Will we ever stop seeing cases of measles?
Last week, officials confirmed the first case of measles in Michigan this year. That may not sound significant. It’s only one case in one state, but it’s actually one of 21 cases of measles reported across 7 different states so far this year.
Last week we also heard the World Health Organization warn of measles outbreaks across Europe. This image, published in an article from The Sun in the UK, illustrates how widespread the outbreaks have been. There are currently 14 countries seeing endemic transmission of measles, to include such countries as France, Germany, Italy, Poland, Romania, Switzerland and the Ukraine. Maybe not the countries you were expecting. And maybe some countries you plan to visit.
Although measles was declared eliminated in the U.S. in 2000, and even eliminated from all of the Americas in 2016, measles still kills an estimated 115,000 children per year all across the globe – that’s 314 measles related child deaths each day. Clearly, measles remains a signifiant global health concern.
And it’s not just measles deaths we worry about. Measles can be a serious illness requiring hospitalization. As many as 1 out of every 20 children with measles gets pneumonia, and about 1 child in every 1,000 who get measles will develop encephalitis – a swelling of the brain that can lead to convulsions, and can leave the child deaf or intellectually disabled. For every 1,000 children who get measles, one or two will die from it.
When we consider the impact of measles worldwide, we begin to understand why every case is relevant and in someway related, and here’s why:
Measles is a highly contagious airborne disease.
When one person has measles, 90 percent of the people they come into close contact with will become infected, if they are not already immune. The virus can linger in the air for up to two hours after an infected person has coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. This means you don’t even have to have contact with the contagious person to become infected. That is why one a case of measles can easily be spread to others.
Disease elimination is not the same as disease eradication.
Measles elimination is defined as the absence of continuous disease transmission for 12 months or more in a specific geographic area. Measles is no longer endemic in the United States, but that doesn’t mean we don’t still see measles cases. The cases we see here begin with transmission elsewhere. Sometimes cases originate with U.S. citizens who unknowingly contract measles while traveling abroad and then became sick and spread the virus upon returning home. Other times, travelers from other countries arrive in the U.S. while contagious. In both instances, these individuals can spread measles to anyone they come in contact with who isn’t already immune. In recent years, this has caused several widespread outbreaks of measles in the U.S.
There are still many people in this world who are not vaccinated against measles.
It’s estimated that in 2010 about 85% of the global population has received at least one dose of measles vaccine. While that may sound good, it’s still not good enough to stop the spread of measles. Because measles is extremely contagious, the immunity threshold – which is the percentage of individuals who need immunity in order to prevent a disease from spreading – is as high as 95%. Sadly, as of 2014, only about 63% of countries have an immunization rate that is above 90% and even 90% isn’t good enough. Read more…
This post is part of a blog relay sponsored by the Centers for Disease Control and Prevention (CDC) in recognition of National Infant Immunization Week (NIIW). You can follow the conversation on social media using hashtag #NIIW and join the #VaxQA Twitter Chat Wednesday, April 20th at 4 p.m. ET
Protecting kids from disease requires more than just getting them their recommended childhood vaccinations. It requires the commitment of an entire community.
Thanks to an abundance of evidence based research, we’re constantly learning new and improved ways to protect our children; from safer rear-facing car seats with five-point harnesses, to wearing bike helmets and recommending that babies sleep on their backs. Thankfully, advancements in medical science have also led to safe and effective vaccines that can protect today’s children from as many as 14 potentially deadly diseases.
This commitment to scientific research has provided us with the safest, most effective vaccine supply in history. Today’s vaccines not only contain less antigens than they did years ago, but they have fewer side effects. There is even a system in place to continually evaluate vaccine safety and a process to update and improve vaccine recommendations as new information and science becomes available.
The impact of infant immunizations is monumental.
It is estimated that vaccines administered to American children born between 1994-2013 will prevent an estimated 322 million illnesses, 21 million hospitalizations, and 732,000 deaths. In looking at the incidence of specific diseases like measles, we can see how beneficial childhood vaccines have been. For instance, before the U.S. measles vaccination program started in 1963, about 3–4 million people in the U.S. got measles each year. In comparison, last year we had 189 cases and even that seemed like a lot.
While these successes are to be applauded, there’s still more that can be done to protect today’s children and future generations from dangerous diseases.
Timely childhood vaccinations are critical.
The recommended childhood vaccination schedule is specifically designed to provide immunity at a time when infants and young children are at the greatest risk of contracting potentially life-threatening diseases.
Take Hepatitis B for example. If a child contracts this disease before the age of one, there is a 90% probability that they will develop chronic symptoms later in life. However, only 30% of children who contract hepatitis B between the ages of one and five will go on to develop these chronic issues.
But vaccinating babies isn’t enough to ensure children will grow to be healthy adults.
Keeping children safe from preventable disease requires community immunity.
Because widespread vaccination programs have been so effective in preventing diseases in the U.S., many parents don’t realize that diseases like polio and diphtheria still exist. Some don’t consider diseases like whooping cough, varicella or measles to be a serious threat to their children. This miscalculation of risk can lead to vaccine complacency or refusal.
