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Emergency Medical Services: "The Walking Dead"

This very popular television show is about post-apocalyptic life after the human population suffered a significant event from a biological disease. According to the story line, every person carries the disease within them, and when they die, they return as “walkers” with the intent of nothing other than to eat a living “nonwalker.” If you are bit by a “walker,” you will die. Even with all of the available resources (the CDC in Atlanta self-destructed when they decided there was no hope), no vaccine or cure has yet to be found.

While we don’t have to worry about the dead returning to eat us, we do have a number of diseases that have few if any cures or vaccines. Our most recent example has been Ebola, but we know about others, such as SARS, bird flu and seasonal influenza variants we seem to consistently miss in each year’s new flu vaccine. These have some solutions if caught early enough, but the death rates can be very high if left unchecked or untreated.

We are very fortunate to have vaccines for a number of diseases, and most of us have received these since we were little kids. Diseases like polio and measles have been easily controlled and nearly eradicated from the United States. Yet, despite availability of vaccinations, we recently saw a multistate outbreak of measles believed to have stemmed from unvaccinated children in Southern California at Disneyland.

A small, but vocal number of parents are concerned about the potential complications from vaccinations and have opted not to vaccinate their children. This lack of vaccination contributed to the recent measles outbreak becoming so widespread so quickly. This belief can also contribute to the proliferation of other diseases once thought gone.

All of this poses a significant risk to our personnel. We have existing standards for firefighters and EMS personnel that call for them to be vaccinated against diseases like measles, mumps, polio, hepatitis A and B, chickenpox and tetanus.

But in reality, not all of our personnel are current with their vaccinations. In some instances, we may even have personnel who hold the same beliefs as those parents who refuse to vaccinate their children. This potentially places our patients as well as our coworkers at risk of exposure.

In the fall 2009 EMS Chief Advisor, the EMS Section published Caring for Our Own: Vaccine Compliance within the Fire/EMS Ranks (PDF). This article, still applicable today, talked about the lack of a requirement for vaccinations as well as compliance rates in some organizations. Some department numbers were very good while others were not, and members have even left organizations to go to others where vaccinations were not required.

Ultimately, vaccinations should be part of every health, wellness and safety program in every department. There are many resources available to educate our personnel on the risk and benefits, and our own Mike McEvoy and Kathy West, members of the section’s Emerging Infectious Diseases Committee, are well versed in this area.

Our patients and our personnel’s lives are too important to be tripped up by the lack of a vaccination. And as diseases become more resistant to vaccinations and treatments, we certainly don’t want our personnel to become infected and end up as the walking dead.

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