Episode Transcript
Speaker 1 00:00:03 Hello and welcome to a Wonder Care podcast. I'm Sheena Mitchell, pharmacist and mom of three. I combine healthcare and practical advice to support you on your parenting journey. I bring you this episode with the support of Salon Plus Breathe Z cell therapy device. Today I'll be talking with Dr. Neve Lynch. We thought it would be very interesting to discuss the long-term neurological effects of measles mumps through Bella and chickenpox. We then explore the arguments for vaccination, both with the MMO and the chickenpox vaccine. Today I am joined by Dr. Neve Lynch, who is a consultant, pediatrician and pediatric neurologist. And you are a graduate of University College Cork and you won a whole load of medals and prizes, <laugh> while studying, and then went on to obviously do your training in Temple Street and in Crumlin and in Cork University Hospital. Can you tell me a little bit about what it is like to be a pediatric neurologist? I feel like, I dunno what your day-to-day looks like.
Speaker 2 00:01:14 That's a good question. That's not something I get asked very often actually. So day-to-day, um, the kind of things that I deal with are mostly children with headaches, epilepsy, or sort of more chronic neurological conditions. Um, sometimes as a long-term consequence of an infectious disease. So there's a wide variety of things. So my typical day would be I get up, get breakfast, get the kids to school, get the dog out to daycare. If he's coming to daycare, get into the ward, do a ward room. So I do general pediatrics as well. So there might be a, a number of kids who've been admitted with various infectious diseases in wintertime. Uh, and then the occasional child who has come in because they've had a first seizure at home or they've had an episode of collapse that can't really be explained or they have headaches or they have developmental problems. So that would be a huge thing what I do as well. So either developmental delays or regression in development. Uh, so those are the kind of things. So I do my wardrobe, then I go out to my clinic and see outpatients there. So that again, would be mostly follow up from the hospital. Um, seeing children who have migraines and epilepsy and other neurological problems and just making sure that their medications are up to date and that they're on the correct treatment and that their symptoms are controlled.
Speaker 1 00:02:33 Okay. And so your hospital work happens in the Bonds cure in Cork, is that right?
Speaker 2 00:02:40 Yeah, yeah. Yeah. So we're the, actually we're the only acute pediatric inpatient private facility. So you know, we're, we're the same as any other acute hospital unit. You know, we'd be similar to in size and to the Mercy Hospital in Cork. The only difference is that p parents and patients who come come in have health insurance about half population has health insurance anyway, so it's very similar to any other hospital really. Um, and people are surprised when they say that because they don't realize that there's an acute pediatric service there. But there is,
Speaker 1 00:03:12 Which is great to know if like you're in the area and I know I've seen you post about that before and you know, as a parent, that's very reassuring.
Speaker 2 00:03:22 Hmm. We get kids from everywhere, really. You know, people have come down from Dublin, people come from all over really to, to, because you know, look, the reality is that emergency departments are crowded and if we have a bed, you go straight into the bed. So, you know, it, it's just a, a clear pathway for people. So they know knownorthern not, they're not gonna be waiting for a particularly long time. So people do travel, you know, it'd be great if there were more units like, well look, and what would be really great is if pediatrics was, you know, was well funded and <laugh> well resourced all over the country, that would be the best thing. Um, but a as it stands, you know, this is, this is probably as good as it gets in terms of speed and efficiency, you know.
Speaker 1 00:03:59 Okay. I want to talk for one second. I just want to emphasize to people that you have an amazing Instagram page where you share a wealth of information and it's really, really a great resource to people. And the fact that you love dogs is another reason why <laugh>. I love hopping on there because I'm a bit obsessed. How did that all start? And do you enjoy that? The
Speaker 2 00:04:26 Dogs are the Instagram <laugh>?
