Ooh, we love to regress around here. If there is a way to slip socially backward into the pages of an Archies Double Digest, Florida will sip happily from that malted milkshake.
For instance, the average Floridian might assume lately that they had inadvertently time-traveled and woken up in 1952. Saddle shoes! Oppenheimer! Vaccine-preventable communicable diseases!
Thats right. Today we are taking a break from fretting over the Jell-O molding of Florida education and pivoting to measles. Measles. This disease that most commonly harms children was eradicated in 2000. Yet, thanks to nationwide vaccine skepticism inflated during the COVID-19 crisis, the infection is making a dreadful comeback. Childhood immunization rates have hit a 10-year low.
Nine new measles cases have been reported in Broward County, followed by another Monday in Polk County cue cringe as measles creeps closer to Tampa Bay. Only two cases were reported in Florida last year, linked to international travel. As of this February, a total of 35 measles cases were reported nationwide. Thats too many instances of an illness with a vaccine introduced around the time Don Draper discovered meditation.
Now, I have not had measles; in the 1980s, my parents let a doctor stick me with a needle and fork over a lollipop. Thanks, Mom and Dad! But to recap, getting measles sounds miserable. Measles comes with a full-body rash; red, watery, swollen eyes; cold symptoms; fever; aches; pains and bumps inside the mouth. About one in five children with measles ends up in the hospital, according to the Centers for Disease Control and Prevention. Patients can suffer brain swelling, long-term complications and death.
What to do? Well, lets lead with the official advice, not the Florida Vibes Advice:
The CDC urges vaccinations, of course. It also says school officials should keep unvaccinated children who have not had the disease home for three weeks. States do not have to heed this advice, though.
Enter Florida, where leaders are thirsty for any chance to challenge the federal government to a greaser brawl. Surgeon general Joseph Ladapo has no track record of being surgeon-general-y, dragging Floridians through the pandemic with unsubstantiated scientific theories and fringe rhetoric. As a noted vaccine skeptic deployed by chaos agent Gov. Ron DeSantis, Ladapos reaction to measles is no shocker.
Rather than encouraging the CDCs simple, life-saving measures, he sent a letter to parents at Manatee Bay Elementary, site of the outbreak. It is normally recommended to keep vulnerable kids out of school, he wrote. But in Florida, its up to parents to do whatever feels neato.
The message is clear time and time again: Parents, when it comes to public health, you are on your own. Our leaders are so inconsistently fetishistic about parental rights that they will confoundingly put children in harms way to win political clout. This state, with its roster of Riverdale High misfits, is never going to lead with clear and accurate control.
Please, if at all possible, get your kids vaccinated. Get yourself vaccinated. Seek medical advice from doctors, not websites with animated gifs. Keep your sick kids home. Time away from the classroom is inconvenient, yes, but a few weeks of remote learning is not the same as the never-ending social isolation of the pandemic.
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I fear in 2024 we have become spoiled. Americans have lived without so many diseases for so long that we have no context for the holy mess they stand to create. Lets interrogate our privilege as a developed nation and once again embrace medical advancements. Lets keep iron lungs out of style. Lets cancel whooping cough. Polio is a no-lio. Diphtheria, get out of here-ia! And, uh, something called Hib? Does anyone remember Hib? No, didnt think so. Can we keep it that way?
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Although immunologists have developed a deep reservoir of knowledge illuminating how antibodies respond to vaccination against SARS-CoV-2, little is known about the elusive cells that produce infection-fighting antibodies.
Despite antibodies being among the first responders when infectious agents invade the body, they're produced by mystifying cells that are complicated by two things: residence in a hidden niche and possessing a convoluted namelong-lived plasma cells, or simply LLPCs.
The trouble with developing a more intimate knowledge of LLPCs is that they dwell deep in the bone marrow in specialized compartments and are difficult to study in humans. A plasma cell develops from an immune system B cell and is a type of white blood cell.
