Discussing causes, origins, evolution, and implications of disease and other phenomena.
"...a veritable expert on tawdry cosmetic procedures gone horribly awry..."--Kevin Beck
Tara C. Smith is an Assistant Professor of Epidemiology. Her research involves a number of pathogens at the animal-human nexus. Additionally, she is the founder of Iowa Citizens for Science and also writes for The Panda's Thumb and WIRED SCIENCE's Correlations. Please note the views expressed on this site are Dr. Smith's alone and may not be representative of the groups mentioned above.
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Category: General Epidemiology • Infectious disease • Outbreak • Public health
Posted on: February 12, 2008 1:45 PM, by Tara C. Smith
Four cases of measles have now been confirmed at a San Diego charter school--the first reported outbreak of measles in school-age kids in that city in 17 years. Unsurprising twist:
None of the children, including the one most recently reported with the disease, has been vaccinated.
New Scienceblogger Drugmonkey already hits the high (or low, such as it may be) points in this case in a much less restrained manner than I'm able to.
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Medicine & Health
Comments
They just thought they had it.
Posted by: William the Coroner | February 12, 2008 3:10 PM
Hm. Surely this does not come as a surprise?
On only a semi-related note -- has anyone had a good look at this yet: http://www.cbc.ca/health/story/2008/02/12/antibody-study.html
--and what do people think?
Posted by: Luna_the_cat | February 12, 2008 4:59 PM
What a twist!
Posted by: J. O'Donnell | February 12, 2008 6:01 PM
The only people who care about this are scaremongering microbe-hunters hoping to capitalize (grants, tests, drugs, interviews, Time Magazine covers) on an outbreak.
Ain't gonna happen. 3 kids getting the measles is not a big deal.
Posted by: Fleming | February 12, 2008 8:19 PM
...Except that,
(a) it's no longer "3 kids getting measles", it's 10 so far, including an 11-month old baby (http://www.upi.com/NewsTrack/Top_News/2008/02/12/measles_break_out_in_san_diego/2321/),
and
(b) measles can be fatal.
So why is it that kids catching a potentially fatal disease because of scaremongering by anti-vaxers, not a big deal?
Fleming, you are a prime, grade-a, nasty little idiot.
Posted by: Luna_the_cat | February 13, 2008 6:46 AM
I thought charter schools had to observe state vaccination laws. In Kentucky, public schools are really insistent about kids having up-to-date vaccination records and won't let them stay in school if parents (umm, no one I know ...) procrastinate about getting those shots.
Forget about global warming. Our greatest challenge as a nation is to stop the US public's steady decline into idiocracy.
Posted by: wheatdogg | February 13, 2008 11:10 AM
wheatdogg, the reporting on this claims that parents can get an exception from vaccination, even in the usual public school systems. In Cali, anyway. One imagines that this derives from religious objections but of course then it would be only fair for people of more, er, recent theological stances to object out as well.
Posted by: DrugMonkey | February 13, 2008 11:21 AM
http://www.nbcsandiego.com/health/15282223/detail.html?rss=dgo&psp=news
"More than 50 children who attend the San Diego Cooperative Charter School, a county-run charter school in the San Diego neighborhood of Linda Vista, and the Murray Callan Swim School and the Baldwin Academy day care center, both in Pacific Beach, are being quarantined as a precaution...The 10-month-old baby remained hospitalized Monday night but was expected to be released on Tuesday."
And the parents who caused all this in the first place should be treated as criminals and forced to pay any restitution to parents missing work with their quarantined children and the medical bills for the hospitalized 10 month old.
Posted by: Jim | February 13, 2008 1:07 PM
Parents who do things like that to their kids deserve to be kicked out of the gene pool. Assholes.
Posted by: Evolved | February 13, 2008 2:33 PM
Evolved: I agree with your sentiment, but many parents are just uninformed. The people who deserve the blame are public health officials who allow exemptions for vaccinations and the buffoons who make it their job to lead credulous parents into foolish inaction and lobby for public health laxity.
Drugmonkey is right; many states in the USA allow exemptions for "religious" reasons.
It's worse than that. California and close to half of all states allow "personal belief" exemptions that include anything under the sun, including "I just don't feel like it."
Other states, like Indiana and Nebraska, take a parental signature as "proof" that the child was vaccinated.
Even in West Virginia and Missouri--the two states with no non-medical exemptions allowed--the vaccination requirement is only as strict as the local school district officials make it. Fortunately, they seem to do a very good job. Pertussis rates in WVa and Missouri are at or near the bottom of the pile.
I recall someone mentioning this paper before, but it bears repeating:
Nonmedical Exemptions to School Immunization Requirements.
Secular Trends and Association of State Policies With Pertussis Incidence
Omer SB et al, JAMA. 2006;296:1757-1763
http://jama.ama-assn.org/cgi/content/full/296/14/1757
Omer find that pertussis rates by state are correlated with the ease of obtaining a vaccination exemption. The longer these assinine policies are in place, the more kids are coming down with pertussis. Say what you want about West Virginia, but at least their health department doesn't trifle with fatal childhood diseases.
Posted by: ElkMountainMan | February 13, 2008 4:56 PM
I had chicken pox as a kid. Probably missed a week of school. Got runny nose, itchy, red blotches all over my body. Nobody cared, nobody died, nobody gave me any medication, nobody wrote about it, nobody blogged it. Just rode it out, stayed away from my younger siblings, natural immunity conquered it, got better.
