Why are measles coming back?

❝ We eliminated measles in the U.S. in 2000. Somebody should tell the measles. Because even though the virus has no permanent home stateside, it keeps getting in—more and more, it seems.

❝ If you were born in the U.S. after about 1968, you’ve lived your entire life with virtually no interaction with the measles. Consider yourself lucky. The virus causes fevers over 104°F, inflamed eyes, a cough, plus a rash that begins as tiny white spots and becomes an itchy red mass spreading outward from the head to cover your entire body. And that’s just your basic measles encounter. About 30 percent of measles patients get extra complications, including diarrhea, pneumonia, brain inflammation, and permanent blindness. In healthy areas, few people died of the disease—only about 0.3 percent—but in impoverished or malnourished populations that figure jumps up to around 30 percent.

❝ Before the measles vaccine, 3 to 4 million people got the disease every year and basically everyone had gotten it by age 15. That might sound like pretty good news. If everyone gets it as a kid, surely it’s like chicken pox—you get it, then you’re over it. In some ways, that’s right. But it also means that the potentially permanent complications (and the fatalities) disproportionately affect little kids.

❝ We’ve kind of forgotten what it’s like to live in a world where young children regularly get serious diseases. It’s difficult to notice an absence of deaths, so here’s some perspective: from 2000-2012, the measles vaccine saved about 13.8 million lives. If we continue the way we’re going, though, we might get a different perspective. From 1989-1991, measles saw a huge comeback because people weren’t getting vaccinated enough—and we may not be too far from that happening all over again.

We’re losing herd immunity and that’s sufficient to allow this childhood killer back. RTFA for sensible discussion. By now – if you’re a regular reader of this blog – I take it down to two questions: ignorance or stupidity.

In this instance, I’d say both. I grew up before vaccines were common in the US. Every spring the kids in our factory town sooner or later got round to figuring out who died over winter…and from what. I had measles and waltzed right through. My kid sister wasn’t so lucky. Ended up in hospital in an oxygen tent with pneumonia before she kicked it.

We also had to contend with scarlet fever, whooping cough, mumps, rheumatic fever and more. The summer was saved for polio.

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Doctors Without Borders Launch Massive measles vaccination campaign in Guinea

Doctors Without Borders says it is launching a massive measles vaccination campaign with Guinea’s government after at least 14 deaths and more than 3,400 cases were confirmed so far this year.

The aid group said Friday that thousands of people were left unprotected in 2014 and 2015 when the Ebola outbreak swept through the West African nation. Vaccination activities were reduced because of infection risks, and frightened families stayed away from health facilities…

MSF health policy analyst Dr. Mit Philips says Guinea now faces health issues without the funding and support promised during the Ebola outbreak to build better systems there. Ebola killed more than 11,300 people in the region and devastated health care systems.

Yup. Unforeseen consequences at work. Who might have foretold an epidemic outbreak grounded in fear of going to a clinic. Yet, Ebola in epidemic stage is so frightening the response was almost automatic.

Now, people have returned to strapped health clinics all too slowly and the measles vector expands into the unvaccinated population.

The ignoranus middle class anti-vaxxers of America should be required to spend a month or so in Guinea as volunteers. They can witness firsthand what life can be in a nation unprotected by basic vaccination. Which is how I grew up – not one year out-of-sequence; but, in an America that hadn’t yet instituted the whole range of vaccine protection now available to our children.

In case you wonder why I hold no forgiveness for folks fighting against vaccination.

Largest current US measles outbreak centered in for-profit prison system

Health officials in Arizona say the largest current measles outbreak in the United States is in part because some workers at a federal immigration detention center refuse to get vaccinated.

Authorities have confirmed 22 measles cases in Arizona since late May. They all stem from the Eloy Detention Center, an Immigration and Customs Enforcement facility managed by the private Corrections Corporation of America.

Pinal County health director Thomas Schryer said the outbreak likely began with a migrant but that detainees have since been vaccinated. Convincing employees to get vaccinated or show proof of immunity has proven much tougher, he said.

“And so they’re actually the ones that are passing along the measles among each other and then going out into the community,” Schryer said.