Having a better understanding of these cells would not only aid the development of better vaccines but would bolster scientific understanding of the immune system itself. Now, a new round of research has both dispelled some of the mystery about LLPCs, and at the same time, has opened a new window of understanding into vaccination against SARS-CoV-2.
What scientists wanted to know is how these mystifying cells respond to SARS-CoV-2 vaccination and whether the team could develop a technique to trace and document the inoculation response. In so doing, researchers would have firsthand evidence of the cascade of molecular events occurring deep within the bone marrow in response to SARS-CoV-2 immunization.
The team of researchers hailed from several centers in the United States and was led by scientists at the Vaccine Research Center of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland.
"We believe that [our technique] provides the technical knowledge required to study this extremely critical yet sparsely studied immunological compartment that mediates long-term serological immunity," lead author Madhu Prabhakaran wrote in Science Translational Medicine.
LLPCs originate in the body's germinal centers, which are highly specialized sites in lymphoid tissue. But these LLPCs literally pack up and leaverelocating to "survival niches" in the bone marrow where they take up residence, persisting in these hideaways for decades. From their survival niches, LLPCs secrete antibodies and help guard against infection over long periods of time.
It is because of their persistence that long-lived plasma cells can offer insights into how well any given vaccine is inducing antibodies and immunity. Yet, it is also because LLPCs migrate to tucked away sites that it has been extraordinarily difficult to study them.
With a newly devised technique that they developed, Vaccine Research Center scientists and their collaborators report being able to detect and capture LLPCs that produced antibodies against a specific pathogen, in this case, SARS-CoV-2.
Writing in Science Translational Medicine, Prabhakaran and collaborators report that they used "an antigen-specific LLPC isolation technique," a way of capturing the elusive cells. The team then purified SARS-CoV-2 spike protein and receptor binding domain-specific LLPCs "from the bone marrow of lab animals and determined that their antibody repertoires matched those of memory B cells in the peripheral blood."
Prior to the research by Prabhakaran and colleagues said it was unclear whether SARS-CoV-2 spike protein vaccination was able to elicit and maintain LLPCs. But with a highly sensitive method to identify and isolate antigen-specific LLPCs by tethering antibodies secreted by these cells onto the cell surface, Prabhakaran and colleagues made a tantalizing discovery: The team found that it takes more than one dose of adjuvanted SARS-CoV-2 spike protein vaccine to induce spike protein-specific LLPC reservoirs. The study was conducted in nonhuman primates.
"Using this method, we found that two doses of adjuvanted SARS-CoV-2 spike protein vaccination are able to induce spike protein-specific LLPC reservoirs enriched for receptor binding domain specificities in the bone marrow of nonhuman primates that are detectable for several months after vaccination," Prabhakaran wrote. "Many of the antibodies secreted by these LLPCs also exhibited improved neutralization and cross-reactivity."
The technique devised by Prabhakaran and colleagues demonstrated that antibodies produced by LLPCs can be readily detected in the laboratory. The nonhuman primate in the research that helped the team develop and hone their technique was rhesus macaques.
The animals received an adjuvanted vaccine based on the spike protein of SARS-CoV-2. Over an eight-month longitudinal study, the team discovered how doses of the vaccine-induced reservoirs of LLPCs specific to the spike protein, which produced powerful neutralizing antibodies.
In their paper, the team said that questions remain about how precisely LLPCs are seeded and maintained, hence the need for further studies, they said.
"These findings establish our method as a means to sensitively and reliably detect rare antigen-specific LLPCs and additionally demonstrate that adjuvanted SARS-CoV-2 spike protein vaccination establishes spike protein-specific LLPC reservoirs," Prabhakaran concluded.
More information: Madhu Prabhakaran et al, Adjuvanted SARS-CoV-2 spike protein vaccination elicits long-lived plasma cells in nonhuman primates, Science Translational Medicine (2024). DOI: 10.1126/scitranslmed.add5960
Journal information: Science Translational Medicine
2024 Science X Network
With a new manufacturing partnership in India, Takeda has added newfirepower to its stated goal of producing 100 million doses ofdengue fever vaccine Qdengaannuallyby the end of the decade.
