Tag: contagiousness

Did Gregory Poland Really Say That MMR Vaccines Can’t Prevent Measles Outbreaks?

One of the pillars of the anti-vaccine movement is their belief that vaccines don’t even work.

They even think that they have graphs to prove it! They don’t…

Did Gregory Poland Really Say That MMR Vaccines Can’t Prevent Measles Outbreaks?

To help them try and argue their point, they also seem to like to cherry pick and misuse quotes from real experts.

Anti-vaccine propaganda from Lawrence Solomon.
Is that what Dr. Poland said?

In 2012, Gregory Poland, the Editor-in-Chief of the journal Vaccine, did publish the article, The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines?

No where in the article does he say that the measles vaccine can’t prevent measles outbreaks.

He is just saying that since the vaccine isn’t 100% effective and because measles is so contagious, that it can’t prevent all measles outbreaks.

“Thus, measles outbreaks also occur even among highly vaccinated populations because of primary and secondary vaccine failure, which results in gradually larger pools of susceptible persons and outbreaks once measles is introduced.”

Poland et al on The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines?

And we likely won’t be able to eradicate measles with our current measles vaccine, “even though measles can be controlled, and even eliminated in some regions for defined periods of time.”

“Thus, while an excellent vaccine, a dilemma remains.”

Poland et al on The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines?

The dilemma is that measles is still around and that people who are too young to be vaccinated, too young to be fully vaccinated, and those with immune system problems who can’t be vaccinated sometimes get measles, in addition to folks who are intentionally unvaccinated.

With a better vaccine, fewer people would get caught up in outbreaks that are typically triggered by folks who are intentionally unvaccinated.

Remember, most outbreaks are traced back to someone who is unvaccinated. This is the person Dr. Poland is describing when he says “once measles is introduced,” as the endemic spread of measles has been eliminated in the United States. All cases are reintroduced from outside the country, typically when someone who is intentionally not vaccinated travels overseas and then returns with measles while they are still contagious.

“But he also said that sometimes people who oppose the vaccines will pick out one sentence in the scientific study and extrapolate it to mean things that it does not mean… He said that measles is the most contagious disease that we know, and yet we found that fear and ignorance is more so.”

Senator Carla Nelson on The Anti-vaxxers Might Wish that What was Lost had not been Found

Unfortunately, a better measles vaccine still won’t protect us from anti-vaccine propaganda.

Vaccines are safe, with few risks, and necessary. Get vaccinated and stop the outbreaks. You don’t have to wait for a new measles vaccine…

More on Did Gregory Poland Say That MMR Vaccines Can’t Prevent Measles Outbreaks?

The Pacific Northwest Measles Outbreak of 2019

Breaking News – There are 2 new cases in Clark County (70 cases), bringing the total case count to 75 cases.

It started with a confirmed case of measles in a child in late December.

The Pacific Northwest measles outbreak on 2019 started when a child exposed others in the area in late December.

There were soon reports of more cases.

The Clark County measles outbreak quickly grew.

And more cases.

The Pacific Northwest Measles Outbreak of 2019

But the measles cases didn’t stay in Clark County.

Two of the unvaccinated kids from Clark County traveled to Hawaii while they were contagious.
Two of the unvaccinated kids from Clark County traveled to Hawaii while they were contagious.

As with other recent large measles outbreaks, cases soon spread to neighboring counties.

As of late January, there are now measles cases linked to this ongoing outbreak in Clark County and King County (Washington) and Multnomah County (Oregon).

The rapid growth of the outbreak led Clark County to declare a local public health emergency and Washington’ governor to declare a State of Emergency in all counties in the state of Washington.

“The measles outbreak and its effects impact the life and health of our people, as well as the economy of Washington State, and is a public disaster that affects life, health, property or the public peace.”

Governor Jay Inslee on proclaiming a State of Emergency

Why so much concern?

Are you familiar with the immunization rates in this part of the country? About the only good thing you can say about Washington’s immunization rates are that they are better than Oregon‘s…

Washington has one of the highest rates of exemptions in the United States.

