Tag: outbreaks

Mumps Outbreaks

Pre-Vaccine Era Mumps Outbreaks

In the pre-vaccine era, mumps was a common childhood infection that could cause orchitis, meningitis, pancreatitis, deafness, and even death.

There were about 212,000 cases a year in the early 1960s, before the first mumps vaccine was licensed in 1968.

Post-Vaccine Era Mumps Outbreaks

Tips to prevent getting sick with the mumps.
A large Ohio mumps outbreak prompted an education campaign to help protect everyone from getting sick.

As with other vaccine-preventable diseases, there was a big drop in cases of mumps once the mumps vaccine was introduced.

In 1968, there were just over 152,000 cases and 25 deaths  and just ten years later, in 1978, that was down to 16,817 cases and 3 deaths.

Once the recommendation for the second dose of MMR came in 1990, it looked like mumps was on it’s way out.

We went from 5,292 cases and one death that year, to just 906 cases and no deaths in 1995. When measles hit its low point of 37 cases in 2004, there were just 258 cases of mumps.

That wasn’t the end for mumps though, as we had some up and down years, including big outbreaks in:

  • 2006 – 6,584 cases among Midwest college students and one death
  • 2008 – only 454 cases, but one death
  • 2009 – 1,991 cases and two deaths
  • 2010 – 2,612 cases mostly among Orthodox Jewish communities and two deaths
  • 2011 – 370 cases
  • 2012 – 229 cases
  • 2013 – 584 cases
  • 2014 – 1,223 cases involving a large outbreak in Ohio and in the NHL
  • 2015 – 1,057 cases mostly among university students in Iowa and Illinois

Could this all be because of waning immunity?

2016 Mumps Outbreaks

So far in 2016, the CDC reports that there have been:

  • at least 4,619 cases of mumps
  • cases have been reported in all states except Delaware, Louisiana, Vermont, and Wyoming
  • seven states, AK, IA, IN, IL, MA, NY, and OK with more than 100 cases in 2016

The most recent, ongoing outbreaks are in:

  • Arkansas (at least 2,159 cases) – which may be fueled by a large community of Marshall Islanders living in close quarters, with low levels of vaccinations among adults in the community
  • Oklahoma (at least 324 cases)
  • Washington (93 cases)
  • Long Beach, New York (45 cases), and at State University of New York (SUNY) at New Paltz in New York (13 cases)
  • Harvard University (4 cases)
  • University of Missouri (31 cases)
  • Tufts University (9 cases)
  • Texas – with most of the cases in North Texas, including a large outbreak in Johnson County (72 cases) and two other outbreaks linked to four different cheerleading competitions.

At SUNY New Paltz, most of the cases were among the swim team. In addition, 20 unvaccinated students were sent home from school under quarantine until December 3.

In Arkansas, 42 workplaces, 39 schools in six school districts, six colleges and two private schools in Benton, Carroll, Conway, Faulkner, Madison, Pulaski, and Washington counties are seeing most of the cases. A quarantine is in effect, with unvaccinated children being kept out of school for 26 days from the date of exposure or for the duration of the outbreak, whichever is longer.

Many of these outbreaks occur despite many of the cases having had two doses of the MMR vaccine. A third dose is sometimes recommended during these outbreaks.

That doesn’t mean that the MMR vaccine doesn’t work. After all, just compare today’s rates of mumps, even if they are a little higher than we would like, to pre-vaccine levels…

Getting two doses of the MMR vaccine is still the best way to avoid mumps.

There is no general recommendations to get extra shots though.

Keep in mind that the MMR vaccine isn’t just for kids. Adults who didn’t have mumps when they were kids (or who were born before 1957, when most kids got mumps), should make sure they are vaccinated (at least one dose) and protected too.

For More Information on Mumps Outbreaks:

References on Mumps Outbreaks:
CDC. Reported Cases and Deaths from Vaccine Preventable Diseases, United States, 1950-2013.

Updated on December 24, 2016

This Year’s Flu Season

Flu activity is increasing across the United States.
Flu activity is increasing across the United States.

Breaking News: Widespread flu activity in 46 states and 29 pediatric flu deaths so far this flu season. (see below)

While flu season typically peaks in February, it is very important to understand that there are few things that are typical about the flu.

Since 1982, while we have been twice as likely to see a flu activity peak in February than other winter months, we have been just as likely to get that peak in December, January, or March. That makes it important to get your flu vaccine as soon as you can.

You really never know if it is going to be an early, average, or late flu season.

Flu Facts

While there will likely be some surprises this flu season – there always are – there are some things that you can unfortunately count on.

Among these flu facts include that:

  • there have been 1,482 pediatric flu deaths since the 2003-04 flu season, including 89 flu deaths last year
  • about 113 kids die of the flu each year – most of them unvaccinated
  • antiviral flu medicines, such as Tamiflu, while recommended to treat high-risk people, including kids under 2 to 5 years of age, have very modest benefits at best (they don’t do all that much, are expensive, don’t taste good, and can have side effects, etc.)
  • a flu vaccine is the best way to decrease your child’s chances of getting the flu

And even in a mild flu season, a lot of kids get sick with the flu.

This Year’s Flu Season

When does flu season start?

In general, flu season starts when you begin to see people around you with signs and symptoms of the flu, including fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue, etc.

To be more accurate, you can also look at reports for flu activity in your area, especially the weekly reports from the CDC.

As of late January, the CDC is reporting that “flu activity continues to increase and is widespread in most of the United States.”

The CDC has also recently reported that:

  • this year’s flu vaccine reduces “the risk for influenza-associated medical visits by approximately half”
  • influenza A (H3N2) viruses, a component of this year’s flu vaccine, are predominating so far this flu season, which could be a sign of a severe flu season. In general, “H3N2-predominant seasons have been associated with more severe illness and higher mortality, especially in older people and young children…”
  • Is it a match? – “…antigenic and/or genetic characterization shows that the majority of the tested viruses remain similar to the recommended components of the 2016-2017 Northern Hemisphere vaccines.”
  • 46 states (up from 43), including Alabama, Alaska, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming, are now reporting widespread flu activity (the highest level)
  • only 4 states, including Colorado, Hawaii, Oregon, and Utah, are still reporting regional flu activity
  • no states are still reporting local flu activity
  • no states are still reporting sporadic flu activity
  • there have been 29 pediatric deaths this flu season, including reports of 9 new deaths this week

Have you and your family gotten been vaccinated and protected against the flu yet?

“Anyone who has not gotten vaccinated yet this season should get vaccinated now.”

CDC Influenza Situation Update

If not, this is still a good time to get a flu vaccine.

Recent Flu Seasons

Are H3N2 predominant flu seasons really worse than others?

  • 2003-04 flu season – 152 pediatric flu deaths (H3N2-predominant)
  • 2004-05 flu season – 47 pediatric flu deaths
  • 2005-06 flu season – 46 pediatric flu deaths
  • 2006-07 flu season – 77 pediatric flu deaths
  • 2007-08 flu season – 88 pediatric flu deaths (H3N2-predominant)
  • 2008-09 flu season – 137 pediatric flu deaths
  • 2009-10 flu season – 289 pediatric flu deaths (swine flu pandemic)
  • 2010-11 flu season – 123 pediatric flu deaths
  • 2011-12 flu season – 37 pediatric flu deaths
  • 2012-13 flu season – 171 pediatric flu deaths (H3N2-predominant)
  • 2013-14 flu season – 111 pediatric flu deaths
  • 2014-15 flu season – 148 pediatric flu deaths (H3N2-predominant)
  • 2015-16 flu season – 89 pediatric flu deaths

In addition to high levels of pediatric flu deaths, the CDC reports that the four flu seasons that were H3N2-predominant in recent years were “the four seasons with the highest flu-associated mortality levels in the past decade.”

For More Information on the 2016-17 Flu Season

Updated February 19, 2017

Save

Save

Save

Save

News on the Latest Measles Outbreaks

Breaking News – We already have reports of measles cases in 24 people from 7 states (California, Colorado, Florida, New Jersey, New York, Pennsylvania, and Utah) in 2017. (see below)

We have come a long way since the development of the first measles vaccines in the early 1960s…

Pre-Vaccine Era Measles Outbreaks

In the pre-vaccine era, measles was a very common childhood disease.

As it is now, it was also a deadly disease.

In the 1950s, there were 5,487,332 cases (just under 550,000 a year) and 4,950 deaths (about 500 each year).

In 1962, there were 469,924 cases of measles in the United States and 432 deaths.

Post-Vaccine Era Measles Outbreaks

The first measles vaccines were licensed between 1963 and 1965, but it was the first national measles eradication campaign in 1966 that got people vaccinated and measles rates down.

In 1970, there were only 47,351 cases and 89 deaths.

Rates continued to drop until the large outbreaks between 1989 to 1991, when there were 55,622 cases and 123 deaths. The addition of a measles booster shot got measles outbreaks under control again. By 2000, when measles was declared eliminated in the United States, there were just 86 cases and one death.

Post-Elimination Era Measles Outbreaks

measles-outbreaks
We ended 2014 with 667 measles cases – a record high.

Declaring measles eliminated in the United States didn’t mean that we didn’t have any more measles, after all, it wasn’t eradicated yet. It just that we were no longer seeing the endemic spread of measles. Since 2000, measles outbreaks have been imported from outside the country, or at least they are started by cases that are imported.

