Thanks to advances in science, many childhood diseases have been nearly or completely eradicated in the United States. A vaccine for pertussis, or whooping cough, was approved in 1914. In the 1960s, vaccines for measles, mumps and rubella were developed. In 1971, the three were combined in one shot.

For decades, cases of pertussis, measles, mumps and rubella, or German measles, declined to the point where most physicians only knew them from textbooks. By 1996, a chickenpox vaccine was added to children’s immunization schedule.

Yet in recent years, we’ve seen an increase in these five infections. Here, Rebecca Schein, a pediatric infectious disease physician with MSU Health Care and assistant professor of Pediatrics and Human Development at the Michigan State University College of Human Medicine, explains why and offers advice to protect children and families.

Let’s start with pertussis — what is it and why is it dangerous for kids?

Pertussis is a highly contagious bacterial infection of the respiratory system. However, it’s not the bacteria that creates breathing problems — it’s the toxins that the bacteria produce.

A small amount of Bordetella pertussis can make a large amount of toxin causing throat swelling, damage to the airway and terrible coughing. Patients cough until they can’t breathe and have to gasp for air — and that’s what makes the whooping sound that gives pertussis its common name, whooping cough.

The coughing can last for three months and there’s nothing we can do to make it stop. Treatment with antibiotics kills the bacteria and helps limit the spread of pertussis, but it doesn’t clear the toxin. It takes 90 to 100 days for the body to eliminate the toxin, and patients will cough for that entire time with a cough that can wake them from sleep and shake their entire body.

It’s terrifying when babies less than 6 months old get pertussis because they don’t have the muscle mass to get air back in after coughing and can stop breathing, which can be fatal.

What does pertussis have in common with chickenpox, measles, mumps and rubella and why are we seeing more kids with these illnesses?

The first thing these diseases have in common is that they are spread human-to-human, although the mechanism varies.

Pertussis, mumps and rubella are transmitted through contact with respiratory droplets from coughing, sneezing and saliva. It spreads when kids share drinks, cough or sneeze on each other. These are common things for kids to do, especially toddlers. Everything goes in the mouth, right?

Measles is an airborne disease. It spreads via microscopic droplets released when an infected person talks, breathes out hard, coughs or sneezes.

The chickenpox virus mainly spreads through contact with the rash itself and, sometimes, it can be airborne — spreading through the air.

The second thing that pertussis, chickenpox, measles, mumps and rubella have in common is that they are preventable with vaccines. Quite simply, we’re seeing more of these diseases due to declining vaccination rates.

What challenges come up with childhood illnesses that are rarely seen?

Four challenges come to mind. One is that many people don’t realize there are no medications to treat these viruses. At best, we have medications that can alleviate the symptoms, like acetaminophen (Tylenol or Motrin) to reduce fever, but we don’t have medications to stop the viruses themselves.

The antibiotic used for pertussis doesn’t stop the prolonged and intensive coughing that results from infection. For measles, mumps and rubella, there is no effective antiviral medication. For chickenpox, we have an antiviral medicine, acyclovir, but it has to be taken in the earliest stages of infection to be effective.

A second challenge is that at the early stages, these diseases can look like the cold or flu. With chickenpox, the window when acyclovir is effective is often closed by the time we know what’s causing the illness.

Also, if symptoms become severe, parents and guardians end up seeking urgent or emergency care for their kids. Complications can include secondary infections like pneumonia, bacterial skin infections and encephalitis, which is an inflammation of the brain. Babies with pertussis can die. Immunocompromised kids can die from chickenpox complications.

Data show that 20% of children who get measles will get sick enough to be hospitalized with severe infections. What’s more, any kid who gets measles can develop secondary side effects that might not appear until years later. Subacute sclerosing panencephalitis, or SSPE, a fatal disease of the central nervous system, can develop seven to 10 years after a bout of measles.

This brings us to the third challenge. Most health care clinicians only know of these childhood diseases from a textbook and perhaps seeing it on a video. Widespread vaccination rates over the last few decades mean that health care providers rarely, if ever, see these diseases in person. This lack of familiarity can contribute to delayed diagnosis or misdiagnosis.

Finally, the fourth key challenge is the one faced by immunocompromised patients. Some children are born with immune systems that don’t work; we call these congenital immune deficiencies. We also see kids with suppressed immune systems due to childhood cancer or steroid use. Children with severe asthma, for example, who are on a prolonged course of steroids and happen to get chickenpox can have very bad cases of chickenpox.

What can families do to help protect kids from this surge in childhood infections?

Lots! And none of the things parents, guardians and grandparents can do are difficult. They may already be doing some of them.

Adults who keep up with their booster shots help protect kids’ health. While we often think of pertussis, chickenpox, measles, mumps and rubella as childhood diseases, adults can get — and transmit — them too. Additionally, adults can make sure kids get their recommended vaccines on schedule.

Another thing parents, guardians and grandparents can do is practice and model good hygiene. Cough or sneeze into a tissue then toss it in the trash right away. If you don’t have a tissue, cough or sneeze into your elbow. Wash your hands properly. Wet, lather, scrub for 20 seconds, rinse and dry. Also, stay home when sick.

We have tools to reduce the surge in once-rare childhood illnesses. Vaccines are accessible and affordable. Everyone can practice good hygiene. We just have to use the tools we have.