Several things are troubling about the measles outbreak in Kansas.
For one thing, it involved a lot of infants who were too young to be vaccinated. Their parents didn’t get to make a choice about getting vaccinated or getting measles. They got measles.
Also, as the case count climbs to 10, we still don’t know how the outbreak got started.
Does that mean someone else is still out there that exposed these kids to measles?
The Latest Measles Outbreak in Kansas
Since the outbreak in a daycare in Johnson County was discovered on March 8, a total of 10 measles cases have been identified, including:
eight Johnson County residents
one Linn County resident associated with the daycare
one Miami County resident not associated with the daycare
These cases may have exposed others at:
Auburn Pharmacy ; 625 E Main. St, Mound City, KS; on March 13th from 4:15 PM to 6:45 PM
Aldi’s ; 15290 W. 119th St Olathe, KS 66062; on March 2nd from 3:00 PM to 5:00 PM
Payless Discount Foods ; 2101 E. Santa Fe St, Olathe, KS; on March 6th from 10:00 AM to 12:30 PM
El Potro Mexican Café ; 602 N Pearl St, Paola, KS on March 7th from 4:00 PM to 8:00 PM
Children’s Mercy Hospital Kansas Emergency Department ; 5808 W 110th St, Overland Park, KS on March 8th and March 10th in the morning
AMC Dine – In Studio 28 ; 12075 S. Strang Line Rd, Olathe, KS; March 9th from 3:30 PM to 7:30 PM
Budget Coin Laundry ; 798 E Main St, Gardner, KS; on March 9th from 8:00 PM – 11:00 PM
Olathe YMCA swimming pool and locker room ; 21400 W. 153rd St, Olathe, KS; on March 10th from 9:30 AM to 1:00 PM
Bath and Body Works at Legends Outlets ; 1803 Village W Pkwy, Kansas City, KS; on March 10th from 1:00 PM to 3:00 PM
Crazy 8 at Legends Outlets ; 1843 Village W Pkwy, Kansas City, KS ; on March 10th after 1:00 PM to 3:00 PM
Orange Leaf ; 11524 W 135th St Overland Park, KS; on March 10th from 3:00 PM to 6:00 PM
If you were exposed and aren’t immune to measles (two doses of the MMR vaccine provide good protection), then you should watch for signs and symptoms to develop 10 to 21 days after your last exposure (in quarantine).
That means that we could expect to see new cases associated with this outbreak any time between March 12th (the earliest exposure) and April 3rd (the last exposure and the longest incubation period).
A History of Measles Outbreaks in Kansas
Some folks probably recall that this isn’t the first big measles outbreak in Kansas.
One of the largest measles outbreaks of 2014 was in the Kansas City metropolitan area. That year, at least 28 people developed measles, including a newborn who was only two weeks old.
In addition to the outbreak in Kansas City, there was another large outbreak that year in Sedgwick County – Wichita, Kansas.
And like most measles outbreaks, other states were affected too. Someone from Texas developed measles after getting exposed to measles at a softball tournament in Wichita.
More recently, outbreaks in Kansas have included:
a suspected case at William Allen White Elementary School in Lyon County, Kansas which has led to the quarantine of unvaccinated students for 3 weeks (2017)
a case in Butler County, Kansas. (2017)
a case in Sedgwick County, Kansas, a child too young to be vaccinated who may have been exposed at a church. Three other exposed infants who were too young to be vaccinated and who were considered at risk to get measles in this outbreak received immunoglobulin treatment. (2017)
a second case in the Wichita, Kansas area, this time in Sedgwick County, with exposures at a church, dental office, elementary school, and multiple stores over at least 3 days. (2017)
Why are there still so many measles outbreaks in Kansas?
Like in other places with outbreaks, it is likely explained by relatively high levels of non-medical exemptions and clusters of unvaccinated children and adults.
Hopefully this outbreak will be a good reminder that vaccines are necessary and everyone will get their kids caught up and protected.