My, we were much smarter 30 years ago.
Posted by: Fleming | February 13, 2008 9:16 PM
Fleming unequivocally self-identifies as a troll. Please do not feed the troll.
Posted by: madder | February 14, 2008 9:19 AM
I had chicken pox as an adult. I was sick for four weeks, nearly broke a tooth with rigors and chills and I could have done without the pneumonia, too.
If I could have had the shot, I'd have taken it like a...shot.
Posted by: William the Coroner | February 14, 2008 10:02 AM
It may be a harsh lesson, but perhaps some parents might get the message if their children end up hospitalized (or worse) if they continue to dodge immunizations. Unfortunately, most of these parents are too young (or clueless) to know about the epidemics of measles, pertussis, polio and other childhood diseases that took ten of thousands of children "out of the gene pool" a century or more ago.
Why do people risk their children's health on the say-so of some misinformed, dogmatic health "experts?" Would they also return to the time before flush toilets and sewers, doctors not washing their hands before surgery or childbirth, treated water supplies, and the toothbrush?
Posted by: wheatdogg | February 14, 2008 10:11 AM
One of the infected San Diegoans brought the disease to Hawai'i: http://www.signonsandiego.com/news/metro/20080213-9999-1n13measles.html
Posted by: wheatdogg | February 14, 2008 10:14 AM
I had chicken pox as a kid. ... Nobody cared, nobody died, nobody gave me any medication, nobody wrote about it, nobody blogged it. Just rode it out, stayed away from my younger siblings, natural immunity conquered it, got better.
Uh huh. See if you care sometime in the future when you get shingles. You know, that really nasty disease in adults that's caused by a resurgence of the virus that causes chicken pox in children and never leaves the body afterwards? My grandmother went blind in one eye from shingles, my grandfather went through six months of hell, and my father went through three days of agony because of lesions erupting in his mouth before the antiviral drugs he got kicked in and tamped it down. He only managed to get off relatively lightly because he got a very fast diagnosis and treatment.
Varicella pneumonia aside, it isn't the chicken pox that is the serious problem; it's what happens years and years (decades, usually) later. I heard somewhere that shingles is a leading cause of suicide among elderly people. If all that can be prevented with a vaccination, you'd be an idiot and an ass to oppose it.
Me, I managed to survive having rubella when I was a baby, with no ill effects. Lots of children don't. Just because I was lucky once doesn't mean that everyone will be, or that my luck will hold forever.
Posted by: Interrobang | February 14, 2008 11:20 AM
I had rubella when I was about one as well. Although I was fine, the problem was that a lot of my Mum's friends at the time were either pregnant or trying for a baby. I didn't give any of them rubella (Mum warned them away as soon as she realised what was wrong) but I shudder to think of what would have happened if she'd been slightly less on the ball.
Posted by: Lilly de Lure | February 14, 2008 12:03 PM
As long as we're sharing sob stories, I really wish they'd had the varicella vaccine when I was a kid. I had chicken pox when I was about 14, and I have at least a half-dozen big scars on my face that'll be with me for the rest of my life. I caught my husband counting them just the other morning. I was no great beauty to start with, but I could do without the additional minor disfigurement.
I'm grateful I had all the vaccinations available during my childhood, and I'm glad kids will have even better protection in the future.
Posted by: jen_m | February 14, 2008 2:02 PM
You guys are all screwy. Clearly, you lack balance and perspective.
It's a tragic thing if a 14-year old gets hit by a car.
It's a tragic thing if a 14-year old, say, gets shuffled off to two homes, after a divorce.
It's a tragic thing if a 14-year old, say, has an unresolved speech impediment.
Sorry, but chicken pox in a 14-year old ain't a big deal.
Some jerk above says: See if you care sometime in the future when you get shingles
Trust me, I'm not worried about shingles in the future, doofus.
One decent tidbit of wisdom from Wheatdogg:
Would they also return to the time before flush toilets and sewers, doctors not washing their hands before surgery or childbirth, treated water supplies, and the toothbrush?
Don't know who "they" are, but these are all very good common sense practices which almost entirely negate the irrational fear of microbes that some have in developed countries like ours.
Posted by: Fleming | February 14, 2008 9:19 PM
Sorry, but chicken pox in a 14-year old ain't a big deal.
Itching is no big deal. Being quarantined is annoying, and, depending on the timing, may be detrimental to a child's academic achievement, but is more of an annoyance than anything else.
But not all cases are that light. Lifelong scarring. Disfigurement. Nerve damage. Paralysis. Blindness. Febrile seizures. Hospitalization. Death. I would not call any of those things "no big deal". A 14-year-old friend of mine, shortly after I had chickenpox (we were caught in the same outbreak), was very ill indeed. Infants are at a particularly high risk, and it causes a number of dreadful birth defects if pregnant women become infected.
Chickenpox is also associated with a number of very nasty secondary infections which are much more dangerous, such as group A streptococcus.
Trust me, I'm not worried about shingles in the future, doofus.
Then you may have a very nasty surprise waiting for you. I hope you are one of the lucky ones. (I hope I am too; I also have had chickenpox.) You probably don't realize that shingles can kill -- and it can do worse as well. Would you like to live your last few decades in constant pain? Or partial paralysis? What about blindness? Must be nice not to worry about those kinds of things. It must be bliss.
