Is that what this bill, which wasn’t even put to a vote, does?
Is There a Plan to Send Unvaccinated People to Concentration Camps to Be Force Vaccinated?
Of course it doesn’t!
“Relates to the removal of cases, contacts and carriers of communicable diseases that are potentially dangerous to the public health.”
Anything about forced vaccination?
Just the part that goes out of its away to reassure folks that it doesn’t allow forced vaccination!
The bill, which never made it out of committee, wasn’t even about unvaccinated people.
It was about being able to manage people who have contagious diseases, who might be a danger to the public, either because they refuse to stay in quarantine, get treatment, or have contacts that refuse public health orders to get treatment.
More on the Plan to Send Unvaccinated People to Concentration Camps to Be Force Vaccinated
Measles outbreaks have reached record levels this year. Unless you’re prepared, with a strict protocol to stop measles, that could mean that someone could get exposed in your office.
“Many of today’s physicians may never have seen a patient with measles— a disease that can cause serious complications in infants, young children, and adults. CDC is urging all physicians to “think measles” when evaluating patients who have fever and rash, and to know what to do to prevent, control, and report measles cases.”
CDC Asking Physicians to “Think Measles” and Help Stop the Spread
Have you ever seen a child with measles?
What Is Your Protocol to Stop Measles Before Kids in Your Office Get Exposed?
To help everyone understand how important it is to think about measles and prevent unnecessary exposures, it can help to understand what happens when a child with measles does go to their pediatrician, an urgent care center, or the ER.
Since measles is so contagious and can remain infectious for up to two hours after a person has left a room, with each measles case, you will have to:
isolate the person with measles (or suspected measles) in a negative pressure isolation room. If that’s not possible, at least have the person wear a mask in their own private room and/or schedule them at the end of the day, bypassing the waiting room. You might even go out to their car for a quick interview and exam before they come into the office.
not use that exam room for at least two hours after the person with measles leaves.
report the case to your local health department ASAP, as they will likely have more extra resources to help you manage your patient.
locate everyone who could have been exposed, including anyone who was in the same area as the suspected case or entered the area over the next two hours. If they aren’t already immune, these folks might need immune globulin (younger than six months or immunocompromised) or a dose of MMR. They will probably also be quarantined to make sure they don’t develop measles and expose others.
only allow those who are immune to measles (two doses of MMR or natural immunity) to take care of the suspected case. Everyone should still wear an N95 respirator or at the very least, a general facemask, just in case.
limit anyone else’s exposure as you work to confirm that they have measles (PCR testing of throat swab and urine), provide supportive care as necessary, or quarantine them at home.
Unfortunately, it usually ends up being more than a single exam room that has to be closed when a child shows up with measles. After all, before they got to that exam room, they were probably in the waiting room and other general areas of the office.
And that’s why you will want to have a protocol in place to avoid or minimize these exposures.
“Failure to promptly identify and appropriately isolate measles cases has led to the investigation of hundreds of healthcare contacts this year. Measles transmission has occurred in emergency departments and other healthcare settings, including transmission to one healthcare worker.”
Recommendations for Measles Case Identification, Measles Infection Control, and Measles Case and Contact Investigations
Next, make sure everyone understands how to recognize the signs and symptoms of measles. Otherwise, some of these kids might unexpectedly end up in your office when they are sick.
Think that’s easy? You just watch out for kids with a fever and a rash, right?
If you wait until they have the classic measles rash, you will likely miss the diagnosis the first time they come to your office. Remember, the rash typically doesn’t show up until they have already had a fever for three or four days.
Unfortunately, these kids are contagious well before they have a rash. They are even contagious before they have a fever and know they are sick.
So you should suspect measles in kids:
with a high fever and cough, coryza, and conjunctivits, even if they don’t yet have a rash
with classic measles symptoms who have had a possible exposure. This includes kids who recently traveled out of the country (get a travel history), had contact with international travelers, or just because there are a lot of cases in your area.
who are unvaccinated or not completely vaccinated, with two doses of MMR. Keep in mind that even fully vaccinated kids can sometimes get measles though.
And then, if you suspect that a child has measles, work to limit their exposure to others. Patients should know to call ahead. Staff at your office, lab, or the ER should be alerted and ready to see anyone with suspected measles. That way the family knows to wear a mask before going inside.
Ideally, if you have a strong suspicion that the child has measles, this visit will occur in a facility with a negative pressure airborne infection isolation room.
What’s the problem with this kind of protocol?
Lots of kids have fever and rashes! And since you can’t send everyone that calls with adenovirus, roseola, or hand, foot and mouth disease to the ER, part of your protocol should likely be that a health care professional carefully assesses the child’s signs, symptoms, and risks for measles before deciding what to do.
Mostly, be suspicious if a child has returned from a trip oversees, especially if they are unvaccinated, and they have a febrile illness.
More on Your Protocol to Stop Measles Before Kids in Your Office Get Exposed
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
429 cases have been in children
85 have been infants
only 24 have been fully vaccinated
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 7th month, which is very long for a measles outbreak in the post-vaccine era, there have been over 200 new cases in just the past few months!
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 continues to grow!
There is no sign of it stopping either, with new 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.
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
The case count jumped again on May 24, to 535 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.