What to Know About the Measles Outbreak in Kansas
Kansas is in the middle of another large measles outbreak and as usual, it is mostly among those who are unvaccinated, including many too young to be vaccinated.
No, I’m not talking about the “crude brew” that was the original DTP vaccine.
This older vaccine used more antigens than the DTaP vaccine that replaced it, so could cause more side effects. Even before that though, there was less oversight of vaccine manufacturers in the early 20th century. This could lead to vaccines that were contaminated or which simply didn’t work.
That certainly was a problem with the early smallpox vaccine, which is typically considered to be the most dangerous vaccine ever routinely used.
Variolation and Smallpox
But even before the smallpox vaccine was developed by Edward Jenner in 1796, we had variolation.
While the smallpox vaccine involved the cowpox virus, variolation actually infected someone with smallpox. The idea was to give the person a milder form by exposing them to a weaker, or attenuated, form of the virus.
They got this weakened virus from the smallpox scabs of someone who had already recovered and:
blowing dried smallpox scabs into their nose
applying pus from smallpox scabs to a small puncture wound on their skin
Variolation worked, giving the person immunity to smallpox – if they survived.
Unfortunately, about 1 to 3% of people who underwent variolation died.
And people who had recently undergone variolation could be contagious, leading to smallpox epidemics.
So why did folks undergo variolation if they had a chance of dying from the procedure?
A natural smallpox infection was so much more deadly. Up to 30% of people who got smallpox died, and many people eventually got caught up in the regular smallpox epidemics that plagued people in the pre-vaccine era.
The Hospital Rock Engravings of Farmington, Connecticut
We don’t have to worry about smallpox anymore.
Well, not about natural smallpox infections, since smallpox was eradicated back in 1980.
And there are many other diseases that we get vaccinated against, with it being extremely easy to get that protection, especially compared to what folks did in the old days.
Do you know how far folks went to make variolation safer?
“Every year, thousands undergo this operation, and the French Ambassador says pleasantly, that they take the small-pox here by way of diversion, as they take the waters in other countries. There is no example of any one that has died in it, and you may believe I am well satisfied of the safety of this experiment, since I intend to try it on my dear little son. I am patriot enough to take the pains to bring this useful invention into fashion in England…”
Lady Mary Wortley Montagu On Small Pox in Turkey (1717)
They actually went to smallpox hospitals to get vaccinated, remaining in quarantine for up to three weeks so that they wouldn’t get others sick.
In Farmington, Connecticut, two doctors established the Todd-Wadsworth Smallpox Hospital and had a lot of success with variolation.
Patients were no longer starved before inoculation, and many had begun to doubt the efficacy and safety of vomiting, sweats, purges, mercurials (toxic mercury salts such as calomel), and bleeding which had previously weakened both inoculees and those who “took the pox in the natural way.”
Charles Leach, MD on Hospital Rock
There, up to 20 patients at a time stayed in quarantine to get variolated, as a smallpox epidemic hit nearby Boston.
Between 1792 and 1794, many who got variolated wrote their names on what is now known as Hospital Rock.
“Many have supposed that the names on this rock were those who had did of the small-pox, but this is a great mistake. Every name on the rock is that of a person who was living when the name was placed there. Norris Stanley lived to own ships which were captured in the war of 1812 by Algerian pirates and still later to receive from the United States an indeminity therefor amounting to a large sum.”
James Shepard on The Small Pox Hospital Rock
The nearby town of Durham seemed to go a different way.
Instead of an inoculation hospital, they had a pest house to quarantine folks with natural smallpox infections.
Adding to the history of smallpox in Connecticut – a smallpox burying ground in Guilford.
Why wasn’t variolation popular everywhere? Folks didn’t have to wait for the first vaccine for the anti-vaccine movement to get started.
What to Know About Smallpox and the Hospital Rock Engravings
Hundreds of people got safely inoculated against smallpox and left their names on Hospital Rock near Farmington, Connecticut just before Edward Jenner discovered the first smallpox vaccine.
