Tag: measles deaths

Is Measles Dangerous If You Are Pregnant?

While folks often try and make it seem like measles is a common childhood illness, we know that it can be dangerous.

“One of the patients was a 20-year-old pregnant woman who had rash onset on January 5 following exposure to her 12-year-old brother. After delivering a healthy baby on January 6, the mother developed severe pneumonia that was followed by respiratory arrest. She was resuscitated and transferred to an intensive care unit in a larger hospital nearby in Tennessee.”

Epidemiologic Notes and Reports Transmission of Measles Across State Lines — Kentucky, New Hampshire, Tennessee, Virginia

Rarely do people who have really had measles describe it as just a fever and a rash. They remember that it was called a harmless killer for a reason.

Is Measles Dangerous If You Are Pregnant?

And there are some situations in which measles can be especially dangerous, including if you get sick when you are very young, very old, or have immune system problems.

Pregnant women should be screened for measles immunity.
Pregnant women should be screened for measles immunity.

And what if you are pregnant when you get measles?

“The Health Department announced today that the number of measles cases has grown to 390, including two pregnant women diagnosed with the infection, one diagnosed in mid-April.”

The Number of Measles Cases Grows to 390

If you are pregnant and you are exposed to someone with measles, you can get IVIG post-exposure prophylaxis to prevent you from actually getting measles, but this typically only works if given within six days of the exposure.

“To date, studies have not identified an increased risk for birth defects when pregnant women get the measles during pregnancy. However, studies suggest that measles infection is associated with an increased risk for miscarriage, stillbirth, prematurity and the baby being born with a measles infection.”

When Measles Strike, It’s Not The Happiest Place On Earth For Pregnant Women

Unlike a rubella infection during pregnancy, a measles infection is not thought to cause birth defects. Tragically, it can, like rubella, lead to an increased risk for having a miscarriage.

“Infants who develop congenital measles are at increased risk for mortality and for subacute sclerosing panencephalitis, which is more common when measles is diagnosed in infancy. In addition, subacute sclerosing panencephalitis in newborns infected with measles either congenitally or shortly after birth appears to be more severe, with a shorter latency and rapidly progressive course.”

What Obstetric Health Care Providers Need to Know About Measles and Pregnancy

And if the mother gets measles very late in her pregnancy, it can also lead to a case of congenital measles, or a baby being born with an active measles infection.

“In 52% of cases, measles was likely acquired from a relative. Complications included pneumonia in one child; two pregnant women required hospitalization, including one who miscarried.”

Notes from the Field: Measles Outbreak Among Members of a Religious Community — Brooklyn, New York, March–June 2013

Don’t take the risk that you might get measles while you are pregnant.

Make sure you are vaccinated and protected before you ever start thinking about getting pregnant, as pregnancy is a contraindication to getting the MMR vaccine. And you should wait at least 4 weeks after getting vaccinated before getting pregnant.

More on Measles in Pregnancy

Why You Have No Business Skipping the MMR Vaccine?

Believe it or not, some folks are still pushing misinformation to scare people away from getting vaccinated and protected against measles.

The Disney outbreak was not caused by a vaccine strain!
The Disney outbreak was not caused by a vaccine strain!

Ironically, this guy talks about propaganda, manipulating parents, and media lies without saying anything that is truthful.

As I’m sure you are aware, the Disney measles outbreak was not caused by a vaccine strain.

Anti-vaccine folks frequently misinterpret the meaning of these vaccine strain cases. They are people who were recently vaccinated and develop a fever and rash. They do not have measles and are not part of the outbreak counts.
Anti-vaccine folks frequently misinterpret the meaning of these vaccine strain cases. They are people who were recently vaccinated and develop a fever and rash. They do not have measles and are not part of the outbreak counts.

The outbreak strain during the Disney outbreak was B3, which can be traced to outbreaks in Africa and the Eastern Mediterranean. Neither the Disneyland outbreak nor any outbreak has been caused by a vaccine strain of measles.

What about the idea that measles is now harmless???

Or that measles isn’t deadly is a developed country with a well-nourished population???

In response to a post praising Italy's decision to dilute their new vaccine laws, some folks thought it was funny that people were dying of measles.
Italy is a developed country with a very well-nourished population, and still, there have been at least 12 measles deaths since 2017.

Why have so many people died with measles in Europe recently if it is so harmless?

Did Chris Kirckof like his own post?
Did Chris Kirckof like his own post?

Yes, research it for yourself and you will find the complications of recent measles infections he left out, including the pregnant woman with who had a miscarriage during the 2013 measles outbreak in Brooklyn.

And the 8 SSPE deaths since 2009.