Speaker 1 00:04:28 You can pick <laugh>
Speaker 2 00:04:30 <laugh>. The Instagram started. Um, why did the Instagram start? Oh, it was on Twitter and um, during the pandemic and you know, there was a lot of information and misinformation on Twitter. Um, and it just felt like, you know, you were kind of swimming against the tide really there. And somebody sent me messages and said, you know what? You should actually start up an Instagram page and share some reliable pediatric information. Cuz people weren't able to access their GPS or any of that kinda usual stuff that they would have during the pandemic. So I was like, oh God, that'd never take off <laugh>, you know? And, uh, how
Speaker 1 00:05:03 Many followers? About a month,
Speaker 2 00:05:04 Two a half. Now <laugh> I like, I'd have about 42,000, but within about a month I had, I'd say within about six weeks I had about 10,000 followers. I couldn't believe it. Like mad. It was mad and it was, it was kind of embarrassing cuz I'm not like, I'm, I'm a geek, you know, that it's not in my nature to be out there. And like, I remember going into work the day that I hit the 10,000 and all my, like the bonds is a lovely small hospital so everybody knows what's going on for everybody else. And uh, all these people are just like really giving me a hard time and teasing me <laugh>. Um, so yeah, so look, it's, it's been a weird, weird journey. I've pulled back a bit now because I think people have, have more ease of contact with their regular healthcare providers now. And uh, really it was just about sharing information just to try and counteract all of the really serious misinformation that was out there, you
Speaker 1 00:05:51 Know, and I love that. That's why I started Wonder Baba, which is Wonder Care. Now after my baby was born 10 years ago, my eldest and um, as you know, a healthcare professional, when you go online it's very frightening. Sometimes the information that you see, you're like, no, in Ireland we really do need a safe place for people to come to access simple healthcare information. So well done. You and during the pandemic was just a wonderful time to do that when people really needed resources and trusted I suppose healthcare information. So today we are here to talk because I've been speaking a lot about chickenpox lately on my podcast and in the missing,
Speaker 2 00:06:29 I'm scratching myself here,
Speaker 1 00:06:30 <laugh>, as soon as you mentioned
Speaker 2 00:06:32 Chickenpox, talking about our head lies,
Speaker 1 00:06:34 I met someone the other day who actually came up to me and it was just after I released the Headli episode and they come up and they just said, I didn't get through. I didn't get through without scratching my head. Cause you just can't. Yeah,
Speaker 2 00:06:45 But didn't, skin starts
Speaker 1 00:06:46 To crawl. It does. So I've spoken a lot about chickenpox, so I know people are fully aware of that. And if anyone wants any information about kind of the over-the-counter remedies and treatments and kind of home hacks to treat chickenpox, that episode is there for you. And I also have one which has a conversation on the vaccine, but we might talk about more about that later cause I'd love to get your view on that. I suppose I was very careful not to share my personal view on that episode because I feel like I don't have all of the information that exists. I'm not sure it exists, you know, a right and wrong scenario with that particular vaccine. So I just tried to outline the pros and the potential cons as they are now. But we were obviously chatting online and said it would be really interesting to have a little look at measles, mumps, rubella chicken box, that kind of thing.
Speaker 1 00:07:38 And you are obviously bringing in your expertise of the neurological complications that can happen to children after that. So I might just highlight brief sentences on those conditions just to explain I suppose what they are. So starting with measles, obviously highly infection, viral illness that starts with cold like symptoms that develop about 10 days after you get infected and you then get a measles rash a few days later, usually get high fever, little white spots in your mouth, loss of appetite and that kind of thing. The spots with measles rash are obviously small, red brown little spots. And they appear two to four days after the symptoms and takes about a week to fade. So then we have, uh, rubella, which is also a contagious disease caused by a virus. And it's spread like we're very familiar with viral spreading now, but close contact through coughing and sneezing.
Speaker 1 00:08:31 And again, it has a rash and mumps, another contagious viral infection, which used to be really common. But now we have the mmo, which is kind of obviously dampened down all of these viruses, but it's really recognizable because you get swelling on the sides of the face just under the ears at the parroted glands. And you know, I suppose it's often described as hamster face. So that's quite mm-hmm. <affirmative> defining for mumps. So they're the kind of three illnesses that I just, I, sorry, I just wanted to give that outline because I haven't discussed them on the podcast so far. And obviously they're not something that is, has been circulating very widely. I know before the pandemic started at work, we would often hear, and it was funny, it would be in like buildings of, you know, office buildings and stuff of people outbreaks of say, mumps happening. And it's interesting. And measles, I know there were some cases in hospitals, again just pre pandemic and so the health authorities were obviously warning us to be kind of vigilant. Is measles common now at the moment?
