Tag: measles outbreaks

Measles on a Plane, Train, and a Cruise Ship

What to most folks worry about when they go on a cruise?

That’s right. Norovirus…

While it isn’t as common as most folks think, norovirus is still often thought of as the cruise ship disease.

Measles on a Plane, Train, and a Cruise Ship

Not surprisingly, many of the same conditions that put you at risk for getting norovirus, including that it is very contagious and you are in close quarters with a lot of other people on a ship, puts you at risk for getting other diseases.

Even measles?

Especially measles.

In 2014, 136 people got measles after an unvaccinated person developed measles on a cruise ship, including 28 people on the cruise.

More recently, an unvaccinated teenager exposed others to measles on a Norwegian Cruise Lines ship while visiting Alaska. It seems like the same person also exposed folks to measles on a few planes and trains too.

How did they get measles? In Thailand.

This is almost certainly the same person who arrived at Vancouver International Airport from Tokyo on an Air Canada flight (July 30), leaving for Portland on Air Canada Jazz that same day.

While in Portland, they exposed people to measles at multiple locations:

  • Leno Medoyeff Bridal, 710 NW 23rd Ave., Portland, 3:30—5:30 p.m. (July 31)
  • Tom’s Pancake House, 12925 SW Canyon Rd., Beaverton, 7—9:30 a.m. (Aug. 1)
  • Max Red Line, Beaverton Transit Center to Pioneer Square, 12:30—1 p.m. (Aug. 2)
  • Max Red Line, Pioneer Place to Beaverton Transit Center, 5:30—6 p.m. (Aug. 2)
  • Verde Cocina, 5515 SW Canyon Ct., Portland, 2—4:30 p.m. (Aug. 5)

They weren’t done yet though.

You really shouldn't have to worry about measles when you board a plane, train, or cruise ship with your kids.
You really shouldn’t have to worry about measles when you board a plane, train, or cruise ship with your kids.

They then traveled back to Vancouver International Airport on an Alaska Airlines flight (August 6) and boarded a Norwegian Jewel cruise ship to Alaska.

Fortunately, the teen was placed in medical isolation shortly after boarding the ship and may have left the typically 7 day cruise early, as they were transferred to PeaceHealth Ketchikan Medical Center on August 8.

How can you protect yourself?

Get vaccinated. You never know when someone who is unvaccinated is going to expose your family to measles or put them at risk for other vaccine-preventable disease.

More on Measles on a Plane, Train, and a Cruise Ship

When is Shedding Season?

Have you heard of shedding season?

Shedding season is starting?
Shedding season is starting?

I’ll give you a hint, we aren’t talking about cats and dogs…

When is Shedding Season?

So it seems that some folks are really worried about vaccines and shedding.

Precautions against viral shedding? Was he giving out smallpox or oral polio vaccines?
Precautions against viral shedding? Was he giving out smallpox or oral polio vaccines?

While some vaccines do actually shed, it is really only the oral polio vaccine and the smallpox vaccine that we get concerned about with shedding.

And even then, shedding from the oral polio vaccine would only be a concern for someone with an immune system problem. Since the oral polio vaccine contains an attenuated virus, if that attenuated virus shed to someone else, they wouldn’t get polio except in the very rare situation when the virus mutates. Instead, they would get protection against polio. That’s one of the benefits of using the oral polio vaccine!

Still, we don’t use the oral polio vaccine in the United States anymore.

Although the smallpox vaccine can shed, it is from the site of injection, where a scab forms in the days to weeks after getting vaccinated. Covering the site should prevent other people from getting exposed to shed virus and fortunately, this vaccine is only used in very special situations.

And the rotavirus vaccine sheds, but you just have to wash your hands after changing diapers to avoid this attenuated virus. Are you going to get rotavirus if you are exposed to an infant who was recently vaccinated? Infants who get the vaccine don’t get rotavirus, so why would you if you are exposed to them?

And other vaccines?

While some live vaccines might shed in very specific situations, like if they caused a rare vaccine-induced disease, they otherwise don’t shed. That’s why we don’t worry about most folks with immune system problems getting exposed to people who have recently been vaccinated.

Don’t believe me?