Are you wondering why he started his measles counts from 2014? It was to avoid mentioning the death of the woman in Washington in 2015.

Mostly remember that the reason we don’t see even more measles cases, measles complications, and measles deaths in the United States is simply because most people are vaccinated and protected.

Vaccines are safe, with few risks, and are obviously necessary.

More on Don’t Skip the MMR Vaccine

Is the MMR Safe for 6-Month-Old Babies?

Most parents understand that the first dose of the MMR vaccine is routinely given to children when they are 12 to 15 months old, at least in the United States.

In some other countries, the first dose is routinely given as early as 8 to 9-months of age.

And in high-risk situations, the MMR can safely be given to infants as early as age 6-months.

Is the MMR Safe for 6 Month Old Babies?

An early MMR, is that safe?

This type of pure anti-vaccine propaganda is what caused the measles outbreaks in New York in the first place...
This type of pure anti-vaccine propaganda is what caused the measles outbreaks in New York in the first place…

Yes, it is safe.

What about the package insert?

“Local health authorities may recommend measles vaccination of infants between 6 to 12 months of age in outbreak situations. This population may fail to respond to the components of the vaccine. Safety and effectiveness of mumps and rubella vaccine in infants less than 12 months of age have not been established. The younger the infant, the lower the likelihood of seroconversion (see CLINICAL PHARMACOLOGY). Such infants should receive a second dose of M-M-R II between 12 to 15 months of age followed by revaccination at elementary school entry.”

MMR II Package Insert

The package insert says to give infants who get an early dose another dose when they are 12 to 15 months old! It doesn’t say to not protect these babies!

But what about the idea that the safety and effectiveness of MMR hasn’t been proven for infants under 12 months of age?

In general, the package insert is only going to list studies that the manufacturer used to get FDA approval for their vaccine. Since it is an off-label recommendation of the ACIP, they would not include the studies that show that an early MMR is safe and effective.

“In conclusion, this study indicated that the MMR was well tolerated and immunogenic against measles, mumps and rubella with schedule of first dose both at 8 months and 12 months age. Our findings strongly supported that two doses of MMR can be introduced by replacing the first dose of MR in current EPI with MMR at 8 months age and the second dose at 18 months in China.”

He et al on Similar immunogenicity of measles-mumps-rubella (MMR) vaccine administrated at 8 months versus 12 months age in children.

Before 8 months, an early MMR isn’t likely to be as effective as giving it later. That’s because some maternal antibodies might linger in a baby’s system and can interfere with the vaccine working, even after six months. How many antibodies and how much interference?

It’s almost impossible to tell for any one child, but the risk that this maternal protection has begun to wear off and these infants are at risk to develop measles is too great. That’s the reason that they get an early MMR, even though we know it won’t be as effective as a dose given later and we know it will have to be repeated.

Is this early dose safe?

“This review did not identify any major safety concerns. These findings may facilitate discussions about the risks and benefits of vaccinating infants who are potentially exposed to this life-threatening disease.”

Woo et al on Adverse Events After MMR or MMRV Vaccine in Infants Under Nine Months Old

Of course! Although the complications of measles can be serious, even deadly, we aren’t going to recommend something that is even worse.

“Early MMR vaccination is well tolerated, with the lowest AE frequencies found in infants aged 6-8 months. It is a safe intervention for protecting young infants against measles.”

van der Maas et al on Tolerability of Early Measles-Mumps-Rubella Vaccination in Infants Aged 6-14 Months During a Measles Outbreak in The Netherlands in 2013-2014.

So an early MMR is safe, with few risks, and is likely effective at preventing measles.

And by now you know what’s not safe. That’s right, getting measles.

More on Early MMR Vaccines

Why Do We Include SSPE When Counting Measles Deaths?

Anti-vaccine folks often like to push the idea that parents shouldn’t worry about measles and that it is just a rash with a little fever.

They leave out the part that it is a week of having a high fever, irritability, and other symptoms too.

In addition to downplaying the symptoms of measles, they never talk about the possible complications, such as encephalitis, seizures, and death.

Why Do We Include SSPE When Counting Measles Deaths?

They certainly never talk about SSPE or subacute sclerosing panencephalitis.

“Subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder of children and young adults that affects the central nervous system (CNS). It is a slow, but persistent, viral infection caused by defective measles virus.”

Subacute Sclerosing Panencephalitis Information Page

SSPE is a late complication of having a natural measles infection.

That’s why it should be included when counting measles deaths.

