Tag: measles outbreaks

How Many People Get Measles Each Year?

It used to be that measles was very common and almost everyone got measles.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.

While it was a so-called rite of passage and a part of growing up, it wasn’t something you looked forward to, as some kids didn’t survive having measles.

How Many People Get Measles Each Year?

Fortunately, measles case counts have dropped in the post-vaccine era.

How much did they drop?

Let’s see..

Year Cases
1920 469,924
1941 894,134
over 400 measles deaths each year
1962 503,282
1969 25,826
1970 47,351
1978 26,871
1979 13,597
1983 1,497
1986 6,282
1989 18,193
1990 27,786
1991 9,643
1992 2,200
1993 312
last record high number of measles cases
1994 963
1995 281
1996 508
1997 138
1998 100
1999 100
2000 86
2001 116
2002 44
2003 55
record low number of measles cases
2004 37
2005 66
2006 55
2007 43
2008 140
2009 71
2010 61
2011 220
2012 55
2013 187
worst year for measles since 1994, with the largest single outbreak (377 cases in Ohio) since the endemic spread of measles was eliminated
2014 667
2015 188
2016 86
2017 120
2018 314+

Can you guess when the first measles vaccines were introduced?

Can you guess when we started to give kids a second dose of the MMR vaccine?

Can you guess when Wakefield became popular and Dr. Bob’s vaccine book was released?

Do you know how much it costs to contain these outbreaks?

Do you understand the consequences of a natural measles infection?

Can you explain why we will almost certainly have the second highest number of measles cases in one year since 1994, even though we see the devastation that high rates of measles is causing in Europe and other parts of the world?

How many people will get measles in the United States this year?

A lot has changed since we got reassurance from the CDC that we were seeing an expected range of measles cases, although there were plenty of warning signs then that this was going to be one for the record books.
A lot has changed since we got reassurance from the CDC that we were seeing an expected range of measles cases, although there were plenty of warning signs then that this was going to be one for the record books.

Although no one is reporting on this, with several large ongoing outbreaks still not under control – it will be another record year for measles in the United States.

The Rockland County measles outbreak already exceeds the total yearly case count for 11 of the past 19 years!
The Rockland County measles outbreak already exceeds the total yearly case count for 11 of the past 19 years!

And with several large outbreaks continuing overseas, next year doesn’t look like it will be much better, especially with reports of a measles resurgence in many regions of the world.

More on Measles and Measles Cases

Updated on December 12, 2018

This Is the Modern Anti-Vaccine Movement

We often like to think that we know how anti-vaccine folks think.

They are just scared and trying to do the right thing for their kids, right? Just like all of the rest of us?

Maybe some of them…

This Is the Modern Anti-Vaccine Movement

Of course, you can’t group all anti-vaccine folks together, as many vaccine-hesitant or on-the-fence parents are truly just scared about the things they see and read about vaccines.

But they should know what they are getting into when they follow their favorite anti-vaccine hero, celebrity or Facebook group.

The modern anti-vaccine movement goes far deeper than worries about possible vaccine side effects.

Don’t believe me?

Hillary Simpson may not share the anti-Semitic views of one of her admins, but many of her followers do...
Hillary Simpson may not share the anti-Semitic views of one of her admins, but many of her followers do…

It is hopefully clear to everyone by now that the modern anti-vaccine movement:

Don’t believe me?

Why should this family have to come out and give an explanation for how their child died?
Why should this family have to come out and give an explanation for how their child died?

After a 4-month-old died of bacterial meningitis, anti-vaccine folks pushed the idea that it was a vaccine injury instead of an infection.

An anti-vaccine parenting group helping spread misinformation about this baby's death.
An anti-vaccine parenting group helped spread misinformation about this baby’s death.

And they push their views that everything is a vaccine injury on everyone, even though most folks understand that vaccines are not associated with SIDS, shaken baby syndrome, autism, and most other things.

There is no connection between vaccines and acute flaccid myelitis, no matter how hard anti-vaccine folks are trying to make one.
To be clear, there is no connection between vaccines and acute flaccid myelitis, no matter how hard anti-vaccine folks are trying to make one.

