Apr 26, 2019
Despite the fact that measles was declared “eliminated from theUnited States” in 2000, there are currently multiple outbreaks around thecountry, with over 55 cases identified in the US since January 1. “ As ofApril 10, 2019, 21 confirmed measles cases, including 13 outbreak-associatedcases (from 2 specific outbreaks) have been reported (in California),” from theCalifornia Department of Public Health website: https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx
New York state is seeing large outbreaks, and certain zip codes in NewYork City are issuing mandatory vaccination orders with a fine of $1000 for non-adherence. Mayor De Blasio has determined that this drastic public health measure is necessary to protect the population of the city.
Measles will be the only disease looked at today. The risk/benefit profile for each illness can be very different. We will discuss these issues next month
● The measles virus is very contagious, spread via droplets in the air after coughing or sneezing,
and it can last a few hours outside of the body.
● Death, deafness, other neurologic sequelae can be seen in children getting the illness.
● There is no treatment for measles, unless the person gets very ill and
needs ICU support.
● 97% of people getting the vaccine are protected from getting the illness.
● Concerns about autism caused by the vaccine have been heavily publicized. Major reputable
studies have been unable to prove any connection.
● There is no mercury or thimerosol in the MMR (Measles, Mumps, Rubella) vaccine.
● “Herd Immunity” is obtained when 90-95% of the local population is immune, either
through vaccination or by already having had the illness. In communities without this level of
protection, the virus can get a solid foothold in the population which allows it to keep spreading,
as an “outbreak.”
● In California, since 2015, all children need to be vaccinated to enter Kindergarten and 7th grades,
unless they get a ‘medical exemption’ signed by a doctor.
● To see about risk in your community, you can check on vaccination rates in local schools:
While we have seen some cases in the US over the last 15 years, there seems to be an upsurge this season. Since 2000, annual US cases have ranged from 37 in 2004 to 667 in 2014, with the last US fatality in 2015. These outbreaks are all felt to start overseas. Travelers bring the virus into the US, and then it is able to get established in areas with low vaccination rates or disaster areas.
A large global campaign has been in process over the last 15 years with billions of dollars being spent on vaccine distribution in poorer countries by organizations funded by the likes of Bill Gates and Ted Turner. An 80% drop in fatalities was noted globally from 2000 to 2016, mainly in children under 5, a most vulnerable group. That number of deaths in children is still at 90,000 a year, even at its lowest, making measles a current devastating killer of children. In the US, about 1/1000 of children who get measles will die. In poorer countries where malnutrition and poverty are more prevalent, it can be as high as 1/10 of those who get the measles can die. About 2 years ago, a global increase in measles cases was noted, and experts attribute that to low rates of coverage in some underdeveloped countries and declining vaccination rates in countries where there has been a breakdown in the medical systems— Syria, Ukraine, Venezuela, Yemen. Missionaries returning from the Philippines appear to be the cause of a 2014 outbreak in Ohio and the “Disneyland Outbreak” of 2015.
Vaccine-preventable diseases are a hot topic right now, especially with measles making a comeback. There have been ongoing infections in under-developed countries, and there have been recent resurgences in countries where the health system has collapsed due to political instability. International travelers then can bring back this very contagious virus, and in communities with low immunization rates, outbreaks can occur. Next month, we will take a deeper look at the reluctance of some families to vaccinate.
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