The facility includes about 350 CCA employees and an unknown number of ICE staffers, although Schryer estimates it’s about 100. ICE doesn’t publicly release staffing levels, nor does it require employees to be immunized. There are currently over 1,200 detainees being held at the facility…

Arizona Department of Health Services Director Cara Christ says the facility has been more responsive in the past few days and that a large number of CCA employees were immunized late last week. “Once they understand how important it is and the outcomes it can have on the community, they tend to cooperate. So we hope to get a cooperative response from ICE,” Christ said.

The problem is reckoned to be one of ignorance rather than stupidity.

Measles is highly contagious and preventable through vaccines. It was eradicated in the US in 2000. But the past couple of years have seen new cases in large part because of unfounded stupid fears that the vaccination causes autism in children, Schryer said. The symptoms are usually mild but can be deadly in babies, who cannot be immunized until they’re a year old…

In Arizona, health officials are providing free vaccines, sending physicians to the detention center and providing educational outreach to staffers in an effort to contain the measles spread.

Now, imagine a whole nation run by Reaganomics hustlers like CCA. Tax dollars diverted into for-profit replacements for public service systems. Increase the profit structure by hiring less-educated, less-qualified scabs. Cross your fingers and hope you don’t end up with so many people dying you attract attention.

Enough to make a Congressional Republican cry with joy.

Melinda Gates’ response to anti-vaccine fools is education, history

On the heels of the measles outbreak at Disneyland, Melinda Gates of the Bill and Melinda Gates Foundation took aim at the vaccine naysayers who make these types of disease outbreaks more likely.

“We take vaccines so for granted in the United States,” Gates told the Huffington Post in a prerecorded interview published on Thursday. “Women in the developing world know the power of [vaccines]. They will walk 10 kilometers in the heat with their child and line up to get a vaccine, because they have seen death. [Americans have] forgotten what measles deaths look like.”

She added, “I’d say to the people of the United States: we’re incredibly lucky to have that technology and we ought to take full advantage of it.”

In response to the Disneyland outbreak, pediatric infectious disease specialist James Cherry told the New York Times the outbreak was “100 percent connected” to the anti-vaccine movement. “It wouldn’t have happened otherwise — it wouldn’t have gone anywhere,” he said.

The key is what the scientific community calls herd or community immunity. If every American of age was vaccinated, measles wouldn’t spread much further even if foreign travelers came into the country with the disease — as appears to be the case with measles.

Vaccinated people essentially act as barriers to measles outbreaks, since the disease can’t pass through them and infect other people. The awful truth of the anti-vaccine movement is that it puts the most vulnerable populations at risk: infants under 12 months of age, who can’t get vaccinated and are more susceptible to infection, and the elderly, who have a higher risk of death if they contract these illnesses.

Between religious nutballs whose anti-science hangups are reinforced by some dude behind a pulpit talking about an invisible dude sitting on a cloud in the sky — and conservative nutballs who indulge hangups that lead to unconcern about someone else dying from a condition we all can prevent – anti-science spookiness runs riot. They haven’t a clue.

Like that woman Melinda Gates talks about in the developing world, I grew up in a time and place where vaccines for many childhood diseases didn’t exist. Every spring we looked around at school to see who died over winter. Measles, scarlet fever, mumps, diptheria – all took their toll. Then we had the summer and polio to look forward to.

No – it wasn’t Africa or Asia. It was a factory town in southern New England. A town like every other in the United States at the time. No one was spared.

So, Melinda Gates’ response to anti-vaccine fools is education, history. My response to that is similar to Dr. King’s response when he was asked if civil rights laws would help bigots to love him. I don’t care if idjits love me. I just want to stop them from killing me and my family.

Fundamentalist measles threat from Canada

TrueBeliever

Health officials in Canada’s westernmost province are battling a large measles outbreak that is now threatening to spill over the border into Washington state.

As many as 330 cases of the highly contagious disease have been reported since early March in British Columbia’s lower Fraser Valley, near Vancouver, according to Paul Van Buynder, MD, chief medical officer of Fraser Health.

All but two of those cases have occurred among members of an orthodox Protestant sect that doesn’t believe in vaccination…

Four ill members of the congregation live across the U.S. border in Washington and have been isolated, but Van Buynder said Whatcom County officials now think a fifth person — not part of the church — has been infected…

The report comes as New York City health officials are reporting additional cases in an outbreak there, bringing the total to 25, including 12 children and 13 adults. Most of the children were too young to have had their measles shots and only four of the adults had a verified vaccination.

