A concern of DH & his workplace

[jen6163]

DD1 (2years) is partially vaxed (up to date at 6mos) except HepB and DD2 (1year) is not vaxed.

My DH just started a new project and he is working with dozens of people from India who go back & forth for holidays, visits etc. He was worried that our girls not being vax'd is risky since he is in contact with these people everyday. I honestly have no knowledge if there is danger with thisJust wanted to see if anyone here had any info on it. I'm not trying to be judgemental against India as a country and really have no idea how prevalent diseases or vaccines are there.

I'd appreciate any insight.

Thank you!

[LisaSedai]

Is DH up to date with all his vaccinations? If so, he shouldn't be worried about "catching" anything to pass on, right? If not, if it were my DH, I'd ask *him* go get the 3 series hep B shots, tetanus/diptheria/pertusis, flu shot, menigitis(sp?),pneumonia shot, hep A shot, ect.

[rabrog]

I'll be honest...if they bring stuff over here, the chance that our vaccines are for the same strain as what they would be carrying is so very small it's not worth vaxing kids specifically for that fear.

DH should wash his hands, change his clothes and perhaps even shower as soon as he comes home. Those are the best defenses.

Jenn

[carriebft]

There is not going to be a blanket answer to this. some vaccines prevent transmission, some do not. some vaccines depend on "strain" and some do not.

With travel to and from India, there are issues depending on where the travel is originating. With my husbands' old job, most of the travel was to and from Bangalore, which does not have polio problems. We did not consider vaccinating for that based on others traveling but considered it for a trip there ourselves. the IPV vaccine does not prevent transmission of polio; therefore, having your husband up to date on IPV would not prevent transmission of polio were he to come in contact with it. However, the chances of a traveler bringing polio here from India are very very very very very low. There has been polio movement out of polio countries into polio free countries (see Russia) but the western hemisphere has not seen this happen.

Measles, mumps and rubella could be an issue simply because travel is the major route by which these diseases enter the USA. The mumps outbreak in NYC started with an import, all rubella cases reported this year and last were imports, most measles cases originate overseas. This vaccine prevents transmission. So if your husband is vaccinated and comes in contact with an infected traveler, he will not transmit the disease to anyone else. There is, however, a small chance that immunity has waned with regards to rubella and mumps, depending on how long ago he had the vaccine. you also have the issue that there are those small small percentages of people who do not gain immunity from 2 x MMR.

Pertussis can be easily spread with travel and we have seen cases of this, especially this year. I do not know if India experiences a lot of pertussis but I would think, with it circulating so widely in the USA right now, you have more of a chance of catching it here that from contact with a traveler now and then, kwim?

Hep A is a big traveler-spread disease, we get a lot of imported cases each year/ cases from oversea or central american travel. I honestly do not know if the vaccine will prevent transmission! something to look up...

[jen6163]

Ahhh so much to think about and so overwhelming. The good news is that he should only be there for about another month and will hopefully be working from home a bit too, but still concerning Also when he is in the office, DDs are usually asleep when he gets home so they aren't even really in contact with him.

I've emailed my pedi to see what she thinks. She is totally supportive of me not vaxing, but I'm curious to see what she will have to say about it.

Grrr... I hate worrying about this!

[13Sandals]

by Carrie

"Hep A is a big traveler-spread disease, we get a lot of imported cases each year/ cases from oversea or central american travel."

Hep A is spread primarily by fecal contact, so unless the op's daughters are in contact with feces, or with contaminated items that they might put directly into their mouths, I think she can cross this off as a concern.

"Measles, mumps and rubella could be an issue simply because travel is the major route by which these diseases enter the USA. The mumps outbreak in NYC started with an import, all rubella cases reported this year and last were imports, most measles cases originate overseas. This vaccine prevents transmission."

I have to say I completely disagree with this statement. I know the CDC maintains that they can 'trace' the origins of every MMR disease outbreak to foreign countries, but IMO, that's nonsense. The MMR is live, can shed and can be passed to immunocompromised people, who can in turn pass it on. Just because they refuse to LOOK at vaccinated people being a source of viral shedding or carriers, doesn't mean it doesn't happen. If they could blame chicken pox on foreign travel, they would, but thanks to shingles, they haven't been able to make that claim. HiB is always blamed on non-vaxers, but this study http://www.medscape.com/viewarticle/710788 shows that because acetaminophen is shown to reduce immune response, tylenol plus Hib vaccination "has implications, especially for Haemophilus influenzae and pneumococcus, for which higher and sustained antibody concentrations are needed to interrupt the carrier state and reduce transmission within the population"

You can't trace disease where you don't believe it can go (the vaccinated)


OP - IMO, when you decide not to vaccinate, you understand that you can acquire these diseases and are ready to deal with the illness. If there is concern, taking other precautions (such as handwashing by hubby etc) and strengthening your dd's immune system are in order. If contracting any individual disease is truly fear inspiring...I think its good revisit your research on that particular disease(s) and see if not vaccinating is the correct choice for you.

[carriebft]

There has never been a documented case of measles transmission from the MMR vaccine. It is completely theoretical. On the other hand, we have plenty of evidence of travelers being exposed to measles and then passing it on.

We would have a heck of a lot of measles cases in infants if MMR passed measles along. But we only get those cases when an active outbreak occurs, look at the index case with exposure, and most of those exposures occur overseas.

There is also the issue that we can trace the measles strains! That is a big clue when things are imported. child travels to area with measles outbreak, is exposed, comes back, exposes others, is tested and the strain matches the outbreak of where they were. should we blame measles vaccine?

Why is chicken pox not considered a disease that travels here? well, that's simple. It's still around here. Measles, on the other hand, is not.


Hep A is spread via fecal oral route, but it is much like rotavirus in that it is very very very contagious, not AS contagious as rota but those with good hygiene still can find themselves infected. Almost everyone comes down with rotavirus at some point in their lives, and it's not because they all go out and have obvious contact with feces and "contaminated objects"...

The other issue with fecal orals, when you try and contain them this way, you are essentially relying on the hygiene of others . Shake the hand of someone with poor hygiene and then rub your nose or brush hair from your face and you could be in trouble, kwim?

and most "contaminated objects" aren't going to jump out and scream at you that they are contaminated. Have you seen the myth busters epsiode on fecal traces? bottom line: they were everywhere!

[carriebft]

HiB is always blamed on non-vaxers,

these days hib is pretty much exclusively found in unvaccinated, undervaccinated or kids with deficiencies that prevent effective vaccination.

[13Sandals]

Why is chicken pox not considered a disease that travels here? well, that's simple. It's still around here. Measles, on the other hand, is not.

Your assertion is that there is absolutely no measles originating in the United States. Its been eradicated if not for travelers. As I stated before, I disagree. I do not believe that every measles outbreak in the US has originated elsewhere in the recent past. An outbreak strain being identified in another country does not guarantee the country of origin.

Hep A is spread via fecal oral route, but it is much like rotavirus in that it is very very very contagious, not AS contagious as rota but those with good hygiene still can find themselves infected. Almost everyone comes down with rotavirus at some point in their lives, and it's not because they all go out and have obvious contact with feces and "contaminated objects"...

yes and almost everyone who gets rotavirus has been around a child in diapers or someone who has changed a baby's diaper. I don't see this being an issue with the op's hubby at work....but if you notice, I did mention washing hands would be a sufficient alternative to vaccinating for a mild, non- threatening illness.

these days hib is pretty much exclusively found in unvaccinated, undervaccinated or kids with deficiencies that prevent effective vaccination.

that has nothing to do with transmission situations. if undervaccinated and kids with deficiencies that prevent effective vaccination (and we can add kids that are given tylenol with vaccinations here) there are untold numbers of vaccinated children that can carry and transmit Hib.

Again, you aren't going to find the disease in places you don't look.

[carriebft]

Hib colonization is much more likely in unvaccinated kids.

Sure, some hib carriage in vaccinated kids, but much more in those who are not:

http://www.jstor.org/pss/30109915 (3-6% of unvaccinated vs 0-1.5% vaccinated)

(and note the use of the word "most" in my statement about where hib is found today)