Measles spreading in San Diego - Page 9 - Mothering Forums

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Old 02-22-2008, 12:30 PM
 
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Originally Posted by attachedmamaof3 View Post
If you look at the mathematical models, it clearly demonstrates that eradication of measles is impossible given our current vaccine efficacy/uptake/seroconversion rates.
I don't think I'd say "impossible", but it's hardly an argument against measles vaccination either way, if you ask me. The San Diego outbreak can be taken as an illustration of the significance of herd immunity. Some unvaccinated children ventured outside the circle of protection which had previously prevented them from being exposed, and travelled to countries with low vaccine uptake, where they immediately became infected. Upon their return, they infected other unvaccinated children. It's not the first time it's happened.

It's not strictly a matter of our current vaccine efficacy/uptake/seroconversion rates. It also has to do with global measles prevalence; as long as there are places where measles is endemic, and unvaccinated travellers visit them, there will continue to be outbreaks even in countries where measles is no longer endemic.

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Originally Posted by Jwebbal
Did anyone stop to think that perhaps the shift to younger children over the decades had to do with the increased day care and preschool enrollment? Kids in the 50's and later didn't go to care providers caring for 10 or more children in one place as much as they do today.
That's a possibility. One of the things that makes epidemiology so complicated (and fascinating) is that at some point, you end up needing to follow every person around to see how many people they come in contact with, and what types of contact, and so forth. There are some really cool computer programs they use to model this. It can also be done from an armchair, and who is to say which results are most accurate? But the evidence indicating decreased susceptibility in infants of vaccinated mothers looks strong (though the amount of decrease looks slight).

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This is why I don't watch TV, I have you guys.
Even if we quit, please don't start watching TV. It rots your brain. There have been studies. I think.
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Old 02-22-2008, 12:57 PM
 
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You posted a link to a news article. That's not a source. Attachedmamaof3 cited a study showing increased susceptibility in infants, and I'll concede that possibility. But neither of these supports a claim of increased incidence, because incidence is not a function of susceptibility alone, but requires actual exposure. Did I miss something? The global population of humans is currently very susceptible to smallpox, yet smallpox incidence is (thankfully) as low as it could possibly get (zero). Deborah seem to understand this analogy. Do you?

Page 77 of this PDF http://www.cdc.gov/nchs/data/vsus/vsus_1950_1.pdf (page 63 in the original) has numbers for reported measles cases in the U.S. from 1941-1950:
1941 - 894,134
1942 - 547,413
1943 - 633,627
1944 - 630,291
1945 - 146,013
1946 - 695,843
1947 - 222,375
1948 - 615,104
1949 - 625,281
1950 - 319,124

In recent years, measles incidence in the US has been limited to a small handful of cases per year, with spikes as high as some few hundreds of cases. Do you really want to argue that hiding in those numbers is an increase in the number of cases in infants over what it was during a time when measles infected something like half a million people per year? If so, and if you think you've got evidence to back it up, I'd like to see it, but let's be clear on this: you haven't provided that evidence yet.

I think we covered this. Eliminate the age group in which most of the severe cases previously occurred, and now most of the severe cases occur in a different group; and this may be the case even if the overall disease burden has been reduced drastically. Look only at one of these age groups strictly from a perspective of the percentage of total number of cases (or cases with complications), and the numbers might suggest that things got worse for members of that group. But the bottom line (visible only when things are viewed in relative rather than absolute terms) is that the chances of becoming infected are still greatly reduced (and the chances of complications tend to follow, no?). I'll say the same thing to you that I just said to suchi: do you really want to argue that current measles incidence represents an increase in overall disease burden over a time when measles infected roughly half a million people a year?
Well, you're getting there. Now if you can include some age specific numbers we can compare them with AM's numbers that cover the next time frame.
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Old 02-22-2008, 02:10 PM
 
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Originally Posted by suschi View Post
Well, you're getting there. Now if you can include some age specific numbers we can compare them with AM's numbers that cover the next time frame.
On page 274 (262):
Deaths under 1 year per 1,000 live births (measles)
1940 - 0.1
1941 - 0.2
1942 - 0.1
1943 - 0.1
1944 - 0.2
1945 - 0.0
1946 - 0.1
1947 - 0.0
1948 - 0.1

Don't know what happened to 1949 and 1950, but let's average those: 0.1 per thousand. I'm going to use the 1950 data for live births: 3,554,149. (if you don't like that, DYOH). I get 355.4 deaths per year in infants under 1 year of age. Feel free to twiddle the math, of course, but good luck getting it down anywhere near the neighborhood of the current numbers. And if you think you'll have any better luck with the next time frame, or by teasing out age-specific incidence rather than age-specific mortality, then by all means, go for it.
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Old 02-22-2008, 03:45 PM
 
