Tag: Ukraine

We Know What Happens If We Stop Vaccinating

It’s no surprise.

If we stop vaccinating, diseases that are now vaccine preventable will come back.

How do we know?

Because it has happened already.

We Know What Happens If We Stop Vaccinating

It has happened a lot, actually.

Remember when Sweden stopped using the DPT vaccine?

Between 1979 and 1996, Sweden suspended vaccination against pertussis because of concerns about the DPT vaccine.

Justus Ström‘s data was wrong…

And what happened?

“In 1979, the Swedish medical society abandoned whole-cell pertussis vaccine and decided to wait for a new, safer, more effective vaccine – a strategy that was soon adopted as national policy. During 1980-83, annual incidence for children aged 0–4 years increased to 3370 per 100000, with rates of serious complications approaching global rates. In subsequent years, Sweden reported more than 10000 cases annually with an incidence exceeding 100 per 100000, comparable to rates reported in some developing countries.”

Ganarosa et al on Impact of anti-vaccine movements on pertussis control: the untold story.

Pertussis came back.

In fact, endemic pertussis came back.

“Our evaluation of pertussis in the unimmunized child population gave an answer to the question of whether pertussis nowadays is a harmless disease which does not demand general vaccination. The present situation regarding pertussis in Sweden and the low efficacy of the antimicrobial treatment indicate an urgent need to prevent the disease by general vaccination as soon as a safe and effective vaccine is available.”

Romanus et al on Pertussis in Sweden after the cessation of general immunization in 1979.

Of course, they already had a safe and effective vaccine at the time. All of the claims against the whole cell pertussis vaccine ended up being untrue.

The same thing happened when Japan stopped using the MMR vaccine.

“Due directly to these gaps in ‘herd’ immunization resulting from politicized transitions in vaccination policy by the government, there were outbreaks of rubella with 17,050 cases reported between the years of 2012 and 2014, and 45 cases of congenital rubella syndrome reported to the National Epidemiological Surveillance of Infectious Diseases from week 1, 2012 to week 40, 2014.”

Yusuke Tanaka on History repeats itself in Japan: Failure to learn from rubella epidemic leads to failure to provide the HPV vaccine

What happened in Ukraine when immunization rates dropped in the 1990s? There were 17,387 cases of diphtheria and 646 deaths from 1992 to 1997. Also high, were cases of measles (over 23,000 cases in 1993) and pertussis (almost 7,000 cases in 1993).

Remember the measles outbreaks that spread across Europe in 2010 to 11, leading to about 30,000 cases of measles each year, and at least 28 deaths?

That should have been enough to warn folks, but it didn’t.

Things are much worse now, with over 120 measles deaths in Europe over the past few years.

More recently, in Venezuela, shortages of most things have led to ongoing epidemics of measles and diphtheria, a “potential for reemergence of poliomyelitis,” and a risk to neighboring countries.

“Officials say the low coverage rate and widespread transmission of the virus is due to many factors, including transport costs for those in rural areas, a high number of people with weakened immune systems, such people living with HIV and tuberculosis – and vaccine refusal.”

Ukraine: Red Cross deployed to help contain largest measles outbreak in Europe in four years

And once again, there are measles outbreaks in Ukraine. This time, they have spread to many other countries, fueling outbreaks in Israel and the United States.

We know what happens if we stop vaccinating. Get vaccinated and stop the outbreaks.

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

More on What Happens If We Stop Vaccinating

Where Is Measles on the Rise?

We have been hearing a lot about ongoing measles outbreaks in the United States this year.

Brooklyn. Rockland County. The Pacific Northwest.

Think 2018 was a big year for measles? It was the second highest number of cases since 1996.

How will 2019 shape up?

Consider that it isn’t even the end of January yet is only May and we have already had more cases, 74 92 273 900+, than we had any years since 1994.

Not surprisingly, this isn’t just happening in the United States.

Where Is Measles on the Rise?