“Available epidemiological data, in line with virus genotyping data, do not suggest that measles vaccine virus can cause SSPE. Furthermore, epidemiological data do not suggest that the administration of measles vaccine can accelerate the course of SSPE or trigger SSPE in an individual who would have developed the disease at a later time without immunization. Neither can the vaccine lead to the development of SSPE where it would not otherwise have occurred in a person who has already a benign persistent wild measles infection at the time of vaccination.”

Subacute sclerosing panencephalitis and measles vaccination

It is not a complication of having a measles containing vaccine. If it were, then why didn’t we see more cases of SSPE as more and more people got vaccinated, instead of a drop in SSPE cases and deaths, corresponding to a drop in measles cases?

But SSPE isn’t gone yet, just like measles hasn’t yet been eradicated.

32 of these SSPE deaths have been since 2000. Source is the CDC Wonder database.
32 of these SSPE deaths have been since 2000. Source is the CDC Wonder database.

Since 2000, when the endemic spread of measles was eliminated in the United States, there have been at least 37 SSPE deaths.

“Investigators learned that, in 2012, at age 11 years, the boy, who was previously healthy and developmentally normal, had been admitted to a tertiary care children’s hospital in Oregon with severe, progressive encephalopathy. Before the onset of his neurologic illness, the patient had been a straight-A, fifth-grade student who played soccer and basketball. The symptoms began approximately 4 months before the hospital admission, when the patient began to struggle with homework, drop utensils, and doze off during meals, eventually progressing to falling asleep while walking.”

Notes from the Field: Subacute Sclerosing Panencephalitis Death — Oregon, 2015

I say at least, because the CDC Wonder database doesn’t list the 2015 SSPE death of a boy in Oregon.

Anti-vaccine folks like to ignore the fact that yes, people have died of measles recently. And measles puts you at risk for SSPE, which is always fatal.
Anti-vaccine folks like to ignore the fact that yes, people have died of measles recently. And measles puts you at risk for SSPE, which is always fatal.

We are fortunate that no one has died since 2015, but as we get more and more measles cases, tragically, in addition of the risk of someone dying of measles directly, it increases the risk that someone will eventually develop SSPE.

“Decreasing rates of vaccination in the United States, particularly among preschool-aged children (children <5 years of age) living in inner-city areas, resulted in a resurgence in the number of cases of measles reported during 1989–1991; during this period, 55,622 cases of measles and 123 measles-associated deaths were reported.”

Bellini et al on Subacute Sclerosing Panencephalitis: More Cases of This Fatal Disease Are Prevented by Measles Immunization than Was Previously Recognized

Remember, there were at least 12 extra SSPE deaths following the large measles outbreaks of the late 1980s.

Will we see any after the rise in the cases the last few years?

Vaccines are safe, with few risks, and obviously necessary.

Don’t risk a complication of measles. Don’t risk getting SSPE.

More on SSPE Deaths

How Many Active Cases Are There in Rockland County?

Three new cases were just reported in the Rockland County measles outbreak, pushing the total count to 161 cases in an outbreak that has been going on since September of 2018.

These are record breaking numbers.

Misleading? Fear mongering? Isn't that ironic???
Misleading? Fear mongering? Isn’t that ironic???

So of course, it’s time to move the goalposts!

How Many Active Cases Are There in Rockland County?

The number of active cases in an outbreak is an important number.

It’s a sign that the outbreak is under poor control.

For example, there were 45 new cases of measles in Brooklyn this week, following reports of 33 new cases the previous week. In fact, in the past 21 days, the case count in Brooklyn went from 158 to 259, which likely means that there have been over 100 active measles cases in Brooklyn during that time.

What about Rockland County?

In the past three weeks, the case count in Rockland County has increased by 16.

Why is three weeks an important number?

Because that’s how long it takes to develop symptoms after they have been exposed to someone with measles.

The problem in Rockland County, as Ed Day said in his press conference, is that people hadn’t been cooperating with the health department. So it is hard to actually know how many active cases there are. Is it five cases, as someone at the health department recently told an anti-vaccine women impersonating a caller who was concerned about her infant?

If so, that’s five cases too many!

The most important thing to understand, is that as we continue to see new cases, there is no sign that the outbreaks are stopping.

And the only numbers that really matter are ZERO new cases for 42 days.

That’s when the outbreaks will be declared over.

Let’s hope that we get there before we are talking about a new number, someone dying with measles.

More on Active Cases in Rockland County


Making America Measly Again

Believe it or not, measles didn’t get it’s name from the measles virus.

Charles Bruxton did his dissertation on measles in 1793.
Charles Bruxton did his dissertation on measles in 1793.

After all, the virus wasn’t discovered until 1954, by John Enders.

Making America Measly Again

So where did the name measles come from?

