Health Column: Measles resurge in United States
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist
MORE ABOUT MEASLES
Measles is the most contagious of all childhood illnesses and infects 95 percent of the unimmunized who are exposed.
95 percent of those adequately immunized are protected against an exposure.
One out of 20 who get the measles will develop pneumonia and one out of a thousand will develop encephalitis (swelling of the brain). For every 1,000 kids who develop measles, one or two will die from it.
A 20-something unimmunized lady from California (let’s call her Melissa for sake of alliteration) with the measles visits the “Happiest Place on Earth.” As she stands in line with dozens of excited kids and adults for the Small, Small World boat ride, Melissa coughs repeatedly. Her measles virus floats in the air and lands on surfaces (like Marvin’s hands or face) where it can remain infectious for two hours. Unfortunately, Marvin and several of the kids standing packed in line with Melissa are unimmunized because their parents fear that vaccines cause autism.
Everyone has a great time at Disneyland and two days later crowd into the Orange County Airport to fly home. Back home, kids develop fever, cough, runny nose and a characteristic red rash that starts on the face and moves down the trunk — measles!
As of Jan. 17, there are at least 26 cases of measles in California, Washington state, Utah and Colorado related to Melissa’s cough. Thousands of adults and kids have been exposed. There will be more Melissa measles cases.
In 2000, public health officials declared that measles had been eradicated from North America. In 2014, the U.S. tallied 640 cases of measles. Two important issues have driven the measles resurgence in our country. First, the “Small World, After All” phenomenon has shown itself with Ebola and now with measles. We are a mobile society. Measles persists in most of the rest of the world. We are a plane ride away from an epidemic.
The second issue is “herd immunity.” When a significant proportion of a population is immunized, usually 90 percent or so, it becomes difficult for an infectious disease to spread. In this era of Dr. Andrew Wakefield’s fraudulent research and dingbat Jenny McCarthy’s nonsensical vaccine-autism connection, more and more parents are opting out of immunizing their children.
There is absolutely no scientific causal relationship between any vaccine and autism.
CAREFREE CARELESS COLORADO
Colorado is one of 16 states that allows parents to opt their children out of the required school immunizations with a simple signature affirming their “personal belief exemption.” In Colorado, we rank second highest in the nation in terms of vaccine refusal. Our levels of immunization of kindergartners thus fall into 80-85 percent range, well below the level of herd immunity. Legislative attempts to link some scientific education with opting out failed last year. House bill 14-1288 passed in 2014 does mandate that schools and day-care facilities provide, when asked, the percentage of kids immunized and the percentage of those who have opted out with the personal belief exemption.
Current Colorado law makes it way too easy to opt out of immunizing our kids. We know that in states where education is attached to vaccine exemptions, immunization levels go up. Colorado public health advocates will push again this year to tighten immunization laws. Next time around, the epidemic may start at Coors Field or Breckenridge. Do you know the immunization levels in your child’s or grandchild’s school?
Free Press health columnist Dr. Mohler has practiced family medicine in Grand Junction for 39 years. He has a particular interest in pharmaceutical education. Phil works part-time for Rocky Mountain Health Plans. Email him at email@example.com.
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