Every time there is an outbreak of measles, someone insists that it was caused by a vaccine strain of measles that was shed from someone who was recently vaccinated. How often is that true?

So when is shedding season?

Anti-vaccine folks consider the start of the school year to be shedding season, because that’s when they think kids get caught up on their vaccines. Is that why we see big outbreaks of measles, chicken pox, and rotavirus at the start of the school year?

Oh wait, we don’t…

“Live vaccine virus shedding is a possible source of transmission of vaccine-strain viral infection but how frequently that occurs is unknown. There is no active surveillance of live virus vaccine shedding and most vaccine strain virus infections likely remain unidentified, untested and unreported.”

NVIC on The Emerging Risks of Live Virus & Virus Vectored Vaccines: Vaccine Strain Virus Infection, Shedding & Transmission

Despite the best efforts of anti-vaccine folks to scare parents about shedding, folks should know that this is no shedding season.

Cases of vaccine strain virus infections from shedding are unidentified and unreported because they don’t happen!

This is why some folks believe in shedding season...
This is why some folks believe in shedding season…

Do you need to teach your kids to fist bump instead of shaking hands during shedding season???

Think about it.

If there were a shedding season, then why wouldn’t there be more outbreaks? Because everyone has learned to fist bump and avoid shaking hands in school?

What to Know About Vaccine Shedding and Shedding Season

Shedding season isn’t a real thing.

More on Vaccine Shedding and Shedding Season

 

Vaccine Tweets to Remember

Are you on Twitter?

Have you seen these tweets about vaccines?

Vaccines work to keep us from getting polio.
Vaccines work to keep us from getting polio.

If you aren’t hip to the latest lingo – lit is good.

A clear message - vaccinate and protect your kids.
A clear message – vaccinate and protect your kids.

There is no debate.

Vaccines work.

They are also safe and necessary.

Let’s all protect our kids.

Who's to blame for low immunization rates and continuing outbreaks?
Who’s to blame for low immunization rates and continuing outbreaks?

We all know who to blame for the outbreaks of vaccine-preventable diseases we are seeing.

Did Jake Tapper know that RFK, Jr and Trump were planning a vaccine safety commission?
Did Jake Tapper already know that RFK, Jr and Trump were planning a vaccine safety commission?

What did Bill Gates really say about Trump? Wasn’t this the meeting when Trump confused HIV with HPV?

Why do celebrities get so much more attention when they say that they aren't going to vaccinate and protect their kids?
Why do celebrities get so much more attention when they say that they aren’t going to vaccinate and protect their kids?

This is a nice reminder that many celebrities advocate for vaccines.

What do vaccines cause? Adults. They cause adults.
What do vaccines cause? Adults. They cause adults.

Again, vaccines work.

Don't make a bad decision about vaccines.
Not vaccinating?

Still on the fence and need some help making a decision about vaccinating your kids? Do your research, but just keep in mind that every anti-vaccine argument has been refuted a thousand times already.

senior-paper-tweet
Need some facts about vaccines?

Don’t make a bad decision about vaccines.

More on Vaccines Tweets to Remember

Vaccine Movies and Videos

All of the attention that Robert De Niro gave the movie Vaxxed has many people realizing that there are anti-vaccine movies out there.

Promoted as documentaries, they mostly include the same anti-vaccine ‘experts’ that scare parents away from vaccinating their kids on the Internet.

These types of movies include:

  • Vaxxed
  • The Greater Good
  • Trace Amounts
  • Who Killed Alex Spourdalakis?
  • Bought
  • Man Made Epidemic
  • Sacrificial Virgins
  • The Truth About Vaccines

Most are propaganda, without even a trace amount of truth in them, and should not be used as a research tool to help you make a decision about vaccines.

Vaccine Movies and Documentaries

What about movies to actually help you get educated about vaccines?

Every Last Child takes a look at the fight to end polio in Pakistan.
Every Last Child takes a look at the fight to end polio in Pakistan.

Watch these movies and documentaries:

Have you seen or heard about any of these movies about vaccines?

Vaccine Videos

Just as bad as so-called vaccine documentaries, many of the vaccine videos that you find on You-Tube are also filled with misinformation and propaganda, including many vaccine scare videos.

