Tag: outbreaks

Are Immigrants and Refugees Spreading Disease in the United States?

Neither the tired, poor, huddled masses yearning to breathe free, the wretched refuse of your teeming shore, nor the homeless, tempest-tossed, are not spreading diseases on our shores or anywhere else.
Neither the tired, poor, huddled masses yearning to breathe free, the wretched refuse of your teeming shore, nor the homeless, tempest-tossed, are not spreading diseases on our shores or anywhere else. (Photo by Vincent Iannelli, MD)

Why do some folks think that immigrants and refugees are spreading disease in the United States?

It certainly doesn’t help that Lou Dobbs once pushed the false idea that “illegal aliens” were fueling outbreaks of disease in the United States:

“The invasion of illegal aliens is threatening the health of many Americans. Highly-contagious diseases are now crossing our borders decades after those diseases had been eradicated in this country.”

Lou Dobbs Tonight

He warned, on his show in 2005, that “there are rising fears that once eradicated diseases are now returning to this country through our open borders. Those diseases are threatening the health of nearly every American as well as illegal aliens themselves.”

The once “eradicated diseases” he was talking about was leprosy. Of course though, he was wrong – leprosy has never been eradicated and it has not been increasing. Since 1985, there have been about 100 to 300 cases a year in the United States – no where near the “7,000 in the past three years” that Dobbs reported.

Immigrant Disease Spreading Propaganda Blitz

More recently, “as the taxpayer funded refugee resettlement industry launches a propaganda blitz about the so-called World Refugee Day” in 2016, Breitbart News reported that “six diseases that were recently near eradication are making a comeback in the United States.”

Of these six diseases, three – measles, mumps, and whooping cough – are vaccine-preventable and have very little to do with immigrants or refugees. Often, they have to do with unvaccinated United States citizens traveling out of the country, getting sick, and coming home to start an outbreak.

There was an outbreak of measles among a Somali community in Hennepin County, Minnesota in 2011, involving 14, mostly unvaccinated people. But they were unvaccinated because the anti-vaccine crowd (Wakefield) scared them away from being vaccinated over fears of autism, not because they were recent refugees.

Another Breitbart disease, scarlet fever, is simply the rash that you get when you have a strep infection, like strep throat. It is very common in kids and the incidence hasn’t changed over the years in the United States. For an unknown reason, the UK is seeing higher rates of scarlet fever though.

The last two Breitbart News warns about are bubonic plague and tuberculosis.

While there were 16 cases of plague in the United States in 2015, that is not unusual. The CDC reports that “in recent decades, an average of seven human plague cases have been reported each year (range: 1–17 cases per year).”

“The bacteria that cause plague, Yersinia pestis, maintain their existence in a cycle involving rodents and their fleas.”

CDC – Plague ecology in the United States

Anyway, you get bubonic plague from infected fleas and flea bites, not other sick people. You can get pneumonic plague from a sick person, but that hasn’t happened in the United States since 1924.

What about tuberculosis? That must be increasing because of new immigrants and refugees, right?

Nope. After years and years of decreasing, the number of cases and incidence rate has leveled off at its lowest level, about 9,500 cases since 2013. That’s compared to just over 14,000 cases in 2005. While that’s not to say that more work has to be done in working to eliminate tuberculosis, it is not making any kind of comeback.

Other Breitbart articles warned that “Syrian Refugees Spreading Flesh-Eating Disease, Polio, Measles, Tuberculosis, Hepatitis” and “EXCLUSIVE – Syrian Refugees Bringing Flesh-Eating Disease into U.S.?”

The “Flesh-Eating Disease” Breitbart is talking about isn’t the flesh-eating bacteria. It is a parasite that isn’t even spread from person to person. It is spread by sand fleas.

And rates of tuberculosis are actually lower in Syria than in most of Europe.

“In spite of the common perception of an association between migration and the importation of infectious diseases, there is no systematic association.”

World Health Organization

Tragically, while there have been some outbreaks of measles, polio, and other diseases in Syria, refugees are not spreading these diseases to Europe or the United States.

Of course, Breitbart isn’t the only  one participating in the immigrant disease spreading propaganda blitz these days.

“Likewise, tremendous infectious disease is pouring across the border. The United States has become a dumping ground for Mexico and, in fact, for many other parts of the world.”

Donald Trump (2015)

From politicians spreading misleading information about “tremendous infectious disease” to everyone else spamming each other with tales of immigrants spreading everything from Ebola and EV-D68 to worms, the net result is folks being scared of immigrants and refugees for no good reason.

Mychal Massie, in an Invasion USA report for WND recently wrote about a briefing given to the Arizona State Senate warning about a “Medical Ticking Time Bomb” warning that “illegals” were bringing scurvy, pernicious lice, and worms, etc. into the US.