In fact, if you understand that the endemic spread of measles was eliminated in the United States in 2000 and that outbreaks are started by folks with measles who travel in or out of the country, then it makes sense that more measles here likely means that there is more measles somewhere else.

Unfortunately, this year, that somewhere else seems to be just about everywhere.

Japan is off to the fastest start in 10 years, with 486 cases so far this year, surpassing 2009, when they ended up with over 700 cases.
Japan is off to the fastest start in 10 years, with 486 cases so far this year, surpassing 2009, when they ended up with over 700 cases.

Are you planning a trip to Europe anytime soon?

With so many measles cases in Europe, it shouldn’t be a surprise to anyone that there are so many deaths.

You should know that their measles outbreaks aren’t over. There are ongoing outbreaks in France, Lithuania, Poland, Romania, Bulgaria and Germany.

“Between 1 April 2018 and 31 March 2019, 30 EU/EEA Member States reported 11 383 cases of measles, 8 396 (74%) of which were laboratory-confirmed. None of the countries reported no cases. The highest number of cases were reported by Italy (2 107), France (2 028), Romania (1 390), Greece (870), United Kingdom (860), Poland (828), Germany (733) and Slovakia (714)…

Twenty-two deaths attributable to measles were reported to TESSy during the 12-month period in Romania (14), Italy (5), France (2) and Greece (1).”

Monthly measles and rubella monitoring report May 2019

Where else are we seeing measles?

  • at least 4,100 cases in Israel, 2 deaths, and a case of encephalitis since 2018, with the majority of cases in Jerusalem, Beit Shemesh, Safed, and Betar Illit
  • over 31,056 cases and 415 deaths in the Philippines (2019)
  • nearly 2,000 cases in Vietnam (2018) and cases are increasing in Hanoi and Ho Chi Minh City already in 2019
  • in Madagascar, as of 3 of April there were 122,840 registered cases, and 1,233 reported deaths
  • at least 517 confirmed cases in the UK (through the 3rd quarter of 2018)
  • India remains the country with the most cases, with over 65,600 cases in 2018
  • a large outbreak in Thailand, with at least 4,327 cases and 4 deaths
  • an ongoing outbreak in Malaysia with over 1,934 cases and 6 deaths (2018)
  • an outbreak in Myanmar with over 1,300 cases and one death
  • at least 79 cases in the Republic of Korea (2019)
  • Ukraine continues to see a lot of cases, over 24,000, and some deaths
  • over 2,200 cases in Russia
  • Australia – 102 cases (2019)
  • Canada – 45 cases (2019)
  • outbreaks in Yemen, Nigeria, Sudan, and DR Congo
Conflict zones plus vaccine hesitancy contribute to measles outbreaks in the Philippines.
Conflict zones plus vaccine hesitancy contribute to measles outbreaks in the Philippines.

And over 16,000 confirmed measles cases, including 86 deaths, were reported in 12 countries of the Region of the Americas in 2018: Antigua and Barbuda (1 case), Argentina (14 cases), Brazil (9,898 cases, including 13 deaths), Canada (29 cases), Chile (2 cases ), Colombia (171 cases), Ecuador (19 cases), Guatemala (1 case), Mexico (5 cases), Peru (38 cases), the United States of America (350 cases), and the Bolivarian Republic of Venezuela (5,643 cases, including 73 deaths).

So far this year, cases have been reported from Argentina, the Bahamas, Brazil, Canada, Chile, Colombia, Costa Rica, Mexico, the United States of America, and the Bolivarian Republic of Venezuela.

Does it seem like measles is on the rise everywhere?

That’s because it basically is.

Since 2017, there has been a measles resurgence in three regions of the world and measles elimination milestones have not been met.

And as you can see, in almost all of these places where we are seeing more measles, we are seeing more people dying of measles?

That’s why it is important to get vaccinated.

There is even a recommendation to get an early MMR if you will be traveling out of the United States. Get vaccinated. Don’t bring home measles and start an outbreak.

