Tag: elimination

Measles Outbreaks in New Zealand

Just like other areas of the world, New Zealand has a problem with measles outbreaks. It shouldn’t be surprising then that they also have a problem with folks pushing anti-vax misinformation.

Where are the areas in New Zealand with 97% MMR vaccination rates?
Where are the areas in New Zealand with 97% MMR vaccination rates? Just askin…

Are they really seeing the most measles cases in the areas with the highest vaccination rates?

Measles Outbreaks in New Zealand

One thing is sure, there are a lot of measles cases in New Zealand.

“From 1 January 2019 to 10 October 2019 there have been 1742 confirmed cases of measles notified across New Zealand. 1416 of these confirmed cases are in the Auckland region.”

2019 NZ measles outbreak information

Do we know which parts of New Zealand have the most measles outbreaks?

We do!

Where are the cases in the measles outbreaks in New Zealand?
The case count is now up to 1742…

Of course, this doesn’t really tell you anything about why some districts have more cases than others…

Is it because they have more unvaccinated people or simply because they have a lot more people?

Many of the measles cases in New Zealand are in infants too young to be vaccinated and in teens and young adults.
Many of the measles cases in New Zealand are in infants too young to be vaccinated and in teens and young adults.

Wherever they live, we know that like measles outbreaks in every other part of the world, few of the folks with measles in New Zealand are known to be fully vaccinated.

And while New Zealand had eliminated home grown-cases of measles just a few years ago, it wasn’t with vaccination rates of 97%.

“For immunisation from measles, rubella and mumps two doses of the vaccine called MMR are needed. Dr McElnay said among New Zealand’s children and infants, 95 percent had had the first dose and 90 percent the full vaccine.”

NZ eliminates NZ-origin measles

Unfortunately, while they were working to get younger kids vaccinated and protected, many older kids and adults are still not vaccinated.

“However, we must remain vigilant and improve our vaccination rates because these diseases can easily spread among unimmunised people from imported cases. In New Zealand, people aged 12 to 32 years have lower vaccination rates than young children so are less likely to be protected against these diseases.”

Measles and rubella officially eliminated in New Zealand

Only about 80% of teens and young adults are fully vaccinated against measles in New Zealand!

Combined with high numbers of folks who were never vaccinated and folks who travel to other parts of the world where measles is still endemic and you have a recipe for disaster.

“While there have been no measles deaths in this outbreak, there have been five pregnant women hospitalised and two fetal losses associated with these events.”

Report investigates high hospitalisation rates for measles in Auckland region

In addition to the two unborn babies who died, there are also reports of at least three hospitalisations for encephalitis.

Two doses of the MMR vaccine is your best protection against measles.

A disaster that could easily be prevented with two doses of a vaccine that is safe, with few risks, and obviously necessary.

More on Measles in New Zealand

The Rockland County Measles Outbreak is Ending

Maybe they don’t want to jinx it or maybe no one else is paying attention, but folks should know that the Rockland County measles outbreak should be very quietly ending this week.

The last new measles case in Rockland County was on August 15.
The last new measles case in Rockland County was reported on August 15.

Wait, don’t you need to go 42 days (two incubation periods) without a new case to declare an outbreak over?

The Rockland measles outbreak will end on September 26, when 42 days have passed since the last new measles case.
The Rockland measles outbreak will end on September 25, when 42 days have passed since the last new measles case.

Yes.

But besides the 16 historical cases which were added on August 26, the last new case in Rockland County was reported on August 15.

Folks were first exposed to an unvaccinated traveler in the Rockland County measles outbreak on September 28, 2018. By mid-November, there were already 68 confirmed cases in the area.
Folks were first exposed to an unvaccinated traveler in the Rockland County measles outbreak on September 28, 2018. By mid-November, there were already 68 confirmed cases in the area.

That means that the Rockland Count outbreak, which started in September 2018, will end, if there are no new cases, on September 25, 2019.

The Rockland County Measles Outbreak is Ending

While it is exciting news that the outbreak is ending, it is even more welcome and exciting that the outbreak is ending this week!

“Outbreaks in New York City and Rockland County, New York have continued for nearly 8 months. If these outbreaks continue through summer and fall, the United States may lose its measles elimination status.”

U.S. measles cases in first five months of 2019 surpass total cases per year for past 25 years

If it had gone any longer, we would have been in danger of losing our status of having eliminated the endemic spread of measles.

Remember all of the talk about medical martial law in Rockland County?

And we would have had to continue to put up with anti-vax propaganda and misinformation that scares parents away from vaccinating and protecting their kids.