Speaker 2 00:09:42 No. So the last measles report we have from the HSE is back from 2018 there was a bit of, uh, there was a couple of clusters of outbreaks back then. There was five, five outbreaks and then, uh, there was about 67 cases and then a couple of linked cases as well. So that means that it was passed on to people. Basically, most of the people who got measles in that cohort were under the age of one. So they were too young to have been vaccinated. And the measles was brought in by somebody who was obviously unvaccinated and traveling. But once it, you know, gets into a community, it is finally contagious. It's, it's one of the most contagious viruses there are. And the problem with measles is that about 30% of children who get measles will need to be hospitalized, which is huge. Um, so if you get a measles outbreak, then there is gonna be a significant burden on the emergency services and hosp and children's hospitals.
Speaker 2 00:10:34 So it's definitely a nasty one in terms of the short term. Children get very sick. Now, when I worked in Nepal, children who, you know, they would be generally back then anyway, prone to a bit of malnutrition. Children who were low in vitamin A and get measles can get very unwell indeed. Um, that's not so much the case here in Ireland, but, uh, it is a serious illness. The immediate sort of symptoms would be, you know, the rash and the discomfort on the sore throat and the red eyes and things like that. But, uh, there can be complications, obviously. Now the most common one is pneumonia. Measles pneumonia is very severe and that's usually what leads to hospitalization. But there are neurological complications as well. So they can get a measles encephalitis, which is an inflammation of the brain caused by the virus actually infecting the brain.
Speaker 2 00:11:18 Um, they can have symptoms of meningitis and they can get a thing called adom, which is acute demyelination of the brain. So it's a bit like an acute attack of multiple sclerosis for to simplify it. So basically the white matter, um, in the brain gets attacked and damaged. Now they can recover from that, but it's obviously a very huge hit for a brain to take and for a child to try and recover from. And then there's a horrible thing called subacute sclerosis panencephalitis, which is S S P E, which can de develop 15 years later. And it's basically, uh, an inflammatory condition of, of the brain. The brain starts to misfire. You have regression so, you know, um, the person becomes withdrawn, may develop seizures, loses, you know, becomes severely neurologically affected and ultimately will usually go on to die. That's rare, but it is a real complication of measles. So those are the kind of things that worry me as a pediatric neurologist or the neurological, uh, implications. But for all children in the short term, they're, they have a one in three chance of ending up in hospital because of this illness.
Speaker 1 00:12:21 God, like that's actually so, so frightening. Now I know obviously that's worst case scenario, but I
Speaker 2 00:12:27 Actually, well see, I, I worked in Dublin during the measles outbreak back in the northeast early, yeah, 19 nine, 2000 I was there. I was in Temple Street and I just saw some really horrible things, um, children who were very, very badly affected and, and, um, at least one or two subsequently passed away. So, you know, it's not, it's not to be trifled with, it's a very, very serious illness.
Speaker 1 00:12:48 Okay. And,
Speaker 2 00:12:49 And that old <laugh>
Speaker 1 00:12:51 <laugh>, I'm like, I think we're probably around the same age, but anyway, <laugh> we're really young. Really, really, really young. Yeah,
Speaker 2 00:12:59 Yeah, yeah. Yeah.
Speaker 1 00:13:00 Rubella, I haven't heard of a case of rubella. I haven't checked,
Speaker 2 00:13:05 Yeah. Germans, German measles, if you remember the phrase German measles. I had it myself cuz I, I'm, I am that old that I wasn't, there wasn't a vaccine. So, um, yeah, it's, I, and I remember it myself, actually, I was about five or six when I had it. Uh, you do get a rash with it. Uh, you do feel kind of miserable muscles aches and pains again, sore eyes, sore throat. But you know what, it's a fairly, it's, it's fairly mild for children, but it has significant implications if a woman who is pregnant gets it, particularly in the first or second trimester, um, it can cause significant, uh, issues for the developing fetus. And one of the most common, uh, effects is congenital deafness. So there were, you know, back in the seventies and eighties, you would, it would be f reasonably common to, uh, meet somebody who had hearing, hearing loss or absence of hearing because of, of congenital rubella.
