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In a recent article published in Pediatrics, researchers investigated a measles outbreak in Minnesota in 2011. The authors, lead by Pamala Gahr of the Minnesota Department of Health, determined that the outbreak began when an unvaccinated 2-year-old travelled to Kenya, where he contracted the measles virus. Upon returning to the United States, the child developed a fever, cough and vomiting, some of the early signs and symptoms of measles. Unfortunately, prior to a diagnosis of measles, the child passed the virus on to three children in a child day-care center and another household member. The measles then spread from individual to individual within a low vaccine uptake area, a Somali immigrant community in the Minneapolis area. Eventually, more than 3,000 people were exposed to the disease.

http://www.dailykos.com/story/2014/06/19/1308169/-One-unvaccinated-child-was-patient-zero-of-a-measles-epidemic#

11 thoughts on “One unvaccinated child was patient zero of a measles epidemic

  1. I guess that shows the importance of vaccinations, even though they are so painful and make children feel so sick at the time. My daughter had all the vaccinations (because I was too terrified not to), but there is a big debate at the moment about how harmful/helpful they are in our community. I think anything which reduces infectious disease has to be a good thing.

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    • There are upsides and downsides to every choice we make in life. It is wise for us to objectively consider all available information before making decisions. In the case of vaccinations, the benefits far outweigh the costs. Naysayers should examine the dire state of public health before vaccines became available in the 19th century. The decision regarding your daughter was obviously the right one, in my opinion.

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  2. The article fails to explain why 25% of the children who developed measles had been vaccinated – and contracted measles anyway? A 25% failure rate seems pretty high to me for a vaccine.

    Also there is a logical error (post hoc ergo propter hoc) in your response. You suggest that the introduction of vaccines caused a decline in infectious disease in the 20th century. Public health data suggests the infection rate for measles and other communicable diseases dropped steeply decades before vaccines were introduced: http://childhealthsafety.wordpress.com/graphs/

    As a medical doctor, I have extensive training in evidenced based medicine and I think it’s high time parents for parents to demand to see research evidence on the long term safety and efficacy of vaccines.

    The reality is that there is embarrassingly little research into either – in fact most contemporary evidence points the other way, that our heavy reliance on vaccines is linked to immune impairments that are possibly responsible for a massive increase in cancer and autoimmune disease in developed countries.

    I know it’s not “politically correct” to express such views. However with vaccines, as with water fluoridation, I think we need to stop accepting the paternalistic attitudes of the medical establishment and ask to see some proof.

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    • I understand your point of view, but believe it is factually unwarranted. The dramatic improvement in public health over the last two centuries is well documented, and results from several factors including better sanitation and hygiene in addition to the availability of antibiotics, antimicrobial medicines, and vaccines (see: Achievements in Public Health, 1900-1999: Control of Infectious Diseases). Figure 2 graph (“Crude Mortality Rates for All Causes, Noninfectious Causes, and Infectious Diseases”) from JAMA – Trends in Infectious Disease Mortality in the United States During the 20th Century plainly illustrates this point.

      From the Australian Medical Association Position Statement on Vaccinations Outside of General Practice – 2011:

      AMA Vice President, Dr Steve Hambleton, said that vaccination against preventable diseases is a proven method of reducing the incidence of and deaths from diseases such as measles, tetanus, diphtheria, and Haemophilus influenza type B.

      “Australia’s comprehensive vaccination program means that the occurrence of vaccine-preventable diseases is now very rare,” Dr Hambleton said.

      “Australia has an excellent record of achievement in the prevention of disease through immunisation. This record has been built on the quality and safety of vaccination, and our high rates of vaccination.

      From the New York Times – Public Health Risk Seen as Parents Reject Vaccines:

      SAN DIEGO — In a highly unusual outbreak of measles here last month, 12 children fell ill; nine of them had not been inoculated against the virus because their parents objected, and the other three were too young to receive vaccines.

      The parents who objected to their children being inoculated are among a small but growing number of vaccine skeptics in California and other states who take advantage of exemptions to laws requiring vaccinations for school-age children.

