It is ironic that the success of modern vaccination programs against ancient scourges such as measles has been part of the reason parents today are so ignorant about what these diseases can do. A recent outbreak in California has demonstrated the effects of this lack of knowledge:
Researchers have found that past outbreaks of vaccine-preventable diseases are more likely in places where there are clusters of parents who refuse to have their children vaccinated...
In California, vaccine exemptions have increased from 1.5 percent in 2007 to 3.1 percent in 2013, according to an analysis by the Los Angeles Times.
That's a surprisingly large number---but hey, this is California:
Researchers have found that those who refuse vaccines tend to share similarities.
"In general, they’re upper-middle to upper class, well-educated — often graduate school-educated — and in jobs in which they exercise some level of control," Offit said. "They believe that they can google the word vaccine and know as much, if not more, as anyone who’s giving them advice."
An enormous amount of damage was also done by fraudulent science in the guise of an influential 1998 article in Lancet claiming a link between vaccines and autism, that has since been proven to be a fraud and retracted. But the study's author, Andrew Wakefield, couldn't have done it alone:
It’s really difficult to tell now when the last day of exposure might be,” said Dr. Gil Chavez, deputy director of the state’s Center for Infectious Diseases. “For the time being, if you are not vaccinated or if you have an infant who is too young to be vaccinated, you should avoid going to Disneyland.”
In all, 59 measles cases have been confirmed statewide, including 13 in San Diego County. Disneyland is associated with 41 of those patients, including five of the park’s employees.
Disneyland did not respond directly to the Wednesday recommendation from public-health officials. It referred journalists to a recent statement made by Dr. Pamela Hymel, the park’s chief medical officer, that said Disney was notified of the outbreak on Jan. 7.
The company has offered vaccinations and immunity tests to its workers.
“Cast members who may have come in contact with those who were positive are being tested for the virus. While awaiting results, they have been put on paid leave until medically cleared,” Hymel said.
I was mulling the idea of taking advantage of the situation, as my family is up-to-date on its vaccinations. However, concerns are increasing about the number of vaccinated individuals becoming ill with the disease.
Some medical experts have also expressed concern about the five patients who contracted measles despite being fully vaccinated.
Posted by Amy Miller
on January 21, 20158 Comments
In last night's State of the Union address, President Obama made a lot of promises. From free community college, to middle class tax breaks, to massive tax hikes on the wealthy and investors, the President served up a bill of goods that, given a Republican-controlled Congress, will take a miracle to become reality.
This is nothing new for Obama, who has a pretty poor record of delivering on his most high-profile promises. He hasn't allowed Congress to address our broken immigration system; he hasn't eliminated the threat of al-Qaeda; he hasn't closed the detention facilities at Guantanamo Bay; and he certainly hasn't brought the kind of "change" that America wants or deserves.
Based on an informal tally, President Obama has broken a whopping 112 SOTU promises during his time as President. I don't think any reasonable person would argue that no president has ever added aspirational policy goals to his annual address to the nation, but coming from a man who came into office claiming revolutionary status, the number seems...high?
Grabien compiled a video montage of all 112 broken promises. Click below the fold for an all-too-long list of bullet points highlighting all the ways Obama has failed to live up to his promises.
112, and counting. I wonder how long this list will be come 2016?
Posted by Leslie Eastman
on January 18, 20159 Comments
At the start of the New Year, I noted outbreaks of measles were being reported across the country.
Unfortunately for one of America's most iconic institutions, the latest set of cases is being christened the "Disneyland Measles Outbreak"!
The number of cases from the initial infections occurring at "the happiest place on earth" is now 51...and more are expected.
The measles outbreak centered in California is rapidly expanding, with officials now confirming 51 cases of the illness -- nearly double the number reported Tuesday -- and warning that more people will probably fall sick with the highly contagious virus.
Officials said there was now evidence that the measles outbreak had spread beyond people who visited Disneyland between Dec. 17 and 20 and begun infecting people in the broader community.
It is the beginning of a scenario experts have feared. Health officials generally hope a measles outbreak can be contained within a manageable group of people and eventually extinguished by keeping the ill at home or in a hospital room until they recover, with the outbreak eventually being stopped by the broader community of vaccinated people.
A case of red measles, also known as Rubeola, was diagnosed earlier this week in Moorseville, North Carolina -- worrying health officials and highlighting the renewed threat of measles in this country.
The infected person was unvaccinated and had recently returned from a trip to India confirmed Rebecca Carter, the public information officer for Mecklenburg county. Carter said she could not release any additional details such as the age or sex of the person due to patient confidentiality.
