A Jan. 16, 1957, file photo shows 7-year-old Greg Cox, who had contracted mumps, looking at his brother, Doug, at their Altamont, Ill., home.

What was it like when mumps was rampant? Ask Greg

Poor Greg.

It was 1957 and Greg Cox, 7 years old, was at home in Altamont, Ill., a compress wrapped from chin to hairline. He was gazing wistfully out the window of the family’s kitchen door at his younger brother, Doug, bundled up outdoors and ready to play.

A sign was tacked to the door. “Greg can’t play,” it said. “MUMPS.”

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This was a decade before the start of the U.S. mumps vaccination program, and about 15 years before the combined vaccine for measles, mumps, and rubella — MMR — was licensed in the U.S. In the early 1960s, hundreds of thousands of American children a year contracted those diseases.

Today, thanks to vaccines, the number of annual mumps cases ranges from hundreds to a few thousand, depending on whether there’s a big outbreak. Measles, a more dangerous disease, is even more rare — a super bad year, like 2014, saw 667 cases reported to the Centers for Disease Control and Prevention. Still, numbers like these make experts worry that the rise of anti-vaccine sentiment is threatening the herd immunity used to keep vaccine-preventable diseases in check.

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But that’s today. Back in the late 1950s, there were only a few vaccines to protect against childhood diseases. Jonas Salk’s polio vaccine was new and widely viewed as a miracle. There was also smallpox vaccine, which drove that disfiguring and sometimes fatal disease out of existence around the world by 1980. The U.S. vaccinated children against smallpox until 1972, but the last domestic cases occurred in 1949.

The 1960s and 1970s would be a golden era for the development and introduction of vaccines to protect against childhood diseases.

Back when Greg and Doug Cox were little, though, kids developed immunity to things like measles, chickenpox, and mumps the hard way. They got sick, and it was no fun.

Mumps viruses attack the salivary glands, creating profound swelling in the cheek and jaw. Sometimes the disease affects both cheeks, sometimes just one. In male teens, it can also cause painful swelling of the testicles, which on rare occasions led to sterility. Some children who had mumps developed encephalitis, a dangerous inflammation of the brain.

When Greg contracted the mumps, his father, Charlie Cox, saw an opportunity. He and his wife, Jennie Lou, owned a small weekly newspaper in Altamont at the time. There wasn’t always a lot of news back then but there were pages to fill. So he asked his sons to pose. He even plumped out Greg’s cheeks a bit more by stuffing some cotton balls in them.

Greg, left, and Doug Cox re-create the photo their father took in 1957. Courtesy Greg Cox

Greg, now 69 and reached recently by phone by STAT, still remembers mumps as being pretty painful. He also remembers having measles and chickenpox, which were “very itchy.”

Charlie Cox submitted the picture of his mumps-suffering son to the Associated Press, which distributed the photo to its member newspapers. Before long, “get well” cards were pouring in from around the world.

“They were different times,” said Greg, now a naval vessel engineer living in Covington, La.

His brother, Doug Cox, now 66 and an actor based in Burbank, north of Los Angeles, knows he had measles and chickenpox, but doesn’t think he caught the mumps; neither does his mother, who turned 97 last weekend. He also recalls taking the picture with his brother.

“I just remember I had to stand outside and it was starting to snow and I just remember it being real cold,” Doug Cox said.

What Dr. Jerome Klein remembers from that time is regularly treating children suffering the serious side effects of mumps and other now mostly forgotten diseases.

Klein spent 60 years as a pediatric infectious diseases specialist in Boston. Growing up, he knew two people who died from measles — a young cousin and the brother of his best friend, who contracted measles and died within weeks of joining the navy.

“It was scary in the sense that it was real. People did suffer,” said Klein, who retired in 2017. “We knew the consequences.”

He also remembers treating young patients comatose with measles encephalitis. “And then they would wake up and the parents were thrilled. But we never knew how many deficits they would have from that period,” noting the brain inflammation always left “a fingerprint.”

The rise of anti-vaccination sentiment is tragic, Klein said.

Greg Cox went on to have a family. He said his two children — a son, now 28 and a daughter, 25 — got all the recommended vaccines.

“We had no hesitation at all,” he said. “It wasn’t even a discussion to vaccinate or not to.”