All told, the CDC said, there have been 104 cases of measles reported so far this year in the U.S., although that total did not include the Washington cases and only 23 cases in New York City. Most states had no cases but California is reporting 50.

Measles is officially eliminated in both the U.S. and Canada, but imported cases [and stupid cases] continue to cause disease.

Van Buynder said the Fraser Valley outbreak is epidemiologically linked to a large continuing epidemic among orthodox Protestants in the Netherlands that has been raging since May 2013 and had caused more than 2,600 cases by the end of February 2014.

An earlier outbreak in Canada — 42 cases in Alberta in the fall of 2013 and winter of 2014 — was also linked to the Netherlands epidemic.

The religion defense against vaccination is such crap when you consider the numbers of unvaccinated children – still too young to vaccinate – put at risk by True Believers.

Hundreds of children dying in Pakistan measles outbreak

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Measles cases in 2012 have surged by almost five times of that the previous year in Pakistan, leading to the deaths of hundreds of children, according to an international health body.

Maryam Yunus, a spokeswoman for the World Health Organisation (WHO) said on Tuesday that 306 children died in Pakistan because of the infectious disease in 2012, a dramatic surge from to the 64 children in 2011.

The WHO said the jump was most pronounced in southern Sindh province, where measles killed 210 children in 2012. Twenty-eight children died there the year before.

The organisation did not give a reason for the increase in deaths, but a provincial health official in Sindh said that the disease hit areas where poor families did not vaccinate their children.

A provincial health minister said 100 children died in Sindh province in December alone, mostly in areas where many people were not vaccinated.

He said health officials recently launched a campaign to vaccinate 2.9 million children in the affected areas of the province and urged parents to get their children vaccinated.

“We are vaccinating more than 450 patients per day. We are working on vaccination since the outbreak of measles in the area,” Dr Shahid Hafeez Shahani, a government official, said.

Do the math. At the current rate, they will have vaccinated 2.9 children in just under 18 years. Some of them will already have children of their own – halfway through the project.

Pakistan has a poor health care system, unsanitary conditions in many regions due to poverty, and a lack of education about how to prevent disease.

Pakistani officials believe that the worst-hit areas are poverty stricken areas where children did not receive vaccination.

Many Pakistanis, especially in rural areas, view vaccination campaigns with suspicion as a western plot to sterilise Muslims…

Most people who contract the disease recover, but it can be fatal for malnourished children.

Ignorance, poverty, religion. You can pick the order of responsibility, which needs to be dragged into modern life, first. They all share the blame – and the same clueless government.

Deliberately unvaccinated students put other children at risk


Give extra credit to Michelle Bachmann

Despite the successes of childhood immunizations, wrote Penn Nursing researcher Alison M. Buttenheim…controversy over their safety has resulted in an increasing number of parents refusing to have their children vaccinated and obtaining legally binding personal belief exemptions against vaccinations for their children.

People who cannot get immunizations because of allergies or compromised immune systems rely on “herd immunity,” the protection they get from a disease when the rest of the population is immunized or immune, explained Dr. Buttenheim. If a high number of children go intentionally unvaccinated because of personal belief exemptions, herd immunity is compromised, she said, giving a disease the chance to spread rapidly…

Vaccines are one of the great public health achievements of the last couple of centuries,” Dr. Buttenheim said. “They protect us from diseases that used to routinely kill hundreds of thousands of children in the United States and still kill hundreds of thousands globally. It’s not just important for a child to be vaccinated, it’s important at a population level to have high rates of coverage.”

In 2008, a measles outbreak spread in California. It was traced to a child whose parents had decided not to vaccinate him. He brought the disease back from Europe, infecting other children at his doctor’s office and his classmates. The boy’s parents had signed a personal belief exemption affidavit stating that some or all of the immunizations were against their beliefs, thereby allowing their son to go unvaccinated before entering kindergarten. California is one of 20 states that allow such exemptions.

Dr. Buttenheim plans to test several interventions at the school level, including new incentive structures for schools to increase adherence rates. She believes the school nurse can play a key role in encouraging parents to get children immunized. “We know everyone is heavily influenced by social norms and pressure,” she explained, and school nurses can set the expectation that children get fully vaccinated. “I think the school nurse can really act as a gatekeeper here, and reset the norm in favor of immunization.”