Speaker 1 00:13:59 And is that really why we screen for Mm. Or, you know, for immunity during pregnancy? Yeah,
Speaker 2 00:14:06 Yeah. Now it, it has other more serious effects as well during pregnancy. Um, you know, that that can result in, you know, miscarriage and things like that. But it, you know, if if the pregnancy continues to the end, then the, the more common one is definite. Yeah.
Speaker 1 00:14:19 Okay. Mumps. So as I was saying, I feel like there was definitely outbreaks going on pre pandemic.
Speaker 2 00:14:26 Yeah, there were, yeah, pre covid, there were, so basically, uh, there was a spike I think in maybe 2019. So what happened with the mumps is that it's really important that children get their booster for, for mumps. So, you know, the way, when they're in fifth of babies, junior infants are senior infants to get a booster, and that's, that's the MMO booster and particularly mumps immunity wanes. So if you look at the age profile of people who were getting it, it was people like in their teens, twenties, and early thirties. And that was, that was a kind of a twofold cohort. One was the group that di didn't get the booster, um, and one was the group of people who around the time of the Wakefield scandal, and it was a scandal back in 1998, there was a big falloff in the number of people actually getting vaccinated at all.
Speaker 2 00:15:12 And those young people were hitting their college years, uh, around 20 18, 19 and 20. So they were 19, 18, 19, 20 years old, and it was spreading amongst those, um, those people because they didn't have any immunity to it. So it's, it's a very painful and unpleasant condition at the best of times. But it can cause an orchid. So inflammation and infection of the testicles in males and can lead to long-term in infertility for men. The other, it can cause an encephalitis as well. So it can, it can cause neurological complications. Um, not as frequently as measles, but it is a recognized complication.
Speaker 1 00:15:47 Okay. And then in terms of chickenpox, I don't know if you're seeing a lot of it in the hospital setting, but certainly in the community, there are a lot of outbreaks of chickenpox this year, I would say more than normal, obviously. Look, it's not a notifiable disease. We don't have figures, but certainly, you know, from my work on wonder care, there is a lot of chickenpox going. I wonder is that just, obviously there's going to be a reduced amount of immunity because kids haven't been able to spread and share <laugh> the love as they would've pre pandemic. It's not something that you're seeing translating into hospital cases anyway.
Speaker 2 00:16:25 No, um, I'm hearing about it a lot, but the kids who tend to get hospitalized with chickenpox in the short term are children who have underlying skin problems. Um, so typically your child with eczema might end up with a more severe rash and be a bit more unwell and uncomfortable with the chickenpox. So those are the ones that we like to keep an eye on. They may, might need to be admitted, they might need, if they're showing signs of skin infection, they might need antivirals and antibiotics. So in the short term it's, it's the kids with, with skin issues that end up, uh, suffering the worst consequences. The other kids that end up quite unwell are if, if they get it around their eyes, um, we have to be very careful because it can cause injury to the, the cornea and things like that. So they need hospitalization as well for care.
Speaker 2 00:17:17 And obviously if their mouth is very sore and they can't eat and drink, they might need to come in for IV fluids. So it's not nice in the short term. Right. But I hate chickenpox because of the neurological complications that it can cause and I've, you know, I've, I've seen them and I would never wish it on any child. So chickenpox can cause a couple of things. One of the milder complications that can cause is cerebritis. So your cerebellum is the part of your brain that controls your balance. So children will lose their balance, start to fall over, have difficulty eating and drinking, speaking. They can be very unwell with it and you just have to sort of support them through it and treat them and make sure that they're safe and not going to injure themselves. Uh, but that resolves. Okay. Then there's encephalitis, which again, you know, is a very dangerous, unpleasant condition.
Speaker 2 00:18:10 And then the other thing that they get is a vasculitis. So inflammation and swelling of the blood vessels that supply the brain. So one of the, the two possible outcomes of that, they may have, uh, a bleed into the brain or they may suffer a stroke. So, you know, the, the neurological complications of chickenpox are really serious and not at all trivial, which is why I think that we should have a chickenpox vaccine because I've seen the sort of the extreme end of what can happen, but also the fact that when your child has chickenpox, you are basically outta circulation for two weeks. Right. And they don't all get it together. So if you've more than one child in the house, you know, the next one develops it about 10 days later. So that's another two weeks. And that's very difficult for people as well to, to have to manage. And it's two weeks of misery, it's not, you know, and then, and then it's, so it goes from like, well, maybe a week of discomfort into a week of like extreme boredom, <laugh>, you know, um, and that's the best case scenario. But the worst case scenario is that they ended up in hospital with a serious neurological complication.