ITP is an abbreviation for idiopathic thrombocytopenic purpura.
It is a condition in which our platelets get destroyed, leading to excessive bruising and bleeding, since platelets are needed for normal blood clotting.
What Causes ITP?
To understand what causes ITP, it is important to know it is also often referred to as immune thrombocytopenic purpura, because it is typically the cells of our own immune system that destroys our platelets.
Well, that’s where the idiopathic part comes in.
We don’t know why people develop ITP, although classically, ITP is thought to follow a viral infection, including Epstein-Barr virus (mono), influenza, measles, mumps, rubella, and varicella (chicken pox). ITP has also been associated with many other viral infections, from Dengue fever to Zika.
“Often, the child may have had a virus or viral infection approximately three weeks before developing ITP. It is believed that the body’s immune system, when making antibodies to fight against a virus, “accidentally” also made an antibody that can stick to the platelet cells. The body recognizes any cells with antibodies as foreign cells and destroys them. Doctors think that in people who have ITP, platelets are being destroyed because they have antibodies.”
These children with ITP, usually under age 5 years, develop symptoms a few days to weeks after their viral infections. Fortunately, their platelet counts usually return to normal, even without treatment, within about 2 weeks to 6 months. Treatments are available if a child’s platelet count gets too low though.
Can Vaccines Cause ITP?
The measles vaccine is the only vaccine that has been clearly associated with ITP.
“The available data clearly indicate that ITP is very rare and the only vaccine for which there is a demonstrated cause-effect relationship is the measles, mumps and rubella (MMR) vaccine that can occur in 1 to 3 children every 100,000 vaccine doses.”
Cecinati on Vaccine administration and the development of immune thrombocytopenic purpura in children
Even then though, the risk of ITP after a measles containing vaccine, like MMR or ProQuad, is much less than after getting a natural measles infection, so worry about ITP is a not a good reason to skip or delay getting vaccinated.
What about other vaccines?
There is no good evidence that other vaccines, including the chicken pox vaccine, DTaP, hepatitis B vaccine, or flu vaccine, etc., cause ITP.
What about Gardasil? ITP is listed in the package insert as an adverse reaction for Gardasil, but only in the postmarketing experience section, so it does not mean that the vaccine actually caused the reaction, just that someone reported it.
Several large studies have actually been done that found no increased risk for ITP after getting vaccinated with Gardasil.
What to Know About Vaccines and ITP
Although measles containing vaccines can rarely cause ITP, vaccines prevent many more diseases that can cause ITP.
We should know that vaccine-preventable diseases were rarely mild, natural immunity comes at a cost, and that those who died from smallpox, diphtheria, measles, and polio aren’t around to talk about their experiences on Facebook (survivorship bias).
We should never forget that vaccine-preventable diseases were once big killers, and the only reason some folks have grown to fear the side effects of vaccines more than the diseases they prevent, is because we don’t see those diseases very much any more. If more people skip or delay getting vaccinated, we will though.
While the oral polio vaccine is indeed associated with shedding and vaccine associated disease, that doesn’t happen with MMR. Experts don’t even recommend any restrictions for use of the MMR vaccine for household contacts of people who are immunosuppressed. And yes, your kids can even visit a cancer patient if they just had their MMR, as long as they don’t have RSV, the flu, or some other contagious disease.
What about the fact that a study once found measles virus RNA in the urine of of kids who had recently been vaccinated? Doesn’t that mean that they were shedding the vaccine virus?
No. It doesn’t.
To be considered shedding, those measles virus RNA particles in their urine would have to be contagious. Now, measles is spread by respiratory secretions. So how are measles virus RNA particles in urine going to become airborne and get someone else sick?
But what about that case in Canada? Anti-vaccine folks like to bring this up when they talk about shedding. In 2013, there was a case of vaccine-associated measles. That proves that the vaccine sheds, right?
“Of note, only one case report of transmission from vaccine-associated measles has been identified.”
Murti et al. on Case of vaccine-associated measles five weeks post-immunisation, British Columbia, Canada, October 2013
That child got measles about 5 weeks after she was vaccinated in the middle of a measles outbreak. Because she had no links to the other cases and she tested positive for vaccine-strain measles, it is thought that she had MMR vaccine-associated measles, which is extremely rare.
Shedding Light on Measles Outbreaks in Daycare
MMR shedding is not causing outbreaks of measles – or rubella and mumps, for that matter.
If shedding from the MMR, by any method, got kids sick, then why aren’t there even more cases of measles?
When a case of measles does pop up though, it isn’t because of shedding, it is typically because someone who wasn’t vaccinated traveled out of the country, got measles, and brought it back home, exposing others.
What to Know About MMR and Shedding
Measles outbreaks are not caused by shedding from the MMR vaccine.
We have come a long way since the development of the first measles vaccines in the early 1960s…
Pre-Vaccine Era Measles Outbreaks
In the pre-vaccine era, measles was a very common childhood disease.
As it is now, it was also a deadly disease.
In the 1950s, there were 5,487,332 cases (just under 550,000 a year) and 4,950 deaths (about 500 each year).
In 1962, there were 469,924 cases of measles in the United States and 432 deaths.
Post-Vaccine Era Measles Outbreaks
The first measles vaccines were licensed between 1963 and 1965, but it was the first national measles eradication campaign in 1966 that got people vaccinated and measles rates down.
In 1970, there were only 47,351 cases and 89 deaths.
Rates continued to drop until the large outbreaks between 1989 to 1991, when there were 55,622 cases and 123 deaths. The addition of a measles booster shot got measles outbreaks under control again. By 2000, when measles was declared eliminated in the United States, there were just 86 cases and one death.
Post-Elimination Era Measles Outbreaks
Declaring measles eliminated in the United States didn’t mean that we didn’t have any more measles, after all, it hasn’t been eradicated yet. It just that we are no longer seeing the endemic spread of measles. Since 2000, all of the latest measles outbreaks have been imported from outside the country, or at least they are started by cases that are imported.
We have seen more than a few records in the post-elimination era, including:
the year with the historic low number of measles cases – 37 cases in 2004
the year with the largest number of cases since 1994 – 667 cases in 2014
the largest single outbreak since the endemic spread of measles was eliminated – 377 cases in Ohio in 2014
In 2015, we got a reminder of how deadly measles can be. Although there have been other measles deaths and SSPE deaths in the past ten years, unlike the 2015 death, they are usually buried in CDC reports and aren’t published in the newspaper.
2017 Measles Outbreaks
The first new case of 2017 was an unvaccinated adult in San Luis Obispo County, California who was exposed to international travelers over the holidays. The person exposed others to measles at the Twin Cities Community Hospital emergency department in Templeton while contagious in early January.
The second case of 2017 was related to an LA county outbreak that started at the end of 2016 – a resident of Ventura County.
And it went on, with other measles cases in 2017 including:
at least 122 cases
cases in 16 states, including California, Florida, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Utah, and Washington
an infant in San Luis Obispo County that was too young to be vaccinated and who had contact with an unvaccinated adult with measles
one new case in the Los Angeles County outbreak, which is now up to 20 confirmed measles cases (including 18 in LA County), all unvaccinated
four new cases in Ventura County, California that are linked to another Ventura County measles case and the LA County outbreak, which is now up to 24 cases
a case in Jersey City, New Jersey following international travel who exposed people at multiple places, including a hospital, pharmacy, mall, and on a commuter train
an unvaccinated 7-month-old baby from Passaic County, New Jersey who had been traveling out of the country and may have exposed others at area hospitals (a good reminder that infants who are at least 6 months old should get an MMR vaccine before leaving the country)
two cases in Salt Lake County, Utah – which began in a resident who had “received all appropriate vaccinations” and developed measles after traveling outside the US and then spread to another person “who had contact with the first case.” According to the SLCoHD, “One of the two individuals with measles had received one MMR vaccine.”