Posted by: Calli Arcale | February 15, 2008 2:26 PM
Fleming you really are a myopic moron and a troll. Measles can be fatal. Chickenpox is more than just an itchy problem for many. Avoiding these problems is pretty simple yet people such as yourself think that your anecdotal experience with one thing or the other is evidence for how the rest of the world will operate. This is simply not the case.
Your continued defense of your stance shows that you're either a complete idiot or a troll or more than likely both.
Posted by: Rev. BigDumbChimp | February 15, 2008 3:43 PM
Both. D. David Steele has been trolling since his days as Wavy Davy on evolution blogs and Hank Barnes on here. The idiocy is lifelong.
Posted by: 007 | February 15, 2008 4:28 PM
Wow Tara, as a citizen in the community of San Diego, I have also been monitoring the situation. Two more kids have come down with measles here bringing the total to 8 cases. I don't think it will be an "epidemic" as most kids do indeed have their vaccinations.
It is however, not so surprising that so many people do have a mistrust of modern medicine to the point that some are reluctant to trust current science and medicine at all. After all, the recent HIV vaccination ended up with more people testing as positive to HIV in the group that was given the vaccine than the group who received a placebo.
And speaking of San Diego, the REALLY BIG NEWS the other day, on Feb 14th: Sexually transmitted diseases HAVE RISEN SINCE 2003 IN SAN DIEGO BY 800%!!! This rise in infections was seen in Syphillis, Gono, and Chlamydia. And 80% of this rise in std infections was in the group of Men who have Sex with Men (MSM).
However, I went to the San Diego County Health site, to look at what HIV infections have done in the exact same time period of 2003 to current in the identical group of MSM's. To my utter amazement, HIV has defied the laws of gravity and has not gone up at all, but actually went down in the very same time period of 2003 to 2007 when all other std's in the MSM community have been skyrocketing!
Clearly something is wrong with this picture, as this clearly INDICATES that whatever is causing HIV tests to show positive simply CANNOT BE A SEXUALLY TRANSMITTED DISEASE!
Dear Tara, can YOU, as an "acclaimed" aetiologist please explain to us why HIV is defying the "laws of gravity" and going down in the MSM community when all other std's are rising?
I certainly hope you can, before even more of us lose "faith" in modern science and medicine.
Posted by: Jeepers Creepers! | February 16, 2008 1:23 PM
Dear Tara,
Now that we have all had a chance to vent our righteous spleen on all those dirty anti-vaccine hippies, perhaps we could get back to the epidemiology. You ARE an epidemiologist right?
In 1920 the incidence of measles was around 470,000. Deaths were estimated at 7,575.
In 1962,the year before introduction of the measles vaccine, incidence of measles was around 500,000. Deaths were 432. Less than one in a thousand
This is illustrative of a long declining trend, which of course continued after 1963. The measles vaccine had, inother words, minimal to zero impact on hospitalization and deaths due to measles in the US.
Now it's 2008, 45 years more of advances in medical and nutritional science, meaning that the risk of dying or becoming seriously damaged by measles should be very, very small for most Americans.
On the other hand: "vaccinating 540,000 children, would result in:
Up to 81,000 cases of rash and fever.
Up to 5,400 cases of parotid (mumps) swelling
Up to 216 cases of febrile seizures
Up to 18 cases of thrombocytopenia (red-blood cell destruction)
Up to [figure missing] cases of chronic thrombocytopenia.
Up to 5 cases of Aseptic Meningitis.
Up to 1 case of Central Nervous system damage.
Up to 15,420 cases of transient joint arthralgia some of these becoming chronic. (pg 95, H. Dept Handbook)"
This, Tara, is quite apart from the question of (denied) effects such as autism.
In view of this, maybe, just maybe, a case could be made that there are worse criminals in the world than those damned dirty anti-vaccine hippies that make it so difficult for those who just want to protect America to control all those terroristic germs sneaking in from Third World countries such as Switzerland?
Or is it against your mainstream academic oath and the subsequent AIDStruth Initiation Rite Booster Shot to view any case from both sides?
PS. don't let me distract you from that interesting epidemiological conundrum brought up by Creepers just above, namely the fact that HIV is rather poorly correlated with other STIs
Posted by: Paramyxos | February 16, 2008 5:26 PM
Paramyxos,
I'm not an anti-vax dude -- I've been vaccinated as have my kids. I just really haven't thought much about the issue.
But, this is a devastating fact:
In 1920 the incidence of measles was around 470,000. Deaths were estimated at 7,575.
In 1962,the year before introduction of the measles vaccine, incidence of measles was around 500,000. Deaths were 432. Less than one in a thousand
If true, to me, this shows that vaccines are real late to the party, and don't deserve many, if not most, of the medical accolades they have received.
Is this trend true for polio and small pox, too?
Posted by: Fleming | February 16, 2008 9:46 PM
Fleming,
The measles statistics I've presented are the bona fide, official NIH approved ones. Rest assured. The incidence of measles in the US may have been lowered considerably by the vaccine - I'm aware of no alternative explanation - but its "deadly effects" have not. To the contrary, when measles does strike, it's more deadly now because there's little natural immunity among adults.
Polio (I'll skip smallpox since it requires even more extensive discussion with quotes)is a different and more complicated story. It's one of the numerous Central Nervous System diseases which were discussed briefly in the rabies thread on this blog not long ago. That makes polio fairly easy to relabel as, for instance, meningitis.
Here's a few more facts easily found on wikipedia:
1. Around 90% of polio infections have no symptoms at all.
2. In fewer than 1% of cases the virus enters the central nervous system, preferentially infecting and destroying motor neurons, leading to muscle weakness and acute flaccid paralysis.
3. Major polio epidemics were unknown before the 20th century. By 1910, much of the world experienced a dramatic increase in polio cases and frequent epidemics became regular events, primarily in cities during the summer months.
If you have problems spotting the red flags here, these articles will provide all the clues you need.
http://www.whale.to/vaccine/polio7.html
You can use this graph (with references especially to the correlation with DDT) for easy overview:
http://www.vaclib.org/intro/present/pol_all.jpg
Most major medical inter- and innovations are hyped, and the real facts grotesquely distorted. That's simply the nature of "free market" competition for the hearts and minds (and bodies) of the consumers. I'm no anti-vax fanatic myself: who can say for sure what the real story is? The only thing that's not difficult to detect is the crude and totalitarian nature of the propaganda.
Posted by: Paramyxos | February 17, 2008 3:06 AM
Paramyxos states:
According to the surveillance statistics compiled by the CDC, measles infections in the United States were associated with the following complication rates from 1993-2004:
Complication----------------Percent Reported
_______________________________________
Diarrhea------------------------------8%
Otits Media--------------------------7%
Pneumonia---------------------------6%
Encephalitis-------------------------0.1%
Seizures------------------------------0.6%
Death---------------------------------0.2%
Widespread immunization has reduced the reported cases of measles from ~500,000 cases per year to less than 200 cases per year. Maintaining this low incidence of measles leads to a decrease in the complications of measles.
At the current incidence of less than 200 cases/year, deaths from measles have been reduced from ~1000 deaths/year to less than 0.04 deaths per year (that is to less than one death every 25 years).
Encephalitis as a complication of measles has been reduced from ~500 cases/year to less than 0.02 cases per year (less than one case of measles encephalitis every 50 years).
Pneumonia as a complication of measles has been reduced from ~30,000 cases/year to less than 12 cases/year.
Paramyxos concedes that:
Is this true? Has vaccination made measles more deadly?
Or is Paramyxos wrong?
Can we observe the beneficial effects of the vaccine?
Yes, the beneficial effects become apparent every time there is a measles outbreak in this country. For example, an outbreak of 34 cases of measles were linked to an index case in Indiana in 2005.
So, in this outbreak 88% of the infected people were old enough to be eligible for vaccination but had not been vaccinated.
In contrast, the population-wide immunization rates for measles in Indiana are 92% for preschoolers and 98% for sixth graders. (NEJM 355:447-455).
The unvaccinated account for ~2-8% of the population of the state but 88% of the people infected in this outbreak.
About 9% of the infections in this outbreak required hospitalization.
The immunization program prevents measles, prevents hospitalization due to measles, and prevents the dangerous complications of measles.
Paramyxos is wrong when he claims that the vaccine has not lowered the "deadly effects" of measles.
Posted by: franklin | February 17, 2008 6:11 PM
My dear Franklin,
I'm not quite sure what you are trying to prove. I said when measles does strike the victims are not so well protected as they were before. Short speech will suffice:
1962 - 432 deaths out 520,000 cases
1989-1991 - 120 deaths out of 55,000 cases
Although medical and nutritional science had advanced 25-30 years (supposedly), and although the authorities had to deal with less cases over a longer period of time, the relative death toll in 1989-1991 was more than double that of 1962.
Posted by: Paramyxos | February 17, 2008 7:06 PM
Paramixedup,
From Acute Measles Mortality in the United States,
1987-2002
"From 1987 to 2002, reports of acute measles mortality in the United States declined by 199%, from 165-184 reported deaths during 1987-1992 to 1 reported death during 1993-2002."
Of those deaths, 90% were in unvaccinated people. Any increase in CFR is a reflection of the increased number of patients with HIV and other immunocompromising conditions, who are much more likely to die if they acquire measles. Those deaths could be prevented if immunization rates were higher.
Posted by: Sister Howitzer | February 17, 2008 7:31 PM
Correction 520,000 should have been 502,000 cases in 1962
Posted by: Paramyxos | February 17, 2008 7:38 PM
Sister Howitzer,
Either you are kidding me or you are kidding me AND you are Adele.
The host of this blog is an epidemiologist and none of you apologists understand the concept of a continually declining trend over the whole century or number of deaths relative to number of cases.
And now measles deaths are blamed on HIV too?
To quoute Bill Clinton, give me a break!
Posted by: Paramyxos | February 17, 2008 7:47 PM
Did you even bother to look at the article?
"Early in the 20th century, measles was a universal childhood illness. The annual number of measles deaths in
the United States fluctuated between 2000 and 10,000,
and the death-to-case ratio (DCR; the number of reported
deaths per 1000 reported cases) generally exceeded
10 (figure 1). The number of deaths and the
DCR began to decline significantly in the 1930s, most
probably as a result of treatments for secondary infections
[1-4], improved nutrition [5], and reduced
crowding [6]. In the 1950s, the annual DCR declined
to ∼1; however, measles remained a common illness,
with an average of 550,000 reported cases and 495 deaths reported each year. The introduction of measles
vaccine in 1963 led to a precipitous drop in measles
cases and measles deaths; however, the DCR did not
change substantially (figure 1)."
No one is denying that measles cases and mortality decreased dramatically prior to the availability of vaccination. It's common knowledge.
And I'm not Adele.
Posted by: Sister Howitzer | February 17, 2008 7:56 PM
Paramyxos Says:
What Paramyxos actually said:
Can Paramyxos come up with another plausible explanation for the dramatic decrease in "hospitalization and deaths due to measles in the US" other than the vaccination program?
Posted by: franklin | February 17, 2008 9:03 PM
I still think Paramyxos has conveyed the most important fact that is probably unknown to most people:
In 1920 the incidence of measles was around 470,000. Deaths were estimated at 7,575.
In 1962,the year before introduction of the measles vaccine, incidence of measles was around 500,000. Deaths were 432. Less than one in a thousand
If mortality rates were decreasing substantially over a 42-year period BEFORE the measles vaccine, this means something. What is it?
Sister Howitzer makes the glib statement:
No one is denying that measles cases and mortality decreased dramatically prior to the availability of vaccination. It's common knowledge.
If this fact is common knowledge, then tell us what you conclude from this data.
Posted by: Fleming | February 17, 2008 11:11 PM
Is this meant to be a rhetorical question?
There were considerable advances in the treatments for the complications from measles in this time period.
You currently have a much better chance of surviving severe trauma from a car accident than you did several decades ago. According to your convoluted logic there is no point in wearing seat-belts or stopping people from driving drunk because modern medicine will probably save you anyway. You might be crippled, you might lose a few limbs but what does that matter because the mortality rate is down.
Posted by: Chris Noble | February 18, 2008 12:12 AM
I had a shingles outbreak 3 years ago when I was 38, I had chicken pox as a child. It was the single most painful thing I've ever had happen to me. Much worse than breaking an elbow or a lower leg bone, worse even than 2nd degree burns over 20% of my body and it went on for months with virtually no let up, long after the rash disappeared. Morphine barely took the edge off the pain and I can quite easily believe that suicide might become attractive after a while, I was told at the time that for some people the pain was permanent and basically untreatable. I'm told that it is unlikely to recur but I almost have a panic attack anytime I get any sort of red spot or rash. Anyone who has had chicken pox who is not concerned about shingles is a fool.
Get your kids vaccinated and save them the agony. I've gotten the shingles vaccine and I recommend talking over getting it with your doctor if you've had chicken pox. It's not recommended for those under 60 but it is possible to have shingles before then and I had no problem from the vaccination.
Posted by: Ken Shaw | February 18, 2008 1:12 AM
"I'm not quite sure what you are trying to prove. I said when measles does strike the victims are not so well protected as they were before.
What Paramyxos actually said:
The measles vaccine had, in other words, minimal to zero impact on hospitalization and deaths due to measles in the US."
My dear Franklin, if this were an election campaign I'd say your base was the lazy voters with the short memory, which means you would probably win the presidency of this particular blog in a landslide. But I am still happy with the votes of the few that can actually read what it says on the ballot.
What Paramyxos said was this:
"when measles does strike, it's more deadly now because there's little natural immunity among adults."
Sorry but there's no way around it; everybody can check for themselves just a few Comments up. By "little natural immunity" is meant the quality of vaccine induced immunity is not as good as the immunity one gets from actually having had measles.
Then, Franklin, you ask me to explain the "dramatic drop" from 432 anual deaths to around zero in a good year. Why even Chris Noble has grasped that by now! It's the combined effects of medical and nutritional advances.
Now try to concentrate and listen to Fleming: The question is not how did measles deaths drop dramatically from 400 to almost zero in the 40 years since the introduction of the vaccine. Neither is the final question how did measles deaths drop from 7,500 to 400 in the 40 years before the introduction of the vaccine.
The question is, if deaths dropped by 7,000 in a continual fashion over 40 years from 1920 to 1962, what makes you think it wouldn't have dropped by the remaining 400 cases in another 40 years also without the benefit of the vaccine?
Posted by: Paramyxos | February 18, 2008 2:57 AM
i too had chicken pox as a kid. i vaguely remember being miserable for days, and all the adults seeming a lot more worried than i was. plus, as mentioned, now i get to worry about shingles in another few decades --- the notion of some damn virus joyriding on my genome through all my life only to come haunt me later is more than mildly creepy.
kids these days don't know how lucky they are for the chance to miss out on all that, IMO.
(i've been told, but cannot remember, that i had the mumps as an infant. apparently sent my older brother's school into a tizzy, or some such story. i'm sure that could've been done without, too.)
Posted by: Nomen Nescio | February 18, 2008 8:53 AM
Paramyxos,
You have done the blog world a great service by providing lucid insight on the question of measles.
The question is, if deaths dropped by 7,000 in a continual fashion over 40 years from 1920 to 1962, what makes you think it wouldn't have dropped by the remaining 400 cases in another 40 years also without the benefit of the vaccine?
That is the ultimate question, no? But, the alarmists will likely dodge this ultimate question, since they are wedded to the notion, a priori, that vaccines work and are good.
I would ask a sub-question:
Given that mortality from measles decreased substantially WITHOUT A VACCINE, why do we need a vaccine?
Posted by: Fleming | February 18, 2008 11:21 AM
More Denialist Propaganda
As we breathlessly await an answer to Para's question (presumably now sufficiently clarified beyond the tipping point of caricature for our resident medical experts) let me be another wet blanket at the glorious biotech party.
By that I mean medical journal articles that document measles epidemics in vaccinated populations.
Tara, once again I'm sorry about spoiling the happy-talk without the requisite references, but alas my retrieval system is inefficient as usual.
So I'll propose more convoluted logic to make Chris' day: the hypothesis, based on horizontal gene transfer in evolution, elevated cortisol (TH1 to TH2 shift) from vaccinations, etc. and my childhood memories; that those childhood diseases, measles mumps and chicken pox were the very "extended development" processes that provided natural immunity. And just to make it really exciting, a corollary. Respiratory syncitial virus, which didn't "exist" in my early no-autism-was-ever-heard-of years, is a recombined agent from multiple childhood vaccinations - unpredictable but determined as the chaos theorists would put it.
Realize this gang, before the 1980's recombination between "species" of RNA viruses was said to be "impossible" by "experts"; a textbook example of denialism, par excellance.
And for those who think I'm just blowing smoke out of my ass, I do have an excerpt handy from (the great) Richard Lewontin's "Biology as Ideology", (1991) pg 39 "Causes and Effects" that speaks to the very subject at hand. It starts out "Modern biology is characterized by a number of ideological prejudices that shape the form of its explanations and the way its researches are carried out. One of those major prejudices is concerned with the nature of causes."
It gets better, but only a teaser for now ...
Posted by: Shots R Us | February 18, 2008 12:41 PM
Paramyxos:
Paramyxos suggests that measles is now deadlier because vaccine-induced immunity is inferior to the immunity induced by a measles infection, and he points to the mortality rate of measles between 1989-1991 in support of his hypothesis:
One prediction of the Paramyxos hypothesis that a "low-quality immunity" induced by the vaccine is to blame for the mortality of measles between 1989-1991 is that these deaths are a reflection of vaccine-failure.
Well, according to the paper linked to by Sister Howitzer, this prediction is not borne out (Jacqueline Gindler et al (2004). Acute Measles Mortality in the United States, 1987-2002. The Journal of Infectious Diseases 189:S69-S77).
This paper reported on 184 deaths due to measles in the United States between 1987 and 1992.
The vaccination status of these measles victims is of interest to Paramyxos' claim that modern mortality from measles is because "the quality of vaccine induced immunity is not as good as the immunity one gets from actually having had measles."
90% of these victims had not been vaccinated.
Only 19 of these 184 deaths occurred among individuals who had been vaccinated.
Paramyxos blames the mortality rate from measles between 1989-1991 on the "low quality" of vaccine-induced immunity, but only 10% of the measles deaths occurred in individuals who had been vaccinated.
Paramyxos is wrong.
If more of these measles victims had been vaccinated, fewer of them would have developed measles and even fewer of them would have died.
Posted by: franklin | February 18, 2008 4:08 PM
And here I thought the AIDS Denialists were stupid.
Posted by: Roy Hinkley | February 18, 2008 6:44 PM
I'll spell it out for you in small sentences.
Let's say that in 1920 there were 470,000 car accidents 7,575 of which were fatal.
In 1962 there are still around 500,000 car accidents but only about 432 are fatal because we are better at getting people into ER and keeping them alive.
Now just because the people are dying at the same rate from car accidents does not mean that they don't suffer significant complications and they also have to spend a long time in hospital.
Imagine if virtually all car accidents could be prevented in the first place by a safety device. Only an idiot would say there is no point in preventing car accidents if the mortality rate is already decreasing.
Posted by: Chris Noble | February 18, 2008 7:25 PM
I'll buy you a beer if at least one of the ant-vaccination kooks isn't one of the familiar HIV Denialists with a new pseudonym.
Shots-R-Us sounds eerily like Gene Semon.
Posted by: Chris Noble | February 18, 2008 7:29 PM
haha more "taboo reactions" from a bunch of government can't tell a lie sycophants. I hate to do this again, but I've gotta post the brilliant mathematicians Dr. Darin Browns post again on what this is all really about. This gives me a total boner.
SLC,
Your comments, even from someone "with a PhD in elementary particle physics", remind me of the central sociological fact surrounding the reaction you embody:
This has nothing to do with the HIV hypothesis. Nothing to do with the pros vs. cons of vaccine administration. Nothing to do with whether global warming is human-caused. Nothing to do with the cause of the 9-11 attacks. Nothing to do with the issues.
It's all about "joining the anti-crankery club". It's all about getting patted on the back for "being skeptical". It's all about wearing "Skeptical Inquirer" t-shirts and throwing around terms like "whackjob" (implying that anyone who doubts a consensus viewpoint is akin to ejaculate fluid) and "denier" (implying that anyone who doubts a consensus viewpoint is akin to Holocaust deniers). It's all about having your ego stroked for helping in the fight against "scientific illiteracy" and "the cult of irrationality". It's all about the "taboo reaction" so eloquently and prophetically expressed by Feyerabend in Against Method years ago:
"Science [relating another person's characterization] ... is characterised by an essential scepticism; 'when failures start to come thick and fast, defence of the theory switches inexorably to attack on it'.' This is possible because of the 'openness' of the scientific enterprise, because of the pluralism of ideas it contains and also because whatever defies or fails to fit into the established category system is not something horrifying, to be isolated or expelled. On the contrary, it is an intriguing 'phenomenon' - a starting-point and a challenge for the invention of new classifications and new theories. We can see that Horton has read his Popper well. A field study of science itself shows a very different picture... Such a study reveals that, while some scientists may proceed as described, the great majority follow a different path. Scepticism is at a minimum; it is directed against the view of the opposition and against minor ramifications of one's own basic ideas, never against the basic ideas themselves. Attacking the basic ideas evokes taboo reactions which are no weaker than are the taboo reactions in so-called "primitive societies." Basic beliefs are protected by this reaction as well as by secondary elaborations, as we have seen, and whatever fails to fit into the established category system or is said to be incompatible with this system is either viewed as something quite horrifying or, more frequently, it is simply declared to be non-existent."
Read over the responses generated at this blog in reaction to HIV, vaccines, global warming, 9-11, etc. REGARDLESS OF THE MERITS OF THE DOUBTERS ON ANY OF THESE ISSUES, can anyone doubt that the "taboo reaction" expressed by the defenders of the faith here is any weaker than that in so-called "primitive societies"??
darin
Posted by: Darin Brown | January 13, 2008 6:57 PM
Posted by: cooler | February 18, 2008 7:58 PM
For those interested in more details about this outbreak...it highlights the communicability of measles. Some of the kids became infected after sitting in a doctor's waiting room for a few minutes. The county has an overall vaccination coverage very close to 90% and many of the kids in the charter school were probably vaccinated. Parents occasionally use the personal belief exemption as a convenience (they have either lost or can't find the vaccination record). Hopefully none of these kids will become seriously ill...
Posted by: san diego | February 18, 2008 9:08 PM
Franklin, get out of the gene pool. Thanks!
Posted by: Evolved | February 19, 2008 1:31 AM
Gene writes,
Respiratory syncitial virus, which didn't "exist" in my early no-autism-was-ever-heard-of years, is a recombined agent from multiple childhood vaccinations - unpredictable but determined as the chaos theorists would put it.
Here (http://news.nationalgeographic.com/news/2006/02/photogalleries/newguinea/)
is a picture of the golden-mantled tree kangaroo, discovered in 2005 in Indonesia, but which of course did not exist before Gene first read about it. As "the chaos theorists" would say, the inherently unstable trajectories of a squirrel and a wombat oscillated in non-periodic fashion sometime in late 2005 and recombined into this delightful new mammal. Something about fractals, too. The zoologists said it couldn't happen, so they must be wrong about everything.
The Reverend Dodgson had nothing on Semon, apart, that is, from a semblance of literary style.
Posted by: ElkMountainMan | February 19, 2008 9:10 AM
Re cooler
I see that the Scienceblogs favorite moron and denier has migrated back over to here from Dr. Oracs' blog to post more of his crap. Mr. cooler hasn't got sufficient intelligence to grab his, I suspect considerable posterior with both appendages.
Posted by: SLC | February 19, 2008 10:40 AM
Since it is plainly obvious Tara, the epidemiologist in residence does not have an answer to the question concerning the role of vaccine in the steady decline in measles deaths over the century, perhaps we should look at some more facts:
One novel feature of the 1898-1991 US measles outbreak was that,
"incidence rates for infants were more than twice as high as those in any other age group. The mothers of many infants who developed measles were young, and their measles immunity was most often due to vaccination rather than infection with wild virus. As a result, a smaller amount of antibody was transferred across the placenta to the fetus, compared with antibody transfer from mothers who had higher antibody titers resulting from wild-virus infection. The lower quantity of antibody resulted
in immunity that waned more rapidly, making infants
susceptible at a younger age than in the past."
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf
The number of cases in which no antibodies are transferred is also higher among vaccinated mother to infant cases. That means the quality of vaccine induced immunity is not only limited to the parent, but affects also the pre-vaccine age infants of the previous generation.
Moreover, when comparing the death to case ratio in vaccinated and unvaccinated parts of the 1989-1991 population, one has to be aware that it was not the middle-class and up, dirty yet mostly white, anti-vax hippies that made up the later group. It was as always predominantly the poor, in particular the poor black and hispanic populations, that were not vaccinated. Incidentally, these are also the ones with highest number of other infections such as pneumonia, lowest level of nutrition, lowest quality health care etc. These are the real determinants of measles death, therefore more cases will occur among these populations regardless of
vaccination status of the patient or the patient's mother.
Again, it would be so much more interesting to have a real and balanced professional assessment including all of these factors instead of the usual lazy linked-newsflash- selected-for-propaganda-value approach from the blog host, who is even afraid of delivering the slander herself and therefore has to link to some other clown's rant.
http://scienceblogs.com/drugmonkey/2008/02/vaccination_woo_nutz_are_getti.php
The self-professed NIH-funded simian whose authority Tara is deferring to could do no better than begin by returning the compliment:
Around here at SciBlogs, people who know what the heck they are talking about like Tara, Orac, revere and Abel Pharmboy usually handle the dissection of the anti-sciencenauts who insist on not vaccinating their children against measles and the consequences thereof. Today however a specific, if anonymous, set of anti-vaccine parents are pissing me off.
Following this cute little session of reciprocal back slapping, our "biomedical research scientist" instantly verifies his claim that he doesn't know what the heck he, and by extension Tara, is talking about:
Except, oops. Children only receive the vaccine at 12-18 months. So for kids under a year, we're talking nearly 100% naked to infection.
Feel free to compare this with the CDC quote I gave above.
Posted by: Paramyxos | February 19, 2008 11:15 AM
Re cooler
I see that the Scienceblogs favorite moron and denier has migrated back over to here from Dr. Oracs' blog to post more of his crap. Mr. cooler hasn't got sufficient intelligence to grab his, I suspect considerable posterior with both appendages.
Re SLC
Perhaps you should suck on Shyh Ching Lo's balls, or Duesbergs for that matter to get some real intelligence in your life, just a suggestion, hugs,
Cooler.
Posted by: cooler | February 19, 2008 12:05 PM
Nice Claus so what your saying is, let's just give everyone measles that way babies under a year are more immune!!
You are a smart dood!!
Posted by: Adele | February 19, 2008 12:09 PM
BTW Claus I am loving your new name!! Molecular entry clap was real old.
Posted by: Adele | February 19, 2008 12:12 PM
I see that in one instance I have written "1898" instead of "1989". More importantly, further down, I have written "previous" instead of "next". The passageshould read
That means the quality of vaccine induced immunity is not only limited to the parent, but affects also the pre-vaccine age infants of the NEXT generation.
Posted by: Paramyxos | February 19, 2008 12:28 PM
Re cooler
I prefer to associate with folks like Owen Chamberlain, Emilio Segre, Julian Schwinger, and Steven Weinberg, all Nobel Prize winning physicists whom I have taken courses from.
Posted by: SLC | February 19, 2008 12:32 PM
All cranks by definition because they believe the 9/11 lie.
Posted by: cooler | February 19, 2008 12:40 PM
Bingo! Adele, you've almost got it. The argument that everybody knows about except epidemiologists and professional vaccination enthusiasts is that childhood measles serves to build up our immune system in general and makes us better prepared to deal with a number of issues besides measles itself.
I don't suppose the professional epidemiologist or her new parallel blogging Drug Pet,would be interested in a fair and balanced look at that aspect, seeing it doesn't easily resolve into propagandistic sound bites.
Posted by: Paramyxos | February 19, 2008 12:42 PM
Re cooler
Since both Prof. Segre and Prof. Schwinger died prior to 9/11, they could hardly have had any opinion relative to 9/11.
Posted by: SLC | February 19, 2008 12:53 PM
Re cooler
By the way, Mr. cooler failed to respond to my query on Dr. Oracs' blog as to whether he agrees with Prof. Singer that cigarettes don't cause lung cancer and that CFCs' aren't responsible for ozone depletion.
Posted by: SLC | February 19, 2008 12:59 PM
Paramyxos says Forced measles innoculation!! and Yes and lets take our kids and get them bit by rabied dogs. And get leprousy! And Ebola! And shoot ourself in the knee! What doesn't kill us makes us stronger we can deal with other issues better. People who die from it are because they are just dumb druggies and scaredycats.
Wait Para how can you get measles if viruses arent real??
Posted by: Adele | February 19, 2008 1:01 PM
Re cooler
By the way, Mr. cooler failed to respond to my query on Dr. Oracs' blog as to whether he agrees with Prof. Singer that cigarettes don't cause lung cancer and that CFCs' aren't responsible for ozone depletion.
Re SLC,
Whats next, do you want to find how many boners I get in a given day?
Posted by: cooler | February 19, 2008 1:16 PM
That's great Elkie; I like your satire of chaos theory, which I find instructive because I don't know a helluva lot about it.
But certainly there are no applications of chaos theory to biology and no one has ever published about such applications.
Of course.
Posted by: Shots R Us | February 19, 2008 3:20 PM
"Nice Claus so what your saying is, let's just give everyone measles that way babies under a year are more immune!"
Adele, please try to grasp the basic argument here. Surely you understand that if ontogeny recapitulates phylogeny (a rough first approximation of course) then we still have "imbedded" horizontal gene transfer within the biosphere effecting the development of living creatures.
Thus, the acquisition of measles "naturally" would be a birthright of humans in a healthy environment thanks to all the refinements of civilization. Why there were "measles parties" for kids in a land of a long time ago and very far away ...
Posted by: Shots R Us | February 19, 2008 3:32 PM
Re cooler
"Whats next, do you want to find how many boners I get in a given day?"
I suspect that the answer to that is 1 per week.
Posted by: SLC | February 19, 2008 3:42 PM
"Surely you understand that if ontogeny recapitulates phylogeny (a rough first approximation of course) then we still have "imbedded" horizontal gene transfer within the biosphere effecting the development of living creatures."
I really do wonder what you think this "werd salid" means?
Posted by: Roy Hinkley | February 19, 2008 6:18 PM
"Perhaps you should suck on Shyh Ching Lo's balls...Whats next, do you want to find how many boners I get in a given day?"
Cooler, you might be taken more seriously if you refrained from writing like a twelve year old who's just learned a bunch of new words for pee pees.
Posted by: Tyler DiPietro | February 19, 2008 6:56 PM
Why Roy, do you think the Lord created viruses only to give vaccinologists something to do? In that case they've hung around a long time waiting to be put to use considering they're several days older than Adam and Eve.
Posted by: Shots R Us | February 19, 2008 7:14 PM
Paramyxos started by claiming that:
and that:
In support of these claims he compared the mortality rate from measles in 1962, before introduction of the measles vaccine, to that of an epidemic in 1989-1991, after widespread immunization for measles in the US: