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Posts for category: Infectious Disease

By contactus@priority-pediatrics.com
March 28, 2019
Category: Infectious Disease
Tags: immunizations   measles   epidemics   MMR   Outbreaks  

There are now 314 confirmed cases of measles in 15 states, with six states reporting measles outbreaks, according to the latest data for 2019 from the Centers for Disease Control and Prevention (CDC).

The situation is severe enough in New York's Rockland County, a suburb of New York City, that an emergency was declared effective today with 155 confirmed cases, according to the local health department.

Rockland County executive Ed Day declared the countywide state of emergency to include anyone less than 18 years of age who is unvaccinated against the measles. They are barred from public places until this declaration expires in 30 days or until they receive the measles-mumps-rubella vaccination.

Most of these cases (82%) are people who have not been vaccinated against measles and most are individuals aged 4 to 18 years (46%) and younger children aged 1 to 3 years (24%), many of them concentrated in an ultra-Orthodox Jewish community, where vaccination rates are far below the average.

In neighboring New York City, as of March 27, there have been 214 confirmed cases of measles in Brooklyn and Queens since October. Most of these cases have also involved members of an Orthodox Jewish community. The initial child with measles was not vaccinated and acquired measles on a visit to Israel, where a large outbreak was occurring.

Other Outbreaks:

States that have reported measles cases to the CDC besides New York are Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, Oregon, Texas, and Washington.

The six outbreaks (defined as three or more cases) reported so far this year in the United States include — along with Rockland County and New York City — the four states of California, Illinois, Texas, and Washington.

As of March 22, Washington State reports 74 cases of measles; 73 in Clark County (most in children aged 1 to 10 years; 63 not vaccinated) and one in King County (a man in his 50s who traveled to Clark County).

Texas has 14 confirmed cases of measles as of March 21 and Illinois has six cases. In California, there are seven confirmed measles cases as of March 22, including one outbreak of three cases linked to a patient with international travel.

The CDC advises anyone traveling internationally to be vaccinated against measles before leaving.

The 314 measles cases and six outbreaks reported to the CDC through March 21, 2019, compare with 372 cases and 17 outbreaks reported in all of 2018. In 2000, the CDC declared that the disease had been eliminated in the United States.

 

Atlanta is primed to experience a similar Measles outbreak as reported above due to an increasing number of families who are chosing NOT to immunize their children against Measles and other childhood diseases. Our International Airport makes importation of Measles from outside the USA a real possibility, not to mentione travel within the country to and from outbreak areas.  It is never to late to immunize yourselves and your families.

Dr. T

By contactus@priority-pediatrics.com
February 10, 2019
Category: Infectious Disease
Tags: Autism   vaccine   measles   Contagious   Complications  

4 things everyone needs to know about measles

Claire McCarthy, MD

Faculty Editor, Harvard Health Publishing

We are in the midst of a measles outbreak here in the US, with cases being reported in New York City, New York state, and Washington state. In 2018, preliminary numbers indicate that there were 372 cases of measles — more than triple the 120 cases in all of 2017 — and already 79 cases in the first month of 2019 alone. Here are four things that everyone needs to know about measles.

Measles is highly contagious

This is a point that can’t be stressed enough. A full 90% of unvaccinated people exposed to the virus will catch it. And if you think that just staying away from sick people will do the trick, think again. Not only are people with measles infectious for four days before they break out with the rash, the virus can live in the air for up to two hours after an infectious person coughs or sneezes. Just imagine: if an infectious person sneezes in an elevator, everyone riding that elevator for the next two hours could be exposed.

It’s hard to know that a person has measles when they first get sick

The first symptoms of measles are a high fever, cough, runny nose, and red, watery eyes (conjunctivitis), which could be confused with any number of other viruses, especially during cold and flu season. After two or three days people develop spots in the mouth called Koplik spots, but we don’t always go looking in our family members’ mouths. The characteristic rash develops three to five days after the symptoms begin, as flat red spots that start on the face at the hairline and spread downward all over the body. At that point you might realize that it isn’t a garden-variety virus — and at that point, the person would have been spreading germs for four days.

Measles can be dangerous

Most of the time, as with other childhood viruses, people weather it fine, but there can be complications. Children less than 5 years old and adults older than 20 are at highest risk of complications. Common and milder complications include diarrhea and ear infections (although the ear infections can lead to hearing loss), and one out of four will need to be hospitalized, but there also can be serious complications:

  • Five percent of people with measles get pneumonia. This is the most common cause of death from the illness.
  • One out of 1,000 get encephalitis, an inflammation of the brain, that can lead to seizures, deafness, or even brain damage.
  • One to two out of 1,000 will die.
  • There is another possible complication that can occur seven to 10 years after infection, more commonly when people get the infection as infants. It’s called subacute sclerosing panencephalitis or SSPE. While it is rare (four to 11 out of 100,000 infections), it is fatal.

Vaccination prevents measles

The measles vaccine, usually given as part of the MMR (measles-mumps-rubella) vaccine, can make all the difference. One dose is 93% effective in preventing illness, and two doses gets that number up to 97%. In general the first dose is usually given at 12 to 15 months and the second dose at 4 to 6 years, but it can be given as early as 6 months if there is a risk of exposure (as an extra dose — it doesn’t count as the first of two doses and has to be given after 12 months), and the second dose can be given as soon as 28 days after the first.

The MMR is overall a very safe vaccine. Most side effects are mild, and it does not cause autism. Most children in the US are vaccinated, with 91% of 19-to-35 month-olds having at least one dose and about 94% of those entering kindergarten having two doses. To create “herd immunity” that helps protect those who can’t get the vaccine (such as young infants or those with weak immune systems), you need about 95% vaccination, so the 94% isn’t perfect — and in some states and communities, that number is even lower. Most of the outbreaks we have seen over the years have started in areas where there are high numbers of unvaccinated children.

If you have questions about measles or the measles vaccine, talk to your doctor. The most important thing is that we keep every child, every family, and every community safe.

By contactus@priority-pediatrics.com
February 01, 2019
Category: Infectious Disease
Tags: Influenza   Flu   immunizations   Vaccines   flu shot   update   Urgent Care   ER  

 

Note: 2018-19 Flu Season Update
As the flu season continues, please review these reminders and updates below:

  • It is not too late to get a flu shot if you have not received a flu immunization during the current flu season.
  • Receiving a flu vaccine every year offers the best available protection against flu and has been shown to reduce illnesses, hospitalizations and deaths in people of all ages. 
  • If you or someone in your family are diagnosed with a respiratory illness even though you've had a flu shot, flu test confirmed or not, the flu vaccine was effective, especially if they are  seen by a doctor and sent home with minimal treatment.
  • If you or someone in your family have flu-like symptoms that unless instructed by a physician to be given for other medical reasons, you should avoid aspirin and aspirin-containing products (such as Pepto- Bismol, Kaopectate and Alka-Seltzer, for example), which have been associated with rare but severe complications when taken by children and adolescents with flu.
  • If your child needs evaluation at a Children's Healthcare of Atlanta facility when your routine office is closed, it is better to seek care at Children’s urgent care locations as an alternative to the Emergency departments. Families can visit choa.org/locations for more specifics regarding the Urgent Care centers or use the Children’s app on their mobile phones to check wait times at the different locations.
  • Please visit these resources at choa.org/flu to learn more about influenza.

 

Dr. T

By contactus@priority-pediatrics.com
January 17, 2019
Category: Infectious Disease
Tags: immunizations   Vaccines   measles   MMR   Atlanta   ATL  
  1. Confirmed Measles Cases in 2 Metro Atlanta Residents!

    The GA Public Health Dept has confirmed measles in 2 residents of metro Atlanta who visited several metro Atlanta locations Jan. 7-14 & may have exposed others. Best protection is to be sure ur family is properly immunized.

    Go to https://www.healthychildren.org/English/health-issues/vaccine-preventable-diseases/Pages/Measles.aspx to learn more about Measles & to to learn what U need to know about the vaccine.t

By contactus@priority-pediatrics.com
September 02, 2018
Category: Infectious Disease
Tags: measles   Rubeola   Outbreaks   Hotspots   CDC NME   Exemptions  

 

CDC Reports 107 Measles Cases Already This Year, Here Are Potential Outbreak Hotspots

 

Will signs like this become more and more common? (AP Photo/Amy Forliti, file)

Harrison Ford once said in the movie Six Days and Seven Nights, "I decided my life is too simple, I wanna complicate the hell out of it." Here's one way to do that. Go against established medical advice. Stop using vaccines that have been preventing a potentially deadly disease and watch the disease return. 

A study published in the journal PLOS Medicine found that over the past decade more and more parents have been opting out of school requirements to get their kids vaccinated in the 18 states that allow such non-medical exemptions (NME).  In other words, more and more parents are taking the option to increase their kids' (and other kids') risk for getting measles, a highly contagious and potential deadly disease.

That's because there is nothing even close to the measles vaccine in preventing the measles. No supplement, food, oil, body position, app, or chant is going to be able to replace the vaccine.

Keep in mind that NMEs are not medical exemptions, otherwise they'd be called medical exemptions. In other words, parents seeking NMEs aren't doing so because a real doctor said that their kids shouldn't get the vaccine because of an immune system disorder or a severe allergy to vaccine components. They are "opting out" because of their beliefs.

 

 

Nikki Craven from Grass Valley joins protestors during a rally in opposition to a bill mandating that California schoolchildren be vaccinated. (AP Photo/Steve Yeater)

If you've pushed for your state to allow NME's, take a look at the PLOS Medicine study to find out what you would be causing. For the study, a research team from the National School of Tropical Medicine (Jacqueline K. Olive, Peter J. Hotez, MD, PhD , Ashish Damania, and Melissa S. Nolan, PhD, MPH) analyzed data from these 18 states and the Centers for Disease Control and Prevention (CDC).  The study found that in 12 of the states that allow NMEs (Arkansas, Arizona, Idaho, Maine, Minnesota, Missouri, North Dakota, Ohio, Oklahoma, Oregon, Texas, and Utah) the number of NMEs has been steadily increasing since 2009. (Colorado, Louisiana, Michigan, Pennsylvania, Washington, and Wisconsin round out the rest of the 18 states that allow NMEs).

The research team also found that that higher NME rates correlated with lower measles-mumps-rubella (MMR) vaccination rate. In other words, MMR vaccination rates tended to be lower, the higher the number of NMEs. This is concerning because scientific studies (and common sense) have showed how locations with lower measles vaccination rates are more likely to have measles outbreaks.

And this week, as this ABC15 news segment reports, health officials are warning about potential measles exposure in Arizona, one of the states that has NMEs:

As Hotez explained, "while national immunization rates may not have changed much over the years, we are seeing a rise in non-medical vaccine exemptions in 18 states that still allow them for reasons of personal belief. These hotspots of antivaccine activity are at risk for breakthrough measles and other childhood infectious diseases."

This study essentially showed the consequences of states offering NMEs. And declining vaccination rates are going against what has been one of the biggest successes in the history of public health and has saved millions upon millions of lives and prevented lots upon lots of suffering. Typically schools will require kids to have the full set of routine vaccinations before entering. That's because schools can be germ buffets. You may think that your kid can stay clear of others and others' bacteria and viruses, but in schools it's "snot" reality. Little kids are constantly smearing things such as snot on themselves, their things, their classmates, and everything else.

Requiring kids to get routine vaccinations has helped control of number of diseases that used to be a lot more commonplace up to the earlier part of the 1900's. It helped eradicate smallpox, control polio, and make measles practically non-existent in the United States, at least at the beginning of this century. When it came to vaccine -preventable infectious diseases such as measles, mumps, and pertussis, life by the end of 1990's had become simple. Just keep the population vaccinated to prevent outbreaks.

Enter the Harrison Ford quote. In 1998, British gastroenterologist Andrew Wakefield claimed that measles, mumps, and rubella (MMR) vaccine may be linked to autism and in 2004 published a study in the Lancet in support of his claims. Wakefield sparked an anti-vaccination movement in England that subsequently spread to the United States. However, when investigations revealed evidence that he may have had a financial motive for making such claims and falsified data, the Lancet subsequently retracted the paper and Wakefield lost his license to practice medicine.

Despite these revelations and lack of scientific evidence connecting vaccines with autism, the anti-vaccination movement has continued. So has Wakefield, as he continues to speak at conferences such as the International Chiropractors Association's Annual Conference on Chiropractic and Pediatrics as I described previously for Forbes. The growing number of NMEs has suggested that the anti-vaccination movement has been picking up steam over the past decade.

This steam has included a lot of hot air because many of the anti-vaccination movement's claims have lacked scientific backing. Plus, the anti-vaccination movement has offered no viable alternative to vaccines to protect people against life-threatening diseases such as the measles. Some anti-vaccination proponents have offered supplements and alternative medicine methods as options (without providing adequate scientific evidence), which makes you wonder what the motivations may be behind attempts to discredit vaccines.

So what does a more complicated life look like compared to the late 1990's when measles was virtually non-existent in the U.S? According to the Centers for Disease Control and Prevention (CDC), as of July 14, 2018, at least 107 people from 21 states (Arkansas, California, Connecticut, Florida, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, and Washington) and the District of Colombia had measles since the start of this year. The majority were unvaccinated. Here are the numbers of reported cases by year so far in this decade:

Year Cases
2010 63
2011 220
2012 55
2013 187
2014 667
2015 188
2016 86
2017* 118
2018** 107

Still want to complicate the heck out of life?