Diseases Are Often Just a Plane Ride Away
May 13, 2011

Like it or not, global health impacts us all.
For all the complaining we do as Americans, it’s easy to see that, by comparison to other nations, we have it pretty good. 
Sure, we still have a lot of national health issues that could be improved upon, but generally speaking, we have an abundance of choices that provide us with good nutrition, plenty of opportunity to exercise and advanced medical care.  We have options that the majority of people in this world will never have.   And while socio-economic status and regional location may limit our individual choices, our overall public health is still far better than most other places around the globe. 
I guess that’s why it is not surprising to hear some parents question the need for vaccines.  They often wonder why we need to immunize against diseases which are rarely seen.  Some go so far as to argue that a healthy diet, adequate exercise and access to clean water and proper sanitation will provide their children with a healthy immune system that will naturally protect them from disease without the need for immunizations.  While being healthy can help prevent disease, the concern here is that many diseases we currently immunize for are highly contagious.  They don’t discriminate based on income, sanitation or diet.  Otherwise healthy individuals can, and do, fall victim to these diseases.  Sometimes these diseases even result in death.  Though these diseases are somewhat rare in the US, they still threaten the lives of millions of people throughout the world.  The concern is that many other countries continue to experience outbreaks of vaccine preventable diseases.  Today, more than ever, it’s evident that these diseases are often just a plane ride away.   
Fortunately, in the United States, diseases like measles, Haemophilus influenza type b (Hib), and even pertussis are not nearly as common as they were some 30-40 years ago.  In the US, the incidence of measles has been reduced 99.95% during the time in which the vaccine was introduced in the 196o’s through the year 1997.  The prevalence of Hib has decreased by 98.62% between the year 1991 and 1997.  Even pertussis has declined 97.56% since 1950, shortly after the vaccine was introduced, and the year 1997.    
Sadly, when you consider the global burden of vaccine preventable diseases, the picture is not so bright.  In the year 2002, the World Health Organization (WHO) estimated that 1.4 million childhood deaths, or 14% of global mortality in children under the age of 5, resulted from vaccine preventable diseases predominately from measles (38%), Hib (27%) and pertussis (20%).    That doesn’t even take into account how many more children suffered or were hospitalized as a result of these diseases.      
While there are many organizations who have taken the initiative to improve global health and reduce the occurrence of vaccine preventable diseases worldwide, (such as The Gates Foundation , the GAVI Alliance, the Measles Initiative  and it’s Partners, among many others), the prevalence of disease in other countries continues to impact the health of us all.    
Take for instance the recent measles outbreaks we have witnessed in the past few months in places like Massachusetts, New Mexico, Minnesota and Utah, to name just a few.  Many of these cases originated from patients who had been exposed to the disease overseas.  In Boston, one case began in February with an unvaccinated French consulate worker.  And this week, Boston saw five new cases.  In New Mexico, an unvaccinated resident  returning from a trip to Europe, exposed thousands of other travelers in VA, MD, Colorado, DC and New Mexico.   In Minnesota, there have been 23 confirmed cases of measles, twenty of which were linked to a case that was acquired by an unvaccinated child who had traveled to Kenya.  Five cases in Utah were linked to a family’s travels to Poland.  
These examples, all within the past few months, illustrate the fact that many US measles cases often originate as a result of overseas exposure.  According to Dr. Rebecca Martin, who heads the Vaccine Preventable Diseases program for the WHO’s European Region, at least 6,500 cases of measles have been reported in a dozen European countries so far this year.  Nearly 5,000 of those cases were in France alone.
This may explain why the United States seems to be on track to have more measles cases this year than any year in more than a decade.  Already this year, The Centers for Disease Control and Prevention reports 98 cases in 23 states, which is double the average number for an entire year. 
While we’ve been criticized for making too much of a “fuss” about the resurgence of measles and other vaccine preventable diseases, it is important for people to realize that these diseases are still circulating in the population.  Just because most of us have been fortunate enough not to experience these diseases first hand, doesn’t mean they don’t represent a continued threat to the health of their children. If you are a parent questioning the need for vaccines, it is important to realize that global diseases impact to us and immunizations offer an effective preventive measure. 
I believe Alex Palacios, a special representative of the GAVI Alliance sums it up in a recent Science Daily article by stating, “It is important that vaccine-preventable diseases are kept under control no matter where they crop up, whether it be in Texas or in Kenya. Diseases don’t recognize borders.”
Anna Dragsbaek, President and CEO of The Immunization Partnership, also explains our concerns with global outbreaks of vaccine-preventable diseases.  “As long as there is polio and other vaccine-preventable diseases in the world, outbreaks are only a plane flight away,” she said. “It may seem like it’s safe to be complacent. But in actuality, diseases such as whooping cough and measles arise only because we have been complacent. We are still all at risk because not enough people are immunized worldwide.” 
Dr. Martin offered her explanation about the French measles outbreak, stating that it is probably attributable to a lack of vaccination since most of the people who got the disease were either not immunized with the measles vaccine, or infants too young to be vaccinated.  In the example of France, and several other European countries, though vaccines are widely available, they are sometimes declined.  In these cases, the consequences seem to be determined by choice.  However, let us not forget that in other areas of the world, low immunization rates are often due to a lack of availability, accessibility or affordability of vaccines.   
By supporting organizations that are committed to improving immunizations worldwide, we will not only improve global health, but we can potentially save millions of lives.  It is ambitious for sure, but entirely possible.  If you represent one of these organizations, perhaps you will consider letting us know just how our readers can support your efforts.

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25 responses to “Diseases Are Often Just a Plane Ride Away”

  1. Steve Michaels says:

    I happen to live in Europe. Funny thing that…. So many people apparently contracting measles and other VPDs and Christine is telling us we need to vaccinate to ‘protect our children’ from these sometimes (read that word as ‘very rarely’ to be accurate) VPDs. You know what is so odd though? Kids aren’t dropping like flies in Europe. Want to hear something even odder? Europeans vacation on a regular basis to high risk areas: Kenya, Morocco, Tunisia, Tanzania, Egypt… These are normal destinations for Europeans, and you know what? The kids are STILL not dropping like flies. In fact, childhood mortality rates throughout Western Europe are substantially lower than the US. In fact, childhood mortality rates in Western Europe are half or even less than the US child mortality rate. Who would have thought it? Unless the ‘plane ride away’ tag is just another attempt at fear mongering those who choose not to vaccinate to comply.

    • Steve Michaels says:

      *that should be ‘sometimes deadly VPDs.

    • Ollie says:

      Steve, …why do children have to be “dropping like flies” for vaccine-preventable diseases to be dangerous? Personally, I feel that even if ONE child dies from a VPD, a situation where the percentage chance that such an outcome could have been DRAMATICALLY reduced had there been more vaccine compliance, …then it’s one death too many. All it takes is one person infected with measles, to take a plane ride to another country to spread it there, and continue to spread such an illness globally. “Dropping like flies” is not really the issue, …not yet anyway. It’s really not that odd that children aren’t dropping like flies. Quite frankly, whether the end result is death or not, suffering from a VPD is also something that children should not have to endure. Fear-mongering is what you are doing, …minimizing the risks of serious illnesses, …taking every opportunity to post on these threads and spread your bizarre way of thinking when it comes to risk-analysis and vaccine compliance. You, and others like you, are the reason we have to fear these diseases now, in the first place.

      • Steve Michaels says:

        Because your logic is flawed. It is not logical or rational to make a claim that one negative outcome trumps another. There is now evidence, cited below, that proves that the Government is fully aware of a link between autism (by many names, but same symptoms) and vaccines are linked. The Hippocratic Oath is ‘Do no harm’. If the link is fully established (which is only a matter of time now), then to destroy the lives of millions of children to (maybe) save that one life makes no sense at all. As I have pointed out on previous threads, if you wish to bring the motor vehicle death rate to zero, simply ban driving. Would you agree with that? To hell with people not being able to work, shop or live! It will save over 20,000 lives per year. Somehow, I’m guessing that you wouldn’t support that one, so why would you support harming many to save one, who incidentally, may be damaged as well.
        I also find it interesting that in one sentence you accuse me of minimizing the risks AND fear-mongering. These are mutually exclusive terms. My entire issue with the risk analysis is that the risks have NOT been assessed. This point has been proven over and over again.

      • Gary says:

        “It is not logical or rational to make a claim that one negative outcome trumps another. There is now evidence, cited below, that proves that the Government is fully aware of a link between autism (by many names, but same symptoms) and vaccines are linked.”
        The juxtaposition of suggesting that one negative outcome does not trump another with the claim that vaccine injuries trump disease injuries is just classic stevie. Its absolutely precious.
        But since you followed that little gaff with numbers, allow me to address them. There are NO reliable sources of information which suggest that millions of children are harmed from routine preventative vaccinations. On the other hand, there are too many reliable sources of information proving that diseases indeed harm and even kill children.
        Indeed, there have been children harmed by vaccines over the decades (or centuries if you want to go back far enough). But the number of children saved from death or debilitation by vaccines out numbers those by orders of magnitude. The simple fact of the matter, stevie, is that YOUR logic is the flawed one, AND you have no evidence to back up your position.
        “Before measles immunization was available, nearly everyone in the U.S. got measles. An average of 450 measles-associated deaths were reported each year between 1953 and 1963.
        In the U.S., up to 20 percent of persons with measles are hospitalized. Seventeen percent of measles cases have had one or more complications, such as ear infections, pneumonia, or diarrhea. Pneumonia is present in about six percent of cases and accounts for most of the measles deaths. Although less common, some persons with measles develop encephalitis (swelling of the lining of the brain), resulting in brain damage. ”
        Even if you assume that infection rates or morbidity rates would be some percentage points lower, you still see large percentages of the population succumbing to debilitating effects from measles without the vaccine.
        The total number of claims filed (not valid or true, just filed) is just under 14000 since 1988. Even if we multiply this by 100, we the number is still dwarfed by the potential number of victims from measles alone without the vaccine.

  2. percival says:

    Great post. Regarding the measles, etc. being just a plane ride away, I’m reminded of how the measles outbreak in San Diego was started by a patient of Dr. Bob Sears, the doctor that recommends delaying and/or refusing vaccines. It’s a pretty good reminder of how doctors that pander, instead of follow the science, impact everyone’s health.

    • Snoozie says:

      Percival–Excellent point about delaying as well as refusing.
      The Dr. Sears part hit home for me as a person who lives in Minnesota. Dr. Sears may practice medicine in San Diego and Mr. Wakefield may have formerly practiced in the UK, but their effect is felt globally. Also, while their clientele (and I will through in Dr. Jay Gordon, pediatrician to vaccine-refusing stars) may be educated, wealthy, and privileged, in Minnesota, it hit a different population. It began with Somali refugees living in Kenya, and spread to a day care center, a homeless shelter, and then an ER waiting room.
      It’s almost like a sick trickle-down of anti-vax information has made its way from those who have the best health care and can afford to be nonchalant about eschewing evidence-based medicine to those who have the fewest resources and can least afford desperately ill children.

    • percival says:

      Yeah, I saw that Wakefield was up there in the middle of the outbreak continuing to spread his nonsense to the Somali population, that’s definitely what I call gall. Good luck to you northerners, Snoozie!!!!

    • MicroMamma says:

      Percival, you are so right! Just look at the recent outbreak in Utah. The measles was imported from Poland via an unvaccinated individual. Fortunately, the vaccination rate in Utah is high or it could have been a disaster. More proof that vaccination works. Of importance around 1000 people were exposed but there are only 9 confirmed cases – 4 unvaccinated and the others are (of yet) unknown vaccination status. http://www.lvrj.com/news/utah-measles-cases-linked-to-one-person-120563149.html

    • Snoozie says:

      MicroMamm–And when I read “unknown vaccination status,” it reminds me that everyone, adults included, should be responsible for knowing their own vaccination status. And adults should also take the responsibility for getting the boosters and other vaccines that they need. The Tdap is a perfect example, but I know often adults my age may only have had one dose of the MMR unless they enrolled in a post-secondary institution that required the booster.
      And it is a sad day that people need to be on guard about bringing their infants to Europe as Europe grapples with its own measles outbreaks.

    • percival says:

      I read that somewhere around half those kids in MN were hospitalized but I expect that’s because doctors aren’t used to seeing measles. Its too bad because they need to stay out of the hospital where there are immunocompromised kids.