More on the Resurgance of Measles

Updated May 17, 2019

Diphtheria in Canada

Breaking News – there is a new case of diphtheria in Canada (June 2018), and no, according to health officials, this one is not cutaneous diphtheria.

A lot of people were surprised by the news of a case of diphtheria in Canada last year.

Some folks were quick to blame the anti-vaccine movement, assuming it was in an unvaccinated child.

News soon came that the child was vaccinated!

“I’ve always been on top of that, I’m a firm believer in immunizations.”

Mother of 10-year-old with diphtheria

What happened next?

Anti-vaccine folks began using the fact that he was vaccinated, but still developed diphtheria, as some kind of proof that vaccines don’t work.

The Case of Diphtheria in Canada

They are wrong.

The diphtheria vaccines have worked very well to control and eliminate diphtheria from Canada, just like it has in the United States.

Diphtheria has become rare since the pre-vaccine era.
Diphtheria has become rare since the pre-vaccine era.

So how did a vaccinated child in Canada get diphtheria?

It’s simple.

He has cutaneous diphtheria, not respiratory diphtheria.

What’s the difference?

“Extensive membrane production and organ damage are caused by local and systemic actions of a potent exotoxin produced by toxigenic strains of C. diphtheriae. A cutaneous form of diphtheria commonly occurs in warmer climates or tropical countries.”

Vaccines Seventh Edition

Cutaneous diphtheria occurs on your skin. It is usually caused by non-toxigenic strains of Corynebacterium diphtheriae.

On the other hand, respiratory diphtheria is usually caused by toxigenic strains of Corynebacterium diphtheriae.

Diphtheria strikes unprotected children.The diphtheria vaccine (the ‘D’ in DTaP and Tdap), a toxoid vaccine, covers toxigenic strains. More specifically, it covers the toxin that is produced by toxigenic strains of Corynebacterium diphtheriae. It is this toxin that produces the pseudomembrane that is characteristic of diphtheria.

It was the formation of this pseudomembrane in a child’s airway that gave diphtheria the nickname of the “strangling angel.”

So why the fuss over this case in Canada? They likely don’t yet know if it is a toxigenic strain. If it is, then it could be a source of respiratory diphtheria.

But remember, even if these kids developed an infection with the toxigenic strain of Corynebacterium diphtheriae, those that are fully vaccinated likely wouldn’t develop respiratory diphtheria. Again, it is the toxin that the bacteria produces that cause the symptoms of diphtheria. The vaccine protects against that toxin.

For example, when an intentionally unvaccinated 6-year-old in Spain was hospitalized with severe diphtheria symptoms a few years ago, although many of his friends also got infected, non of them actually developed symptoms because they were all vaccinated.

Diphtheria Is Still Around

Diphtheria is DeadlyTragically though, especially since diphtheria is still endemic in many countries, we are starting to see more and more lethal cases of diphtheria, including cases in many more countries where it was previously under control:

  • at least 142 diphtheria deaths in Venezuela since 2016, among about 1,602 cases
  • at least 85 deaths in Yemen, among about 1,584 cases since 2017
  • at least six deaths among Rohingya refugees in Bangladesh
  • at least two cases of diphtheria in Ukraine
  • a family that became infected in South Africa in which at least one child died (August 2017)
  • an unvaccinated 3-year-old who died in Belgium (2016)
  • a 22-year-old unvaccinated women who died in Australia (2011)

It is even more tragic that diphtheria is not under control in so many more countries.

In 2016, the WHO reported that there were just over 7,000 cases of diphtheria worldwide. While that is down from the 30,000 cases and 3,000 deaths in 2000, thanks to improved vaccination rates, there is still work to be done.

And as this recent case in Canada shows, diphtheria is still around in many more places than we would like to imagine.

Get educated. Vaccines are necessary.

What to Know About Diphtheria in Canada

A case of diphtheria in Canada is a good reminder that vaccines are still necessary.

More on Diphtheria in Canada

Updated on June 25, 2018