Speaker 1 00:19:13 How common, like, do you have kind of, I suppose, stats for how common it is? Cuz you know, you hear a lot that in the majority of children it's mild.
Speaker 2 00:19:21 I'll have to check my stats there now. One second. I mean, I can tell you what happens. One second now.
Speaker 1 00:19:26 Yeah. Ultimately the fact that it's happening is, is enough fear for any parent, you know,
Speaker 2 00:19:31 Children who develop chickenpox maybe at a fourfold increased risk of stroke in the following six months. So it it, it increases your risk of stroke fourfold. Um, now how many, I don't have your numbers per like so many in a hundred thousand or anything like that. I guess I am the hammer. Everything looks like a nail to me, do you know what I mean? So when you see these complications, you kind of resolve that you're never going to, um, let a child have chickenpox ever again. You know, the, the best study I can quote for you right, is that, you know, stroke is rare in children, but it does happen. And you know, it's as important to know the signs of stroke in children as it is in adults, right? But in a study of 70 consecutive children in America, um, who'd had a stroke, a third of them had had chickenpox in the preceding year. So there's, there is a correlation between chickenpox and stroke.
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Speaker 1 00:21:01 Okay. Sold on your views to vaccination, however, right. Just for the interest of conversation, because my perspective on this is that it is just not as simple as let's roll out a vaccine program for all children. For a few reasons. First of all, not every child can clinically receive a live vaccine, you know, if they're immunocompromised or whatever reason that they're just not able. So I suppose ultimately those children aren't going to be exposed as children then because if we have everyone else vaccinated, it's not circulating so much in childhood. And as we know, chickenpox becomes a more severe D disease as you get older, are we then potentially putting those children who can't be vaccinated at greater risk of contracting it at an older age?
Speaker 2 00:21:53 So you're, you're into the realms of herd immunity there. Uh, so you need 95% approximately uptake of a vaccine for herd immunity to be bestowed. And, and if you have herd immunity, then that person is a, is buffeted and protected by the herd around them. So, so there's that argument. The, I suppose the best evidence we have is to look at what has happened in countries where they've introduced the chickenpox vaccine, right? So in the USA and in Australia, the vaccine has been there for many years now, and they're just not seeing that problem emerging. The other thing is that you have a specific immunoglobulin, varicella zoster immunoglobulin that you can administer to people who've, who you know are high risk, uh, if they're exposed to chickenpox. So there is a rescue treatment there so that, you know, you're not sort of saying, oh, tough, you know, <laugh> chickenpox, take your time.
Speaker 2 00:22:44 Yeah. Um, yeah, there, there is, there there is, uh, measures and protocols that can be taken for people who are vulnerable, high risk and exposed to chickenpox. So you have your sort of safety net there. Okay. I think on a, on a, on a population wide basis, the argument for chickenpox vaccine is strong, but obviously I, I see where people are coming from, but what bothers me about some of the narrative in this is that, you know, if we introduce the chick chickenpox vaccine, adults won't be regularly exposed to chickenpox virus and therefore they may be more prone to shingles, uh, in later life. Because we know that exposure to the chickenpox vaccine from the pediatric population boosts the adults immunity so that they're not prone to developing shingles. I don't think that's really fair when you look at the suffering that's being inflicted on children so that we can stop adults getting shingles. I don't think that's fair. I don't think that's just or equal. And there is now also a vaccine for shingles. So, you know, in an equal sort of, um, dialogue, you should consider the needs of children as equal to the needs of the adult and consider the sort of the potential devastating consequences of a com a complication of chickenpox for a child.
Speaker 1 00:23:55 I totally accept that. Yeah. One thing that has me concerned is that obviously the established, I suppose, length of immunity for the chicken box vaccine is kind of 15 to 20 years. So say if we go right gungho, it's on the childhood schedule, let's go for herd immunity, which obviously is an ideal scenario. My concern would be that in 15 to 20 years time, and this is more a concern with the management and planning of our government, because I think at that point we need to be proactively either giving a booster vaccine because you've got all these, say like, say you have a six year old child, little girl who gets vaccinated now 20 years time, she's suddenly, she's 26, she's in her childbearing years. We do know that there are huge risks associated with chickenpox during pregnancy. And so I don't think it would be fair to our children now just talking about equity for children and taking their needs into consideration.
