A look at recent measles outbreaks in the United States finds more than half of the cases involved unvaccinated children. Vaccine refusal was also often the culprit in whooping cough (pertussis) outbreaks as well, according to the new study. "When vaccine refusal rates are high, the rates of measles and pertussis are higher," said researcher Dr. Varun Phadke, a fellow in infectious diseases at Emory University in Atlanta.
In 2000, the United States was declared measles-free. But infected travelers returning to the country have caused outbreaks, and unvaccinated children are most at risk, research has shown. This study found that among more than 1,400 cases since 2000, more than half of patients had no history of vaccination. Most had nonmedical exemptions -- based on religious or philosophical beliefs -- not medical exemptions, researchers said. The report was published March 15 in the Journal of the American Medical Association.
In 2000, the United States was declared measles-free. But infected travelers returning to the country have caused outbreaks, and unvaccinated children are most at risk, research has shown.
Measles and whooping cough are highly contagious, and when fewer people are vaccinated, widespread protection known as herd immunity breaks down, giving these viruses free rein to spread. Dr. Matthew Davis is a professor of pediatrics and communicable diseases at the University of Michigan and author of an accompanying journal editorial. "Vaccination is one of the most effective and safest tools to protect our population against many diseases," he said. But rates of nonmedical vaccine exemptions have increased steadily over the past 20 years, the researchers said in background notes.
Davis and Phadke agreed that states need to make it harder to obtain vaccine exemptions. In California, where a 2014 measles outbreak led to 111 cases, legislation was passed to eliminate nonmedical exemptions to vaccination, Phadke said. He'd like to see other states follow California's lead. "States that make it harder not to get vaccinated have lower rates of vaccine-preventable diseases," Phadke said. "Strategies aimed at decreasing vaccine refusal may have an important impact on the community."
MORE
Despite labels on cold and cough medicines warning not to use them with children under six, researchers in Canada found a significant number of parents disregard them and suggest stronger warnings could help lower the problem. A study at St. Michael's Hospital found nearly one in five children receive over-the-counter cold and cough drugs, even with warnings about the potential for adverse effects. The Canadian government has required warnings for parents that the drugs may not be effective in children and could lead to harm since 2009, but researchers say some may not be aware of the relatively recent change in recommendation.
Based on the success of warning labels on potentially dangerous products such as cigarettes and alcohol, researchers think more parents could be reached and the number of young children exposed to the drugs could be reduced. "Young parents and those who used these medications with older children prior to the Health Canada warning may not be aware of the change, so it's important for health professionals to raise awareness," Dr. Jonathon Maguire, a pediatrician and researcher at St. Michael's Hospital, said in a press release. "When a child has a cough or cold, it's extremely challenging for families and parents are looking for some relief." For the study, published in the Canadian Journal of Public Health, for the study researchers analyzed data on 3,515 healthy children recruited between ages 1 and 5 from 2008 to 2011, about one-third of whom had a cough or cold in the preceding month.
Most over-the-counter cold and cough medicines are ineffective in children younger than 6, and can lead to adverse health effects, but researchers say current warning labels do not dissuade parents enough from using them anyway.
Among the children, 20.7 percent were treated using cold or cough medicine. The number of children treated with the drugs from the time new label requirements were put in place dropped from 22.2 percent overall to 17.8 percent a year after the labels went into use. "I think a lot of parents would be surprised to learn that these medications can be harmful to children," Maguire said. "Better public awareness as well as making these readily available medications harder to purchase may help to reduce their use."
Large number of children given cough, cold meds despite warnings
Health officials in Arizona say the largest current measles outbreak in the United States is in part because some workers at a federal immigration detention center refuse to get vaccinated. Authorities have confirmed 22 measles cases in Arizona since late May. They all stem from the Eloy Detention Center, an Immigration and Customs Enforcement facility managed by the private Corrections Corporation of America. Pinal County health director Thomas Schryer said the outbreak likely began with a migrant but that detainees have since been vaccinated. Convincing employees to get vaccinated or show proof of immunity has proven much tougher, he said. "And so they're actually the ones that are passing along the measles among each other and then going out into the community," Schryer said.
The facility includes about 350 CCA employees and an unknown number of ICE staffers, although Schryer estimates it's about 100. ICE doesn't publicly release staffing levels, nor does it require employees to be immunized. There are currently over 1,200 detainees being held at the facility. Yasmeen Pitts O'Keefe, an ICE spokeswoman, said the agency is working closely with health officials to monitor detainees and employees and that it instituted several measures to prevent the disease from spreading more, including providing immunizations, referring staffers to nearby clinics, handing out flyers and pamphlets on the dangers of measles and providing masks and gloves. CCA, the Tennessee-based corporation that operates the facility, says most of its staffers have been vaccinated or shown proof of immunity. Those who have not are required to wear surgical masks or stay home.
A sign warns of the dangers of measles in the reception area of a pediatrician's office in Scottsdale, Arizona
Arizona Department of Health Services Director Cara Christ says the facility has been more responsive in the past few days and that a large number of CCA employees were immunized late last week. "Once they understand how important it is and the outcomes it can have on the community, they tend to cooperate. So we hope to get a cooperative response from ICE," Christ said. Measles is highly contagious and preventable through vaccines. It was eradicated in the US in 2000. But the past couple of years have seen new cases in large part because of unfounded fears that the vaccination causes autism in children, Schryer said. The symptoms are usually mild but can be deadly in babies, who cannot be immunized until they're a year old. Officials last year said that a massive measles outbreak that sprouted at Disneyland in California and spread to several other states was largely fueled by parents refusing to vaccinate children.
In Arizona, health officials are providing free vaccines, sending physicians to the detention center and providing educational outreach to staffers in an effort to contain the measles spread. Schryer said officials were considering asking the Arizona governor to declare a state of emergency, although Christ said that might not be necessary. Efforts to encourage immunization have been met with resistance in part because some people underestimate the danger of measles, Schryer said. One staffer spent about four days hospitalized after coming down with severe symptoms, he said. "To trigger a four-day stay in the hospitals require that you be pretty darn sick. It's not really something to play with, and maybe they just underestimated the seriousness of it," Schryer said.
Arizona Is Site of Largest Current US Measles Outbreak
You forgot Ebola.
How many caught obesity and died from it, dufus?
Doctors kill 786,000
