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‘It Will Take Off Like a Wildfire’: The Unique Dangers of the Washington State Measles Outbreak

posted by mrpg on Friday February 08 2019, @05:50PM   Printer-friendly
from the will-this-end? dept.

upstart writes:

Submitted via IRC for Bytram

'It will take off like a wildfire': The unique dangers of the Washington state measles outbreak

[...] "You know what keeps me up at night?" said Clark County Public Health Director Alan Melnick. "Measles is exquisitely contagious. If you have an under-vaccinated population, and you introduce a measles case into that population, it will take off like a wildfire."

[...] Anti-vaccination activists, for their part, contend that state officials are twisting facts to stoke public fear.

"It shouldn't be called an outbreak," Seattle-area mother Bernadette Pajer, a co-founder of the state's main anti-vaccine group, Informed Choice Washington, said of the measles cases, arguing that the illness has spread only within a small, self-contained group. "I would refer to it as an in-break, within a community."

[...] Clements eventually changed her mind, deciding to give her kids the shots after a doctor at a vaccine workshop answered her questions for more than two hours, at one point drawing diagrams on a whiteboard to explain cell interaction. He was thoughtful, factual and also "still very warm," she said.

[...] In Washington, state lawmakers supporting tougher vaccine requirements are mounting their second effort in the past three years to make it harder for parents to opt out of vaccinations.

Original Submission

 
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  • (Score: 2, Informative) by Anonymous Coward on Friday February 08 2019, @07:28PM (18 children)

    by Anonymous Coward on Friday February 08 2019, @07:28PM (#798495)

    It looks like the vaccine is 95% "effective" (as judged by an antibody test, not actual exposure) for a few years, then of those 95% of people only 91% still have positive antibody tests 30 years later: https://academic.oup.com/jid/article/189/Supplement_1/S123/821041 [oup.com]

    So if you were vaccinated there is ~.91*.95 = 86% chance you will still have a positive antibody test. Since about 90% of people in the US are vaccinated or had measles that means about a quarter of the adult population is not immune (.86*.9 ~ .77).

    This is all assuming a lot about the antibodies being effective (measles could mutate, etc).

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  • (Score: 0) by Anonymous Coward on Friday February 08 2019, @08:22PM (16 children)

    by Anonymous Coward on Friday February 08 2019, @08:22PM (#798529)

    So the real thank-you is that I'm now playing worse than Russian roulette odds of getting adult measles if we have an outbreak? How bad is measles for adults?

    • (Score: 1, Informative) by Anonymous Coward on Friday February 08 2019, @08:44PM (3 children)

      by Anonymous Coward on Friday February 08 2019, @08:44PM (#798535)

      No idea, I just know people used to spread it around on purpose when one kid would get it because it wasn't considered a big deal for children. Same as chicken pox until recently.

      “Before the introduction of measles vaccines, measles virus infected 95%–98% of children by age 18 years [1–4], and measles was considered an inevitable rite of passage. Exposure was often actively sought for children in early school years because of the greater severity of measles in adults.”

      https://pdfs.semanticscholar.org/b7e0/c83a2232536a507ef061563000b59d97db66.pdf [semanticscholar.org]

      Parents largely came to see measles as an unpleasant, although more or less inevitable, part of childhood. Many primary care physicians shared this view.
              [...]
              In the United States and Western Europe, which did, measles mortality was low and declining and parents seemingly accepted it as an unpleasant part of childhood. What reasons could there be for introducing a measles vaccine?
              [...]
              There seemed to be no reason to begin a mass immunization program; the decision to immunize could be left to individual medical practitioners and parents.
              [...]
              Any decision to begin mass measles vaccination in the early 1960s thus involved numerous uncertainties. Was the disease serious enough? Would parents feel it worth having their children vaccinated?
              [...]
                  in 1967 a campaign was launched to eliminate measles from the United States. “To those who ask me ‘Why do you wish to eradicate measles?’” wrote Alexander Langmuir, chief epidemiologist at the Centers for Disease Control and Prevention from 1949 to 1970,

                      I reply with the same answer that Hillary used when asked why he wished to climb Mt. Everest. He said “Because it is there.” To this may be added, “… and it can be done.”16

              [...]
              There is a real danger that the general public may become weary of the ever-increasing number of immunizing injections which are being urged upon their children. The administration of this [inactivated] vaccine would require three further injections. Measles is often regarded as a normal part of childhood development, and though this view is misguided parents may not easily be persuaded to depart from it.
              [...]
              One must consider whether those caring for the child will readily accept prevention of what is generally an unproblematic illness and/or whether this could lead to resistance against vaccination and attendance at the children’s clinic
              [...]
              Parents, it was hoped, would gradually come to accept the desirability of vaccinating against what was widely seen as an unpleasant, although inevitable, childhood illness.

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4007870/ [nih.gov] [nih.gov]

      Found this about adults, who knows if it is typical though:

      Methods:Wepresent three adult cases (one of whom was pregnant) admittedto our University Hospital who were diagnosed to have measlesand who had uncommon clinical features such as hepatitis andhyponatremia.

      Results:All patients were markedly hypoxic; onerequired mechanical ventilation. Two patients received therapy withintravenous ribavirin and all patients received high dose vitamin A for three days. The respiratory distress of all the patients promptlyrelieved with the above mentioned and supportive treatment. Thesecases demonstrated that life-threatening measles pneumonitis inadults may be more common than previously appreciated, regardlessof the patient's immune status. Therapy with intravenous ribavirinand vitamin A were well tolerated by our patients except one patientwho developed acute renal failure and were associated with reversalof respiratory compromise. All patients were discharged in good health.

      https://www.ejinme.com/article/S0953-6205(13)00708-5/fulltext [ejinme.com]

      • (Score: 1) by Sulla on Saturday February 09 2019, @12:04AM (2 children)

        by Sulla (5173) on Saturday February 09 2019, @12:04AM (#798603) Journal

        I have always been interested in the idea of our species changing the world around us in ways that would benefit us. While it is worth keeping cultures of viruses and bacteria that cause us issues, I think it is also very worth it to eradicate them in our environment. To some extent we would have issues with new ones evolving, but why then not trace those back to their hosts and eradicate them there? Would bats be worse off if we eradicated the diseases the effect them? Chickens? I don't know, but I think it would be worth finding out.

        Something else that falls into the same category is eradication of pest species
        https://en.wikipedia.org/wiki/Cochliomyia_hominivorax [wikipedia.org]
        Is an example of this where we eradicated the Screw Worm north of the Mexico border and in some countries in South/Central America. Is it playing god? Yeah. But is it worth it? Very.

        A concept I like that pops up in SF is populating new virgin planets but doing so without any of the baggage we bring with us from earth. If you populate a planet with the settlers not having any of the viral holdovers from Earth, will they be able to evolve on their own with enough speed that they could not be eradicated before they spread?

        --
        Ceterum censeo Sinae esse delendam

        • (Score: 2) by SpockLogic on Saturday February 09 2019, @02:50PM (1 child)

          by SpockLogic (2762) on Saturday February 09 2019, @02:50PM (#798826)

          we eradicated the Screw Worm north of the Mexico border and in some countries in South/Central America.

          No so fast, there was a recent outbreak in the Florida Keys. Mother Nature has a habit of making a comeback.

          Not that the nasty little flesh eating fuckers don't need eradicating, they do*.

          https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/nvap/vet_acred_alert [usda.gov]

          *I ain’t got nothing against double negatives.

          --
          Overreacting is one thing, sticking your head up your ass hoping the problem goes away is another - edIII

          • (Score: 1) by Sulla on Saturday February 09 2019, @03:12PM

            by Sulla (5173) on Saturday February 09 2019, @03:12PM (#798833) Journal

            I hate florida so god damned much

            --
            Ceterum censeo Sinae esse delendam

    • (Score: 2, Interesting) by Anonymous Coward on Friday February 08 2019, @08:48PM (10 children)

      by Anonymous Coward on Friday February 08 2019, @08:48PM (#798536)

      Also, this video shows how scary measles used to be (getting measles was treated as a joke on tv): https://www.youtube.com/watch?v=o7zwNZOg8mE [youtube.com]

      • (Score: 0) by Anonymous Coward on Friday February 08 2019, @09:08PM

        by Anonymous Coward on Friday February 08 2019, @09:08PM (#798547)

        "Measles", said the doctor.
        "Mumps", said the nurse.
        "Nothing", said the lady with the alligator purse.

      • (Score: 2) by sjames on Friday February 08 2019, @11:50PM (8 children)

        by sjames (2882) on Friday February 08 2019, @11:50PM (#798597) Journal

        It is important to keep this in perspective. The worst effects of Measles aren't that common. At the same time, they aren't non-existent and kids that didn't get the measles vaccine also didn't get mumps or rubella vaccine. While most people who get those are just fine as well, when complications do happen, it can be bad.

        Complications from the vaccine are FAR less common.

        • (Score: 1, Informative) by Anonymous Coward on Saturday February 09 2019, @09:24AM (7 children)

          by Anonymous Coward on Saturday February 09 2019, @09:24AM (#798764)

          Complications from the vaccine are FAR less common.

          It seems to be around 1 in 10k people for both. Actually much higher (6 in 10k) for brain injury after the vaccine...

          I don't want to bother with digging up my source at the moment but will check back tomorrow with it if you respond with interest.

          • (Score: 2) by sjames on Sunday February 10 2019, @04:49AM (6 children)

            by sjames (2882) on Sunday February 10 2019, @04:49AM (#799009) Journal

            I would like to see some real figures, particularly for brain injuries since my recollection is that it is far less common.

            • (Score: 1, Interesting) by Anonymous Coward on Sunday February 10 2019, @06:56PM (5 children)

              by Anonymous Coward on Sunday February 10 2019, @06:56PM (#799169)

              Sources:

              Of the 535 544 children who were vaccinated, 199 were hospitalized for encephalitis, 161 for aseptic meningitis, and 352 for autistic disorders.

              https://www.ncbi.nlm.nih.gov/pubmed/12415036 [nih.gov]

              Ignoring autism:

              (199 + 161)/535,544 = .00067

              Then, percent of cases of serious measles just before vaccination was introduced in western countries:

              The secondary infections, and deaths from measles have steadily declined-from 307 in 1949 to 98 in 1959.1 Nevertheless up to the end of September this year 749,251 cases of measles had been notified in England and Wales.

              https://www.ncbi.nlm.nih.gov/pubmed/20789272 [nih.gov]

              98/749,251 = .00013

              I wouldnt take these more seriously than as order of magnitude estimates though...

              • (Score: 2) by sjames on Monday February 11 2019, @01:08AM (4 children)

                by sjames (2882) on Monday February 11 2019, @01:08AM (#799302) Journal

                I don't think those figures mean what you think they do. In the first study, those numbers are for all causes. Only 9 cases of encephalitis and 10 of aseptic meningitis (all causes) occurred within 3 months of the vaccination. No data is provided on how many of those resulted in permanent disability (if any). They concluded that there was no clustering of those, autism, or irritable bowel around measles vaccination. From what we know from other studies, there is some clustering of encephalitis at least, but apparently a sample size of half a million isn't large enough to see it.

                The figures from the second article were just the deaths.

                • (Score: 0) by Anonymous Coward on Monday February 11 2019, @03:50AM (1 child)

                  by Anonymous Coward on Monday February 11 2019, @03:50AM (#799374)

                  Nope in one sense. They choose to study what they want the results to mean. It doesn't take more than trusting what they say to see that.

                  • (Score: 2) by sjames on Monday February 11 2019, @08:43AM

                    by sjames (2882) on Monday February 11 2019, @08:43AM (#799443) Journal

                    I'm not really sure what you're saying there...

                • (Score: 0) by Anonymous Coward on Monday February 11 2019, @12:58PM (1 child)

                  by Anonymous Coward on Monday February 11 2019, @12:58PM (#799485)

                  Cases of pneumonia after measles is also "all causes", there is no magic way to attribute it specifically to the measles infection just like there is no way to attribute a case of brain injury to a vaccine.

                  • (Score: 2) by sjames on Monday February 11 2019, @09:47PM

                    by sjames (2882) on Monday February 11 2019, @09:47PM (#799761) Journal

                    You can never be absolutely certain, but it is reasonable to do what the first study did and apply a 3 month window compared to 3 month windows where the patient did not have measles (or the vaccine).

    • (Score: 2) by legont on Saturday February 09 2019, @04:54AM

      by legont (4179) on Saturday February 09 2019, @04:54AM (#798706)

      Bad. One should be ready for pneumonia as a side effect.

      If you are worried, you should get a refreshment shot.

      --
      "Wealth is the relentless enemy of understanding" - John Kenneth Galbraith.

  • (Score: 2) by HiThere on Friday February 08 2019, @11:33PM

    by HiThere (866) Subscriber Badge on Friday February 08 2019, @11:33PM (#798591) Journal

    Yes, but that was 30 years later. What about 60 years later? I'm not sure you can count on the drop off being linear.

    --
    Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.