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instead of spending so much money, time and effort in trying to prevent measles, why aren't they researching/developing TREATMENT for the complications of measles? doesn't that make more sense?
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Old 02-22-2008, 05:57 PM
 
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Originally Posted by kidspiration View Post
instead of spending so much money, time and effort in trying to prevent measles, why aren't they researching/developing TREATMENT for the complications of measles? doesn't that make more sense?
The way you phrased that suggests that you appreciate the fact that in general, the ability to treat acute viral illness is presently rather limited. A century or two from now, things like intubation and antiviral drugs may seem as crude and ineffectual as bloodletting and mustard plasters do to us today -- who knows? But I wonder if you do appreciate what you're asking for. It's like suggesting that the best solution to the impending global energy/global warming crisis is for the scientists to get on the ball with the whole fusion thing. No doubt, that would be jake, but the requisite breakthroughs tend to come in their own time, not ours. The ounce of prevention we have available right now is still worth a pound of whatever cure may be available to our Nth generation descendants. If we get everybody on the same page, I don't see why measles cannot join smallpox among problems they won't have to spend time solving. Which would be good, because it looks like they'll pretty much have their hands full as it is.
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Old 02-22-2008, 07:32 PM
 
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Dymanic,
I bet those numbers on the rate of deaths under one year are based on reported cases, not actual cases. Which would mean 500,000 per year, not 3.5 million cases per year.

And reducing the number of deaths from measles doesn't have to do with greater skill at treating viral diseases. It has to do with vulnerability. What hasn't been done is to study, in extreme detail, everything about those who died. How were they treated? What was their condition before they got sick? Living conditions? Diet? Stressors? Digestion?

The popular story about disease, as it is currently circulating is something like this:

There are evil bugs that lurk, waiting for anyone who walks by. When some hapless soul turns the corner, bug leaps out and destroys them.

In this version, everyone is equally vulnerable and the only things that matter are:
a)exposure
AND
b)vax status

In real life, the hapless bug leaps on many thousands of us every day. In the majority of exposures, the person's immune system chews up the bug and spits it back out. In a few cases someone gets mildly sick, in an even smaller number of cases, someone will get noticeably sick, a few will get terribly sick and once in awhile someone dies. The range of responses has to do with the level of exposure and the ability to respond to attack.

In the vaccination version, there are only two ways to be armed against attack: to have had the illness before or to have been vaccinated. This is true of some illnesses, but not all.

The narrative is screwed up.

It is all in the framing.
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Old 02-22-2008, 08:05 PM
 
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I bet those numbers on the rate of deaths under one year are based on reported cases, not actual cases. Which would mean 500,000 per year, not 3.5 million cases per year.
Right. I referred to the number of reported cases as "roughly half a million". Twice; once in response to suchi, and once in response to attatchedmamaof3. The number of actual cases was surely higher, and probably included some infant deaths which were not reported (or diagnosed) as measles. The 3.5 million is live births in the U.S.

Quote:
And reducing the number of deaths from measles doesn't have to do with greater skill at treating viral diseases.
I agree. With the total number of cases reduced a thousand-fold, the reason for the reduction in deaths is pretty much a no-brainer.

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In this version, everyone is equally vulnerable and the only things that matter are:
a)exposure
AND
b)vax status
I would say that it is:
a)exposure
AND
b) specific immune status

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In real life, the hapless bug leaps on many thousands of us every day.
I see nothing whatsoever to support such a claim.
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Old 02-22-2008, 11:15 PM
 
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I actually AM okay with my child getting measles. To be completely honest, I would LIKE it.

There is some evidence that childhood diseases (childhood -- like chicken pox and measles NOT like polio) ...anyway, there is some evidence that childhood diseases can be beneficial. There is quite a bit of evidence that measles reduces the chance of a child developing cancer.

http://www.mayoclinic.org/news2007-rst/3954.html

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In the 1970s, measles infections were observed to cause regression of pre-existing cancerous tumors in children. This information was noted, but nothing was done to study this phenomenon until the late 1990s, when, under the direction of Stephen Russell, M.D., Ph.D., Mayo Clinic Cancer Center's Molecular Medicine Program began investigating it. The current study and other related projects resulted.
I also know a good fever will help my child to fight off measles ...and that doing things to reduce that fever increases the risk of complications. I'm not going to link that, but feel free to look it up. I have read it in several sources and it is readily available.

Not everyone is terrifyed of everything. I don't think we should be messing with nature ...

Plus, vaccines are NOT 100% effective, so children with the MMR shot could get measles just as easily as children without. Look at the current flu outbreak.

Anyway ....I didn't read all 13 pages, but I wanted to put that information out there.

I don't want my child to get certain things like polio ...however, I'm just not scared of childhood diseases like chicken pox, mumps and measles. I study them and know how to treat them. I think, in the long term, there is a reason for the diseases and we need to pay attention to that instead of being terrified of them.

That's all I have to say, but I did want to get that information out there about measles and cancer in case it had not been mentioned.
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Old 02-23-2008, 01:39 AM
 
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vaccines are NOT 100% effective, so children with the MMR shot could get measles just as easily as children without.
Not even close. The first dose will provide protection for 90-95% of recipients.

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Look at the current flu outbreak.
The ability of influenza to vary its antigens surpasses that of measles by orders of magnitude, evidenced by the fact that a single encounter with measles confers lifelong immunity, while the same person can become infected with influenza many times. One reason for this is that while measles is single-stranded, the influenza genome is separated into eight segments. That you would think for even a moment that it is a reasonable comparison suggests that you still have more studying to do.
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Old 02-23-2008, 02:03 AM
 
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Actually dymanic, that doesn't seem to be the case.

Manufacturer’s Inserts and efficacy statements:

MMR II (live virus)-Package Insert states efficacy is based on the individual vaccine components.
http://www.merck.com/product/usa/pi_.../mmr_ii_pi.pdf

*Per The CDC: The vaccine effectiveness for one dose of MMR is 70-80% and 80-90% for two doses

(It varies...here are two quotes)

Quote:
The vaccine effectiveness for one dose of MMR is 70-80% and 80-90% for two doses. Since no vaccine is 100 percent efficacious (even though people are vaccinated, the vaccine doesn't ‘take' in every person), it is to be expected that there will be some cases of disease in individuals that have been vaccinated.
Quote:
About 80% of persons who have received 1 dose can be considered protected and 90% after 2 doses.
Then there's yours...found in the parent pages. Wonder why the difference?? Interesting.
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Old 02-23-2008, 04:02 AM
 
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How many of the cases of measles in San Diego occurred in children too young to be vaccinated?

How many of the cases of measles in San Diego occurred in children fully vaccinated? Or partially vaccinated?

Enquiring minds want to know.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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Old 02-23-2008, 04:13 AM
 
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How many of the cases of measles in San Diego occurred in children too young to be vaccinated?

How many of the cases of measles in San Diego occurred in children fully vaccinated? Or partially vaccinated?

Enquiring minds want to know.

I was wondering these things as well. I was on another board earlier and someone was saying how "this is what happens when people don't vaccinate their children." (speaking about the measles in San Diego)

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Old 02-23-2008, 04:20 AM
 
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How many of the cases of measles in San Diego occurred in children too young to be vaccinated?
Two, as far as I can see. The infant on the Hawaiian Airlines flight was 11 months old, and they're saying a 10-month old was hospitalized on Feb 10.

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How many of the cases of measles in San Diego occurred in children fully vaccinated?
Zero.

If anyone can find a complete breakdown of ages, that would be interesting to look at.
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Old 02-23-2008, 04:34 AM
 
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seems it's not even newsworthy in san diego anymore.

no new cases reported since earlier this week, and the quarantine at sd coop ends on monday, iirc. no complications reported.

outcome: 12 more kids, now immune to measles.

for life.

:
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Old 02-23-2008, 06:54 AM
 
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The "outbreak" barely made our paper, I'm in No. San Diego County, about thirty miles or so from the city. It was reported, but not in an alarmist manner and didn't make the front page or anything.

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Old 02-23-2008, 10:58 AM
 
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How many of the cases of measles in San Diego occurred in children too young to be vaccinated?

How many of the cases of measles in San Diego occurred in children fully vaccinated? Or partially vaccinated?

Enquiring minds want to know.
All newspaper reports are saying that all the children who have been confirmed measles cases have been unvaccinated. Of the 12 cases, we know 2 (10 and 11 months) were too young and 4 were old enough (ages 5,6,8,9)...though I have not read anything about the others.

http://www.cbsnews.com/stories/2008/...n3842334.shtml

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Old 02-23-2008, 12:28 PM
 
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What I'd like to know is how many cases of measles cropped up in vaccinated children and the doctors misdiagnosed it because they had been vaccinated....
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Old 02-23-2008, 12:32 PM
 
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My youngest son and niece had measles and were too young for the vaccine. The young doctor did not even recognize the disease since doctors are not educated in recognizing VPD any longer. How do we know whether or not other VPDs are missed by misdiagnosing because the doctors are not educated in diagnosing they are looking at?