Now unless immigrants are stealing all of our vitamin C, I don’t think that we have to worry that we will start see epidemics of scurvy any time soon.

We might have to worry about even larger outbreaks of measles and other vaccine-preventable diseases, but it won’t be immigrants or refugees causing them. It will be because more folks are skipping out on getting vaccinated and protected.

For More Information on Immigrants and Refugees

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 decreasing, but remains elevated in most of the United States.
Flu activity is decreasing, but remains elevated in most of the United States.

Breaking News: Flu season isn’t over yet. Influenza activity is decreasing, but remains elevated in the United States, and there have been 5 new pediatric flu deaths. (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.

Those flu reports can also help you determine when flu season ends.

As of mid-March, the CDC is reporting that “flu activity decreased, but remained elevated.”

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.”
  • As often happens on the downside of a flu season peak, we are starting to see more and more influenza B each week
  • There are reports of a new avian influenza A(H7N9) epidemic in China. Although deadly, there is fortunately no reports of sustained human-to-human transmission of this flu virus strain that is usually associated with poultry exposure.
  • Next year’s flu vaccine won’t be changing much, except that “The  A(H1N1)pdm09  virus  has  been  updated  compared  to  the  virus recommended  for  northern  hemisphere  2016-2017  influenza  season.”
  • 36 states (down from 39), including Alabama, Alaska, Arkansas, California, Connecticut, Delaware, Florida, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, and Wisconsin, are still reporting widespread flu activity (the highest level)
  • 11 states (up from 8), including Arizona, Colorado, Georgia, Idaho, Illinois, Montana, South Dakota, Texas, Washington, West Virginia, and Wyoming, and Puerto Rico are now reporting regional flu activity
  • 3 states (up from 2), Hawaii, Oregon, and Utah, are now reporting local flu activity
  • no states (down from 1) are now reporting sporadic flu activity
  • there have been 53 pediatric deaths this flu season, including reports of 5 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 March 22, 2017

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News on the Latest Measles Outbreaks

Breaking News – We already have reports of measles cases in 23 people from 8 states (California, Colorado, Florida, New Jersey, New York, Pennsylvania, Utah, and Washington) 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 hasn’t been eradicated yet. It just that we are 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 23 cases (as of late February)
  • cases in 8 states, including California, Colorado, Florida, New Jersey, New York, Pennsylvania, Utah, and Washington
  • 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)
  • two cases in Salt Lake County, Utah – which began in a resident who had “received all appropriate vaccinations” and developed measles after traveling outside the US and then spread to another person “who had contact with the first case.” According to the SLCoHD, “One of the two individuals with measles had received one MMR vaccine.”
  • two cases in King County, Washington – a man and his 6-month-old infant, both unvaccinated, developed measles after traveling to Asia, and exposed many others around Seattle, including at a Whole Foods, a sandwich shop, their apartment building, and two Amazon buildings.

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:

  • 78 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.

International Measles Outbreaks

The endemic spread of measles was stopped or eliminated in 2000. Since then, most of the measles outbreaks in the United States begin when someone travels out of the country, gets sick, and exposes others. Or less commonly, when an international traveler brings measles into the country.

That makes it easy to understand that large outbreaks of measles in other parts of the world could increase the risk that we have more outbreaks here. And that’s what happened in 2014 when there was an epidemic of measles in the Philippines and we ended up with the most cases since 1994, many linked to travel to and from the Philippines.

This year, the world is seeing large outbreaks of measles in:

  • European Union – Austria, Belgium, Germany, Italy (Florence), Romania, and Spain. The largest outbreak is in Romania, where there have been 3,071 cases and 16 deaths in the past 13 months.
  • Italy – cases have tripled already in 2017, which means that the country should look forward to many more cases than they had in 2016 (844).
  • Switzerland – the Swiss Sentinel Surveillance Network already reports 42 measles cases in 2017, compared to 36 in 2015 and 71 in 2016. Many of the cases are in young adults, aged 20-24 years.
  • Congo
  • Guinea – a measles epidemic has been declared in the country, with at least 1,527 cases and 2 deaths this year
  • South Africa
  • Republican of South Sudan
  • Yemen
  • Uganda
  • Laos
  • Nigeria

These outbreaks are a great reminder to review the special vaccine travel requirements, including that adults who “plan to travel internationally should receive 2 doses of MMR at least 28 days apart,” that infants traveling abroad can get their first dose of MMR as early as age 6 to 11 months, with a repeat dose at age 12 months, and that “children aged who are greater than or equal to 12 months need 2 doses of MMR vaccine before traveling overseas,” even if they aren’t four to six years old yet.

Get Educated. Get Vaccinated. Stop the Outbreaks.

For More Information On Measles Outbreaks:

Updated on March 22, 2017

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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: