It is hard in the modern Western world to comprehend the scourge of what are commonly regarded as childhood illnesses. Children in the past died during the epidemics that regularly swept through the community, others had life long health problems (people are still dying from post-polio syndrome from the mid Twentieth Century epidemics), others were rendered sterile (particularly as a result of mumps), and those mothers who contracted rubella during pregnancy had babies who were born blind and deaf.
Much work has been done to develop vaccines to counter these diseases and children from newborn up to adulthood, in Australia, today have access to a comprehensive program of free immunisation. This issue is topical for me personally, as a friend, of mature years and with limited exposure to children, has recently contracted whooping cough (pertussis). This is a most unpleasant illness for adults (sometimes described as '100 days cough') but is potentially life threatening for babies.
Writing about it on our Facebook page threw up some interesting information. After being very rare in the community, whooping cough is on the rise and it is now believed that childhood immunisation does not necessarily give life long immunity. There has also been a rise in the number of people who are not immunised, both among recent migrants and those who make a conscious decision not to have their children immunised.
Except in rare instances (eg where a child has a seriously compromised immune system while being treated for cancer) people who conscientiously oppose immunisation hold strong beliefs which tend to be based on discredited and erroneous research connecting immunisation and autism. There is NO link between immunisation and autism. and while eating a healthy diet may strengthen an immune system there is no evidence that it protects against illnesses like whooping cough, measles, mumps chicken pox, hepatitis, polio and the rest. Children who have not been immunised must be excluded from a child care centre or school for prescribed periods of time if illnesses which can be prevented by vaccine are found to be present in the facility.
For parents, this means ensuring your child receives all the prescribed immunisation, which are listed in the health record book you received from the Maternal and Child Health Centre. You will need to produce this record when your child enrols at school. Yes, injections are unpleasant and we hate to see our little ones subject to them, but better a few seconds pain than the consequences of the illnesses. It also means discussing with you doctor your own immune status and possibly arranging booster shots, or even primary immunisations if you have never received them. Either you or your child might have a mild reaction to the immunisation, but this is NOT the same as the illness. Sometimes it is possible for even immunised children to at some stage get a mild case of the illness but they are not subject to the same intensity of symptoms and risk of side effects. If they show signs of particular illnesses they must be kept home from child care or school for given periods of time.
What does this mean for nannies, child carers and teachers? The first step is to discuss your immune status with you doctor and have the necessary injections. If at some stage you think you are showing signs of the illness, do not go to work until you have seen the doctor and had your condition confirmed or cleared. If children in your care are notified as having one of the diseases you can attend work if you have been immunised. If you have not been immunised, you cannot attend for the required exclusion periods.
If you are a parent employing a nanny, it is obvious that a question to ask at interview is whether the nanny has been immunised. You may wish to make this a condition of employment.
Modern medicine is often criticised, but the prevention of common illnesses through immunisation has been a wonderful advance. It is up to us as a community to take advantage of such measures to protect us and our children. Small pox, as a disease was successfully eradicated from the world by vaccination, and in time hopefully other illnesses will be too.
The Science of Immunisation questions and answers. Australian Academy of Science
Immunise Australia Program, Department of Health and Ageing
Blue Book, Guidelines for the control of infectious diseases, Department of Health, Victoria
Raising Children Network, Immunisation