Award winning?

Please.

Sure, everyone and everything in anti-vaccine world is the very best, except if they are, then why are they trying so hard to convince you of that… So maybe you will agree with some of their more far-out claims, suggestions, and conspiracy theories?

Learn the risks of following bad advice. Are you really going to say no to chemotherapy if your child has cancer?
Learn the risks of following bad advice.

After all, it’s one thing to consider skipping or delaying your child’s vaccines when you think you can get away with hiding in the herd or to buy some essential oils and supplements, but are you really going to say no to chemotherapy if your child has cancer? Brandy Vaughan seems to think you should.

If there is a RISK, there must be a CHOICE.

Do you think it is okay to put infants who are too young to be vaccinated at risk for measles and other vaccine-preventable diseases because you don’t like the choices you have been given between getting your kids vaccinated and protected or keeping them out of school?

What about the parents of the kid who is being treated for cancer who gets exposed to chicken pox because someone else made the choice to not vaccinate their kid? Do you think that’s fair?

The modern anti-vaccine movement is only about choice when it is about their choices and doesn’t seem to care about the risks their unvaccinated kids pose to others.

Believe it or not, the modern anti-vaccine movement also equates getting vaccinated with rape…

Don’t believe me?

Meryl Dorey has also claimed that vaccination is rape.
Meryl Dorey has also claimed that vaccination is rape.

Do you agree?

What else do most folks in the modern anti-vaccine movement believe?

They believe that:

And of course, they believe that vaccine advocates are behind a big conspiracy, are lying to you, and are trying to force everyone to get vaccinated.

Is that what you believe?

Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.
Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.

Even though these and every other anti-vaccine point you have heard has already been refuted a thousand times already.

The RhoGAM shot helps prevent hemolytic disease of the newborn. It is not a vaccine and is not part of a Big Pharma profit ploy...
The RhoGAM shot helps prevent hemolytic disease of the newborn. It is not a vaccine and is not part of a Big Pharma profit ploy…

Do you believe in chemtrails or that Bill Gates has a plan to depopulate the world using vaccines?

“As a result, multiple breakouts of measles have occurred throughout different parts of the Western world, infecting dozens of patients and even causing deaths.”

Hussain et al on The Anti-vaccination Movement: A Regression in Modern Medicine

If you do, understand that you have been fooled by the propaganda of the modern anti-vaccine movement. If you don’t, understand that many of the folks in your anti-vaccine groups probably do.

More on the Modern Anti-Vaccine Movement

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

What Are the Recommended and Minimum Ages and Intervals Between Doses of Vaccines?

Most parents likely don’t think about the minimum age or minimum intervals between vaccines, as they just get their kids vaccinated according to the routine immunization schedule.

Things don’t always go according to schedule though…

Recommended and Minimum Ages for Vaccines

After their birth dose of the hepatitis B vaccine, your baby’s next vaccines are usually at two months.

Can you get them earlier?

When necessary, many vaccines can be given earlier and faster than the standard schedule.
When necessary, many vaccines can be given earlier and faster than the standard schedule.

Yes. The minimum age for the first dose of rotavirus, DTaP, IPV, Hib, Prevnar, is 6 weeks.

Some other vaccines can be given earlier than their recommended age too, including:

  • the first MMR vaccine, which can be given as early as age 6 months in certain high risk situations, like traveling out of the country or in an outbreak situation, although this dose will have to be repeated once the child is 12 months old
  • the 4th dose of DTaP, which can be given as early as age 12 to 15 months, as long as at least 4 to 6 months have passed since the third dose
  • the 2nd dose of Varivax, which may be given as early as 1 to 3 months after the first dose
  • the Tdap vaccine, which can be given as early as age 7 years, instead of the more typical 11 to 12 years
  • the HPV vaccine, which can be given as early as age 9 years, instead of the more typical 11 to 12 years

Why would you get a vaccine early?

What if you are going to be traveling just before you infant is going to be 2 months old? Or your 9 year old stepped on a rusty nail, and it had been just over 5 years since his last tetanus (DTaP) shot?

Recommended and Minimum Intervals for Vaccines

In addition to earlier ages, you can sometimes get vaccines more quickly, on an accelerated schedule.

For example:

  • the minimum interval between the 1st and 2nd dose of rotavirus, DTaP, IPV, Hib, Prevnar is 4 weeks, instead of the standard 2 months
  • the minimum interval between the 2nd and 3rd dose of rotavirus, DTaP, IPV, Hib, Prevnar is 4 weeks, instead of the standard 2 months
  • the minimum interval between the 1st and 2nd dose of HPV is either 4 weeks (3 dose schedule) or 5 months (2 dose schedule)
  • the minimum interval between the 2nd and 3rd dose of HPV is 12 weeks
  • the minimum interval between the 1st and 3rd dose of HPV is 5 months, instead of the standard 6 months

Why give these vaccines more quickly than usual?

The usual reason is that a child is a little behind and is working to get caught up.

Absolute Minimum Ages for Vaccines

It is important to remember that in some cases, there are some hard and fast rules about minimum ages. That means that if you get these vaccines any earlier, they won’t count and you will likely have to repeat them, including getting :

  • the 3rd dose of hepatitis B before 6 months (24 weeks) or sooner than 8 weeks after 2nd dose and  16 weeks after 1st dose
  • the first dose of MMR, Varivax or hepatitis A before 12 months
  • the 4th dose of Hib before 12 months
  • the 4th dose of Prevnar before 12 months
  • the 4th dose of DTaP before 12 months
  • the 5th dose of DTaP before 4 years
  • the 4th dose of IPV before 4 years

Sticking to the routine schedule helps to avoid vaccine errors, like giving a vaccine too early. In some situations, the 4 day grace period helps if a vaccine is given a little early.

More on Recommended and Minimum Ages and Intervals Between Doses of Vaccines

How Do They Figure out Who Starts an Outbreak?

As we continue to see outbreaks of vaccine-preventable diseases in the post-vaccination era, it is important that these outbreaks be quickly contained.

But it is important to understand that these outbreaks don’t simply stop on there own. A lot of work goes into containing them.

Working to Contain an Outbreak

And that work containing outbreaks is expensive. Much more expensive than simply getting vaccinated.

For example, the total personnel time and total direct cost to the New York City Department of Health and Mental Hygiene responding to and controlling the 2013 outbreak in NYC were calculated to be at least $394,448 and 10,054 personnel hours.

Why it is so expensive is easy to see once you understand all of the work that goes into containing an outbreak. Work that is done by your local health department as soon as a case of measles, or other vaccine-preventable disease, is suspected.

Work that, for a measles outbreak for example, includes:

  • initiating a case and contact investigation
  • quickly confirming that the patient actually has measles, including testing
  • assessing the potential for further spread – identifying contacts who aren’t immune to measles and are at risk for getting measles
  • isolating people with measles and quarantining contacts who aren’t immune to measles for at least 21 days after the start of the measles rash in the last case of measles in the area, including everyone who is intentionally unvaccinated
  • offering postexposure vaccination, a dose of the MMR vaccine within 72 hours of exposure to contacts who are not fully immune so that they can get some protection maybe don’t have to be quarantined
  • having targeted immunization clinics in the affected population, such as a school or church, to get as many people vaccinated as possible, even after 72 hours, so they have can be protected in the future

That’s an awful lot of work.

Work that continues until the outbreak officially ends.

Finding the Source of an Outbreak

Another big part of the work that goes on to contain an outbreak is identifying the source of the outbreak.

Was it someone who had recently been traveling overseas, a visitor from out of the country, or someone that was already part of an another outbreak?

Why is that so important?

If you don’t find the source of the outbreak, then you can’t be sure that you have found all of the people that have been exposed, and the outbreak might go on for an extended period of time.

And no, it is never shedding, a vaccine strain, or a recently vaccinated child that causes these measles outbreaks.

Anatomy of a Measles Outbreak

A closer look at the measles outbreak in San Diego, California in 2008 can help folks understand even better what happens during one of these outbreaks.