Where are you Jon Stewart? Measles is still around...
Where are you Jon Stewart? Measles is still around…

Watch the following vaccines videos instead:

Still have questions?

More on Vaccine Movies and Videos

Vaccines While Immunosuppressed

It seems to be a big surprise to many folks, but kids can get most vaccines when they are immunosuppressed. In fact, they sometimes get extra some extra vaccines, like Pneumovax, because the  “incidence or severity of some vaccine-preventable diseases is higher in persons with altered immunocompetence.”

They should also get all of their vaccines if they are around someone who is immunosuppressed.

Surprised?

Vaccines While Immunosuppressed

Which vaccines your kids can get while they are immunosuppressed is going to depend greatly on the reason why they are  immunosuppressed.

Are they getting chemotherapy?

Did they just get a stem cell transplant?

Were they born with a specific immunodeficiency, like X-linked agammaglobulinemia, selective IgA deficiency, severe combined immunodeficiency, or chronic granulomatous disease?

Whatever the reason, they likely won’t get a medical exemption to skip all of their vaccines.

“Killed vaccines will not cause infection in immunodeficient or any other children. The fear of increased community-acquired vaccine-preventable diseases should lead to adherence to and completion of recommended immunization schedules in the community to reinforce herd immunity, such that all vaccine-preventable diseases become exceedingly rare.”

Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts

In most cases, immunocompromised kids can get all inactivated vaccines. It is only live vaccines that could pose a problem. Even then, it depends on the specific immunodeficiency as to whether avoiding live vaccines is necessary.

For example, after chemotherapy and a stem cell transplant, kids can usually get live vaccines.

Your doctors can review the latest guidelines to come up with a safe vaccination plan for your child with an immune system problem. If necessary, consultation with an infectious diseases or immunology specialist can also be helpful.

Don’t overlook other causes of possible immunosuppression when getting vaccinated, like taking daily oral steroids for more than two weeks, certain biologic immune modulators, or other medications like methotrexate, azathioprine, 6-mercaptopurine.

“Limited evidence indicates that inactivated vaccines generally have the same safety profile in immunocompromised patients as in immunocompetent individuals. However, the magnitude, breadth, and persistence of the immune response to vaccination may be reduced or absent in immunocompromised persons.”

2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host

And keep in mind that just because they can and should get vaccinated, it doesn’t mean that their vaccines are going to work as well as in someone who isn’t immunocompromised.

That’s why herd immunity is so important for these kids.

Vaccines for Close Contacts of Immunocompromised People

What about people who come into contacts with kids and adults who are immunocompromised?

Can they get vaccines?

“Close contacts of patients with compromised immunity should not receive live oral poliovirus vaccine because they might shed the virus and infect a patient with compromised immunity. Close contacts can receive other standard vaccines because viral shedding is unlikely and these pose little risk of infection to a subject with compromised immunity.”

Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts

Yes, close contacts can get vaccinated, especially since we don’t use the oral polio vaccine in the United States anymore.

There are some exceptions for the smallpox vaccine, which few people get, and Flumist, but only in very specific situations, including a recent hematopoietic stem cell transplant.

Johns Hopkins Medicine, which includes the Johns Hopkins University School of Medicine and the The Johns Hopkins Hospital and Health System went out of their way to correct this anti-vaccine misinformation.
Johns Hopkins Medicine, which includes the Johns Hopkins University School of Medicine and the The Johns Hopkins Hospital and Health System went out of their way to correct this anti-vaccine misinformation.

Worried about shedding?

You should be worried about getting a vaccine-preventable disease and giving it to those around you with immune system problems. That’s the real risk!

This is the modern anti-vaccine movement - taking an immoral stand against vaccines and putting sick kids at risk for life-threatening disease.
This is the modern anti-vaccine movement – scaring parents and taking an immoral stand against vaccines and putting sick kids at risk for life-threatening disease.

And no, you are not being selfish to expect those around you to get vaccinated.

Vaccines are safe and necessary – for all of us.

More on Vaccines While Immunosuppressed

Do Anti-Vaccine Parents Ever Change Their Minds?

Most anti-vaccine folks think that nothing could ever change their minds and get them to vaccinate and protect their kids ever again.