Dr. William Schaffner said this case is no trivial matter, warning that measles is highly contagious, spreading easily through coughing and sneezing. Symptoms include high fever, cough, runny nose, red eyes and sore throat followed by a rash that spreads all over the body. It can also lead to death, he added.
“People without gray hair forget that before vaccines became available, measles used to kill approximately 400 children a year in this country,” he said.
Posted by Leslie Eastman
on December 26, 20149 Comments
I got the gift of karma last night, after returning home from a wonderful Christmas dinner with the in-laws.
Why karma? Because one of the articles about infectious diseases I missed covering noted that this year's flu shot was ineffective against the most dominant strain of the virus:
The flu vaccine may not be very effective this winter, according to U.S. health officials who worry this may lead to more serious illnesses and deaths.
Flu season has begun to ramp up, and officials say the vaccine does not protect well against the dominant strain seen most commonly so far this year. That strain tends to cause more deaths and hospitalizations, especially in the elderly.
Though we cannot predict what will happen the rest of this flu season, it's possible we may have a season that's more severe than most," said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, at a news conference Thursday.
CDC officials think the vaccine should provide some protection and still are urging people to get vaccinated. But it probably won't be as good as if the vaccine strain was a match.
So I came down with a case of that dominant strain last night, as I had received the 2014 vaccine in September. The nausea is so awful that it cannot be described with words -- it must be experienced.
We spend millions of our taxpayer dollars for professionals to asses which strains to feature in the annual vaccine mixture. Yet, once again, the Centers for Disease Control and Prevention fail at its primary job task.
Nearly 10,000 cases have been reported in the state so far this year, and babies are especially prone to hospitalization or even death.
...Whooping cough is cyclical in nature and tends to peak every three to five years. The last outbreak of the disease in California was in 2010.
But doctors are discovering that immunity from the current vaccine may be wearing off on a similar timeline. Medical recommendations suggest booster shots after eight years, but doctors are seeing kids who received a booster three years ago getting sick. Public health officials are considering an update to the recommendations to account for the dip in immunity seen after three years.
Plus, many kids in some areas aren't getting vaccinated at all. The highest rates of whooping cough are found in the Bay Area counties of Sonoma, Napa and Marin, which also have some of the highest rates of parents who opt out of vaccinating their children.
Doctors believe these kids are the root of the current and recent epidemics.
Whooping cough feels like a cold at first, but an intense cough that develops later can produce a "whooping" sound. The disease is caused by the bacterium Bordetella pertussis. It can be treated with antibiotics, but the drugs may not be effective when the illness is in the severe coughing stages. Whooping cough can last for weeks and is especially dangerous to infants under 1 year.
California isn't the only state seeing jumps in pertussis infections.
This is the most baffling sports medicine story of the year: Thirteen NHL players and two referees have been diagnosed with mumps—a potentially severe and exceedingly viral infection that classically causes fever, body aches, malaise, and in about half of cases, parotitis (a painful swelling of the salivary glands). It's gotten so bad in the NHL that Sidney Crosby set off a mumps alert last week when he spoke to reporters with a welt on his face. (On Sunday, the Penguins confirmed Crosby does indeed have the disease.) So what's going on?
The story of this outbreak appears to have begun in early November, when Anaheim Ducks defenseman Francois Beauchemin noticed a swelling in his jaw after a game against the Arizona Coyotes on November 7th. A few hours later, he developed a fever, chills, muscle aches, and lost his appetite. Four days later, he was ten pounds lighter. By then, the virus was spreading around the Ducks locker room. Three of his teammates would catch the disease before it leapt to other teams: the New Jersey Devils, New York Rangers, and the Minnesota Wild, where five players came down with mumps, including all-star defenseman Ryan Suter.
"Ten percent of our team population contracted it," Minnesota Wild general manager Chuck Fletcher recently said. "As far as I know, everybody received the immunization when they were young." If that's true, what's the explanation? We know that the mumps vaccine unquestionably works—cases in the United States declined by 99 percent following its introduction in 1967—so why is an outbreak in hockey happening now?
Massachusetts General Hospital is treating a patient suspected of having contracted the Ebola virus, Public Affairs Officer Noah Brown has confirmed to Boston.com.
Dr. Paul Biddinger, Director Of Emergency Preparedness at MGH, said the patient involved in the suspected Ebola case meets the CDC definition of a “person under investigation” to possibly have the ebola virus.
“This definition involves the possibility of travel to where Ebola is present, the possibility of exposure to that virus, and symptoms that are consistent with that virus,” Biddinger said at a press conference Tuesday evening.
The patient is in stable condition and good spirits, according to Biddinger. He declined to answer specific questions about the patient—including travel history, potential exposure to others, and location in the hospital—citing an inability to comment on individual patient details. Biddiger did say, though, that there is not a reason for panic.
There were still some flare ups in the south-east, but things were improving in other prefectures, WHO co-ordinator Dr Guenael Rodier told the BBC.
More than 5,400 people have died in the latest outbreak, with Guinea, Sierra Leone and Liberia the worst hit.
The outbreak can be ended by mid-2015 if the world speeds up its response, UN Secretary General Ban Ki-moon has said.
Although the rate of new cases shows signs of decreasing in parts of West Africa, Mali - where six people have died and a seventh case has been reported - is now of concern. Additionally, the United Nations Ebola Emergency Response Mission has formally announced that it will not meet its self-imposed December 1st deadline of containment.
The mission set the goal in September, seeking to have 70 percent of Ebola patients under treatment and 70 percent of Ebola victims safely buried. That target will be achieved in some areas, head of UNMEER Anthony Banbury told Reuters news agency, citing progress in Liberia.
"We are going to exceed the December 1 targets in some areas. But we are almost certainly going to fall short in others. In both those cases, we will adjust to what the circumstances are on the ground," he said in an interview.
The U.S. death toll from the mysterious Enterovirus D-68 continues to rise.
The latest CDC update on the current outbreak of the polio-like Enterovirus D-68 states that it has now been detected “in specimens from eight patients who died and had samples submitted for testing.” That’s one more death than was disclosed in last week’s update. The CDC account does not provide any information as to where the patient died and does not disclose his/her name, age or other details.
According to the latest weekly update from CDC, 167 more people have been sickened with EV-D68 in the past week: a total of 973 patients in 47 states and the District of Columbia. That’s up from last week’s total of 796 people in 46 states.
Unlike the popular saying, if it quacks like a duck, then it probably is a duck. Health department workers tell us Enterovirus D-68 is a lot like having the common cold, except it isn't.
...Elmira Warren a Gainesville resident said, "I am concerned, I think it's important for us to be in touch with our bodies and if we have any type of symptoms that may be similar to that we should see our physicians."
Posted by Leslie Eastman
on October 07, 201430 Comments
Earlier, I weighed in on how the media and administration are handling the Ebola epidemic, using language to minimize the fact that it is a hemorrhagic fever.
It the wake of reports that Colorado children who suffered from an infection of the very aggressive respiratory pathogen, Enterovirus D-68, have also experienced limb paralysis, today's "Bio-Insurrection" research has revealed that there is a nice, new moniker associated with it: Non-Polio Enterovirus.
From our Department of Health:
I made this discovery while I was searching for confirmation that a child's recent death was associated with an Enterovirus D-68 infection. Sadly, it was.
Posted by Leslie Eastman
on September 17, 201417 Comments
Last week, there were dozens of stories about American children flooding emergency rooms in 10 states; they were infected with a cold-like virus that devastated their respiratory systems.
This week, the list of states reporting cases of the virus, now classified as Enterovirus D68, has risen to 12:
Since mid-August, the Centers for Disease Control and Prevention has confirmed more than 100 cases of Enterovirus D68 in 12 states: Alabama, Colorado, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Montana, New York and Oklahoma.
Yet the real number of severe respiratory illnesses caused by this virus is probably even higher, the CDC says.
The respiratory virus that’s been sweeping the nation and sending asthmatic children to the hospital may have only been officially reported in 97 children, but experts say that’s just the tip of the iceberg.
Dr. Claudia Hoyen said the virus, called enterovirus D68, probably affected thousands of children -- and that’s just in Cleveland, where she works. The virus has been reported in 21 states, according to state health departments.
At UH Rainbow Babies and Children's Hospital in Cleveland, about 20 children normally go to the intensive care unit each month with respiratory symptoms, said Hoyen, who heads the hospital’s pediatric infection control program. But for the last two months, the hospital’s intensive care unit has treated 80 children per month, she said.
The rare enterovirus starts out like the common cold but can quickly turn more serious -- especially in children with asthma. Enteroviruses often appear in the summer and fall, but an outbreak like this hasn’t occurred since the 1960s, Hoyen said.
A fourth American who contracted Ebola in West Africa was expected to arrive in the U.S. for care Tuesday and will be treated at an Atlanta hospital where two other aid workers successfully recovered from the disease, the hospital said Monday.
The other three patients appear to be recovering from their infections at this point. I suspect the quality of medical care here is still higher than in in West Africa (even in the wake of Obamacare). Koby Sebastian Spio-Garbrah, Global Managing Director at DaMina Advisors, indicates that the doctor-patient ratios may be key in predicting the spread of the disease:
An analysis of a basic global healthcare metric - doctor-patient-ratios - may be the key in helping identify the next most vulnerable West African states to the ongoing Ebola outbreak. Unsurprisingly, Liberia and Sierra Leone, which have remained the epicenters of the pandemic, have the worst doctor-patient ratios in West Africa, at over 86,000 patients-per-1-doctor in Liberia, and 45,000 patients-per-1-doctor in Sierra Leone. Nigeria, which has lately received a lot of media attention ironically has the best doctor-patient ration of any West African state and is probably the least vulnerable during this outbreak. Due to climatic factors connected to the epidemiology of Ebola, the northern arid West African states of Mali, Burkina Faso, Chad or Mauritania are unlikely to see any major outbreaks. However the tropical coastal states, whose porous land borders adjoin Liberia and Sierra Leone, remain very vulnerable.
A good video review of the situation comes from Paper News TV:
Posted by Bruce Carroll
on June 21, 201415 Comments
The international volunteer medical organization Doctors Without Borders has issued a chilling warning -- that the deadly Ebola virus is "totally out of control."
The Ebola virus spreads through direct contact with infected people and causes internal bleeding and organ failure. There is no cure or vaccine so infected patients must be quarantined to stop the rapid spread of the virus. According to the World Health Organization, an Ebola outbreak can result in over 90% fatality rates.
Bart Janssens, director of operations for Doctors Without Borders, said Friday that the international community must send in more resources to stop the current Ebola epidemic.
"The reality is clear that the epidemic is now in a second wave," Janssens said. "And, for me, it is totally out of control."
The outbreak has caused more deaths than any other of the disease, said another official with the medical charity. Ebola has been linked to more than 330 deaths in Guinea, Sierra Leone and Liberia, according to the World Health Organization.
The current outbreak, which began in Guinea either late last year or early this year, had appeared to slow before picking up pace again in recent weeks, including spreading to the Liberian capital for the first time.
Posted by William A. Jacobson
on December 09, 201332 Comments
With each passing day, we learn more and more about the horrible effects of Obamacare.
Here are just some of the "new" revelations.
While there is ample evidence that premiums have risen for many if not most people, the NY Times finds that the supposedly lower premiums come with much higher deductibles, On Health Exchanges, Premiums May Be Low, but Other Costs Can Be High:
For months, the Obama administration has heralded the low premiums of medical insurance policies on sale in the insurance exchanges created by the new health law. But as consumers dig into the details, they are finding that the deductibles and other out-of-pocket costs are often much higher than what is typical in employer-sponsored health plans....
In El Paso, Tex., for example, for a husband and wife both age 35, one of the cheapest plans on the federal exchange, offered by Blue Cross and Blue Shield, has a premium less than $300 a month, but the annual deductible is more than $12,000. For a 45-year-old couple seeking insurance on the federal exchange in Saginaw, Mich., a policy with a premium of $515 a month has a deductible of $10,000.
In Santa Cruz, Calif., where the exchange is run by the state, Robert Aaron, a self-employed 56-year-old engineer, said he was looking for a low-cost plan. The best one he could find had a premium of $488 a month. But the annual deductible was $5,000, and that, he said, “sounds really high.”
By contrast, according to the Kaiser Family Foundation, the average deductible in employer-sponsored health plans is $1,135.
That is not exactly news, but that the NY Times is now up to speed with the rest of us is important because it helps filter the information down even to low information NY Times readers.
https://twitter.com/gabrielmalor/status/410029530636894208
Jim Geraghty has more bad news, But Other Than All That, Obamacare Had a Good Weekend!:
Posted by William A. Jacobson
on December 20, 201112 Comments
From The Daily News:
Santa won't bother going to poor countries this year, so the United Nations Children's Fund will go instead -- or at least that's the message behind a satirical new UNICEF advertisement released in Sweden...
Posted by William A. Jacobson
on September 23, 201156 Comments
My initial reaction last night was that Rick Perry did not have a good night.
My reaction this morning is that he had a disastrous night, possibly ending his chances of getting the nomination unless he gets his act together real soon. I say "possibly" because it...