two cases in King County, Washington – a man and his 6-month-old infant, both unvaccinated, developed measles after traveling to Asia, and exposed many others around Seattle, including at a Whole Foods, a sandwich shop, their apartment building, and two Amazon buildings.
a confirmed case in Omaha, Nebraska, who exposed people on a Delta flight and multiple places in Douglas and Sarpy counties, including the Bergan Mercy Hospital Emergency Room.
two children in Minnesota without a known source of infection
another child in Minnesota – among the three Somali Minnesotans in this outbreak are two children who are just two years old – all of the cases were unvaccinated and two required hospitalization, although the common source is still not known. Vaccine hesitancy has been a problem among the Somali Minnesotans because of Wakefield‘s MMR study.
five more unvaccinated children in Minnesota, as the outbreak grows to 8.
a confirmed case in North Platte, Nebraska who may have exposed others at a middle school, church youth group, the Great Plains Health Emergency Room, a medical office, and a lab.
a resident of Livingston County, Michigan who exposed others at area restaurants and St. Joseph Mercy Brighton Hospital after getting measles on a plane ride with an unvaccinated child
another case in Minnesota, bringing the outbreak count to 9 unvaccinated children.
three more cases in Minnesota, bringing this outbreak case count to 12, with at least 200 people in quarantine.
eight more cases in Minnesota, bringing this outbreak case count to 20 young children under age 5 years, and now including an infant under age 12 months.
four more cases in Minnesota, bringing this outbreak case count to 24 young children under age 5 years and surpassing the size of the 2011 measles outbreak in the Somali community in the same area, which was also mostly among intentionally unvaccinated children.
five more cases in Minnesota, including the first outside of Hennepin County – spreading to nearby Stearns County, bringing this outbreak case count to 29 young children under age 5 years, with only one that was vaccinated.
three more cases in Minnesota, as the outbreak spreads to the third county – Ramsey County.
more measles (2 new cases) in Minnesota (Hennepin County, Ramsey County, Crow Wing County, and now Le Sueur County), where the ongoing outbreak is up to 66 cases, almost all unvaccinated children and where there has been a call to accelerate the two dose MMR schedule for kids over age 12 months.
a child in Maryland who was admitted to Children’s National Medical Center in Washington, D.C.
more measles (3 new cases) in Minnesota (Hennepin County, Ramsey County, Crow Wing County, and Le Sueur County), where the ongoing outbreak that has been confirmed to be from the wild type B3 strain is up to 68 cases, almost all unvaccinated children.
a case in Pennsylvania who exposed others at a visitor center
someone who visited the MIT Museum in Cambridge, Massachusetts.
two new cases in Minnesota, ending speculation that the outbreak, now up to 70 cases, was over…
one new case in Minnesota, raising the number of cases in this ongoing outbreak to 78 cases.
a healthcare worker in New York who is employed by Hudson Headwaters Health Network and also works at a Warren County medical practice.
someone in Franklin County, Maine (their first case in Maine in 20 years!) who traveled out of the country and caught measles, returning home and possibly exposing others at a movie theater, restaurant, farmers market, and hospital.
A case in Butler County, Kansas. Many remember that one of the largest outbreaks of 2014 was in Kansas.
an unvaccinated man who lives in Hennepin County, raising the number of cases in this ongoing outbreak (an outbreak that has already cost over $500,000 to contain and which many hoped would soon be over) that started in March to at least 79 cases. With the new case, the clock starts ticking again and Minnesota will have to wait to see if new cases appear over the next 3 weeks.
passengers from 13 states on an American Airlines flight from New York to Chicago were exposed to a person with measles in early July, including a 12-week-old infant who required preventative treatment with immune globulin (IG), as she was too young to be vaccinated.
a fully vaccinated resident of Onondaga County, New York who was exposed on a domestic flight, only developed mild symptoms, but did expose others.
someone who exposed others at the Penn State University Hetzel Union Building Bookstore and other places in State College, Pennsylvania.
a second case in the Wichita, Kansas area, this time in Sedgwick County, with exposures at a church, dental office, elementary school, and multiple stores over at least 3 days.
a possible case in Sedgwick County, Kansas, a child too young to be vaccinated who may have been exposed at a church. Three other exposed infants who were too young to be vaccinated and who were considered at risk to get measles in this outbreak received immunoglobulin treatment.
a traveler who spent time in Hampton Beach in New Hampshire, exposing others.
a 46-year-old male in Ohio that got the disease while traveling internationally.