That’s right.

High non-medical vaccine exemption rates and low vaccination rates. A recipe for very large outbreaks of vaccine-preventable diseases, especially measles which is so highly contagious.

Immunization rates by county in Washington.

And a recipe for disaster. These outbreaks are getting harder to control, are lasting longer, and are getting bigger and bigger.

Also remember that the last measles death in the United States, in 2015, was a woman who got caught up in a measles outbreak in Clallam County. Why didn’t that trigger folks in the area to get Vaccinated?

Pacific Northwest Measles Outbreak of 2019
Clark County (WA)70 cases
King County (WA)1 case
Multonomah County (OR)4 case
 75 cases

How many of them are vaccinated? Anti-vaccine folks are pushing hard to convince folks that everyone in the outbreaks are vaccinated. Don’t believe them!

As in most outbreaks, almost all of the people in this outbreak are unvaccinated.

How many people will get sick in the Pacific Northwest Measles Outbreak of 2019 before it ends?

You will have to make an extra appointment if you followed his immunization plan and left your kids unvaccinated and at risk during this outbreak.
You will have to make an extra appointment if you followed his immunization plan and left your kids unvaccinated and at risk during this outbreak.

Are parents going to keep listening to anti-vaccine folks who push the idea that measles isn’t that bad and make you think that it is riskier to get vaccinated?

Are they going to realize that unless they are malnourished or have a vitamin deficiency, that taking extra vitamin A that you order from someone’s online store will not reduce their risk of severe complications if their unvaccinated child gets measles?

“Please contact your pediatrician or doctor if your child is scary sick, struggling to breathe or unable to eat or very lethargic or otherwise seriously ill. Let them know you are worried they may have measles so they can arrange not to contaminate the waiting room or the whole office.”

Paul Thomas, Integrative Pediatrician

Getting vaccinated can help keep your kids from getting “scary sick” from measles…

“The above recommendations are informational only. Please consult with your doctor before implementing anything you might learn here.”

Paul Thomas, Integrative Pediatrician

The only good advice he gives.

Anti-vaccine misinformation has gotten us to the place where these outbreaks are becoming more common. Vaccinate your kids so they don’t get measles and don’t expose anyone else.

And for the anti-vaccine folks who are asking:

  • it isn’t going to be shedding or a vaccine strain that caused the outbreak
  • everyone or almost everyone in the outbreak is going to be unvaccinated
  • the measles vaccine does work against all the different genotypes of measles
  • more people don’t die from getting the MMR or any other vaccine than from the diseases they protect us against
  • whether the death rate of measles is 1 in 1000 or 1 in 10,000 cases, remember that just before the measles vaccine came out, in the early 1960s, nearly 500 people would die of measles each year. And it isn’t that a person dies after 1,000 or 10,000 cases. With more cases, there is just a higher chance that someone will eventually die.

And you are still worried about the MMR vaccine because anti-folks are still scaring you away from vaccinating and protecting your kids.

Vaccines are safe and necessary with few risks. There is no good reason that we should still have outbreaks like this.

More on The Pacific Northwest Measles Outbreak of 2019

Updated March 3, 2019

How Contagious Is Measles?

Did you hear about the folks in New York who got quarantined isolated on the Emirates plane from Dubai?

Turns out that about 10 passengers had the flu or other cold viruses.
Although the worry was likely about MERS, it turns out that about 19 passengers had the flu or other cold viruses.

News like that and folks getting exposed to other infectious diseases, probably has them wondering just how contagious these diseases are. Do you have to be sitting next to someone to get them? In the same row? On the same floor?

Understanding Your Risk of Catching a Disease

Fortunately, most diseases are not terribly contagious.

We worry about some things, like SARS and Ebola, because they are so deadly, not because they are so contagious or infectious.

Wait, contagious or infectious? Aren’t they the same thing?