One of the reason we have government – as opposed to libertarian anarchy – is to protect the overwhelming majority of the population from the ignorance and foolishness of a small number of citizens. We have traffic lights and rules for 4-way stops at intersections. We don’t leave the decision-making up to who has the biggest SUV on the street.

If Dr. Buttenheim’s well-intentioned plan is as ineffectusl as I think it will be – we need to have the Feds step in and provide oversight to the sillyass states that let parents decide it’s OK to place the children of others in danger. There is no shortage of stupid regulations like this around the nation. This is one of the dumbest.

Whooping cough epidemic hits Washington State

Whooping cough, or pertussis, a highly infectious respiratory disease once considered doomed by science, has struck Washington State this spring with a severity that health officials say could surpass the toll of any year since the 1940s, before a vaccine went into wide use.

Although no deaths have been reported so far this year, the state has declared an epidemic and public health officials say the numbers are staggering: 1,284 cases through early May, the most in at least three decades and 10 times last year’s total at this time, 128.

The response to the epidemic has been hampered by the recession, which has left state and local health departments on the front lines of defense weakened by years of sustained budget cuts…

Did you think Republicans and Blue Dog Dems were going to cut funds for Naval Bases in Washington State?

Skagit county’s top medical officer, Dr. Howard Leibrand, who is also a full-time emergency room physician, said that in the crushing triage of a combined health crisis and budget crisis, he had gone so far as to urge local physicians to stop testing patients to confirm a whooping cough diagnosis.

If the signs are there, he said…doctors should simply treat patients with antibiotics. The pertussis test can cost up to $400 and delay treatment by days. About 14.6 percent of Skagit County residents have no health insurance, according to a state study conducted last year, up from 11.6 percent in 2008…

State health officials estimate that because of incomplete testing and the assumption that many people with mild cases are not seeking medical treatment, perhaps as few as one in five pertussis cases is being recorded and tracked, suggesting that the outbreak is far more widespread than the numbers indicate.

Pertussis was once a dreaded disease of childhood — killing 5,000 to 10,000 Americans a year from the 1920s through the 1940s — but is now a risk mostly to infants, to whom it is fatal in about 1 percent of cases. Most of the victims in Washington, as in previous outbreaks in other states, are between 8 and 12…

The pertussis vaccine is commonly given in childhood, and many states require it for children of school age. But Washington State, according to a federal study last year of kindergarten-age children, had the highest percentage of parents in the nation who voluntarily exempted their children from one or more vaccines, out of fear of side effects or for philosophical reasons…

Or sheer stupidity, ignorance compounded by religious blather.

Ms. Selecky said immunizations were meant to protect not only individuals but also the broader population: the so-called herd immunity threshold. If a large enough segment of the population is unprotected from a disease — generally considered 5 percent to 15 percent, depending on the disease — even people with some degree of immunity through vaccination can have an elevated risk, she said.

I’ve told this tale before – to people too ignorant to know what life in this land was like before widespread availability of vaccines. Every year, at the end of winter, you could look around the urban neighborhood where I grew up and ask – “Who died this winter?”

There would be other school-age kids who died of scarlet fever, measles, diphtheria, whooping cough, German measles – all the ailments these vaccines fight against. Then, we could look forward to summer vacation – and polio.

Review confirms few health problems ever caused by vaccines


The “traditional” alternative

An analysis of more than 1,000 research articles concluded that few health problems are caused by or clearly associated with vaccines. A committee of experts convened by the Institute of Medicine to review the scientific literature on possible adverse effects of vaccines found convincing evidence of 14 health outcomes — including seizures, inflammation of the brain, and fainting — that can be caused by certain vaccines, although these outcomes occur rarely. It also found indicative though less clear data on associations between specific vaccines and four other effects, such as allergic reactions and temporary joint pain. In addition, the evidence shows there are no links between immunization and some serious conditions that have raised concerns, including Type 1 diabetes and autism…

The majority of these problems have occurred in individuals with immunodeficiencies, which increase individuals’ susceptibility to the live viruses used in MMR and varicella. Six vaccines — MMR, varicella, influenza, hepatitis B, meningococcal, and the tetanus-containing vaccines — can trigger anaphylaxis, an allergic reaction that appears shortly after injection. And, in general, the injection of vaccines can trigger fainting and inflammation of the shoulder, the committee noted.