      The exemptions have been growing since the early 1990s at a rate that many epidemiologists, public health officials and physicians find disturbing.

      Children who are not vaccinated are unnecessarily susceptible to serious illnesses, they say, but also present a danger to children who have had their shots — the measles vaccine, for instance, is only 95 percent effective — and to those children too young to receive certain vaccines.

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      • I think you miss my point. Where are the studies on the long term effect of vaccinations on long term personal health? For example, when you get a measles vaccine, how long does that immunity last and are there any long term risks to the individual? Are there any long term risks to combining vaccines? What are the cumulative effects of mercury exposure from vaccines, dental amalgams, seafood and coal-fired plants on human health? Do vaccines have any effect on the health of the microbiota (intestinal bacteria that are the cornerstone of human immunity). Problems with the microbiota are heavily implicated in the current epidemic of obesity and type II diabetes, and these are surely bigger problems than infectious diseases.

        I think parents have a right to ask these questions and to be skeptical until doctors answer them.

        I am very skeptical about claims about public health interventions in reducing disease prevalence because many factors are involved, including sanitation, hygiene, better diet (especially during pregnancy).

        I also think the rise in infectious diseases probably has more to do with income inequality (and poor diet, overcrowding, etc) than the decline in the vaccination rate. But we don’t really know, do we, unless someone studies it?

        Public health professionals still try to tell us that water fluoridation is the main reason tooth decay has declined – when European countries (who don’t fluoridate) have the same rate of decline as the US (where most cities fluoridate).

        People are far more knowledgeable about their health now than when I was in medical school. I think this trends needs to be encouraged. There’s no question people will be healthier when they start taking responsibility for their own health.

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        • Those are all valid questions to which I would expect a medical doctor, such as yourself, to have some level of expertise on. However, they are questions and not statements of fact. As bad as obesity and type II diabetes are, comparing them to the destructive potential of infectious disease would seem inappropriate. The 1918 flu pandemic alone killed 3-5% of the world’s population, some 50-100 million people. The Black Death in the 14th century was probably even worse, killing 75-200 million people worldwide and reducing Europe’s population by 30-60%.

          The New England Journal of Medicine released the results of Project Tycho late last year. From The Huffington Post:

          Pittsburgh researchers also gave their new data trove a test drive to illustrate what could be done with the data. They mined Tycho for information on eight common diseases detailed in the records–polio, measles, rubella, mumps, hepatitis A, diphtheria and pertussis. Looking at available records before and after vaccines were discovered for those diseases, they estimated that 103 million cases of those contagious diseases have been prevented since 1924, (assuming the reductions were all attributable to vaccination programs). Their findings are published in this week’s New England Journal of Medicine. The data also points to what can happen when communities become too lax about vaccinations (among other factors). They quantified the resurgence in recent years of pertussis throughout the country, particularly in the Midwest to Northwest and in the Northeast and also ongoing cases of mumps. “Reported rates of vaccine refusal or delay are increasing,” the authors write. “Failure to vaccinate is believed to have contributed to the reemergence of pertussis, including the large 2012 epidemic.”

          Today, the Daily Kos published this report on autism, perhaps the most worrisome side-effect attributed to vaccines by skeptics:

          A study performed by the University of California at Davis has found a correlation between exposure to pesticides and autism.

          The author of the report suggests that families near agricultural fields being sprayed get their children out of town. The study also found that pregnant women after the first trimester had an increased risk of their infant becoming autistic with the exposure closer to the due date being the most harmful to the fetus.

          Organophosphates were the culprit identified. Developed by the Nazis in the 1940’s these pesticides have a host of deadly and debilitating consequences when humans(and other critters) are exposed.

          I’m sorry, but your point about water fluoridation seems a little paranoid and reminds me of the General Ripper character in the 1964 Stanley Kubrick classic Dr. Strangelove. But, if you would like to share some medical information on this issue – that would be fine. I’m always ready to learn.

          Although I have a great appreciation for naturalism, I am an empiricist at heart and therefore do not reject technology as a matter of course. Facts and evidence govern my judgement, not philosophy or ideology. From this perspective, the benefits of vaccines far outweigh the costs. Those costs, however, should be fully studied and understood.

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        • The New England Journal of Medicine paper you cite isn’t scientific fact. It’s an extremely speculative retrospective study attributing the reduction in infectious disease to vaccination. The key statement here is in the parenthesis: “(assuming the reductions were all attributable to vaccination programs)”. Thus you can only accept the conclusion they reach if you accept their premise that other variables – diet, hygiene, sanitation, etc. played no role in the reduction. In my view, they don’t set up a convincing case for rejecting these other factors.

          You’ve also set up a straw man here in raising the connection between vaccine and autism – that’s not what I’m arguing.

          One of the principles drummed into me in medical school was that doctors had an absolute responsibility to inform patients of the risks of specific medical interventions – and allow patients (and parents of patients) to weigh whether potential benefits warranted the risks.

          All I’m saying here is that we can’t inform parents about the long term potential risks associated with vaccines (and combinations of vaccines) – because they have never been rigorously studied.I find the studies which have been done linking vaccines with autoimmune disease quite alarming and I think parents should be informed about them: http://www.smartvax.com/index.php?option=com_content&view=article&id=102:autoimmune-diseases-vaccines-as-a-possible-trigger

          As for the controversy over water fluoridation (160+ US cities and most of the EU have lobbied to have fluoride removed from their drinking supply), you will find the best summary of all the research evidence in biochemist Paul Connett’s book The Case Against Fluoride. Here in New Plymouth, a citizens’ lobby group assembled all the scientific evidence, as well as doctors and dentists to present it, and persuaded our district council to discontinue water fluoridation here.

          Here’s Connett at his book launch: https://www.youtube.com/watch?v=Zqh95yqVpsI

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        • “The New England Journal of Medicine paper you cite isn’t scientific fact. It’s an extremely speculative retrospective study attributing the reduction in infectious disease to vaccination.”

          That’s your opinion which isn’t likely to be shared by the vast majority of health care professionals.

          I did not attribute the “autism” argument to you. This is what I wrote about it: “… perhaps the most worrisome side-effect attributed to vaccines by skeptics…”

          On the one hand, you assert that: “… we can’t inform parents about the long term potential risks associated with vaccines (and combinations of vaccines) – because they have never been rigorously studied.” Then on the other hand, you claim that: “I find the studies which have been done linking vaccines with autoimmune disease quite alarming and I think parents should be informed about them…” Do you seriously want to present isolated, poorly-studied and non-peer reviewed medical information to patients? I find that to be an incredibly dangerous attitude, and one which is antithetical to the scientific method that lays the foundation of sound medical decision making. If you don’t believe the potential risks of vaccines have been rigorously studied (an opinion which I do not share), then you should be actively trying to get those studies performed.

          While I am not an advocate of water fluoridation, I consider the opposition to it to be medically groundless and rooted in anti-government paranoia dating back to the McCarthy Era. In 2010, the CDC reported that 73.9% of the U.S. population using community water systems were receiving fluoridated water.

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    • I’ve read all of the comments posted here about vaccines. I must tell you that after hearing from a cousin of mine a few years ago that she believes vaccines to be harmful, I decided to do my own research on it. I found that all the articles/websites that made claims that vaccinations can be harmful were written by people who either were not doctors, or were doctors who could not give any information/proof that they belonged to a reputable (or, in some cases, even existing) clinic, hospital, medical association, research facility, etc. These articles tended to make a lot of scary claims about how vaccines can harm kids, but didn’t provide any proof (peer-reviewed research, etc.).

      On the contrary, the articles/websites that say people benefit from vaccines come from doctors, universities, peer-reviewed research articles, reputable news organization, medical associations, etc. They each had hard data to back up what they were saying.

      So I ask you, why choose to rely on unsubstantiated info for such an important thing? And why use faulty info to make a life-or-death decision for a child (that will also affect other children)? How would you feel if you failed to vaccinate your child against a disease, and your child, as well as other children, got sick and died? Is a conspiracy theory worth betting a life on? I think not.

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