  3. Red Queen says:

    Snoozie- Correct me if I’m wrong but in the recent cases in Minnesota, there’s been a large percentage of the measles infected children requiring hospitalization, yes? I’d imagine that comes at quite a cost and increases the likelihood that Measles could spread to other patients in hospital. Hopefully there won’t be any deaths due to Measles complications as in Europe. Great article and a great reminder that we are truly a global community… Which is why my children are fully vaccinated.

    • percival says:

      According to this
      there were 23 cases at the end of april and 14 were hospitalized. But I’m pretty sure that’s because one, doctors are more likely to admit to the hospital more than they used to, and two they haven’t seen measles before. Obviously 50% of measles cases weren’t hospitalized back in the day. Still, not a good thing.

      • Red Queen says:

        @Percival: Thanks for clarifying. So if 450 people died per year on average prior to the vaccine, would this increased hospitalization and cautiousness of doctors now result in a decrease in deaths from severe complications like encephalitis? I guess I’m asking, would the increase in the hospitalization rate now make it easier to identify severe complications earlier and make them more treatable? I’m not well versed on how treatable encephalitis is.

      • Snoozie says:

        Red Queen–Because I don’t work at the Department of Health, it is hard for me to tell exactly why half of the measles cases in Minnesota have resulted in hospitalization. I also wonder if the age of the people with measles makes a difference, as a number of the cases were among infants.

      • percival says:

        I would imagine so, but if thats the case, and measles came back in a big way from loss of herd immunity, then doctors would have to stop admitting so many people and that risk complications would go up, or there would be one huge increase in health care costs from all the hospitalizations.

  4. Red Queen says:

    I should say 450 died of measles complications per year in the US. Obviously, well over 100,000 people still die from measles globally every year.

    • Steve Michaels says:

      Isn’t that around the same amount that die from prescription drug interactions and reactions in the US alone? Lot’s of talk about this huge European measles epidemic. Problem is, it’s a lose/lose claim for this site. If there is NOT an epidemic, then claims of vaccine driven eradication are flawed. If the IS an epidemic, and the child mortality rates in Europe are lower than the US (which they are) then the claim that this is a deadly disease is flawed. Either way, it shows that vaccines are hype and largely unnecessary. Personally, I have chosen to risk a 1 in 1,000 chance that my kids will end up with something more than a fever and rash than risk a potential 1 in 110 of autism. And yes, the autism/vaccine link IS gaining traction now that the Government’s own figures on compensation payouts prove that behind closed doors, it is already admitted that there is a link.

      • Gary says:

        “If there is NOT an epidemic, then claims of vaccine driven eradication are flawed. If the IS an epidemic, and the child mortality rates in Europe are lower than the US (which they are) then the claim that this is a deadly disease is flawed. ”
        stevie, you logic is once again severely flawed. It is absolutely possible for a measles epidemic to be raging in Europe, be less pronounced in America AND for the total European child mortality rate to be lower in Europe. Additionally, it is perfectly possible for measles to exist in less than epidemic numbers AND for the claims of vaccine effectiveness to be true.
        Allow me to demonstrate with made up numbers. Assume for a moment that before the age of 5 100 out of every 100,000 children die in Europe. While 200 die in America. It is still possible for 5 of those American deaths to be due to measles while 50 of the European ones are so attributable. Certainly the real numbers are not these. However, my point is that your claim of a logical truth quoted above is simply false.
        Just in case anyone is interested in the real numbers, here are some sources:
        In 2006 and 2007 “12 132 cases of measles were recorded with most cases (n=10 329; 85%) from five countries: Romania, Germany, UK, Switzerland, and Italy. Most cases were unvaccinated or incompletely vaccinated children; however, almost a fifth were aged 20 years or older. For the same 2 years, seven measles-related deaths were recorded. ”
        Meanwhile in the united states no measles deaths occured in that time AND the total cases was much lower (about 56 annually imported between 2001 and 2008). http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6020a7.htm?s_cid=mm6020a7_w
        Meanwhile, the child mortality numbers are certainly lower in much of Europe than in the US. http://www.who.int/healthinfo/statistics/02.whostat2005graph_under5infantmortality.jpg
        Its hard to see in the picture, but the European rate is indeed slightly lower than the American one.
        While measles does not contribute a great deal to the death rates of America or Europe CURRENTLY, the much larger number of cases AND deaths in Europe can be explained primarily by differences in vaccination rates over the last few decades.
        So, neither truth nor logic is on your side, stevie.