The evidence suggests that certain vaccines can lead to four other adverse effects, although the data on these links are not as convincing, the report says. The MMR vaccine appears to trigger short-term joint pain in some women and children. Some people can experience anaphylaxis after receiving the HPV vaccine…

The committee’s review also concluded that certain vaccines are not linked to four specific conditions. The MMR vaccine and diphtheria-tetanus-acellular pertussis (DTaP) do not cause Type 1 diabetes, and the MMR vaccine does not cause autism, according to the results of several studies. The evidence shows that the flu shot does not cause Bell’s palsy or exacerbate asthma. Suggestions that vaccines can lead to these serious health problems have contributed to parental concerns about immunization for their children.

Establishing a cause-and-effect relationship between an agent and a health outcome requires solid evidence. The committee’s conclusions are based on the strengths and weaknesses of several types of evidence, including biological, clinical, and epidemiological research. In many cases of suggested vaccine-related adverse outcomes, there is too little evidence, or the available evidence offers conflicting results or is otherwise inadequate to draw conclusions…

Which won’t mean much to those suffering from the most notable American disease – irrational, spooky conspiracy theories relying on gossip for decision-making.

Computational analysis comes to the aid of modern medicine once again. I know it won’t touch the fears of the conspiracy crowd – but, it’s a delight to have a sufficient level of readily-available computing horsepower at hand nowadays to throw at a task like this one.

Rejecting vaccines is as dangerous as it is dumb!

Given the success of vaccines in preventing a long list of diseases, why is opposition to vaccination gaining hold? Decision-making expert Valerie Reyna contends that it’s because anti-vaccination messages tell a compelling story compared to official sources, and they meet people’s need to understand rare adverse outcomes.

“In the era of Web 2.0, the contagion of ideas, transmitted rapidly through social media, is as concerning as the contagion of diseases because of their power to reduce vaccination rates, leaving populations vulnerable to preventable death and disability,” said Reyna…

This spring, the Centers for Disease Control reported that the United States is experiencing the highest number of measles cases in more than a decade. According to the alert, measles was declared eliminated in the United States in 2000 due to a high vaccination rate. This could change should vaccination rates decline…

Since most people don’t understand how vaccines work, the Internet, which facilitates users across the globe to sharing personal experiences and ideas about health care, fills the vacuum.

According to Reyna, anti-vaccination messages are expected when people don’t understand how vaccination works and when adverse events that are difficult to explain appear to be connected. Autism, for example, is diagnosed in children during the same time period that children receive a battery of vaccinations. Despite research to the contrary, anti-vaccination messages have claimed vaccines are to blame. Official sites, on the other hand, tend not to provide a convincing narrative story line that helps people connect the dots.

Under these circumstances, how do people approach the decision to vaccinate? In Reyna’s model, the decision to get a flu shot, for example, could be a seen as a decision between feeling OK (by not getting the vaccine) or taking a chance on not feeling OK (due to a vaccine side effect). Without better information, most people would choose not to get a vaccine.

In a culture as anarchistic as ours here in the United States, the misreading can be deliberate. There is a pundit I know who considers rejecting flu vaccination a point of libertarian ethics – and he stores/replenishes his supply of anti-virals at a cost of hundreds of dollars every flu season as appropriate “protection”. I guess if you can afford such lengths to satisfy rejecting one of medical history’s best solutions to recurrent illness – rock on!.

Rejecting a solution, a methodology – on the basis of the statistically-tiny number of long-term reversals or, worse, products demeaned by sleazy profiteers on occasion [as are all products], is illogical. I don’t mean to sound too much like Mr. Spock; but, the Age of Reason took our species past this sort of rationale a century-and-a-half ago.

I know my choice of words may offend good people; but, I grew up before most childhood vaccines were commonplace. My neighborhood in that New England factory town extended to 3 or 4 elementary schools, public and Catholic. When we finished winter and schoolkids gathered together again for the new season of sandlot baseball, one of the first things we sorted out was who died over the winter. Who had scarlet fever, who had diphtheria, who had whooping cough or mumps, who had measles, who died from the flu – la grippe. The only exception was the summer special, polio.

I know what it feels like to count up who was missing from a smallish community on just one side of a small city. Who died before we had access to vaccines. Those numbers were a hell of a lot more than the fears and trembling of people who don’t really look at statistics. Or have my memories.