Takeda linked up with Indias Biological E. Limited (BE) to speed up access to Qdenga. The new partner will producemulti-dose vials that will be ready for endemic countries to buy by 2030 at the latest, the Japanese drugmaker saidin arelease.
The multi-dose vials offer several advantages for national vaccine programs, Takeda explained, including cutting packaging and storage expenses.
Under the deal, BE will scale up to a manufacturing capacity of 50 million doses a year, helping Takeda move toward its effort to produce 100 million doses annually. Takeda, for its part, manufactures the vaccine at its Singen, Germany, facility and through its long-time partnership with CDMO IDT Biologika GmbH.
The India-based manufacturer has deep expertise in vaccine manufacturing and longstanding support of public health programs around the world, the head of Takedas global vaccine business unit, Gary Dubin, M.D., said in the release.
So far, the company has launched Qdenga in private markets inEurope, Indonesia and Thailand as well as in private and some public programs inArgentina and Brazil. There has also been strong initial demand in private markets, Takeda said in an earnings presentation earlier this month.
The vaccine has made it onto some government immunization programs, including in Brazil. The company has engaged in productive discussions with governments in other endemic regions to add the shot to their national immunization programs, Takeda added in its presentation.
Meanwhile, Takeda pulled its FDA bid last year after the agency requested additional data that the drugmaker figured it couldnt produce within the review cycle.
At the time, the company said its future plan for the U.S. would be further evaluated given the need for travelers and those in dengue-endemic areas of the U.S. such as Puerto Rico.
The company has pegged its peak Qdenga sales projection at $1.6 billion to $2 billion.After generics hit Takeda'spopular attention-deficit/hyperactivity disorder (ADHD) drug Vyvanse last year, Takeda will rely more on Qdenga and other recent launches to pick up the slack.
As the United States sees an increase in measles casesincluding 23 confirmed cases between December 1, 2023 and January 23, 2024, and seven more in Floridathe Centers for Disease Control and Prevention cautions that these outbreaks reflect a growing global threat.
Measles, known for its characteristic red rash, is caused by the morbillivirus virus, and is spread through the air. For every10 unvaccinated people who are exposed to the virus, nine of them will get sick, making it one of the most contagious viruses in existence. Although most measles cases are mild, an infection can cause several potentially serious complications, including conditions that emerge months to years after the initial infection.
Before the introduction of the measles vaccine in 1963, the U.S. had an estimatedthree-four million cases every year, which resulted in roughly 48,000 hospitalizations, 400-500 deaths, and 1,000 cases of encephalitis. After the introduction of the vaccine, these numbers dropped by more than 99 percent.
In a sense, we are victims of our own success, because when its out of sight and out of mind, its not considered a problem, says Luis Ostrosky, an infectious disease physician and epidemiologist at UTHealth Houston.
One of the major issues is that given how contagious measles is, preventing outbreaks requires that a very high percentage of people need to be vaccinated. As Camille Sabella, an infectious disease physician at the Cleveland Clinic, explains, unless a community has a very high rate of vaccination, you are going to have outbreaks, he says. It really has a way of finding the people who are susceptible.
Susceptible people include children who are too young to have received their first dose of the vaccine, immunocompromised people, who are ineligible for the vaccine, as well as children who have only received one dose; two doses are needed for maximum effectiveness.
Measles is characterized by a fever, cough, runny nose, red, watery eyes, and a bright red rash. People who are infected are contagious for up to four days before the onset of the rash, and for about four days after.
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Although most people who get measles will make a full recovery, the disease has significant morbidity associated with it, and significant mortality as well, Sabella says.
According to the CDC, one out of five unvaccinated people who get measles will need to be hospitalized. One out of every 20 children who get measles will develop pneumonia, which is the leading cause of death from measles in children. The other major risk is encephalitisbrain swellingwhich affects an estimated one out of 1,000 children within a week of being infected with measles.