A 7-year-old who is unvaccinated because his parents have a personal belief vaccine exemption travels to Switzerland with his family.

A week after returning home from the trip, he gets sick, but returns to school after a few days. He then develops a rash and sees his family physician, followed by his pediatrician, and then makes a trip to the emergency room because he continues to have a high fever and rash (classic measles symptoms).

He is eventually diagnosed with measles, but not before eleven other children are infected with measles. This includes two of his siblings, five children in his school, and four children who were exposed at his pediatrician’s office.

It is not as simple as that though.

During this measles outbreak:

  • Three of the children who became infected were younger than 12 months of age, and were therefore too young to have been vaccinated
  • Eight of the nine children who were at least 12 months old were intentionally unvaccinated because they also had personal belief vaccine exemptions
  • About 70 children were placed under voluntary quarantine for 21 days after their last exposure because they were exposed to one of the measles cases and either didn’t want to be vaccinated or were too young
  • One of the infants with measles traveled to Hawaii, raising fears that the measles outbreak could spread there too

All together, 839 people were exposed to the measles virus.

This family didn't have a choice about their son getting sick - he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.
This family didn’t have a choice about their son getting sick – he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.

At least one of them was a 10-month-old infant who got infected at his well child checkup, was too young to have gotten the MMR vaccine yet, and ended up spending three days in the hospital – time his parents spent “fearing we might lose our baby boy.”

The parents of this 10-month-old weren’t looking for a vaccine exemption and didn’t want their child to catch measles, a life-threatening, vaccine-preventable disease. Instead, they were counting on herd immunity to protect him until their child could be protected with an MMR vaccine. They were one of “those who come into contact with them” that got caught up in a decision of some other parents to not vaccinate their child.

The kids who are at risk and get a vaccine-preventable disease because they are too young to get vaccinated, have an immune system problem that prevents them from getting immunized or their vaccine from working, and the kids who simply didn’t get protected from a vaccine are the hidden costs of these measles outbreaks that we don’t hear about often enough.

What to Know About Finding the Source of an Outbreak

Without all of the hard work that goes into containing outbreaks, the outbreaks of measles, pertussis, mumps, hepatitis A, and other vaccine preventable diseases would be even bigger.

More on Finding the Source of an Outbreak

 

Does Having Measles Protect You from Cancer?

Anti-vaccine folks often try to tout the benefits of natural immunity.

So that's why Big Pharma wants you to get measles! So you will get cancer.
So that’s why Big Pharma wants you to get measles! So you will get cancer.

That measles reduces your risk of cancer is probably one that you haven’t heard.

Neither are you likely to have heard of the conspiracy theory that Big Pharma wants you to get vaccinated and protected so that you don’t get measles, just so you are at increased risk of cancer later.

Does Having Measles Protect You from Cancer?

The idea of a viral infection protecting you from cancer doesn’t make much sense, after all, many viral infections actually cause cancer.

That’s why we have vaccines to protect us against hepatitis B and HPV infections! So much for the idea that Big Pharma wants you to get cancer. If they did, then why did they develop vaccines that prevent cancer?

But Brandy Vaughn has evidence for her claim, doesn’t she?

Kind of. She has a study, “Febrile infectious childhood diseases in the history of cancer patients and matched control,” that was published 20 years ago in the journal Medical Hypothesis. A study that consisted of a questionnaire that was sent to cancer patients who were seen by anthroposophic general practitioners in Switzerland.

Anthroposophic general practitioners? Think Rudolf Steiner and Waldorf Schools.

Understand the connection with vaccines now?

That’s right, a “study” done by alternative health providers who are against vaccines found a benefit to getting febrile infectious childhood diseases, many of which are vaccine preventable.

What Are the Benefits and Risks of Measles?

Not surprisingly, few other people talk about any benefits to having a natural measles infection.

Unfortunately, we also don’t hear enough about the complications of these infections either, mostly because they are rather uncommon these days since most folks are vaccinated and protected.

Not uncommon enough though, as we still do have outbreaks.

Measles Benefits Measles Risks
natural immunity death
can miss 7-10 days of school or work encephalitis
SSPE
seizures
pneumonia
7 to 10 days of high fever and irritability
can trigger an outbreak
a few years of immune amnesia

Immune amnesia?

That’s a risk that you might be unfamiliar with, but it is the increasing popular theory that a natural measles infection resets your immune system to that of a newborn, so that you are once again susceptible to many infectious diseases. That’s likely why mortality rates from other diseases besides measles goes down when folks start to get vaccinated against measles.

Measles and Cancer Risks

What about the association of measles and cancer?

Unlike the idea that a natural measles infection might be protective against cancer, there are more than a few studies that actually associate measles with a risk of developing cancer, including:

  • lung cancer
  • Hodgkin’s lymphoma
  • endometrial cancer
  • breast cancer

Are these associations real?

Probably not, after all, why don’t rates of these cancers go way down after measles gets under control or eliminated?

Still, most of us know that measles isn’t a mild disease and don’t need any extra benefits to getting vaccinated and protected.

We know what life was like when measles was a common childhood disease and see what is happening in parts of the world where measles is still much more common than it is in the United States.

And we understand the most dangerous association between measles and cancer that affects the most people – when unvaccinated people get measles and expose children and adults on chemotherapy who are immunosuppressed and can’t be vaccinated.

More on Measles and Cancer

Fake News About Measles Outbreaks?

Many news organizations ran with a story about a multi-state measles outbreak recently.

The CDC tweeted a correction about the multi-state measles outbreak story.
The CDC tweeted a correction about the multi-state measles outbreak story.

They got something wrong though.

There is no ongoing, single, multi-state outbreak of measles this year.

Fake News About Measles Outbreaks?

Is it understandable that some media outlets would have been confused by recent CDC reports?

Not really.

The CDC Measles Cases and Outbreaks page hadn’t been updated since late-July and is still reporting case numbers that are “current as of July 14, 2018,” so there really was no recent CDC report to generate all of this extra attention.

“From January 1 to July 14, 2018, 107 people from 21 states (Arkansas, California, Connecticut, Florida, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, and Washington) and the District of Colombia were reported to have measles.”

CDC on Measles Cases and Outbreaks

Although it has been changed to say “107 individual cases of measles have been confirmed in 21 states,” there was nothing to indicate it was a single outbreak that the CDC was monitoring as many sites reported:

Few sites were immune to using a click-bait title to scare folks about the "outbreak."
Few sites were immune to using a click-bait title to scare folks about the “outbreak.”

Unfortunately, many of these reports are still online.

How did it happen?

It’s likely because you have reports from organizations and websites that seem to want to push out content, but don’t have much of a budget to pay health or medical writers to make sure it is accurate.

2018 Measles Cases and Outbreaks

It’s also unfortunate that some of these sites, in trying to correct the idea of a single, nation-wide outbreak, are now trying to minimize this year’s measles outbreaks.

No, there isn’t one large outbreak that is spreading across the United States, but there are a lot of smaller outbreaks, some of which are still ongoing.

And these outbreaks are not something that should still be expected, as we have had a safe and effective measles vaccine for over 50 years and measles was declared eliminated in the United States in 2000!

There is also something very much different about 2018, that not surprisingly, no one is reporting about.

With over 107 cases, things seem very similar to last year right, when we had about 118 cases?

The thing is, in 2017, there was one large outbreak, in Minnesota, with 79 people.

In 2015, at least 139 of 189 cases were from just three large outbreaks, in California (Disneyland), Illinois, and South Dakota.

See what’s different?

This year seems to have more individual cases in more states, each with the potential to grow into one of those big outbreaks.

Why?

You can blame the rise in measles outbreaks in Europe and other parts of the world. And some folks not getting vaccinated and protected and exposing the rest of us when they get sick.

Putting us at risk even though measles is a life-threatening infection, a safe and effective vaccine has been available for 50 years, and every anti-vaccine myth that scares folks has been refuted a thousand times.

That’s the story.

Who’s telling it?

More on Reporting on Measles Outbreaks