We have seen more than a few records in the post-elimination era, including:

  • the year with the historic low number of measles cases – 37 cases in 2004
  • the year with the largest number of cases since 1994 – 667 cases in 2014
  • the largest single outbreak since the endemic spread of measles was eliminated – 377 cases in Ohio in 2014

In 2015, we got a reminder of how deadly measles can be. Although there have been other measles deaths and SSPE deaths in the past ten years, unlike the 2015 death, they are usually buried in CDC reports and aren’t published in the newspaper.

2017 Measles Outbreaks

While we are still watching the outbreaks in Denver and LA county, the first new case of 2017 was an unvaccinated adult in San Luis Obispo County, California who was exposed to international travelers over the holidays. The person did expose others to measles at the Twin Cities Community Hospital emergency department in Templeton while contagious in early January.

The second case of 2017 was related to the LA county outbreak – a resident of Ventura County.

And it goes on already, with other measles cases in 2017 including:

  • at least 24 cases (as of early February)
  • cases in 7 states, including California, Colorado, Florida, New Jersey, New York, Pennsylvania, and Utah
  • an infant in San Luis Obispo County that was too young to be vaccinated and who had contact with an unvaccinated adult with measles
  • one new case in the Los Angeles County outbreak, which is now up to 20 confirmed measles cases (including 18 in LA County), all unvaccinated
  • four new cases in Ventura County, California that are linked to another Ventura County measles case and the LA County outbreak, which is now up to 24 cases
  • a case in Jersey City, New Jersey following international travel who exposed people at multiple places, including a hospital, pharmacy, mall, and on a commuter train
  • an infant in Suffolk County, New York who had been overseas
  • an unvaccinated 7-month-old baby from Passaic County, New Jersey who had been traveling out of the country and may have exposed others at area hospitals (a good reminder that infants who are at least 6 months old should get an MMR vaccine before leaving the country)
  • a new case in Utah – a resident who had “received all appropriate vaccinations” and developed measles after traveling outside the US

How many cases will we end up with this year? It is certainly getting off to a quick start, which could mean a big year for measles, although it is certainly hard to predict what will happen.

2016 Measles Outbreaks

Starting slow, 2016 ended as a fairly average year for measles:

  • 79 cases
  • cases in 17 states, including Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, Tennessee, Texas, and Utah
  • a large outbreak in Arizona, 23 cases, linked to a private detention center
  • a large outbreak in Shelby County, Tennessee, at least seven cases, including six unvaccinated and one partially vaccinated child
  • an ongoing measles outbreak in Los Angeles County and Santa Barbara County that has been linked to the Los Angeles Orthodox Jewish community
  • a case in Colorado in which an unvaccinated adult traveled internationally and ended up exposing many people “from Dec. 21 to 29, 2016, who was at a wide variety of locations in the Denver-Boulder area,” including an Urgent Care center and the Parker Adventist Hospital Emergency Department

As in other years, many of these outbreaks involved unvaccinated children and adults. One case involved a child at the Yuba River Charter School in California, a Waldorf School with very high rates of unvaccinated children.

For More Information On Measles Outbreaks:

Updated on February 19, 2017

Save

Save

Save

Save

Save

Save

Save

Save

Meningococcal Disease Outbreaks

There are two types of meningococcal vaccines that can help prevent meningococcal disease, including:

  • Menactra and Menveo – meningococcal conjugate vaccines that protect against serogroups A, C, W, Y
  • Bexsero and Trumenba – meningococcal conjugate vaccines that only  protect against serogroup B

And while children routinely get their first dose of either Menactra or Menveo when they are 11 to 12 years old and a booster at age 16 years, the MenB vaccines only have a “permissive” recommendation. That means that there isn’t a formal recommendation that all kids get Bexsero or Trumenba. Instead, older teens and young adults between the ages of 16 and 23 years can get vaccinated if they want to protect themselves from most strains of serogroup B meningococcal disease.

Meningococcal Disease Outbreaks

Although the CDC reports that the incidence of menB disease is low, since 2013, there have been at least seven outbreaks of menB disease, including:

  • University of California, Santa Barbara Four cases – one student had both his feet amputated (2013)
  • Princeton University – Nine cases  and one death – a student at Drexel University (2013-14)
  • Providence College – Two cases (2015)
  • University of Oregon – Seven cases and one death (2016)
  • Santa Clara University – Three cases (2016)
  • Rutgers University- New Brunswick – two cases (2016)

The latest outbreak is at University of Wisconsin-Madison. Two students were diagnosed with menB disease in early October 2016 and the school is now recommending that all students get vaccinated with 2 doses of Bexsero.

For more information: