Tag: quarantines

Timeline of the Measles Outbreak in Brooklyn

Breaking News – there are 31 new cases in Brooklyn, as a judge upholds the order, and more parents face penalties (see below).

There have been several big outbreaks of measles in the United States this year, but until recently, the biggest hadn’t gotten much attention.

As the outbreak in Brooklyn kept getting bigger and bigger, most people focused on the outbreaks in Clark County, Washington and Rockland County, New York.

Timeline of the Measles Outbreak in Brooklyn

Of course, with the emergency order in Brooklyn, the focus is now shifting.

So what do we now about the Brooklyn measles outbreak?

  • the outbreak began in October 2018 and was started by a traveler returning from Israel, where there is a large outbreak
  • as of early April, there have been 285 cases (we rarely see that many cases in an entire year, even when combining all of the cases in the whole country!)
  • most cases are in the Orthodox Jewish community, even though this is not a religious issue, except that this community has been targeted by an antivaccine group
  • 246 cases have been in children
  • the youngest case was an infant who was only 4 weeks old!
  • 21 people have been hospitalized
  • 5 have been admitted to the ICU!

What else do we know?

Although the outbreak is in its 5th month, which is very long for a measles outbreak in the post-vaccine era, there have been 152 new cases in just the past month!

There were 133 measles cases in Brooklyn in early March.

So at a time when cases should have already stopped (most outbreaks only last a few months), or at least be decreasing, the Brooklyn outbreak has more than doubled in size!

There have been 285 cases of measles in the Brooklyn outbreak.

There is no sign of it stopping either, with news reports of more than 20 to 40 cases each week.

And that’s what brought on the April 9 declaration of an emergency order.

“IT IS HEREBY ORDERED that any person who lives, works or resides within the 11205, 11206, 11221 and/or 11237 zip codes and who has not received the MMR vaccine within forty eight (48) hours of this Order being signed by me shall be vaccinated against measles unless such person can demonstrate immunity to the disease or document to the satisfaction of the Department that he or she should be medically exempt from this requirement. “

ORDER OF THE COMMISSIONER to All persons who reside, work or attend school in the neighborhood of Williamsburg, Brooklyn, New York and to the parents and/or guardians of any child who resides, works or attends school in the neighborhood of Williamsburg, Brooklyn, New York

Does this mean that they will be forcing everyone in Williamsburg to get vaccinated? And arresting those that don’t?

“I want to do the common sense point. We are trying to get people vaccinated. Our goal is not to find anyone. Our goal is not to shut down schools. Our goal is to get people vaccinated.”

Mayor Bill De Blasio

It should be clear that they are just trying to end the outbreak.

“People in violation of the order will be identified through identification of exposures. Disease detectives will check for immunization status or immunity when tracing the contacts of a person who has developed the illness. “

Oxiris Barbot, M.D. Commissioner of Health

And no one will be forced to get a vaccine. You might be fined if you insist on not getting vaccinated and you have been exposed to someone with measles, but you still won’t be forced to get the vaccine.

Why did it come to this?

Couldn’t they just quarantine folks who are exposed?

Well, they have been trying that…

And it hasn’t been working.

Williamsburg press conference with NYC Mayor Bill De Blasio, with Herminia Palacio, MD, NYC Deputy Mayor of Health and Human Services, and Oxiris Barbot, MD, NYC Commissioner of Health
Williamsburg press conference with NYC Mayor Bill De Blasio, with Herminia Palacio, MD, NYC Deputy Mayor of Health and Human Services, and Oxiris Barbot, MD, NYC Commissioner of Health

In addition to schools continuing to let in unvaccinated students, the health department is concerned that people in the community might actually be having measles parties!

“So we have not used a public health emergency to mandate vaccine in recent history. The circumstance of the combination of a large anti-vax movement in combination with a large outbreak has not happened in the way that it has happened right now.”

Dr. Herminia Palacio, NYC Deputy Mayor of Health and Human Services

As in Rockland, there is also an aggressive anti-vaccine campaign in Brooklyn that is pushing misinformation and is scaring parents away from vaccinating their kids.

30 new cases this week

The case count jumped again on April 24, to 390 cases.

“The Health Department announced today that the number of measles cases has grown to 390, including two pregnant women diagnosed with the infection, one diagnosed in mid-April… Twelve individuals have received summonses for being non-compliant with the Emergency Order since the City began issuing summonses last week. “

If you are upset that this is happening in Brooklyn, the outbreaks and the response to the outbreaks, just remember that it is the anti-vaccine groups working in the community are to blame.

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

Get vaccinated. Stop the outbreaks.

Timeline of the Measles Outbreak in Brooklyn

Updated April 18, 2019

Did CNN Rename Mumps?

It’s a common anti-vaccine myth that we rename diseases to make them go away. It helps them explain the control, elimination, and eradication of diseases, since many of them don’t believe that vaccines actually work.

Simply saying that your article is "Fact Checked" doesn't make it so...
Simply saying that your article is “Fact Checked” doesn’t make it so…

Now imagine that “they” actually found evidence that we did rename vaccine-preventable diseases!

That would be something, wouldn’t it…

Did CNN Rename Mumps?

Of course, they haven’t.

The original CNN story about the USS Fort McHenry stated that the sailors and Marines had parotitis, which was “due to an outbreak of a viral infection similar to mumps.”

Why didn’t they just say that they had mumps?

Because that’s not what they were told by the US Navy’s Fifth Fleet.

“… a military medical team specializing in preventative medical care is expected to deploy in the coming days to make an assessment if further steps may be needed, according to the official.”

US warship quarantined at sea due to virus outbreak

It may come as a surprise to some people, but many viruses and bacteria can cause parotitis. And until the outbreak was further investigated, they didn’t know if it really was mumps or another condition.

Since then, the Navy’s Bureau of Medicine and Surgery (BUMED) has stated that “based on clinical presentation and laboratory testing, these cases are currently classified as probable cases of mumps.”

Still, a very small percentage of the sailors and Marines on board have gotten mumps. That’s because vaccines work, even when they don’t work perfectly well.

More on the Myth that CNN Renamed Mumps

Mumps on the USS Fort McHenry

Like measles, we are seeing more mumps these days.

“Beginning in 1991, the military services implemented universal recruit immunization with a single dose of MMR vaccine, regardless of prior vaccination history. Shortly thereafter, and informed by the results of population serosurveys, the Air Force transitioned to a policy of targeted MMR vaccination, limiting the administration of MMR vaccine to recruits lacking serologic evidence of immunity to measles or rubella. With recent outbreaks of mumps, concerns have arisen that the practice of not specifically screening for mumps immunity in determining the need for MMR vaccine could lead to a relative increase in mumps risk among military recruits subject to screening. “

Eick et al on Incidence of mumps and immunity to measles, mumps and rubella among US military recruits, 2000–2004

Unlike measles, the MMR vaccine provides good, but not great protection against mumps.

And although military recruits are screened to see if they have low titers for measles and rubella, they still aren’t screened for mumps. The theory is that if their measles and rubella titers are low, then their mumps titer will be low too and they will get an MMR vaccine. Of course, this misses some who just have a low mumps titer, possibly an effect of waning immunity.

Mumps on the USS Fort McHenry

And that’s why we have been seeing mumps outbreaks on college campuses and most recently, on a Navy ship, although that isn’t a reason for everyone to go out and check their titers.

A tiny handful of measles outbreaks? There have been over 700 cases in the US during the past two years! There were only 37 cases in 2004.

Robert F. Kennedy, Jr has a lot to say about mumps…

He says that mumps outbreaks have devastated fully vaccinated populations at Harvard, Temple, Syracuse, Louisiana State, IU, and the U of Missouri…

And that mumps “epidemics” haven’t been covered by the media, because they don’t want to embarrass Merck…

Why won’t the media cover the mumps outbreaks! Oh, wait…

He also seems to think that these mumps cases have caused a national security threat

Is any of this true?

The simple fact that you can find a ton of stories in the media about the mumps outbreaks (they are not epidemics) gives you a good clue that they aren’t.

What about the quarantined sailors on the USS Fort McHenry?

That is true, but consider that only 27 of 700 of them have gotten parotitis, presumed to have been caused by mumps.

While you would expect that no one would get mumps or any other vaccine-preventable disease these days, that is just under 4% of those on board the ship.

What would have happened in the pre-vaccine era?

Although deaths were rare, mumps caused a lot of considerable loss of service and sick time in the military in the pre-vaccine era.
Although deaths were rare, mumps caused a lot of considerable loss of service and sick time in the military in the pre-vaccine era.

A whole lot more people would have gotten sick!

In the pre-vaccine era, although mumps was supposed to be a common childhood illness, about 1/3 to 1/2 of military recruits had never had mumps.

That meant big outbreaks of mumps that were hard to control, unlike what we see today.

“This article reports a recent public health response to 3 imported mumps cases occurring at Fort Campbell, Kentucky, that resulted in a contact investigation for 109 close contacts across varied settings. No secondary mumps cases were identified.”