Speaker 1 00:24:55 I think it would be reckless for us not to consider them as adults and their potential childbearing years. So I think there has to be, if we're rolling it out, a commitment that we're not rolling it out as a one-off childhood vaccine, that there's either immunity checks done, but like you can't do an immunity check every year if someone's twenties on the chance that they may get pregnant. You know what I mean? And a lot of people like the, the age of child, like, you know, you can be pregnant from the age of 17 to what, 50, you know? So I think we need to have a second rollout then a commitment to a delivery of a national live vaccine rollout again, unless obviously immunity can be proven to last longer than the current s spc 15 to 20 years, which it is at the moment.
Speaker 2 00:25:43 Yeah. The only thing I'd say to that concern is that the, the vaccine has been present in the states now for approximately that time span, if not a bit longer. And they're just not seeing that happening. You know, that, um, because your reservoir, if you like, of chickenpox is the pediatric population. Once you get immunity within that population, it tends not to trickle up, you know? So I, I don't know is the answer. I suppose I'm just seeing the devastating consequences of chickenpox, vasculitis, stroke, severe infections, things like that. You know, your,
Speaker 1 00:26:16 Your point there is very valid, and I hadn't really thought about it that way, but you know, if you've got a 26 year old who received their vaccine when they're six, well, all the children around them are, you know, that are 25, 24, 23, all the way down to, you know, one are, are vaccinated. So you're right, you're still gonna have herd immunity protecting those people. That strengthens the argument for sure.
Speaker 2 00:26:38 Yeah, yeah, yeah. Like, it's not like we just vaccinate one cohort and let them off. It's, it's a, it's a rolling thing. Do you know what I mean? So that's where look, you know, I mean these, these discussions are way above <laugh> my level of qualification anyway. And, you know, they're, they're advancing the discussion in the dialogue in the uk and typically when something happens in the N H s, it happens pretty quickly in the HSE as well. Huh. In my experience,
Speaker 1 00:27:04 20 years you're talking <laugh>, I'm like,
Speaker 2 00:27:07 Yeah, but with regards to vaccines and with regard to, there was something else that came in recently. Oh, I can't, was it one of the heal prick tests or something? Um, yeah, that had been introduced in the UK and was, um, the skid one, you know, the one about the severe immune deficiency, I think that was a UK move and then it came over to Ireland pretty quickly, you know, so
Speaker 1 00:27:25 I'm a, I'm a strong advocate for following your neighbors, you know, because clearly the uk, to be fair to them, do, I've seen that as pharmacists. They have a huge, they have huge resources available to them, and the capacity for research and study is greater than it is here in Ireland. And you know, generally, like you don't need to reinvent the wheel in terms of healthcare systems, which is what I've been talking about in the, the practicalities of the pharmacy world in that I've been talking a lot about a minor ailment scheme and that kind of thing, which works very successfully in the uk. So yeah, it'll be very interesting to see what the UK decide to do then. And I think I didn't have, I didn't have a, an opinion, that's what I'm saying. I didn't have a, I couldn't form an opinion and I think my two concerns you've kind of addressed. So
Speaker 2 00:28:15 Look, but then, you know, I'm not an immunologist or an epidemiologist, so I mean, I can't, I'm just that, that, those are my opinions. Like they're not, um, they're informed by my own reading and my own experience, I suppose, of the severe effects and impacts of chickenpox. But I know it's, it's not a perfect vaccine. It is a live vaccine. It's not perfect, but it's still, I, I think it, it still has merits and it still warrants good discussion and, and good analysis of the, the pros versus the cons.
Speaker 1 00:28:42 And I understand your perspective coming from seeing, you know, the worst case scenarios, I suppose, surrounding the conditions. You're absolutely right about the shingles vaccine and while it's available, it's not currently a reimbursable vaccine. So far the government haven't taken a proactive attitude to lifelong vaccination programs. It's just really the childhood program we have. And shingles, I think did they see in the USA by the introduction of chickenpox vaccine, right? They saw the average age of people affected by shingles reduce. So instead of being something that was, you know, kind of happening to 60 year olds is now happening more in the 40 year old year old age. So
Speaker 2 00:29:28 Who would've had their immunity boosted by exposure to children with chickenpox. But that's not no longer happening. Yes. And that's where the shingles is coming younger.