A small number of people infected with the measles virus, may later develop a condition called subacute sclerosing panencephalitis (SSPE), which occurs when the virus infects the brain, where it remains dormant until it progresses to SSPE years later. SSPE is characterized by cognitive decline, behavior changes, issues with motor functioningsuch as uncontrollable movements and seizuresand blindness.
In the later stages of the disease, patients may lose their ability to walk, or go into a coma. There is no cure for SSPE. It is 100 percent fatal, says Rik de Swart, a virologist at Erasmus University Rotterdam, in the Netherlands. It is really a terrible disease. For every 100,000 cases of measles, there will be between four and 11 cases of SSPE, with these case numbers rising to 18 for children who get measles before the age of one.
In the decades following the introduction of the measles vaccine, the risk of dying in childhood dropped between 30 to 86 percent (depending on the country), far more than could be attributed to a decline in measles-related deaths.
Scientists discovered that the vaccine saved lives because in addition to measles protection, children were no longer dying from other common childhood infections, such asdiarrhea or respiratory illnesses.
It has been known for decades that those who recover from measles become immunosuppressed, says Mansour Haeryfar, a professor of immunology at Western University in London, Ontario, and are much more vulnerable to dying from other unrelated infections.
Researchers figured out that although considered a respiratory virusbecause it is spread through the airthe measles virus infects and kills the memory cells of the immune system, explains de Swart, who co-authored the paper which was published in Nature Communications in 2018.
These memory cells are responsible for recognizing and destroying pathogens it has encountered in the past. Once the virus destroys them, they are replaced with cells that predominantly recognize the measles virus. This enables the body to fight off another measles infection, but impairs its ability to recognize other common pathogens, such as the common cold or the influenza virus.
However, as de Swart notes, the good news is that this effect is not permanent. Its not like you lose everything, de Swart says. If you are given time, and you are not, at the wrong moment, exposed to the wrong pathogen, your system will restore to its normal self.
This immune amnesia is most pronounced in the months following a measles infection but can persist for years.
Given how measles can suppress the immune response, experts fear that an increase in cases will make future pandemics more severe.
In a 2021 study, researchers modeled the impact of lower measles vaccination rates on pandemics and found that relatively small drops in vaccination rates can make it harder to contain another pandemic due to immune amnesia.
You can believe you have herd immunity, but because of a small effect of a lack of measles vaccination, you dont, says Miguel Muoz, a professor at the University of Granada, and one of the authors of the 2021 paper. The results can be dramatic.
The measles vaccine, which is administered in two dosesthe first between the ages of 12 and 15 months and the second between years four and sixoffers long-lasting protection against infection.
One dose of the vaccine is about 93 percent effective at preventing infection; two doses provide 97 percent protection, which lasts a lifetime.
It is one of the most effective vaccines that we have available to us, Ostrosky says. We only very rarely need to revaccinate someone. For those people who arent sure about their vaccination status, their immunity against measles can be confirmed through laboratory testing, or in lieu of testing, they can receive another dose of the vaccine.
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A grieving mother brings her message about measles all the way from England to Tampa Bay. FOX 13's Aaron Mesmer reports.
TAMPA, Fla. - As a small measles outbreak spreads across Florida, with state health officials confirming a case in Polk County Monday, a grieving mother is bringing her message about vaccinations all the way from England to Tampa Bay.
The measles case in Polk County marked at least the ninth case in Florida this month, following eight cases at an elementary school in Broward County.
"It's a disease that shouldn't still be here," said Gemma Larkman-Jones, a mom who lost her 6-year-old son following a measles infection.
READ: Long COVID is more prevalent in these states, CDC data shows
Larkman-Jones spoke to FOX 13 from her home in London, England and said she wanted to get her son, Samuel, vaccinated for the measles, but was advised by doctors to briefly delay his measles, mumps and rubella, or MMR, vaccine. During that delay, Samuel caught measles when he was two years old.
Samuel recovered after a couple weeks and seemed to be fine. But four years later, Larkman-Jones said her son suddenly began having trouble with his balance and memory. A few months after that, he was admitted into the hospital and lost the ability to walk, talk and eat. Doctors determined he had a rare form of measles that slowly attacks the brain.
Pictured: Gemma Larkman-Jones with her son, Samuel.
A few days after he was hospitalized, Samuel passed away.
"I knew that you could go blind, and I knew that you could go deaf, but I didn't know it had other complications," Larkman-Jones said. "I don't want one other family to have to go through this unnecessarily."
READ: After child lead poisonings, FDA asked to require testing for heavy metals in baby food
That's why she gets so concerned about measles outbreaks, even ones happening halfway around the world, in Florida.
Following the first confirmed measles cases in Broward County, Florida Surgeon General Dr. Joseph Ladapo released a letter acknowledging unvaccinated students are commonly advised to stay home for 21 days during an outbreak because 90 percent of unvaccinated people who are exposed to measles will catch the virus.
Ladapo, however, is leaving it up to parents to decide whether to keep their kids home from school because of "the high immunity rate in the community, as well as the burden on families and educational cost of healthy children missing school."
Some Florida doctors consider Ladapo's advice reckless.
"He is once again doing a real disservice to the population here in Florida and probably that population in the country as a whole for spreading misinformation," said USF Health Dr. Thomas Unnasch. "It's never too late to get them vaccinated and to protect them. And you're rolling the dice if you [leave them] unprotected."
The Florida Department of Health has not responded to an email request for comment about the measles cases.
Pictured: Florida Surgeon General Dr. Joseph Ladapo
Gemma, who wishes she had the chance to vaccinate Samuel, has turned her grief into action and has become a vaccine advocate, urging others to protect their children to avoid the same type of situation she's experienced.
"To vaccinate or not to vaccinate, you need to look at every single piece of information. Don't ask people on the internet. Look to your health care provider, your doctor," she told FOX 13, adding she wishes her son was still around to see the impact he's having around the world. "I always knew he would change the world, I just kind of thought he'd be here while doing it."
Health experts said concerns about the MMR vaccine contributing to autism were debunked years ago, with a British doctor charged with professional misconduct after promoting false research on the topic.
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Researchers have found a link between COVID-19 vaccinations and very rare neurological, heart and blood related medical conditions.
An international study was conducted on 99 million COVID-19 vaccine recipients and offers new data on vaccine benefits and possible side effects.
Nevertheless, the researchers on this study and immunology experts still unequivocally support the COVID-19 vaccination program, with the findings translating to an extremely small risk.
COVID is less severe, but elderly still at high risk
Getting COVID disease increases the risk of these conditions much more than a vaccine, says Julie Leask a social scientist specialising in immunisation at the University of Sydney.
That is why, like with many medicines, we weigh up risks against benefits, she says.
The research, published inVaccine, has identified vaccine safety signals for myocarditis (inflammation of the heart muscle), pericarditis (swelling of the thin sac covering the heart), Guillain-Barr syndrome (where the immune system attacks the nerves) and cerebral venous sinus thrombosis (a type of blood clot in the brain). A potential new acute disseminated encephalomyelitis (inflammation and swelling in the brain and spinal cord) signal was also detected but requires further investigation.
Based on comprehensive data and numerous publications, I firmly advocate that the risk of adverse events remains substantially lower with vaccination compared to contracting SARS-CoV-2 (COVID-19), says Vinod Balasubramaniam a Molecular Virologist at Monash University Malaysia.
Considering the scale of vaccination efforts, with 13 billion doses administered and approximately 2,000 reported cases of adverse events, COVID-19 vaccines have contributed significantly to preventing over 19 million deaths globally, including three million in the United States alone.
Thus, vaccination remains the vastly safer choice for protecting against COVID-19, says Balasubramaniam.
The vaccine rVSVG-ZEBOV-GP (Ervebo) not only reduces the risk for Ebola infection but also halves mortality rates. This is the result of a study published in The Lancet Infectious Disease.
Rebecca Coulborn, an epidemiologist at Epicentre in Paris, France, and colleagues analyzed data collected during the 10th Ebola epidemic in the Democratic Republic of the Congo. Their analysis revealed that among the 2279 patients with confirmed Ebola who were admitted to an Ebola health facility between July 27, 2018, and April 27, 2020, the mortality risk was 56% for unvaccinated patients. In vaccinated patients, however, it was only 25%. The reduced mortality applied to all patients, regardless of age and gender.
The study was funded by Doctors Without Borders. For data collection, Epicentre, the epidemiological division of Doctors Without Borders, collaborated with the Institut National de Recherche Biomdicale and the Ministry of Health of the Democratic Republic of the Congo.
The study authors focused on the Ervebo vaccine, which is approved for use against Zaire ebolavirus in the European Union, the United States, and some African countries, among others. It is the only Ebola vaccine currently recommended for use during an epidemic. Ervebo is administered intramuscularly as a single dose and is approved for adults aged 18 years and older.
The vaccine is primarily recommended for ring vaccination of individuals at a high risk for infection during an epidemic. In vaccine studies, the vaccine has been used for ring vaccinations among contacts of diagnosed cases since the end of the Ebola outbreak in West Africa in 2014 and 2015 and since 2018 in the Democratic Republic of the Congo.
The preliminary estimated vaccine effectiveness 10 days after vaccination is 97.5%-100%. The duration of protection is unknown. Individuals who became ill despite vaccination typically experienced a milder course of illness.
Although people should be vaccinated as early as possible during Ebola outbreaks, the results of the Epicentre study showed that the vaccine still protects against the risk for infection even when administered after exposure to the virus.
Furthermore, Coulborn and her team found no antagonistic effect between vaccination and Ebola treatment in their analysis. "Vaccination following exposure to a person infected with Ebola still provides significant protection against death, even if administered shortly before the onset of symptoms," said study author Coulborn in a press release from Doctors Without Borders.
This story was translated from the Medscape German edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Nearly 20 years after the first vaccine against human papillomavirus became available, many eligible Americans still are not getting the shot even though it provides powerful protection against the leading cause of cervical cancer and a strong risk factor for anal cancer.
HPV is the most common sexually transmitted infection in the United States, and while most infections are asymptomatic and clear up on their own within two years, a small number persist and can cause cancer. HPV causes nearly all cases of cervical cancer, and can also lead to penile, anal, oral, vulvar and vaginal cancers.
The HPV vaccine, delivered as two or three doses, can significantly cut the risk of infection. It is really one of the most effective vaccines we have, said Dr. Lauri Markowitz, the HPV team lead in the Centers for Disease Control and Preventions division of viral diseases. But uptake remains stubbornly low: A report released by the C.D.C. this month showed that in 2022, only 38.6 percent of children ages 9 to 17 had received at least one dose of the HPV vaccine. Other new research suggests that HPV vaccination rates stalled in the wake of the coronavirus pandemic.
A study published this week laid out some of the primary reasons cited by parents in the United States who dont plan to vaccinate their children against HPV, including safety concerns, a lack of knowledge about the vaccine and a belief that it isnt necessary.
We are still facing an uphill battle from what I would call inappropriate messaging or incomplete messaging when the vaccine rolled out about why this is so important, said Karen Knudsen, chief executive of the American Cancer Society.
The HPV vaccine fools the body into thinking it has come into contact with the virus, marshaling antibodies in defense. Those antibodies can help clear the virus and prevent infection if someone is later exposed, which can happen through oral, anal and vaginal sex.
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Cases of measles are spreading in South Florida.
On Monday, officials in Broward County confirmed an eighth case of the virus nearly a week after news broke about a concerning rise in measles at a Broward County elementary school. The outbreak has quickly become politicized as Florida Surgeon General Joseph Ladapo and conservative officials have openly disregarded public health norms. While the Centers for Disease Control and Prevention (CDC) recommends that unvaccinated students stay home from school for three weeks after exposure, Ladapo said that the state's Department of Health "is deferring to parents or guardians to make decisions about school attendance.
According to CBS News, around 200 students at one elementary school didn't attend class last Tuesday, and 174 missed class Wednesday a sign that parents decided to keep kids home. Still, infectious disease experts tell Salon the rise of measles in Florida is something that should be of concern to all Americans, especially as spring break nears and people travel to the state for vacation, and that Ladapos response is disappointing and frustrating.
Whenever politics gets into public health, it can become a problem, Dr. Sean OLeary, who is the chair of the committee on infectious diseases at the American Academy of Pediatrics. And in this case, it may end up harming children, which will just be a real tragedy if that's how this plays out.
"Whenever politics gets into public health, it can become a problem."
OLeary said while it's important to keep children in school, that must be when its safe. Many children who get measles will be hospitalized, he said. That's not a safe environment. I think it's terribly frustrating.
Measles deaths occurred by the thousands in the first two decades of the 20th century. But by 2000, measles was declared eliminated from the United States, and no deaths were reported until 2015 when a woman in Washington was the first to die in 12 years due to complications from measles.
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Since then, there has been an overall significant resurgence in the incidence rate of measles across the United States. Last year, more than a dozen unvaccinated children in Ohio were infected with the measles, with nine of them hospitalized. The Centers for Disease Control and Prevention (CDC) responded and deployed a small team to help assist with the outbreak. But by December, the number of infected children grew to 59. Most recently, as of January 6, the number of measles cases has increased to 82 cases; 33 of those were hospitalized.
Measles cases rise rapidly because the virus is so contagious. It can be easily spread by coughing, talking or being in the same room. It is estimated to infect 90 percent of unvaccinated people who are exposed.
Measles is one of the most infectious diseases known to humankind, Dean Blumberg, chief of pediatric infectious diseases and associate professor in the Department of Pediatrics at the University of California, Davis, told Salon. And because of that, it requires a really good vaccine and a really high vaccination rate in order to control measles transmission.
"If you don't really address it, you know if that crack can widen and then it can just lead to a flood of cases."
The measles and rubella vaccine is extremely effective. After two doses, nearly 99 percent of people will be shielded against infection. While the vaccine was first developed in 1963, it wasnt until 1980 when all 50 states had laws that required measles immunization for school enrollment. But since then, the so-called Wakefield effect has unrolled this progress. This effect refers to a thoroughly discredited British doctor, who claimed to document changes in behavior in children given the MMR vaccine, suggesting it could cause autism. This has seemingly contributed to the decline in vaccination rates.
Blumberg said once a community has a small cluster of cases, its like small leak in a dike.
If you don't really address it, you know if that crack can widen and then it can just lead to a flood of cases, he said. Thats why mainstream public health doctors and scientists take that very seriously and do recommend isolation and quarantine measures.
In order to control the spread of measles, a community needs a vaccination rate of around 95 percent. If it drops below that even by a single percentage point it can lead to localized outbreaks. Blumberg emphasized that measles isnt just a fever and a rash. An estimated one in four cases will be hospitalized. In severe cases, there can be complications like pneumonia and encephalitis, which is when the brain swells. Before the measles vaccine was widely available in the U.S., nearly 400 to 500 children would die from measles and its complications each year.
Measles was a very, very nasty infection, Dr. William Schaffner, a professor of infectious disease at Vanderbilt University Medical Center, told Salon. In addition to these illness components, it had major social consequences number one, parents had to stay home to take care of the children, and that disrupted many parents' incomes.
Schaffner emphasized its important to vaccinate children against measles, especially during a time when its being spread, because it helps protect the child and other unvaccinated children, usually children with immune system deficiencies.
As spring break nears, and many head to south Florida to vacation, is there a risk? OLeary said if you and your children are vaccinated, there isnt a risk.
Immunocompromised children are an important exception because certain immunocompromised children can't receive the MMR vaccine because it's a live vaccine, he said. And so for those families, yes, I think staying away from anywhere where there's a measles transmission is a good idea.
He noted that when an outbreak is first identified that's just the tip of the iceberg.
The incubation period for measles is relatively long, he said. It may have gotten beyond that small community, and we don't really know that yet for sure, but I think I think time will tell.
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The ongoing, deadly war we are embroiled in tends to overshadow the multitude of pressing issues faced by our health care system. Nevertheless, the challenges of health system overload, overcrowding and workforce constraints persist.
During the initial months of this conflict, use of hospital in-patient departments was unusually low as people tried to avoid health care facilities as much as possible. However, since mid-January, we've seen the onset of winter-related illnesses, albeit with a delay compared to most years when significant morbidity typically begins in December. This delay likely resulted from people staying indoors and refraining from international travel during the early months of the conflict, factors that helped postpone the onset of winter illnesses.
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Patients in hospital hallways
(Photo: Wolfson Medical Center)
However, confinement at home also had less favorable health outcomes. Among other things, it appears to have led to a decline in flu vaccination rates compared to previous years. Furthermore, the appeal for the elderly and those with suppressed immune systems to get out to receive an additional COVID-19 vaccine didn't resonate well, resulting in very few people getting vaccinated.
Now, our health care system must grapple with these realities. This year's viral winter morbidity,according to the Health Ministry's weekly report, is the highest we've seen at least since the 2019-2020 season, and one of the highest in recent decades. This intense burden is acutely felt in health fund clinics, triage rooms and in-patient departments, manifesting as extended waiting times for hospital beds or even for space in the hallways of in-patient departments. Intensive care units are overflowing with a large number of patients on ventilators. It remains uncertain if the rise in winter illness rates will also translate into increased mortality compared to previous years. We'll only know this at the end of the flu season.
Long-term data confirms that the flu vaccine reduces infection rates and also mitigates severe illness and mortality among those already infected, even in years when the vaccine coverage is partial. While the vaccine doesn't provide optimal or absolute protection against the disease, it does protect against the flu virus, though not against other viruses with very similar symptoms that are quite prevalent in the winter season but typically result in fewer complications and deaths. Diagnosing the exact virus causing the illness is impossible without diagnostic tests.
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Rosie a medical clown wearing safety gear visits patients in the coronavirus ward of Shaare Zedek hospital in Jerusalem
(Photo: Olivier Fitoussi/Flash90)
Additionally, there's a year-to-year variation in the composition of the proposed vaccine due to the ability of influenza strains to undergo genetic changes. This sometimes enables them to partially "escape" the vaccine. All of these factors contribute to the vaccine not always being optimal, and there are years when the vaccine components don't effectively target the main strain causing the illness, resulting in only a partial vaccine response.
The frequent genetic mutations of viruses necessitate our annual renewal of vaccinations to bolster immunity against evolving strains.
Other viruses co-circulate with the flu during the colder months. The present iteration of the coronavirus manifests with flu-like symptoms and has not shown the same level of danger as it did at the peak of the pandemic. Nonetheless, it remains a threat to the elderly and immunocompromised, who were advised to receive an extra vaccine dose at the onset of winter. Regrettably, very few people within these vulnerable groups got this extra vaccine dose.
RSV, a virus previously known to cause severe illness in young infants, is now acknowledged as a serious winter illness and has caused fatalities even among adults, particularly older adults. Advancements in medical research have led to a new vaccine against RSV, which has demonstrated efficacy in recent comprehensive studies, and is expected to be available in the near future.
It's disheartening to note that skepticism fueled by anti-vaccination rhetoric during the coronavirus era appears to have effectively discouraged widespread vaccination. Israel has observed a concerning dip in the adherence to established childhood vaccination schedules, a domain where it previously stood out. Consequently, diseases such as measles and mumps are resurfacing. A similar trend of waning vaccination engagement is observed among adults, with a notable impact on the management of winter illnesses.
Amid the zenith of winter sickness season, and with virus activity particularly from the flu hitting a peak, vaccination remains strongly advised. Despite the vaccine's limitations in covering all viruses, it's particularly crucial for the elderly and chronically ill (truly, for everyone) to seek flu vaccination before winter sets in. It is my hope that we'll see an upturn in vaccination rates in the coming year.