But the fact is that vaccine-preventable diseases are still circulating in the U.S. and around the world. Even when diseases are rare in the U.S., they can still be commonly transmitted in many parts of the world and brought into the country by unvaccinated individuals, putting entire communities at risk.
This explains the recent resurgence of measles cases in the U.S. , despite measles having been declared eliminated from the U.S. in 2000. Today’s outbreaks are often the result of unvaccinated individuals who contract the disease oversees and then return to the states where they spread it to others. But unvaccinated individuals don’t just put themselves at risk; their choices impact the health of our communities as a whole. Read more…
In the midst of the current measles outbreak, now is the time for states to take action to prevent against further outbreaks and to protect children who attend licensed daycare and schools. Do you support protecting children against vaccine-preventable diseases? Do you believe that vaccinating not only protects the individual, but also the community?
If so, sign Every Child By Two’s petition on Change.org!
Our petition calls for state governments to take two simple actions to support parents and the medical and public health communities: 1) Tighten laws for non medical exemptions to school vaccination mandates and 2) Release vaccination exemption rates for licensed daycare centers and public schools in every state.
We believe these steps will help protect children from needless illness. If you agree, sign our petition today and share it with everyone you know who cares about their children’s and community’s health! After attaining our signatory goal we hope that our partners will make use of this petition to reflects the public’s ongoing support for school vaccine mandates.
Click here to view a detailed map of school vaccine mandate exemptions permitted in your state.
As the number of measles cases tied to the Disneyland outbreak continues to rise, parents are growing concerned about possible measles exposure in children who are not yet old enough to receive their first dose of MMR (measles, mumps rubella) vaccine. The CDC recommendation is to administer the first dose of MMR between the ages of 12-15 months. However, this recommendation leaves children under one year of age at risk, and so Abigail, like many other parents with young children, raised her concerns on our Vaccinate Your Baby Facebook page by asking
Does anyone have information on giving the MMR vaccine early? My child is just 6 months old. We live in Southern California, a hotbed of the latest measles outbreak. We’re right in it…even our local grocery store was exposed.
I’m a stay at home mom and he has no siblings, and at this point, we are not taking him to public areas often. But this outbreak is incredibly worrisome. I read that children who travel can be offered the MMR vaccine at 6 months. At what point should we consider it for our child? Any studies on early vaccination — risks, effectiveness, etc?
Every Child By Two Scientific Advisory Board Member, Mary Beth Koslap-Petraco, DNP, PNP-BC, CPNP, FAANP responds to Abigail’s question as follows:
Measles was declared eliminated from the U.S. in 2000, but every now and then we hear about an outbreak in this country. Typically it goes something like this:
An unvaccinated American travels to some place like Europe, Asia, the Pacific, or Africa where there are 20 million measles cases a year. They are exposed to the disease, arrive back in the states and begin exhibiting symptoms. Eventually they’re diagnosed with measles and public health officials work diligently to identify and isolate subsequent cases. Within a few weeks the outbreak is contained and people go about their business like nothing ever happened.
So why has there been such a fuss about the recent measles cases in Disneyland?
At first, news reports identified nine cases among visitors of the Southern California amusement park in December 2014. Eight of the patients – ranging in age from 8 months to 21 years – had been vaccinated, and two were too young to have been vaccinated.
But then the outbreak appeared to be spreading to different states and lots of new cases. The latest report from the CA Department of Public Health confirms 59 cases of measles in CA since December 2014. Of the confirmed cases, 42 have been linked to an initial exposure in Disneyland and include five Disney employees. Patients range in age from seven months to 70 years and the vaccination status is documented for 34 of the 59 cases. Of these 34, 28 were unvaccinated, one had received one dose and five had received two or more doses of MMR (measles, mumps, rubella) vaccine. The CDC indicates that the measles cases we’ve seen so far in 2015 span six different states, largely due to the outbreak that originated at Disneyland. As the outbreak spreads, we’re seeing evidence of secondary infections and secondary effects. For instance, in an effort to contain the spread of measles in Orange County schools, public health officials are requiring some parents to keep their unvaccinated children home from school for 21 days after a fellow student was diagnosed with measles as part of the outbreak.
Now many people are wondering,”Is measles something I should be worried about?”
Most vaccinated individuals aren’t very concerned. After all, they were vaccinated against measles as children. Doesn’t that make them immune to measles infection for the rest of their lives? Not exactly.
And then there are those who have chosen not to get themselves or their children vaccinated. They’re not all that concerned either. After all, measles isn’t all that dangerous, right? People don’t die from measles in this country, do they? Besides, if they eat an organic diet and avoid toxins than their immune system should easily be able to fight off a measly measles infection. Right?
In order to determine whether we should be concerned, we need to starts with the facts. The truth is that measles presents a risk to everyone, even the vaccinated, and here’s why:
As we prepare for the challenges of 2015, we want to thank everyone who has contributed to our success in 2014. Once again, the past year has been one of tremendous growth. We’ve seen a record number of views and shares on a variety of Shot of Prevention blog posts, and we’re especially grateful to our blog contributors and many new subscribers.