2017 would have been a mild year for measles, except for the really big outbreak in Minnesota… 79 people got measles, 71 were unvaccinated, more than 500 people were quarantines, and the outbreak cost over $1.3 million to contain.
2016 Measles Outbreaks
Starting slow, 2016 ended as a fairly average year for measles:
cases in 17 states, including Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, Tennessee, Texas, and Utah
a large outbreak in Arizona, 23 cases, linked to a private detention center
a large outbreak in Shelby County, Tennessee, at least seven cases, including six unvaccinated and one partially vaccinated child
a case in Colorado in which an unvaccinated adult traveled internationally and ended up exposing many people “from Dec. 21 to 29, 2016, who was at a wide variety of locations in the Denver-Boulder area,” including an Urgent Care center and the Parker Adventist Hospital Emergency Department
As in other years, many of these outbreaks involved unvaccinated children and adults. One case involved a child at the Yuba River Charter School in California, a Waldorf School with very high rates of unvaccinated children.
2015 Measles Outbreaks
With a large outbreak in California, 2015 got off to a very strong start.
Most concerning, more and more, cases don’t seem to have an source that is easy to find, which could mean that the endemic spread of measles has returned in the United States. So instead of having to travel out of the country or be exposed to someone who got measles with a link to international travel, you could get measles just by going to a ball game, a movie theater, or to Disneyland. That makes it more important than ever to learn how to avoid measles.
Among the 189 measles cases and outbreaks in 2015 were:
113 cases that were associated with a multi-state outbreak that was linked to Disneyland in California. Before it was declared over on April 17, a few unvaccinated travelers also help spread measles from this outbreak to large outbreak in Quebec, Canada. All in all, the outbreak was linked to at least 113 cases in California and an additional 169 cases in Arizona (5), Nebraska (1), Utah (3), Colorado (1), Washington (2), Oregon (1), Mexico (1), and Canada (155).
13 cases, including an adult worker and 12 infants too young to be vaccinated at the KinderCare Learning Center in Illinois.
At least 13 cases, all intentionally unvaccinated, in a South Dakota outbreak that started with an unvaccinated adult traveling to India.
Five cases in Clallam County, Washington, including four who were not vaccinated, which cost at least $36,000 to contain and led to the death of an immunosuppressed woman.
In addition to these large outbreaks, 2015 also saw a number of quarantines for unvaccinated students, closing of daycare centers, and a recommendation from a California Department of Health state epidemiologist that people who are not vaccinated against measles “avoid visiting Disney” and “crowded places with a high concentration of international travelers, such as airports.”
Other measles cases in 2015 include:
A student at UC Berkeley who may have exposed others to measles on a public bus.
A confirmed case in Fairbanks, Alaska – their first case in 15 years, who flew in from Seattle (and is probably the King County case discussed below) and may have exposed others at an area Walmart, Home Depot, Walgreens, several supermarkets, the airport, and hospital, etc.
A confirmed case in King County, Washington, who may have exposed others in Seattle, including at an area McDonalds, the Baroness Hotel, a drug store, and the Sea-Tac Airport.
A confirmed case in Branson, Missouri, a traveler from Asia, who was contagious when visiting the ER, three local businesses, and perhaps his flight to town.
A confirmed case in the Washington D.C. area.
Another case of measles in Spokane County, Washington – an unvaccinated person that was exposed to the other case in the area.
An unvaccinated student from Europe in Boston, Massachusetts who also traveled to Maine and New Hampshire.