To confuse matters, some infectious diseases aren’t contagious, like Lyme disease. And some vaccine-preventable diseases are neither infectious nor communicable. Think tetanus. You may have never thought of it that way, but you aren’t going to catch tetanus from another person. Of course, that’s not a good reason to skip getting a tetanus shot!

To understand your risk of getting sick, you want to understand a few terms, including:

  • infectious disease – a disease that can be transferred to a new host
  • communicable – an infectious disease that can be transferred from one host to another
  • non-communicable – a non-infectious disease which can not be transferred from one host to another
  • contagiousness – an infectious disease that is easily transferred from one person to another
  • infectivity – the ability of an infectious agent to cause an infection, measured as the proportion of persons exposed to an infectious agent who become infected. Although this doesn’t sound much different from contagiousness, it is. The Francisella tularensis bacteria is highly infectious, for example, to the point that folks exposed to a culture plate are given antibiotics or put on a fever watch. Few of us get tularemia though, because transmission is through tick bites, hunting or skinning infected rabbits, muskrats, prairie dogs and other rodents, or inhaling dust or aerosols contaminated with F. tularensis bacteria. So if you get exposed, you will probably get sick, but there is a low probability for getting exposed.
  • incubation period – the time it takes to start having symptoms after you are exposed to an infectious disease. A longer incubation period increases the chances that someone will get exposed to a disease and travel home before getting sick. A shorter incubation period, like for influenza, means that a lot of people can get sick in a short amount of time.
  • contagious period- the time during which you can spread the illness to other people and may start before you have any symptoms
  • quarantine – used to separate people who have been exposed to a contagious disease and may become sick, but aren’t sick yet
  • isolation – used to separate people who are already sick with a contagious disease
  • transmission – how the disease spreads, including direct (direct contact or droplet spread) vs indirect transmission (airborne, vehicleborne, or vectorborne)
  • R0 (r nought) – the basic reproductive number or the number of new infections originating from a single infectious person among a total susceptible population
  • Rn – the net reproductive number, which takes into account the number of susceptibles in a community
  • infectious period – how long you are contagious

Got all that?

How Contagious Is Measles?

If not, understanding how easily you can get measles should help you understand all of these terms.

Measles is highly contagious, which is likely why all of the Brady kids got sick.
Measles is highly contagious, which is likely why all of the Brady kids got sick.

Measles is highly contagious, with a very high R0 number of 12 to 18.

That’s because:

  • the measles virus can live for up to two hours on surfaces and in the airspace where an infected person coughed or sneezed
  • infected people are contagious for up to four days before they have a rash and even know that they have measles, so expose lots of people even if they get put in isolation once they get diagnosed
  • infected people continue to be contagious for up to four days after the rash appears, so can continue to expose people if they aren’t put in isolation

So you don’t need to have someone with measles coughing in your face to get sick. If they coughed or sneezed at the grocery store, on the bus, or at your doctor’s office and then you entered the same area within two hours, then you could be exposed to the measles virus and could get sick.

Why don’t we see at least 12 to 18 people in each measles outbreak anymore?

That’s easy. The definition for R0 is for a total susceptible population. Most folks are vaccinated and protected, so even if they are around someone with measles, they typically won’t get sick.

Still, up to 90% of folks who aren’t immune and are exposed to measles will catch it. That includes infants too young to be vaccinated, kids too young to be fully vaccinated, and anyone who has a true medical exemption to getting vaccinated.

The measles has a very high R0 is easier to see when you compare it to those of some other diseases

 

Infection R0
Diphtheria 6-7
Ebola 1.5-2.5
Flu 1.4-4
MERS 2-8
Mumps 4.7
Pertussis 5-17
Polio 2-20
RSV 3
SARS 2-5
Smallpox 5-7
Varicella 8-10

Why such a big range for some diseases?

These are estimates and you are more or less contagious at different stages of each illness.

Fortunately, in most cases you can just get vaccinated and protected and don’t have to worry too much about them.

More on the Contagious Periods of Diseases