In looking back over our efforts from this past year, we would like to share a list of some of our most popular blog posts from 2014. We hope that you will revisit these posts and share them with others so that we can continue to engage more people in these important immunization discussions.
This blog post was written by Joe Lastinger, Board Member of Families Fighting Flu, who lost his young daughter Emily to flu. He explains that guilt and regret are often the hidden forces behind a lot of the good that is done in the world. And he explains the guilt and regret that he feels in his failure to adequately protect his daughter from influenza. To here more about Emily’s story, click here.
Infants don’t get begin getting immunized against pertussis until they are two months old. Prior to that, they remain vulnerable to this highly contagious disease at a time when they’re most fragile. In this post, Kathy shares the story of her son Brady’s battle with pertussis in the same way that she did with her closest friends and family; through her Facebook status updates. This small glimpse into one family’s heartbreak reminds us of how fragile a young life can be, and highlights how important adult pertussis boosters are in preventing pertussis in infants. Read the story for yourself here.
After five years and four miscarriages, Katie and Craig Van Tornhout celebrated the birth of their miracle baby, Callie. But their joy quickly turned to grief when Callie contracted pertussis and lost her life at just 38 days old. This story, which you can read here, talks about Callie’s struggle, but also highlights the important work the Van Tornhout’s have done to try to save the lives of other children by advocating for adult Tdap boosters in their community and across the country.
The U.S. is experiencing a record number of measles cases, with 610 cases in 24 states so far this year. This is the highest number of cases since measles elimination was documented in the U.S. in 2000. This may also explain why our fourth most popular blog post of the year was one that explained why measles outbreaks are concerning even to the vaccinated. To find out why everyone should be concerned about measles outbreaks, read the blog post here.
Dr. Dorit Reiss, is a Professor of Law, at the University of California Hastings College of Law. She has contributed several guest posts throughout the year, utilizing her legal expertise to examine the social policies of immunization. This particular post, which ranked as our fifth most popular blog post of the year, highlights the cost of vaccine misinformation. In this post, Dr. Reiss explores who may be liable when harm occurs as a result of a parent’s decision not to vaccinate – a decision often based on misinformation from a third-party. Read the details of Dr. Reiss’ explanations here.
If you have suggestions for topics you would like us to address in 2015, or you would like to contribute a guest post for publication, please feel free to let us know by commenting below or emailing us at email@example.com.
If you want to ensure you don’t miss any of our new posts in 2015, simply subscribe to Shot of Prevention by clicking the link at the top right of this page. You can also “Like” our Vaccinate Your Baby Facebook page to receive updates on important immunization news and join in on group discussions.
Thanks again for your continued support and best wishes for a happy and healthy new year!
As a long-time staffer for Rep. Henry Waxman (D-Calif.), Sarah Despres knows a bit about Congress. As counsel working on public health issues for the Democratic staff of the House Government Reform Committee for over a decade, Despres also knows a lot about immunization policy.
So why does she believe that Congress is responsible for the return of measles?
Despres’ recent op-ed published in POLITICO Magazine’s Public Arena section is based upon her experiences as a Congressional insider and makes a bold declaration that is very convincing.
“Public health has taken a giant, 20-year step back, and we have Congress to thank”, she explains.
Her no-holds barred article connects the dots between a stunning Congressional declaration in 2000, in which measles was believed to have been eliminated in the United States, to our current day concerns over the highest resurgence of measles cases in the U.S. since 1994 (as of today there are 514 reported cases in 2014). She describes how our nation’s immunization program, which was once considered the crown jewel of public health, has suffered from repeated attacks. Congressional members have fallen prey to unscientific theories at high-profile congressional hearings and inflammatory rhetoric has skewed the public’s opinions of life-saving vaccines. And she faults Congress for not taking appropriate action to fix the problems they have essentially created.
What is most admirable about Despres’ article is not just in the evidence she presents, but in the purpose behind it. She is not concerned about being politically correct. Rather, she is assertive about demanding public accountability for an issue that she finds personally and socially concerning – an issue we should all find personally and socially concerning.
Her article drives home the point that what Congress says and more importantly, doesn’t say – matters. Hearings held 14 years ago have set the stage for a disease comeback of dangerous proportions, and Sarah Depres is one woman who is bold enough to declare that Congress take responsibility.
Congress has an opportunity now to remedy its previous mistakes. It should use the return of measles to demonstrate its commitment to protect the public from vaccine-preventable diseases and give the CDC adequate resources to fund immunization programs. But Congress also has the bully pulpit. Committees can hold hearings to correct the record. Members should record public-service announcements, reminding parents to get their children and other family members vaccinated. And members should participate in immunization clinics in their districts as a show of support for the local public-health departments who are on the front lines preventing outbreaks.
I suggest we should all make similar demands on Congress and request that they help rectify a dangerous situation.
If you agree, please share Sarah Depres’ Politico article and send a similar message to your own Members of Congress. It’s time we speak up in order to put measles back on the eradication list.
Sarah Despres is an Every Child By Two Board Member. She is also a Director of Government Relations for the Pew Charitable Trusts specializing in health related projects and a member of the National Vaccine Advisory Committee. You can follow her on Twitter @sarahhdespres.