating their goddamn kids.
And sometimes you find yourself, after years of imagining yourself a serious reporter, writing for the public about what it’s like to cough so hard that you pee yourself. At 31.
Pertussis, named after the elegantly latinate bacterium Bordetella pertussis, starts the way of any cold or mild flu. Then, a week or two later, the coughing starts. That’s because B. pertussis glom onto and paralyze the cilia, the lash-like filaments in your airways that clear it out of mucus, the stuff your body uses to trap and get rid of the infection. The bacterium also emits various toxins, some of which mask the infection and don’t allow your immune system to recognize and attack it. It therefore takes longer for your body to clear it and leaves your trachea so inflamed that it is sensitive even to things like water and air, leading to those wild coughing fits that sound like this in kids and this in adults. And while my having pertussis at my age seems absurd, it can also be tragic: In babies, the infection can easily be fatal.
There’s a reason that we associate the whooping cough with the Dickensian: It is. The illness has, since the introduction of a pertussis vaccine in 1940, has been conquered in the developed world. For two or three generations, we’ve come to think of it as an ailment suffered in sub-Saharan Africa or in Brontë novels. And for two or three generations, it was.
Until, that is, the anti-vaccination movement really got going in the last few years. Led by discredited doctors and, incredibly, a former Playmate, the movement has frightened new parents with claptrap about autism, Alzheimer’s, aluminum, and formaldehyde. The movement that was once a fringe freak show has become a menace, with foot soldiers whose main weapon is their self-righteousness. For them, vaccinating their children is merely a consumer choice, like joining an organic food co-op or sending their kids to a Montessori school or drinking coconut water.
The problem is that it is not an individual choice; it is a choice that acutely affects the rest of us. Vaccinations work by creating something called herd immunity: When most of a population is immunized against a disease, it protects even those in it who are not vaccinated, either because they are pregnant or babies or old or sick. For herd immunity to work, 95 percent of the population needs to be immunized. But the anti-vaccinators have done a good job undermining it. In 2010, for example, only 91 percent of California kindergarteners were up to date on their shots. Unsurprisingly, California had a massive pertussis outbreak.
It would be an understatement to say that pertussis and other formerly conquered childhood diseases like measles and mumps are making a resurgence. Pertussis, specifically, has come roaring back. From 2011 to 2012, reported pertussis incidences rose more than threefold in 21 states. (And that’s just reported cases. Since we’re not primed to be on the look-out for it, many people may simply not realize they have it.) In 2012, the CDC said that the number of pertussis cases was higher than at any point in 50 years. That year, Washington state declared an epidemic; this year, Texas did, too. Washington, D.C. has also seen a dramatic increase. This fall, Cincinnati reported a 283 percent increase in pertussis. It’s even gotten to the point that pertussis has become a minor celebrity cause: NASCAR hero Jeff Gordon and Sarah Michelle Gellar are now encouraging people to get vaccinated.
How responsible are these non-vaccinating parents for my pertussis? Very. A study recently published in the journal Pediatrics indicated that outbreaks of these antediluvian diseases clustered where parents filed non-medical exemptions—that is, where parents decided not to vaccinate their kids because of their personal beliefs. The study found that areas with high concentrations of conscientious objectors were 2.5 times more likely to have an outbreak of pertussis. (To clarify: I was vaccinated against pertussis as a child, but the vaccine wears off by adulthood, which, until recently, was rarely a problem because the disease wasn't running rampant because of people not vaccinating their kids.)
So thanks a lot, anti-vaccine parents. You took an ethical stand against big pharma and the autism your baby was not going to get anyway, and, by doing so, killed some babies and gave me, an otherwise healthy 31-year-old woman, the whooping cough in the year 2013. I understand your wanting to raise your own children as you see fit, science be damned, but you're selfishly jeopardizing more than your own children. Carry your baby around in a sling, feed her organic banana mash while you drink your ethical coffee, fine, but what gives you denialists the right to put my health at risk—to cause me to catch a debilitating, humiliating, and frightening cough that, two months after I finished my last course of antibiotics (how’s that for supporting big pharma?), still makes me convulse several times a day like some kind of tragic nineteenth-century heroine?
If you have an answer, I’ll be here, whooping, while I wait.
http://i.imgur.com/6L0Z5bKl.jpg
At this writing, I have been coughing for 72 days. Not on and off coughing, but continuously, every day and every night, for two and a half months. And not just coughing, but whooping: doubled over, body clenched, sucking violently for air, my face reddening and my eyes watering. Sometimes, I cough so hard, I vomit. Other times, I pee myself. Both of these symptoms have become blessedly less frequent, and I have yet to break a rib coughing—also a common side effect. Nor do I still have the fatigue that felled me, often, at my desk and made me sleep for 16 hours a night on the weekends. Now I rarely choke on things like water, though it turns out laughing, which I do a lot of, is an easy trigger for a violent, paralyzing cough that doctors refer to not as a cough, but a paroxysm.
Since I came down with pertussis, more commonly known as whooping cough, waking up on Saturday, August 31, with what felt like a light fever and a tightness in my chest, I’ve celebrated the Jewish high holidays, covered Washington's response to the crisis in Syria, hosted several out of town friends and a dinner party or two, attended the funeral of a close relative and the wedding celebration of a close friend, given a lighter strain of the whoop to my mother, and, somewhere in there, managed to turn 31, whooping all the while. I even spent a long weekend on a beach in north Florida, where a friend commented on my now killer abs—odd since, because of my illness, I had not been to the gym at that point for 35 days. “The coughing,” she said cheerfully, “must’ve helped!”