  5. Steve Michaels says:

    And lest anyone claim that I am making up numbers about how our friend pharma is responsible for 100,000 deaths and 700,000 hospital visits because of their products (in this case prescription drugs), here are the citations:

    • Chris says:

      That is off topic. Cases of imported measles are not caused by the use of pharmaceutical drugs. More accurately the lack of use of the MMR vaccine. The only way those links could be a rational response was if you showed that there was poisoning specifically from the MMR vaccine in the USA.

  6. Snoozie says:

    I really believe that recent outbreaks have proven that vaccine-preventable diseases are “just a plane ride away.” And emphasizing this may help combat the complacency many parents have about such diseases.
    But I also applaud GAVI and the Bill and Melinda Gates Foundation for providing vaccines to the poorest parts of our world because children all over the world deserve protection from diseases. Taking care of a child who is ill is difficult enough without adding in the extra burden of lack of access to doctors, poverty, or war.
    I often hear from people in my parents’ generation how their parents cautioned children against going to a friend’s house because that friend lived near a boy who got polio. I imagine the Salk vaccine came as a great relief, to say the least. But parents in Afghanistan must still fear polio while living in the midst of an active war.
    I think we all have a responsibility to the health of children around the globe.

    • Red Queen says:

      GAVI and The Gates Foundation are doing some amazing work. Their work to eradicate Polio in the small pockets in which it is still endemic is a direct result of how easily polio could be spread again due to international travel. I agree that making vaccines available to all is the responsible thing for the global community to do.

    • percival says:

      I agree, though I never would have said a good thing about Microsoft products in the past I am extremely impressed by Gates philanthropy but not enough to get rid of my Mac though.
      This is another foundation I ran across recently trying to get vaccines to save lives in Africa. Its called One.org and is presumably named after the classic U2 song as Bono is one of the founders. They seem to be more focused on gaining support to lobby for more funding for vaccinations and other worldwide relief projects than soliciting for money. I can’t even find a place to donate on their site but I’m sure its there somewhere. Great video, like the Gates video that demonstrates how powerful and live saving vaccines can be.

  7. Alathea says:

    The “just a plane ride away” idea has been illustrated by many outbreaks, not all of them vaccine preventable diseases. A group called BIO.DIASPORA (http://www.biodiaspora.com/) is developing a model to help predict the emergence of infectious disease due to commercial air travel.
    The Olympics have illustrated two measles outbreaks due to unvaccinated and/or undervaccinated individuals. In 1991, there was an outbreak of measles during the Special Olympics caused by a 12-year old boy from Argentina that had only received one dose of the vaccine. Twenty-five measles cases were traced back to this index case. One case was in a 5-month old infant, too young to be vaccinated. Of the remaining 24 cases, 18 were unvaccinated. The remaining 6 were vaccinated with just 1 dose, which we now know is insufficient. High herd immunity was credited in preventing further spread of the measles in the community. http://jid.oxfordjournals.org/content/171/3/679.full.pdf
    Another measles outbreak was associated with the 2010 Winter Olympics in Vancouver. No formal report has been published yet, but the epidemiology was presented at Grand Rounds at BC Center of Disease Control (BCCDC). The presentation slides can be viewed here: http://www.bccdc.ca/NR/rdonlyres/0135E978-A153-40A7-A994-0335A1D2052D/0/VSahniMNaus_MeaslesAnUnwelcomeConsequenceofthe2010WinterOlympicGames.pdf
    This outbreak possibly originated with 3 persons (one unvaccinated, one unknown, one vaccine status not reported) and expanded with a family that was opposed to the vaccination:

    So far, measles has spread to 16 people in Vancouver, Naus says. Half of them are in one large unvaccinated household. The parents reject vaccination.
    “It’s not a religious issue,” Naus says. “A friend of the family who had anti-vaccination sentiments was influential in convincing them not to get vaccinated.”

    I think the Vancouver outbreak really demonstrates the need for vaccine advocacy. By the end of the outbreak, 9 babies, too young to be vaccinated and where measles can be the most serious were infected. Also, 65% went to an ER and 23% were hospitalized. Although the cases reported are likely underestimates of the actually number of cases, these numbers does not confirm that measles is a mild disease in a well-nourished, healthy population to me.

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