Even after California banned medical exemptions for vaccines, the vaccinated adolescent boy in the country still fired half a dozen last year. The results show that, although legislative gaps are important to stop measles spreading, it is not enough.
An outbreak investigation published today at the Disease Control and Prevention Center Week of illness and mortality reportfollowed by a 15-year-old boy who returned to England at the end of February 2018 with measles. Shortly thereafter, he was infected by a second boy at the Boy Scout event, a third at school, and the fourth at a training center. All were unvaccinated. And the outbreak does not stop here – it continued in a complex network of contacts.
The third boy infected at school was quarantined, so he didn't offer it to anyone. But public health officials were not aware that the fourth boy infected at the training center was unvaccinated. So he stayed quarantined and infected his 33-year-old unvaccinated uncle and his four-year-old unvaccinated brother.
The second boy who was infected with the Boy Scout continued to infect the vaccinated 21 year old man a different Boy Scouting Event. In this particular chain, bait was stopped by the age of 21 vaccinated. He suffered a less severe infection called modified measles – if the measles infects someone who is not adequately protected by the vaccine. It is possible that he did not distribute it to anyone, because people with modified measles tend to reduce the number of viruses, according to George Han, Deputy Health Care Officer of the Santa Clara County Health Care Department, and research leader.
The measles vaccine protects about 97 percent of people who receive both doses, so it doesn't provide all the protection. People who are not completely immune and people who are too young or too sick to get a vaccine rely on everyone other to vaccinate to save the virus. Therefore, these networks of unwanted people are so alarming. "We should not have a false sense of security that the new vaccine law will completely eliminate all outbreaks in California," says Han. "It's a reminder that we need to continue vaccination – because there are people who can't be vaccinated."
The fight against the return of measles will take place in a multi-faceted strategy, according to Peter Hotez, Dean of the National Tropical Medicine School at Baylor Medical College, who was not involved in the study. "It has a policy option that continues to close medical exemptions," says Hotez. "But it will not fit in itself." He believes that vaccination propaganda must also be restricted, and federal agencies will have to strengthen their defense of vaccines.
Not surprisingly, the bait spread so easily from this single boy in 2018 – the virus is incredibly infectious. It's also dangerous. In addition to rash and fever, it can cause pneumonia, brain damage and death. Before the measles vaccine, about 48,000 people were hospitalized at the measles hospitals and about 400 to 500 people were killed each year by the US under the CDC. In 2000, thanks to the safe and effective use of the measles, mumps and rubella (or MMR) vaccine, public health officials said the US virus had been eliminated.
But the virus can come with people traveling from regions where measles is still endemic, and it can spread through unvaccinated human pockets across the United States, such as New York, New Jersey, Washington State, and Texas. Texas and Washington are among the 17 countries with legislative loopholes that allow parents to miss their child's vaccination because of their personal views, according to the National Legislative Conference. But in California are not one of these countries: after the outbreak associated with Disneyland, who died 147 at the end of 2014 and early 2015, California eliminated personal views on vaccines. It only means children with medical exceptions a doctor can go to a kindergarten (or if they were already in school, seventh grade) without vaccines after 2016.
At the expense of general exemptions fell, but the number of medical exceptions – in particular in areas where there was a high level of personal confidence relief in the past, according to a study published in the study. T. Journal of the American Medical Association The authors of the study speculated that parents who do not want to vaccinate their children might have been looking for a doctor who wants to write medical exemptions, even if there is no medical reason to do so.
That's it could what happened in this particular California outbreak in 2018, although the authors of today's study do not come directly and say it. Remember the fourth boy – one infected at a training center who continued to infect his relatives? It turns out that the boy and his four-year-old brother had received medical relief everything vaccines from a doctor who worked hundreds of miles from his home. None of the boys had any significant medical reason for the exemption, which includes treatment of cancer or organ transplantation. "We know that the medical exceptions that these two brothers received were identical, which are a bit strange in themselves and do not contain these known medical reasons," Han says.
Currently, there is no standardized set of criteria that a patient has to achieve in order to receive medical relief in California, Han says. Therefore, one possible solution is to strengthen these standards. "There is regulation that could be done to try to better define the medical relief in California," says Han.
Hotez for one is optimistic are not home industry dealing with a doctor for medical reasons. But if it does, "the state licensing authority and medical councils will have to ask," says Hotez. "The closure of non-medical exceptions such as California in 2016 was an important first step, but it is not the only step," he says. "There are still things to do."