My friends have gotten used to the whoop, and so, it seems, have my colleagues. When they hear it waft across the cubicle walls, that hacking cough melting into a high-pitched, desperate gasping, they now just say, “There’s the whoop!” Which is good because, given that pertussis’s other name is the “100 day cough,” they have a good month of my hackery left to joke about.
It’s funny having the whooping cough at 31 in 2013. Sometimes, you’re at the kind of nice restaurant you can now afford at 31, when the audacity of saying “Mm-hmm” as you chew ends with your choking—actually choking—on a shred of grilled scallion. Sometimes, you’re waiting to go on television to comment on world events, and the producers, having seen how hard make-up was because of your constant, violent coughing, keep you in the hallway until the very last minute so that you don’t interrupt the show with your paroxysms. And sometimes, you’ll start coughing so hard in that hallway that sound engineers peek out and flaccidly offer you some useless cough drops.
Sometimes, you’re interviewing a source and the whoop gets you. When it lets go, you look up and see your source staring at you with eyes squared by horror, and you, still catching your breath, have to soothe and reassure them that you are, after two Z-packs, no longer contagious. Sometimes, you find yourself explaining a sudden paroxysm on a date, and, at first, the guy might think your sense of humor is particularly edgy, with the occasional Victorian flourish. When you explain that, no, I am actually recovering from whooping cough, it can make, after that first stunned and quiet “Oh,” for a nice discussion of public health that ends, inevitably, with a profanity-laced rant about “Park Slope parents” not vaccinating their goddamn kids.
And sometimes you find yourself, after years of imagining yourself a serious reporter, writing for the public about what it’s like to cough so hard that you pee yourself. At 31.
Pertussis, named after the elegantly latinate bacterium Bordetella pertussis, starts the way of any cold or mild flu. Then, a week or two later, the coughing starts. That’s because B. pertussis glom onto and paralyze the cilia, the lash-like filaments in your airways that clear it out of mucus, the stuff your body uses to trap and get rid of the infection. The bacterium also emits various toxins, some of which mask the infection and don’t allow your immune system to recognize and attack it. It therefore takes longer for your body to clear it and leaves your trachea so inflamed that it is sensitive even to things like water and air, leading to those wild coughing fits that sound like this in kids and this in adults. And while my having pertussis at my age seems absurd, it can also be tragic: In babies, the infection can easily be fatal.
There’s a reason that we associate the whooping cough with the Dickensian: It is. The illness has, since the introduction of a pertussis vaccine in 1940, has been conquered in the developed world. For two or three generations, we’ve come to think of it as an ailment suffered in sub-Saharan Africa or in Brontë novels. And for two or three generations, it was.
Until, that is, the anti-vaccination movement really got going in the last few years. Led by discredited doctors and, incredibly, a former Playmate, the movement has frightened new parents with claptrap about autism, Alzheimer’s, aluminum, and formaldehyde. The movement that was once a fringe freak show has become a menace, with foot soldiers whose main weapon is their self-righteousness. For them, vaccinating their children is merely a consumer choice, like joining an organic food co-op or sending their kids to a Montessori school or drinking coconut water.
The problem is that it is not an individual choice; it is a choice that acutely affects the rest of us. Vaccinations work by creating something called herd immunity: When most of a population is immunized against a disease, it protects even those in it who are not vaccinated, either because they are pregnant or babies or old or sick. For herd immunity to work, 95 percent of the population needs to be immunized. But the anti-vaccinators have done a good job undermining it. In 2010, for example, only 91 percent of California kindergarteners were up to date on their shots. Unsurprisingly, California had a massive pertussis outbreak.
It would be an understatement to say that pertussis and other formerly conquered childhood diseases like measles and mumps are making a resurgence. Pertussis, specifically, has come roaring back. From 2011 to 2012, reported pertussis incidences rose more than threefold in 21 states. (And that’s just reported cases. Since we’re not primed to be on the look-out for it, many people may simply not realize they have it.) In 2012, the CDC said that the number of pertussis cases was higher than at any point in 50 years. That year, Washington state declared an epidemic; this year, Texas did, too. Washington, D.C. has also seen a dramatic increase. This fall, Cincinnati reported a 283 percent increase in pertussis. It’s even gotten to the point that pertussis has become a minor celebrity cause: NASCAR hero Jeff Gordon and Sarah Michelle Gellar are now encouraging people to get vaccinated.
How responsible are these non-vaccinating parents for my pertussis? Very. A study recently published in the journal Pediatrics indicated that outbreaks of these antediluvian diseases clustered where parents filed non-medical exemptions—that is, where parents decided not to vaccinate their kids because of their personal beliefs. The study found that areas with high concentrations of conscientious objectors were 2.5 times more likely to have an outbreak of pertussis. (To clarify: I was vaccinated against pertussis as a child, but the vaccine wears off by adulthood, which, until recently, was rarely a problem because the disease wasn't running rampant because of people not vaccinating their kids.)
So thanks a lot, anti-vaccine parents. You took an ethical stand against big pharma and the autism your baby was not going to get anyway, and, by doing so, killed some babies and gave me, an otherwise healthy 31-year-old woman, the whooping cough in the year 2013. I understand your wanting to raise your own children as you see fit, science be damned, but you're selfishly jeopardizing more than your own children. Carry your baby around in a sling, feed her organic banana mash while you drink your ethical coffee, fine, but what gives you denialists the right to put my health at risk—to cause me to catch a debilitating, humiliating, and frightening cough that, two months after I finished my last course of antibiotics (how’s that for supporting big pharma?), still makes me convulse several times a day like some kind of tragic nineteenth-century heroine?
If you have an answer, I’ll be here, whooping, while I wait.