Another unvaccinated child in St. Lucie County, Florida – bringing the total to five cases in central Florida in what so far looks like two separate outbreaks.
Another case in Indian River County, Florida – an unvaccinated child.
An unvaccinated adult in Spokane, Washington – the first case in the area since 1994.
Two unvaccinated adults in Indian River County, Florida, one of whom contracted measles while traveling out of the country.
An unvaccinated 6-year-old in St. Lucie County, Florida who attended Fairlawn Elementary School in Fort Pierce – leading to five unvaccinated students being kept out of school until early May.
The first case in Oklahoma since 1997, a case in Stillwater.
A case in Florida, a traveler who was contagious while attending a conference at the Gaylord Palms Resort and Convention Center and also in Maimi-Dade, Orange, and Sarasota counties.
A new case in Illinois, the 15th – and so far not linked to the other two outbreaks in the state.
A student at Princeton University in New Jersey.
Another case of measles in the Washington D.C. area, a case without a known source.
A case in a student at Elgin Community College in Kane County, Illinois.
A hospitalized infant in Atlanta, Georgia.
An unvaccinated 1 year old in Jersey City, New Jersey.
A traveler in King County, Washington that may have exposed others in Seattle. The unvaccinated visitor is from Brazil, where there was a large outbreak of measles last year (almost 400 cases).
At least one more case in Clark County, Nevada and four more possible cases in Southern and Northern Nevada, which led to the quarantine of at least 11 students at the Spanish Springs Elementary School.
A case in Franklin County, Pennsylvania.
Four cases of measles in travelers, including two international travelers, who visited Florida.
A case in Washington D.C.
A student at Bard College in Dutchess County, New York, who exposed many people while traveling on an Amtrak train to Penn Station in New York City.
An unvaccinated woman in New Castle County, Delaware who had recently traveled out of the country.
A case on the University of Minnesota Twin Cities campus in a student that had recently returned from out of the country. Although others were exposed, it is considered to be a “highly immunized” population, so hopefully the outbreak won’t spread.
Two more cases in Arizona that are tied to the Disneyland outbreak, including a woman in Phoenix who may have exposed others up to 195 children at the Phoenix Children’s East Valley Center, including a 3-year-old getting chemotherapy for leukemia.
An adult in Cook County, Illinois which in not linked to Disneyland.
A student at Valley High School in Las Vegas which led to the quarantine of 36 unvaccinated students until early February.
Four cases among an unvaccinated family in Kearny, Arizona that is directly linked to the Disneyland outbreak.
A child in Sioux Falls, South Dakota that is unrelated to 13 recent cases in the area and which has no link to travel out of the area.
A new case in Oakland County, Michigan that is likely linked to the Disneyland measles outbreak, meaning that the outbreak has now spread to include 7 states and 2 countries.
A case in Maricopa County, Arizona has been linked to the Disneyland outbreak.
A person in Nebraska who could have exposed others in Omaha and Blair, including at the Omaha Children’s Museum.
A case in Lane County, Oregon that has been linked to the Disneyland measles outbreak.
A resident of Tarrant County in North Texas who developed measles after a trip to India.
Another unvaccinated person in Utah with links to the Disneyland outbreak has tested positive for measles, bringing the total in that state to 3 cases.
In addition to the 36 measles cases that have been associated with the Disneyland outbreak, California already has 5 additional measles cases this year with no link to Disney, including cases in Alameda, Orange, and Ventura Counties.
Mostly though, parents in North Texas do a good job of getting their kids vaccinated and protected.
The Plano Smallpox Outbreak of 1895
Of course, that’s not what’s keeping smallpox away.
Routine smallpox vaccination, which was typically given when children were about 12 months old, ended in 1972 in the United States. And smallpox was declared eradicated in 1980.
“Today, Preston Lakes is a quiet, manicured neighborhood in an affluent area of Plano. Almost 120 years ago, it was the site of one of Plano’s darkest hours.”
Plano Smallpox Outbreak of 1895
Driving around Plano now, it is hard to imagine that this city once battled smallpox.