Even if they don’t believe any of the current evidence that vaccines are safe and necessary, what if we showed them some new evidence?

Nope.

They have ‘woken up’ and won’t be convinced.

Do Anti-Vaccine Parents Ever Change Their Minds?

Of course, folks change their minds all of the time.

They learn to see past the myths and propaganda of the anti-vaccine movement and they eventually get their kids vaccinated.

A megachurch in Texas that was the site of a large measles outbreak quickly hosted free vaccination clinics.
A megachurch in Texas that was the site of a large measles outbreak quickly hosted free vaccination clinics.

Unfortunately, it sometimes takes an outbreak to get them motivated to do so, or their child actually catching a vaccine-preventable disease.

Remember the Disneyland measles outbreaks in California?

“I’ve given more measles, mumps, rubella vaccines in the past 10 days than I gave in the entire 12 months previously.”

Dr. Jay Gordon on Demand for Measles Vaccine Sends Crowds Even to Anti-Vax Docs

Other times, it is a good pediatrician who doesn’t pander to their fears, and instead, answers their questions about vaccines and helps them understand the risks (very small) and benefits (very big) of getting vaccinated and protected.

Or they might have a friend, family member, or other immunization advocate that helps them be more skeptical of the information and advice that is scaring them away from vaccines.

Remember. The great majority of parents vaccinate their kids. And those that don’t, do often change their minds.

More on When Anti-Vaxxers Change Their Minds

Measles Deaths in Italy

There have been a lot of measles deaths in Europe over the last few years?

How many?

Would you believe over 100?

Measles Deaths in Italy

Among those measles deaths in Europe, there have been at least eight measles deaths in Italy (four in 2017 and another four in 2018, among just 6,601 cases), including:

Why so many deaths in a developed country with a well-nourished population?

Dr. Bob Sears actually reassured parents that measles wasn't deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe - another well-nourished population with lower vaccination rates than the U.S.
Dr. Bob Sears actually reassured parents that measles wasn’t deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe – another well-nourished population with lower vaccination rates than the U.S.

If you haven’t guessed yet, as in other countries in Europe, we are seeing more deaths from measles simply because folks aren’t vaccinated and more people are getting measles.

Measles is a life-threatening disease, even in an age of modern medicine, indoor plumbing, sewage systems, clean water, whole foods, vitamins and minerals, etc.

Italy, with about 1/5 the population of the United States, but about equal to the size of California, has had over 600 times as many cases of measles as we have had in the United States over the last few years. To put it in perspective, that would be like having 33,000 cases of measles in the United States.

Think it couldn’t happen? During the measles outbreaks from 1989 to 1991, when vaccination rates had dropped, there were 55,622 cases and 123 deaths in the United States.

Measles in Italy

Again, in Italy, as in other places, almost all of the measles cases, about 90%, have been in those who aren’t vaccinated.

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.
In response to a post from Dr. Bob Sears praising Italy’s decision to dilute their new vaccine laws, some folks thought it was funny that people were dying of measles.

That’s why they passed new vaccine laws – to get back to herd immunity levels of vaccination.

But shouldn’t folks have a choice about getting vaccinated?

Of course.

Even with the new vaccine laws, parents have a choice. As with vaccine laws in the United States, Italy’s new vaccine mandates had nothing to do with forced vaccination.

That’s unlike most of the people who died of measles in Italy. Most of them didn’t have a choice about being vaccinated and getting measles. Some were immunocompromised and couldn’t be vaccinated and at least one was too young to be vaccinated.

Parents had been set a July 10th deadline to provide schools with the relevant documentation, but it will now be possible for parents to simply submit their own confirmation that the child has been vaccinated, according to Giulia Grillo, Italy’s Health Minister, who was speaking at a press conference on Thursday.

Mandatory vaccinations: Italian parents will no longer need to provide doctor’s note

And that’s why it’s unfortunate that the a newly elected government severely watered down a vaccine law that had made getting vaccinated mandatory to go to school.

And it’s unfortunate that people continue to push misinformation about vaccines and vaccine-preventable diseases.

What to Know About the Measles Deaths in Italy

A drop in vaccination rates has led to measles outbreaks and a number of measles deaths in Italy.

More on Measles Deaths in Italy