Having measles was no big deal for these two. She is now 19 and he is 16.

Why would they be vaccinated later when they have acquired lifetime immunity after having through the disease?

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Old 02-23-2008, 12:34 PM
 
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What I'd like to know is how many cases of measles cropped up in vaccinated children and the doctors misdiagnosed it because they had been vaccinated...
While we're at it, another good question is: how many vaccinated children (and others) were exposed to measles through contact with one of the infected children yet did not become infected themselves due to the protection provided by the vaccine?
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Old 02-23-2008, 01:38 PM
 
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I asked our doc about the idea of not being able to recognize VPD, but he just laughed and said it was good I came to him and not one of these unable doctors. Though he also added maybe he is more confident having been educated abroad and in the USA. I wouldn't stick with a doc that told me he didn't have the ability to recognize VPD.

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Old 02-23-2008, 01:47 PM
 
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I am talking about younger doctors who probably never had measles, mumps and rubella themselves, let alone see a clinical case.

I agree with a PP that if a patient is fully vaccinated, it is unlikely that a doctor will diagnose the patient with a VPD even if the patient is presenting with all of the classic symptoms. So if a patient has a loud whooping cough, the doctor will diagnose chronic bronchitis instead.

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Old 02-23-2008, 03:29 PM
 
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While we're at it, another good question is: how many vaccinated children (and others) were exposed to measles through contact with one of the infected children yet did not become infected themselves due to the protection provided by the vaccine?
While we're at it, another good question is: how many unvaccinated children (and others) were exposed to measles through contact with one of the infected children yet did not become infected themselves due to the protection provided by their immune systems?

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Old 02-23-2008, 03:46 PM
 
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While we're at it, another good question is: how many unvaccinated children (and others) were exposed to measles through contact with one of the infected children yet did not become infected themselves due to the protection provided by their immune systems?

i'd say none. measles is one of the most contagious viruses out there. an intact immune system can help prevent a second infection though.

http://www.vaccineinformation.org/measles/qandadis.asp
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Old 02-23-2008, 05:45 PM
 
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So why does it only seem to work for the children who were vaccinated? I don't see anything to suggest a difference in immunocompetence between the unvaccinated children who did become infected and the vaccinated children who did not, but let's look at the implications of that being the case. Are you suggesting that among all of the vaccinated children who must have been exposed, every single one had a robust immune system, while every single one of the unvaccinated children was immunocompromised in some way? Is not one of the most frequent arguments against vaccination based on the claim that it negatively impacts overall immunity? Should not the vaccinated children therefore have been more at risk?
first of all, my posing the question in response to yours was to highlight that there are SO MANY unknown questions regarding not only this outbreak specifically, but also about vaccinations in general. i find myself saying constantly "if only we knew blah blah blah" about vaccines and the immune system.

some people are ok with that, and go along with the vaccination program with the utmost of trust that it is what is best for their children's health in the short and long term.

others realize that once you start asking certain questions, instead of being met with satisfactory answers, we are generating even MORE questions, some of which science has attempted to answer, and some of which aren't even acknowledged no less studied/analyzed.

i was not suggesting that there was a difference in immunocompetence between vaccinated and unvaccinated populations. i have my theories, of course...but they're not substantiated by science yet so i will sit here comfortably making the choices that i do while i wait patiently for more information.
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Old 02-23-2008, 06:13 PM
 
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ITA with applejuice here... I fully believe that most (young, new) dr's wouldn't recognize measles, just as they probably would misdiagnose even chickenpox now in a child who was vaccinated. For the same reason that most dr's now, young through middle-aged and even older dr's don't recognize normal, healthy childbirth ~~ because all they were ever taught is intervention.

If you don't learn something you can't know it ~ this may sound obvious but it is no more true than in the contemporary medical profession.
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Old 02-23-2008, 07:58 PM
 
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All newspaper reports are saying that all the children who have been confirmed measles cases have been unvaccinated. Of the 12 cases, we know 2 (10 and 11 months) were too young and 4 were old enough (ages 5,6,8,9)...though I have not read anything about the others.

http://www.cbsnews.com/stories/2008/...n3842334.shtml

There were also at least 2 7 year olds and one 3 year old (unvaxed) and a 2 year old whose mother was on tv very upset abou the whole thing, even though she hadn't had herchild vaxed on schedule (she says they were out of the vax when her daughter was supposed to be vax'd, but isn't 15 months when they give the MMR? I can't believe it took the doctor's office that long to get more doses.)
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Old 02-23-2008, 08:14 PM
 
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This thread is closed and in review.

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