While that is probably true of any modern city, the curious thing is that the area in and around Plano wasn’t settled until the early 1840’s, at which time an effective smallpox vaccine had been available for over 40 years.
“On May 6, 1895, Plano City Council called an emergency meeting, establishing a strict quarantine “to protect our citizens from this loathsome disease.” Anyone within the area between what is now Spring Creek Parkway, Park Boulevard, Coit and Preston Roads was forbidden to leave. An armed guard patrolled the border.”
Plano Smallpox Outbreak of 1895
Farwick Collinsworth, whose family owned large portions of what is now West Plano, lost his 11-year-old granddaughter in the smallpox outbreak.
Next, his wife and two sons died.
Then two more grandchildren and a nephew.
All together, at least 15 people died in the smallpox outbreak of 1895 in Plano, Texas.
“In 1806 the first smallpox inoculations were administered in San Antonio de Béxar. After initial resistance to the experiment, the townspeople came to accept the procedure, and the threat of smallpox was lessened for a time.”
Texas State Historical Association Public Health
While the Plano outbreak is certainly sad, it is truly tragic that smallpox was already a vaccine-preventable disease at this time.
History of Smallpox in Texas
Still, as late as 1900, 894 people died of smallpox in the United States. Globally, at least 300 million people died of smallpox during the 20th century.
So why weren’t folks vaccinated against smallpox in the late 19th century in North Texas?
While some people talking about issues with vaccine availability, remember that this is just after almost 100,000 people participated in the Leicester Demonstration March of 1885 to protest the smallpox vaccine.
While Leicester is quite a ways from Plano, a little bit closer to home we had the Laredo Smallpox Riot.
“When he realized that Laredoans were not fully embracing the quarantine program, especially the mandatory inoculation, he asked the governor to send in Texas Rangers. A contingent of rangers under Captain J.H. Rogers arrived on March 19, 1899, and began enforcing the health official’s orders more vigorously than some of the city’s residents thought proper. Milling protestors pelted rangers and health workers with harsh words and harder rocks, leading to a couple of minor injuries.
The next day, when the rangers got word that someone had telephoned a local hardware store to order 2,000 rounds of buckshot, the officers began a house-to-house search of the part of town where the order had come from. The situation soon deteriorated into a riot, with the rangers killing two citizens and wounding 10 others. It took cavalry from nearby Fort McIntosh to restore order.
The inoculation and fumigation program continued, and by May 1, Dr. Blunt lifted the quarantine in the border city.”
Frontier Medicine: Texas Doctors Overcome Disease and Despair
It maybe shouldn’t be surprising that the last smallpox outbreak in the United States was in Texas – in 1949. Eight people got sick, and one person, Lillian Barber, died.
But Texas wasn’t at the center of the anti-vaccine fight against protecting kids against smallpox. In Utah (the McMillan bill), Minnesota, and California, laws were passed banning mandatory vaccination for attending school. While the governors of Utah and California vetoed their bills, in Utah, legislators overcame the veto.
What came next?
Outbreaks of smallpox.
In 1906, AMA President William J. Mayo, a Minnesota physician, charged that his state’s “inability to enforce vaccination” had unleashed a smallpox epidemic, infecting 28,000 of the state’s citizens – “all due to a small but vociferous band of antivaccination agitators.”
Pox: An American History
That was over a hundred years ago.
What comes next?
Will we let today’s “vociferous band of antivaccination agitators” guide vaccine policy and put our kids at risk for vaccine-preventable diseases, as they push the same old anti-vaccine propaganda and fight against vaccine mandates, which are only necessary because they scare parents away from vaccinating and protecting their kids?
Let’s hope not.
What to Know About the Plano Smallpox Outbreak of 1895
Fifteen people died in Plano, Texas in 1895, even though a smallpox vaccine was available at the time that could have prevented this and most other smallpox outbreaks and epidemics. Tragically, the fight against its use mirrors much of what we see in today’s anti-vaccine movement.