One idea is that it came from the Middle English word mesel, which means a leper. Another that it is from the Latin misellus, the diminutive form of miser – wretched.

“Measles is, he says, derived from the Dutch maseln (measles) ; the disease is also called in Holland mczsel-sucht, the measle-sickness; so translated by an old English writer. The literal sense is “small spots.” The original word occurs in the Middle High German mase,’ Old High German masa, a spot. Hirsch also states that the English word “measles” corresponds to the German Maal, and Masern, and the Sanscrit masurra, spots. Doubtless it is to this meaning of spots, hence spotty, that we owe the term “measly pork,” as applied to the meat of the pig when infested with scolices of tasnia.”

Sykes On the Origin and History of Some Disease Names

Most people think that the etymology of measles is Dutch.

It’s shouldn’t be a surprise that few of us know where the name comes from, as few folks have actually seen a kid with measles, even with the recent rise in measles cases.

“Typical case of measles – a couple days of high fever, with a sick (miserable) looking kid with running nose, bad cough, and red eyes. You can see Koplic’s spots if you know to look for them on the buccal mucosa (I describe them as grains of salts on red tablecloth). Fever gets higher and rash appears at peak of fever (day 3-4). The rash disappears with a brawny hyperpigmentation appearance. The child frequently gets diagnosed with an ear infection. If no complications (ear infection or pneumonia), recovery is quick once the fever resolves, but these kids look really sick, miserable, and sad during the acute phase. They have a measly look.”

Jeed Gan, MD

But I’m sure most of us can imagine that measly look

A child with measles and four days of the classic measles rash.
A child with measles and four days of the classic measles rash. Photo by CDC/NIP/ Barbara Rice

What else can you imagine?

Roald Dahl's daughter died of measles in 1962, the year before the development of the first measles vaccine.
Roald Dahl‘s daughter died of measles in 1962, the year before the development of the first measles vaccine.

Can you imagine losing your child to a vaccine-preventable disease?

Measles deaths were once common in the United States. Let’s stop the outbreaks, as we have a safe vaccine, with few risks, and not bring measles deaths back as we get even more measles cases.

More on Making America Measly Again

Bob Sears on Hiding in the Herd

How do some intentionally unvaccinated kids get away without getting sick?

Mandatory vaccination laws still don't mean forced vaccination.
Mandatory vaccination laws still don’t mean forced vaccination.

How does a pediatrician get away without seeing kids harmed by vaccine-preventable diseases?

Bob Sears on Hiding in the Herd

Most folks know the answer

“And in my 20 years of pediatric practice, I have never once seen a child seriously harmed by a vaccine-targeted infection. Oh sure, I’ve seen kids get sick. And they all get better. And this is in a practice where most of my patients don’t vaccinate (or don’t anymore after one child suffers). So if anyone should be seeing kids get harmed from infections, it should be me, right? But not even one. “

Bob Sears

There are a few simple reasons that all of Dr. Bob’s intentionally unvaccinated kids all get better when they get sick.

In addition to respiratory problems (think iron lungs), polio causes muscle atrophy.
In addition to respiratory problems (think iron lungs), polio causes muscle atrophy. (CC BY-NC 4.0)

For one thing, vaccine-preventable diseases don’t kill every single person that gets them! Even in the pre-vaccine era, most kids did recover. Tragically though, not all did. And not all did without complications.

That’s why we say that you have to earn your natural immunity.

Even more importantly though, since most other parents vaccinate their kids, his intentionally unvaccinated kids are simply at less risk to get a vaccine-preventable disease.

They are hiding in the herd – free-riding and benefiting from the herd immunity that’s provided by those of us who do vaccinate and protect our kids.

Mostly though, Dr. Bob has been lucky.

185 kids, mostly unvaccinated, died with the flu last year.
185 kids, mostly unvaccinated, died with the flu last year.

And so have his patients.

They are especially lucky that more folks don’t listen to him and instead understand that vaccines are safe, with few risks.

“Here’s the thing…it doesn’t matter if vaccines played a role in reducing the incidence of certain diseases in industrialized nations 60 years ago. Yep, I said it. ***Decades have passed and we’re STILL vaccinating like we are in a developing country and it’s the year 1900.***”

Melissa Floyd

Remember, it wasn’t that long ago that kids were dying from Hib meningititis, Hib epiglotittis, pneumococcal disease, meningococcal disease, hepatitis B, and rotavirus. You don’t have to go back 60 years or all of the way to 1900!

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

And that so many people do get vaccinated is the only thing keeping these diseases from coming back at even higher numbers.

Even Dr. Bob used to know that…

More on Bob Sears on Hiding in the Herd