Speaker 1 00:29:35 Yeah. So I think obviously look, they're all caused by the same virus L virus. And I think we, if you're looking at one, you have to kind of look at the other really. They're, they're kind of part and part
Speaker 2 00:29:47 Also. Yeah. And I forgot Justin Bieber <laugh>. So Justin Bieber had this thing called Ramsey hunch syndrome whereby he had complete paralysis of the facial nerve. And that is a late onset complication of chicken pox as well.
Speaker 1 00:30:00 God, I did not know that. My Bieber information is not obviously <laugh> too high upstanding.
Speaker 2 00:30:05 See, I'm such, I'm such a neurology geek that, that kind of thing now I found very interesting. But yeah, it is, it's a late, it's a, it's a varicella complication.
Speaker 1 00:30:14 And just before we kind of finish up, you mentioned earlier fears that people had surrounding the, mm, I just, I think it's really important to say that there was one study which has been completely defunct, that drew a link between conditions, developmental conditions like autism and the mmo. And there has been so much research done into that area and has been completely disproven. So I really, really just urge patients to feel confident in the MM. Or and obviously talking to you today ne there's not really a good alternative. You don't know with immunity to everything is weirdly affected and I think we'll be seeing that for a few years post pandemic, we thought with the strange RSB seasons over the last two years. And influenza again was a bit erratic this year, um, peak and early and hard, you know? Mm-hmm. I, I think we'll have an interesting few years before things settle back down. And with obviously people traveling so much, there are a lot of countries that do still have high levels of things like rubella. And so it's important to maybe review decisions that you may have made about vaccination and try and be proactive.
Speaker 2 00:31:30 I, I think, I think for, uh, you know, that generation of children who were not vaccinated by parental choice back in the late nineties, early naughts, they're now coming into adulthood. They should check, they mightn't know their vaccination status. So that's something for, you know, and some of them are starting their journey of having families and things like that, you know, they may not have gotten their booster for example. So, you know, the sort of people in their early twenties now should probably try and find out what their vaccination status is, you know? Yeah. Important to know.
Speaker 1 00:32:00 It is. And it's no good waiting until you're pregnant cuz a lot of the times people, you know, aren't planning to have a baby. So it, it's better to, to I suppose,
Speaker 2 00:32:08 Well the majority of pregnancies are, are not planned, so Yeah. You know, it's, it's, it's something to, it's good for everybody to know anyway, especially with the mumps as well for male fertility, you know? Yeah. Um, it's not just women, it's it's men as well, you know, that it, it can affect fertility. So it's, it's good for people to know. They did offer, I think in U c I think they offered a, well they certainly had an outbreak there a couple of years ago and um, I don't know if a hundred percent sure, but I think vaccination catchup might have been offered. I'm not sure though.
Speaker 1 00:32:36 Okay. Okay. Thank you so much for all, all of that information. I did learn a lot about the neur neurological effects. I told you I was very clueless coming into this and it's actually quite frightening really, cuz you do tend to think about mild illness. So it's important to hear every side of the story and kind of,
Speaker 2 00:32:56 Well look, I mean, I don't want be like, you know, little miss scary over in the corner and these, these silent, these complications are rare, but they are real and they're avoidable. That's the thing. They're completely avoidable. Yeah. Um, so that's the important thing for people to remember.
Speaker 1 00:33:10 Thank you so much.
Speaker 1 00:33:15 I really hope that you have found the information in this podcast episode helpful. If you did, I'd really love if you could give us a little review on Spotify or Apple Podcasts or wherever you get your podcasts. That helps me to get more free accessible healthcare information out to parents because the streaming platforms start to show my podcast more. I really, really appreciate everyone listening and joining in and helping and sending in questions so that I know what you want to learn about. And I'll be here soon with another infectious disease for us to tackle. Don't forget to keep an eye on my Instagram page at Wonder Care underscore i l You can pop any questions you have into the question boxes when they open so that I can address your questions during a podcast. Thanks for listening.