Almost all of the measles cases in Rockland County were children and almost all of them were unvaccinated.
Almost all of the measles cases in Rockland County were children and almost all of them were unvaccinated.

Instead, as the outbreak ends, we will hopefully learn some lessons, get more folks vaccinated and protected and move towards having record low numbers of measles cases once again.

Still, the Rockland County measles outbreak, with 312 cases, will end as the longest measles outbreak since the end of the endemic spread of measles in 2000.

With 654 cases, the Brooklyn outbreak, which lasted 11 months and cost over $6 million to contain, gets the record for being the largest measles outbreak in recent history.

More on the Rockland County Measles Outbreak

The Myth That Measles Never Left

Measles cases are on the rise. Where? Pretty much everywhere. But some folks are still pushing the myth that measles never left.

The highest number of measles cases in over 25 years? Don't call it a comeback?
Don’t call it a comeback? Cases in the US average 283 cases per year over the past 12 years (if you don’t skip 2019…)

It is easy to see that measles myth, like most AV myths, isn’t true.

The Myth That Measles Never Left

In the pre-vaccine era, everyone would get measles.

That translates into about 500,000 reported cases each year. Technically, it was likely closer to about 4 million cases in the United States each year, but either way, we know that lots of people got measles.

Then we got a measles vaccine and not surprisingly, cases of measles dropped. Except for a small uptick from 1989 to 1991, we were on our way to eliminating measles.

And we did, in 2000, when the endemic spread of measles was eliminated in the United States. From then on, all measles cases were imported.

In 2004, we had an historic low of just 37 measles cases in the United States!

Will we ever have fewer than 37 cases in a year?
Will we ever have fewer than 37 cases in a year?

And from 2000 to 2012, we averaged just 87 measles cases each year, which is far below the US average of 283 cases we are now seeing.

No, measles never completely left. It was not eradicated.

But it is certainly making a comeback and soaring to levels that we haven’t seen since 1992!

Just think about it… We had 37 cases of measles in 2004 and this year, we often had 37 cases in a single week!

Get vaccinated and protected so that you don’t get caught up in the next outbreak.

More on Measles Cases

Why Are Vaccinated Australians Now Catching Measles?

Measles is on the rise in Australia, like many other places. But why are vaccinated Australians now catching measles?

More vaccinated Australians are catching measles because there is more measles in Australia.
More vaccinated Australians are catching measles because there is more measles in Australia.

And has this got folks thinking it is because the disease is evolving?

Why Are Vaccinated Australians Now Catching Measles?

Well, apparently it has some folks thinking that.

Remember, Andrew Wakefield has also been talking about mutant measles.

Is that what this story in Australia was about?

No.

“In recent years, 13 Victorians have been hospitalized with measles despite having one or two vaccinations that should have made them immune. Why? Well, experts believe that because measles is so rare in Australia, we pretty much never come into contact with it, so our immune systems are starting to let their guards down and wane a little bit.”

Nathan Templeton on Measles Immunity Concerns

What is he talking about?

It’s the idea of exogenous boosting from being around natural infections. In other words, after you become immune from being vaccinated, you could get a boost in your immune protection if you are around someone with the disease.

“The exogenous boosting (EB) hypothesis posits that cell-mediated immunity is boosted for individuals reexposed to varicella-zoster virus (VZV).”

Talbird et al on Understanding the role of exogenous boosting in modeling varicella vaccination.

While this is thought to happen with chickenpox, we aren’t sure if it happens with measles.

It might, but the “problem” is that it is known that folks can have an amnestic response, so can be immune even though they have low antibody levels.

Mostly though, it is important to keep in mind that most of the people who get measles are unvaccinated, often intentionally unvaccinated.

“The key to measles elimination is increasing vaccination coverage and monitoring of measles antibody status for all ages, as well as enhancing surveillance of both domestic and overseas incidences.”

Inaida et al on Measles elimination and immunisation: national surveillance trends in Japan, 2008-2015.

So how many vaccinated Australians are getting measles?

Overall, there are 154 cases of measles in Australia so far this year.

“In Australia, the majority of measles cases are due to unvaccinated individuals becoming infected while travelling to countries in which measles is either common or there are outbreaks occurring. As measles is highly contagious, these people can then spread the disease to others, causing outbreaks, often before they are aware that they have the virus.”

Australia’s Measles Outbreaks 2019

And just as in the United States and most other countries, most of their outbreaks are started by folks who are unvaccinated.

More on Measles in Australia