Tag: Alexander Langmuir

Is Measles Really Airborne?

As we reach record numbers of measles cases, what are anti-vaccine folks concerned about?

Anti-vaccine folks trying to do research about measles and miss dozens of articles describing how measles is indeed airborne.
Anti-vaccine folks trying to do research about measles and miss dozens of articles describing how measles is indeed airborne.

Making sure their kids get caught up on their vaccines so that they don’t catch measles, since it is so contagious? Nope. They are still trying to find reasons to justify their decision to leave their kids unvaccinated and unprotected.

Is Measles Really Airborne?

Guess what?

Measles really is airborne!

Surpised?

Are you thinking that I am relying on a single experiment from 1964 or do you think I found some more evidence when I did my research?

Is this something folks really doubt, after all, if measles isn’t airborne, how would it be so contagious? How would people get sick after simply being in the same room as someone else with measles, even if the sick person had already left?

“During the past decade, increasing attention has been giving to the theory that indoor air is a vehicle of respiratory infection and to the logical sequence of such a theory, that the transfer from person to person of such infection can be reduced by increasing ventilation.”

Wells et al on Ventilation in the flow of measles and chickenpox through a community

In fact, even before the measles virus was actually discovered in the 1950s, it was known that measles was airborne. Wells did her experiments in the 1940s.

“It is far from clear to me yet whether measles is solely an airborne infection, as I think Wells believed, or whether contact and airborne routes both play roles in different circumstances. It is clear however that airborne infection is sufficiently common and important to be a dertermining factor in the continuance of measles at the present time. It must receive due respect and weight in planning the future steps necessary for eradication.”

Langmuir on Changing concepts of airborne infection of acute contagious diseases: a reconsideration of classic epidemiologic theories.

And those experiments were revisited in the 1970s, when measles wasn’t eradicated as quickly as expected. Alex Langmuir was Chief Epidemiologist at CDC at the time.

Did you ever hear about the story of the folks who got measles International Special Olympics Games in the Minneapolis-St. Paul metropolitan area during July 1991? It’s not a story the anti-vaccine groups would tell you. It’s a published case report, An outbreak of measles at an international sporting event with airborne transmission in a domed stadium.

“…the dynamic airborne transmission of measles illustrates the potential for transmission in the absence of a recognized exposure.”

Ehresmann et al on An outbreak of measles at an international sporting event with airborne transmission in a domed stadium

Several people at the Games got measles simply because they were in the domed stadium, even though they had no direct contact with anyone who had measles.

There are also reports of kids getting measles at their pediatrician’s office, simply because another kid with measles had been seen a little earlier.

Airborne Transmission of Measles in a Physician's Office

The kids described at the Michigan pediatrician’s office didn’t have any direct contact with the child with measles. They simply showed up in the same office an hour later.

“Four children had transient contact with the source patient as he entered or exited through the waiting room; only one of the four had face-to-face contact within 1 m of the source patient. The three other children who contracted measles were never in the same room with the source patient; one of the three arrived at the office one hour after the source patient had left.”

Block et al on Measles outbreak in a pediatric practice: airborne transmission in an office setting

Researchers described a similar situation at a pediatrician’s office in DeKalb County, Georgia at around the same time.

“Airflow studies demonstrated that droplet nuclei generated in the examining room used by the source patient were dispersed throughout the entire office suite. Airborne spread of measles from a vigorously coughing child was the most likely mode of transmission.”

Block et al on Measles outbreak in a pediatric practice: airborne transmission in an office setting

And increasing, we are seeing that airborne transmission means more folks are at risk on airplanes.

There is no doubt that measles is contagious and that measles really is airborne. Just like there is no doubt that vaccines are safe, with few risks.

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Alexander Langmuir on Measles

It’s a shame that most people only know of Alexander Langmuir because anti-vaccine folks like to make it sound like he was against vaccines.

How do they do that?

By making up quotes and using some real quotes out of context.

Alexander Langmuir on Measles

Remember the Alexander Langmuir quotes about flu vaccines?

He never really said that “no one should take the flu vaccine.”

And now folks are misrepresenting what he said about measles.

Alexander Langmuir was a big advocate of the measles vaccine.

So what did he really say?

“This self-limiting infection of short duration, moderate severity, and low fatality has maintained a remarkably stable biological balance over the centuries. Those epidemiologists, and there are many, who tend to revere the biological balance have long argued that the ecological equilibrium of measles is solidly based, that it can not readily be disrupted and that therefore we must learn to live with this parasite rather than hope to eradicate it. This speaker, not so long ago, was counted among this group and waxed eloquent on this subject in print.

Happily, this era is ending. New and potent tools that promise effective control of measles are at hand. If properly developed and wisely used, it should be possible to disrupt the biological balance of measles. Its eradication from large continental landmasses such as North America and many other parts of the world can be anticipated soon.”

Alexander Langmuir et al on The Importance of Measles as a Health Problem

Alexander Langmuir didn’t think that measles was a benign disease.

“…any parent who has seen his small child suffer even for a few days with persistent fever of 105, with hacking cough and delirium wants to see this prevented…”

Alexander Langmuir

And he thought that we should work to eradicate it.

“The availability of potent and effective measles vaccines, which have been tested extensively of the past 4 years, provides the basis for the eradication of measles in any community that will raise its immune thresholds to readily attainable levels.”


Alexander Langmuir et al on Epidemiologic Basis For Eradication Of Measles In 1967

Alexender Langmuir, who was Chief Epidemiologist at CDC for 21 years and founded the Epidemic Intelligence Service (EIS), said that “all infants should receive measles vaccine at approximately 1 year of age.”

What else did he say?

“When measles has become so widespread that epidemics are already present in several schools and in different communities within a city or county, more extensive communitywide measures must be undertaken. Then the full resources of the health and medical services of the total community, backed by well-coordinated voluntary agencies, will need to be mobilized. Again, priority should be directed first to the immunization of susceptible children in schools or who congregate in other enclosed spaces. If such immunization programs are carried out promptly and effectively, an epidemic of measles can be contained within 2 to 3 weeks.”

Alexander Langmuir

It would be nice to get back to where we could contain outbreaks in 2 to 3 weeks.

It would be nice if folks really listened to what Alexander Langmuir had to say and vaccinated their kids.

More on Alexander Langmuir on Measles

Who is Alexander Langmuir?

Alexander Langmuir is typically described as a hero or titan of public health.

Then why do some folks think he was against the flu and measles vaccines?

Who is Alexander Langmuir?

Dr. Alexander Langmuir has been called the father of infectious disease epidemiology.

Why?

In 1949, he established the CDC’s Epidemiology Program. Actually, at the time, the CDC was still called the Communicable Disease Center.

Dr. Alexander Langmuir and his Polio Surveillance Unit at the EIS in 1955.
Dr. Alexander Langmuir and his Polio Surveillance Unit at the EIS in 1955.

Dr. Langmuir, as Chief Epidemiologist at CDC for 21 years, also:

  • founded the Epidemic Intelligence Service (EIS)
  • instituted a malaria surveillance system
  • established national disease surveillance system for the United States
  • was involved in resolving the Cutter incident
  • brought the Morbidity and Mortality Weekly Report to CDC
  • investigated the swine influenza virus vaccine incident, when it was thought that some people developed GBS after getting the new swine flu vaccine in 1976

His work saved the lives of hundreds of thousands of people.

Don't believe any propaganda or quotes without sources attributed to Alexander Langmuir.
Don’t believe any propaganda or quotes without sources attributed to Dr. Alexander Langmuir.

Did he ever tell folks to not get a flu shot?

Was he ever concerned about mercury in flu shots?

Considering that Dr. Langmuir died in 1993, before folks became concerned about thimerosal in vaccines, that’s unlikely. That’s especially so considering that the only place you can find these types of quotes are on anti-vaccine websites.

Still, Langmuir was critical of flu shots.

“From this appraisal of the experience in the past three and one-half years, it is apparent that progress in the control of influenza has not been impressive.”

Langmuir et al. on The Epidemiological Basis For The Control Of Influenza

He didn’t think that they worked well enough. Or more importantly, he didn’t think we had enough information about how well they worked.

“Our information regarding the occurrence of influenza is largely qualitative. Schools close, absenteeism increases, medical services become taxed, virus isolations and serological identifications are made in great numbers, and daily accounts appear in our newspapers and on television. We know we have an epidemic and we know its specific cause, but we have few quantitative measures of incidence, age- and sex-specific attack rates, and character and severity of complications. Further- more, we have only crude data regarding mortality. We do not know what proportion of excess deaths occurs among reasonably active and productive citizens in contrast to deaths among persons who are already invalids suffering from severely debilitating pre-existing disease. Despite this serious deficiency we base our recommendations for vaccine use largely on mortality experience. We undertake major efforts to produce influenza vaccine in large amounts, but we have no meaningful information regarding its actual distribution. We do not know to what extent it actually reaches persons at highest risk.”

Langmuir et al. on A Critical Evaluation of Influenza Surveillance

But he wasn’t anti-vaccine.

And he never said that flu shots weren’t safe.

“The availability of potent and effective measles vaccines, which have been tested extensively over the past 4 years, provides the basis for the eradication of measles in any community that will raise its immune thresholds to readily attainable levels.”

Langmuir et al. on Epidemiologic Basis For Eradication Of Measles In 1967

And concerning all that he did in the field of public health, he is certainly not someone that anti-vaccine folks should be quoting.

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