Public Health Response to Imported Mumps Cases – Fort Campbell, Kentucky, 2018

Instead, not only do fewer people get sick during mumps outbreaks these days, but fortunately, they have fewer complications.

What kind of complications?

Mumps causes kids to have fever, puffy cheeks, and a painful, swollen jaw.
Mumps causes kids to have fever, puffy cheeks, and a painful, swollen jaw.

In addition to a swollen jaw, mumps is known to cause orchitis, aseptic meningitis, oophoritis, pancreatitis, and encephalitis.

“Risk was reduced for hospitalization, mumps orchitis and mumps meningitis when patient had received 1 dose of measles, mumps, and rubella vaccine. The protective effect of vaccination on disease severity is critical in assessing the total effects of current and future mumps control strategies.”

Young et al on Mumps Complications and Effects of Mumps Vaccination, England and Wales, 2002–2006

Fortunately, those complications are reduced when you get vaccinated. And so are your risks of actually getting mumps in the first place!

“This study demonstrates a significant preventive effect of two-dose vaccination against mumps complications (orchitis, meningitis, or encephalitis) and hospitalization for mumps.”

Orlíkováet al on Protective effect of vaccination against mumps complications, Czech Republic, 2007-2012.

Kennedy doesn’t mention a protective effect of the MMR vaccine, does he?

Remember, vaccines aren’t perfect, but even those that don’t work as well as the others still protect you from many of the worst complications and are much better than getting the disease naturally.

Mumps was often described as one of the top diseases that incapacitated soldiers in the prevaccine era.
Mumps was often described as one of the top diseases that incapacitated soldiers in the prevaccine era.

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

Is the mumps vaccine a national security threat? The only threat are the folks who continue to push anti-vaccine misinformation.

More on Mumps on the USS Fort McHenry

How Many Active Cases Are There in Rockland County?

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

These are record breaking numbers.

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

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

How Many Active Cases Are There in Rockland County?

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

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

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

What about Rockland County?

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

Why is three weeks an important number?

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

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

If so, that’s five cases too many!

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

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

That’s when the outbreaks will be declared over.

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

More on Active Cases in Rockland County


Why Does the BMJ Post Anti-Vaccine Propaganda?

Getting something posted in a medical journal is a big deal?

Getting something posted in The BMJ? Not so much…

Why Does the BMJ Post Anti-Vaccine Propaganda?

Oh, I’m sure it used to be, as they are one of the world’s oldest general medical journals, going back to 1840.

“Reader feedback online is actively encouraged in the form of Rapid Responses were introduced in 1998, and 20 years later, had generated 115,000 fully-moderated responses.”

History of The BMJ

The thing is, they allow just about anyone to post these Rapid Responses, without making it very clear that they aren’t in a peer reviewed section of the journal.

What’s wrong with this Rapid Response?

  1. The Federal government isn’t issuing any kind of quarantine in this matter, the county is, so why would it be an issue as to whether or not measles is subject to Federal isolation and quarantine law? Anyway, while there are few diseases on the list that are subject to Federal isolation and quarantine law (they do include cholera, diphtheria, plague, smallpox, Ebola, and pandemic flu, etc.) measles could be added by a Presidential Executive Order. Still, the authority to issue Federal Quarantines has rarely been used. Quarantines for measles is usually handled by states and local governments.
  2. Supposed to be protected anyway??? There are plenty of infants, children, and adults who simply can’t be directly protected by a vaccine. They are too young to be vaccinated, can’t be vaccinated because they have true medical contraindications, or could be among the very small minority for whom their vaccine wasn’t effective. They are at risk when your intentionally unvaccinated child gets measles.
  3. The vaccination rates for everyone in the Rockland outbreak is posted and is updated weekly. Only 3.8% of the folks in the outbreak are fully vaccinated.
  4. Since almost all of the folks in the outbreak are unvaccinated, that kind of busts John Stone’s last point – the Rockland measles outbreak has been caused by waning immunity and a failed vaccine. It is simply a failure of folks to vaccinate and protect their kids.

I get that The BMJ wants their “users to debate issues raised in articles published on bmj.com,” but they are simply contributing to the false balance we see in many other places if they want to allow folks to think there is a debate going on about the safety or necessity of vaccines.

More on Anti-Vaccine Propaganda in The BMJ

The Rockland County Emergency Declaration

As their measles outbreak enters its six month, Rockland County health officials are making a big move to prevent more cases – an emergency declaration banning unvaccinated kids from public places.

Not surprisingly, anti-vaccine folks are reacting as you would expect.

The Rockland County Emergency Declaration

So what’s in this emergency declaration?

Does it force parents to vaccinate their kids, as anti-vaccine folks have been warning us about? Does it quarantine unvaccinated kids in their homes?

It must be pretty outrageous if folks are willing to basically incite others to riot, right?

“Every action we have taken, since the beginning of this outbreak has been designed to by the department of health of Rockland County in conjunction with the state department of health to do two things, maximize vaccinations and minimize exposures. We are taking today the next step in that endeavor… In order to prevent any more children from falling ill from this deadly disease, I am today declaring a county wide state of emergency. Effective at the stroke of midnight tonight, March 27, anyone who is under 18 years of age and is unvaccinated against the measles will be barred from public places until the declaration expire in thirty days or until they receive at least their first shot of MMR.”

Ed Day, Rockland County Executive

The emergency declaration:

  • exempts those with a medical contraindication to getting vaccinated
  • does not mean that law enforcement will be asking for vaccine records
  • does mean that your case will be referred to the District Attorney if you are in violation (class B misdemeanor) – your child is in a public place without at least one dose of MMR
  • holds parents accountable if they are in violation
  • exempts homes
  • exempts many public places, like streets and parks

So basically, the emergency declaration supports what the health department is already doing to end the outbreak and will hopefully get the attention of those who are keeping the outbreak going.

Are they out to arrest people?

No.

“We owe this to the residents of this great county so that we never ever have to go through this again. This is an opportunity for everyone in their community to do the right thing for their neighbors and come together. That’s what this is about now. We must do everything in our power to end this outbreak and protect the health of those who can not be vaccinated for medical reasons and those children too young to be vaccinated and also those who are risk…”

Ed Day, Rockland County Executive

They are trying to get their attention and educate them.

“Get your children vaccinated.”

Ed Day, Rockland County Executive

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

Let’s stop the outbreaks.

The Rockland County Emergency Declaration

Why Is a Kentucky Teen Who Refused to Get Vaccinated Suing His School?

One extra consequence of the rise in cases of vaccine-preventable diseases we have been seeing lately, in addition to the fact that more kids are getting sick, is that we are seeing more kids being quarantined and kept out of school.

“The parents of 42 children affected by the ban at the school, the Green Meadow Waldorf School, sued the Rockland County health department, asking a federal judge to issue an injunction to allow the children to return.”

Parents Wanted Their Unvaccinated Children in School, but a Judge Said No.

And in a few cases, we are seeing lawsuits trying to get some of these kids, mostly intentionally unvaccinated kids, back into school.

Why Is a Kentucky Teen Who Refused to Get Vaccinated Suing His School?

While most outbreaks are related to measles, in Kentucky, a large outbreak of chickenpox at Our Lady of the Sacred Heart/Assumption Academy in Walton has led to the quarantine of a number of unvaccinated students.

A chickenpox quarantine sign

One student, a senior and the starting center on the school basketball team, is suing to get him back in school.

“The Kunkels filed their lawsuit Thursday in the Boone County Circuit Court alleging that the Northern Kentucky Health Department had violated Jerome’s First Amendment rights. Accepting the chickenpox vaccine would be “immoral, illegal and sinful,” they said, according to their Catholic beliefs. The lawsuit also alleges that the health department violated due process when officials enacted the extracurricular and school attendance bans without declaring an official emergency, which would have triggered the involvement of the state legislature.”

God, country and chickenpox: How an outbreak entangled one school in a vaccine showdown

So they are actually suing the health department, not his school, to get him back into school…

Wait a minute though?

Is the Catholic Church against vaccines?

“Since there is no Catholic teaching that the use of these vaccines is sinful, schools cannot allow Catholic parents to claim a religious exemption from the requirement of immunization.”

National Catholic Bioethics Center on Vaccines and Exemptions Granted by Schools

Are they against the chickenpox vaccine?

“One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them.”

National Catholic Bioethics Center

No, they aren’t, which is why most Catholics vaccinate and protect their kids.

“In the event that the county health department or state health department declares an outbreak of a vaccine-preventable disease for which proof of immunity for a child cannot be provided, he or she may not be allowed to attend childcare or school for up to three (3) weeks, or until the risk period ends.”

Kentucky Parent or Guardian Declination on Religious Grounds to Required Immunizaitons

A judge will have to decide the merits of the case, but from a moral standpoint, it seems like they are on shaky ground.

More on Quarantines for Intentionally Unvaccinated Kids