Tuesday, February 17, 2015

Straight Talk About Measles

Epidemic?

We are in the middle of a massive media fear frenzy about measles. This measles mania appeared just as the ebola frenzy subsided, as if the American public has to be worrying about an "epidemic" at all times. The problem is that there was no ebola epidemic in the US, and there is no measles epidemic either. "Epidemic" is defined as "a widespread occurrence of an infectious disease in a community at a particular time." As of February 13 (the latest CDC update), there have been 141 cases of measles reported in 17 states and the District of Columbia in 2015. Of those 18 locations, nine have had only ONE reported case (Colorado, the District of Columbia, Delaware, Michigan, Minnesota, New Jersey, Oregon, Pennsylvania, and Texas), and five have had only two cases (Nebraska, New York, Nevada, South Dakota, and Utah). Washington has had four cases, Arizona seven, Illinois eleven, and California has had 98 cases of measles.
http://www.cdc.gov/measles/cases-outbreaks.html

One case of measles in a state isn't even worth mentioning. Seven cases in a state with a population of 6.7 million or eleven cases in a population of 12.9 million can hardly be considered an epidemic either. Even the 88 cases in California don't qualify as an epidemic. In a population of 38.8 million, 0.0002% of the population has contracted measles in 2015. This is not "a widespread occurrence."

The focus of the media fear-mongering is on unvaccinated children. Parents who opt out of vaccines are being blamed for the "epidemic." The interesting reality from the California Department of Public Health is that 59% of the cases have been in ADULTS. Let me say that again. In the California measles outbreak, 59% of cases were not in children at all, let alone unvaccinated children.
http://www.cdph.ca.gov/HealthInfo/discond/Documents/Measles_update_2_13_2015_public.pdf
(Note that the CDPH statistics include December 2014 cases, so the numbers don't match the CDC numbers for CA in 2015.)

None of this matters to the media. Here in Michigan, the ONE case of measles was in a VACCINATED ADULT. This adult had received one dose of MMR, which was all that was recommended when this person was vaccinated as a child. The measles vaccine originally promised to confer lifelong immunity with one dose. In 1990, there were 27,672 cases of measles reported in the US, the highest number of cases since 1977. While there was no media fear frenzy at the time, a second dose of MMR was added to the vaccine schedule in the wake of this outbreak. It appears that waning immunity even in those who have had two doses may now lead to the recommendation for additional boosters. What other product can convince us to buy more of it when it fails?

Most of the media coverage in Michigan has omitted the fact that the one case of measles was in an adult who had been vaccinated. There has also been no media acknowledgment of the fact that this person recovered without complication and without spreading measles to anyone else (the incubation period has passed with no additional cases). The focus in the media has been on unvaccinated children and vaccine exemptions, which are completely irrelevant to the one case of measles in our state so far this year.


Deaths?

While misinformed people on Facebook are ranting about "babies dying of measles in California because of the anti-vaxxers", the truth is that there has not been a measles death in the US since 2003. These are the most recent measles deaths I have been able to find though combing the CDC data, and the CDC confirmed this in an email to a member of one of my vaccine groups a few days ago:

From: CDC NCIRD DVD Inquiry <ncirddvdinquiry@cdc.gov>
Date: February 11, 2015
Subject: RE: CDC-INFO: Inquiry [ ref:_00DU0YCBU.500U0HSGf:ref ]
Thank you for you inquiry regarding measles deaths. Measles data available to the public can be found in www.cdc.gov/measles, MMWR (http://www.cdc.gov/mmwr/), and other publications such as those listed on http://www.cdc.gov/measles/resources/ref-res.html.
The last documented deaths in the US directly attributable to acute measles occurred in 2003. Before the measles vaccination program started in 1963, we estimate that 3-4 million people got measles each year in the US, and 400-500 of those died (http://www.cdc.gov/measles/about/faqs.html).
Regards,
Division of Viral Diseases
Centers for Disease Control and Prevention

There were two measles deaths in 2003, and both of them involved extenuating circumstances. One was a 75-year-old who caught measles in Israel but later died of complications in the US. The other was a 13-year-old who died of measles encephalitis three months after receiving a bone marrow transplant. "Despite an intensive search, no additional cases were detected in the surrounding area." So this immune-compromised child died of measles EVEN THOUGH THERE WERE NO LOCAL MEASLES CASES. A bone marrow transplant puts someone in the highest risk category for contracting measles through vaccine shedding. There were no measles cases in the area. How many recently vaccinated kids were there?
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5331a3.htm

Americans today are very afraid of death by measles, but the reality is that measles is usually a self-limiting virus in the developed world. The death rates being tossed around by the media are from rural Africa, where there is no sanitation, no clean water, and severe malnutrition. Under these circumstances, measles (or any other infection) is far more likely to lead to death.  One CNN reporter apparently announced a 50% mortality rate for measles, which is not true anywhere in the world, let alone in the United States. According to the CDC's pre-vaccination era US data, about 1 in 10,000 people who got measles died as a result.

The death rate most often being quoted currently is 1-2 in 1000 cases. Has the measles death to case ratio in the US really increased 10 to 20 fold since 1963? If it has, it is because vaccination has pushed the disease out of its natural age range and into more vulnerable infants and adults. Before the vaccine, measles most often affected school-aged children, who usually recovered quickly and with lifelong natural immunity to protect them as adults, for whom measles may be more serious. A woman who had measles as a child conferred maternal antibodies on her own infants, protecting them when they were most vulnerable. Dr. Suzanne Humphries explains this phenomenon, and the way vaccination disrupts it:
Prior to vaccination, mothers were naturally immune to measles and passed that immunity to their infants via placenta and breast milk. Vaccinated mothers may have vaccine immunity, which is not the same immunologically, as natural immunity. One of the major differences in the vaccine-induced immunity is that it cannot be passed from mother to infant. 
Since most vaccines are delivered by injection, the mucous membranes are bypassed and thus blood antibodies are produced but not mucosal antibodies. Mucosal exposure is what contributes to the production of antibodies in the mammary gland. A child’s exposure to the virus while being breastfed by a naturally immune mother would lead to an asymptomatic infection that results in long-term immunity to that virus. Vaccinated mothers have lower levels of virus-specific antibodies in the serum and milk compared to naturally immune mothers and thus their infants are unprotected. 
“Infants whose mothers were born after 1963 had a measles attack rate of 33%, compared to 12% for infants of older mothers.” Infants whose mothers were born after 1963 are more susceptible to measles than are infants of older mothers. An increasing proportion of infants born in the United States may be susceptible to measles.” [7]
For the disease of measles, we see that while the clinical case rate may have declined with vaccination, the most sensitive members of the herd are at an increased risk- as a result of vaccination. 
- See more at: http://www.vaccinationcouncil.org/2012/07/05/herd-immunity-the-flawed-science-and-failures-of-mass-vaccination-suzanne-humphries-md-3/#sthash.ClXvPFpU.dpuf

Even if the more dire death rate is real, let's look at what that really means for Americans. We have 141 cases reported in a population of 320,000,000 people of a disease with a death rate of perhaps 1-2 in 1000 cases. We would need at least 5-10 times the current number of measles cases to expect to see one measles death in our population of 3.2 million people. Incidentally the US saw 644 measles cases in 27 states in 2014, with no deaths and no widespread panic.
http://www.cdc.gov/measles/cases-outbreaks.html

What puzzles me about the success of the current fear-mongering is that we still have an entire generation of Americans alive today who experienced measles as a normal, expected part of childhood. The vast majority of them remember staying in bed for a few days and then getting better, and watching all their siblings and friends go through the same experience. None of the older adults I've spoken with remember anyone they knew suffering any complications from measles, let alone dying from it. This page from my childhood book, Babar and the Doctor, is a good representation of how measles was viewed in 1969.



This video compilation from 1959, 1961, and 1969 also gives a good sense of how measles was viewed at the time. Why isn't my parents' generation speaking out against the serious misinformation being spread by today's media?




Eradicated?

The media loves to talk about how measles was eradicated in the US in 2000, and to blame vaccine refusers for bringing it back. The reality is that measles was never "eradicated" in the US, where there has never been a year without measles (there were 86 cases in 2000). The CDC declared measles "no longer endemic in the US" in 2000. This is a big distinction. Let's look at definitions:(http://www.merriam-webster.com/dictionary/):
Eradicated: "to remove (something) completely : to eliminate or destroy (something harmful)."
Endemic: "belonging or native to a particular people or country; restricted or peculiar to a locality or region."
Measles was never completely eliminated in the US. It was declared no longer endemic in 2000 because all cases could be traced to importation from other countries. In the CDC's own words:
During March 2000, CDC convened a consultation of measles experts§ to evaluate data on the elimination of endemic measles from the United States. The data indicated that, during 1997--1999, measles incidence has remained low (<0.5 cases per 1,000,000 population) and that most states and 99% of counties reported no measles cases. In addition, measles surveillance was sensitive enough to consistently detect imported cases, isolated cases, and small outbreaks. Evidence of high population immunity included coverage of >90% with the first dose of measles vaccine in children aged 19--35 months since 1996 (2) and 98% coverage among children entering school (3). In 48 states and the District of Columbia, a second dose of measles vaccine is required for school entry (4). A national serosurvey indicated that 93% of persons aged >6 years have antibody to measles (5).
On the basis of these findings, the experts concluded that measles is no longer endemic in the United States.   
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4925a1.htm
In other words, nothing has changed. The current measles outbreak can also be traced to importation. Measles is still not endemic in the US. Like many other diseases, there is a natural cycle to measles. Even before the vaccine, measles infection was cyclical. It is completely normal to have years with fewer cases and years with more cases.


The Power of the Media

I leave you with an example of the power of the media to dictate our perception of reality. The current US measles outbreak of 121 cases and zero deaths that has taken over the national headlines has been traced to the Philippines, where in 2014, there were 57,564 suspected cases of measles (21,403 confirmed), and 110 associated deaths in the a population of 98.4 million people. (http://wwwnc.cdc.gov/travel/notices/watch/measles-philippines) Suzanne Waltman, the president of Michigan Opposing Mandatory Vaccines, emailed a friend living in the Philippines last month to ask him about the measles situation there. Here is his response:
"I'm not aware of a measles outbreak over here, I didn't hear anything about it. At least it's not in the news."

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