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  #541  
Old 05-02-2019, 08:32 AM
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SPOILERS! (ok, maybe not)

CALIFORNIA
MEASLES
https://www.nbclosangeles.com/news/l...509328371.html

Quote:
'Avengers: Endgame' Crowd Possibly Exposed to Measles in Orange County
Moviegoers who think they have been exposed should contact their health provider or call 800-564-8448

Spoiler:
A woman who went to the midnight showing of "Avengers: Endgame" at an Orange County movie theater last week was diagnosed with measles, and now health officials are warning others in the crowd that they may have been exposed.

The Placentia woman in her 20s, who had just returned from an international trip, was infected with measles when she went to see the midnight showing of the finale in the Avengers saga.

The Orange County Health Care agency said the woman visited the AMC Theater in Fullerton Thursday, April 25, and other moviegoers may have been exposed from 11 p.m. in the evening until 4 a.m.

Health officials were advising others who believe they may have been exposed to check their vaccination history, and notify their health providers, especially if they haven't had measles before.


Symptoms include inflamed eyes, runny nose, high fever, and an unexplained rash seven to 21 days after being exposed.

Theater employees said the news comes as a shock, especially after such a busy week with huge crowds eager to see "Avengers: Endgame."

"The last place I would ever expect it was at my job. I wasn't even expecting Orange County," AMC Fullerton employee Carlee Greer-McNeill said. "People, if you know you have the measles, please don't come to a movie theater, let alone a public place."

Pratt Shares 'Illegal' Video From 'Avengers: Endgame' Set[NATL-AH] Chris Pratt Shares 'Illegal' Video From 'Avengers: Endgame' Set
Chris Pratt took to Instagram to share a video from the set of the Marvel film, "Avengers: Endgame." In it, you can see an awesome collection of stars. Watch to find out more!(Published Monday, April 29, 2019)
Another location where residents may have been exposed was in Fullerton is St. Jude Emergency Department between 7 and 9 a.m. April 27.

The woman who went to the theater was under quarantine after being diagnosed. She is considered infectious from April 23 to May 1.

This case is the fist reported in Orange County, on the heels of Los Angeles County announcing its sixth Tuesday.

The sixth case reported this week also occurred after a Southern California resident traveled to another country, and noticed symptoms after returning.

Health officials advise that if anyone believes he may have measles to contact his doctor by phone before coming in to the doctor's office.

Those with measles can also infect others before they are even aware that they have it. Measles is very contagious, and can stay in the air for up to 2 hours after the infected person has left the area.

Los Angeles County Exposure Spots

The following locations have been identified as potential measles exposures:

● LAX, Tom Bradley International Terminal, Gate 218 on April 23 from 4 p.m. to 7 p.m.

● Fox Auto Parks LAX Shuttle on April 23 from 4:30 p.m. and 7:30 p.m.

● Home Depot, 44226 20th St W, Lancaster, CA 93534, on April 26 from 8 a.m. and 11 a.m.

Orange County Exposure Locations

● 5 Hutton Centre Dr., Santa Ana, CA 92707, on April 23 — 25 from 7:45 a.m. to 7:15 p.m. daily

● St. Jude Emergency Department, 101 E. Valencia Mesa Dr., Fullerton, CA 92835, on April 27 from 7 a.m. to 9 a.m.

● AMC Movie Theater, 1001 S. Lemon St., Fullerton, CA 92832, on April 25 from 11 p.m. — April 26 at 4 a.m.

The majority of those with measles were unvaccinated.
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  #542  
Old 05-02-2019, 08:48 AM
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Scientology cruise ship is quarantined in St Lucia due to measles outbreak.

https://www.cnn.com/2019/05/02/healt...ine/index.html
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  #543  
Old 05-02-2019, 02:50 PM
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MEASLES
VACCINATIONS

https://www.popsci.com/measles-other-outbreaks#page-2

Quote:
Measles is an early warning sign for outbreaks of more serious diseases
We never achieved the vaccination levels necessary to prevent outbreaks.
Spoiler:
We’re not even four full months into 2019 and it’s already the worst year for measles in the United States since 1994. All over the world, in fact, places that had previously eliminated or drastically reduced these kinds of outbreaks are seeing flashes of the potentially-deadly virus, which causes dramatic fever, cough, sore throat, and a characteristic spotted, itchy rash.



To some, this came out of the blue. Prior to the invention of the measles vaccine in 1963, more than 90 percent of kids had gotten measles by their 15th birthday. But today, few parents of young children remember what that was like, and the rapidity with which measles spread has taken many people by surprise.

To medical experts, though, this was downright predictable.



“It’s sort of expected that measles is going to be episodic,” says Katrina Kretsinger, a medical epidemiologist who focuses on vaccine-preventable diseases at the World Health Organization. Once you have less than 95 percent of the population immune, you have enough people to keep the disease in circulation, Kretsinger explains. Most countries simply never attained that herd immunity level. Even if you maintained at 92 percent every year, as the population overall increases you’re increasingly likely to see an outbreak. “You get this accumulation over years, and then you introduce measles and it spreads. At some point it burns out of individuals and it goes away, and then the next epidemic will occur.”

Even if there weren’t an increasing pushback from vaccine-hesitant parents, the truth is that over the last nine years our global vaccination rates have flatlined for pretty much all vaccines. Vaccination rates haven’t been decreasing over that time, Kretsinger says, it’s just that we never really achieved the level we needed to. “And measles is so infectious it’s going to be the first disease that shows up,” she adds. “But it’s not just a problem with measles.”

Many countries give a combined vaccine called MMR, for measles, mumps, rubella. If measles vaccine coverage isn’t high enough, it could in theory be sufficient to prevent major mumps and rubella cases—you need 95 percent of the population vaccinated to guard against measles, but only about 85 to 90 for mumps and rubella. Globally, we’ve held steady at about 85 percent for both MMR and the DTAP vaccine, which protects against diphtheria and also requires 85 percent coverage for herd immunity. (Pertussis and tetanus, the other two viruses in the DTAP shot, can exist in the environment, not just the human body, making herd immunity less relevant).

Should those diseases come back, we may be worse prepared in some ways than before. For a long time, the older generations in our society grew up in the pre-vaccine era, which meant that the overwhelming majority of them were exposed to these viruses. Now we have much less circulation of viruses, but also not sufficiently high vaccine coverage to prevent transmission altogether, and the combination is worrisome. “I’m concerned that there are progressively more countries which have had many years of insufficient vaccine implementation,” Kretsinger says. “It’s hard to predict what will be next.”

If we really want to stamp out measles, along with the other vaccine-preventable maladies, Kretsinger says what we need is political will and for countries to have a sense of ownership of the problem. It’s been so long now since measles was a visible childhood killer that we’ve lost a lot of the fear that originally drove people to get vaccinated.

Without that motivation, many developed nations have prioritized other health issues. Coupled with a backlash against vaccinations, this shift in focus has given us the current vaccine stagnation. As a 2011 paper on the potential for measles eradication points out, “recent progress in reducing measles mortality may have reduced the perception of threat.” But the threat is very real. According to the same paper, “measles has been a disease of high burden historically, and as recently as 2000, an estimated 733,000 individuals, mainly children, died from complications of measles.”

What happens next is within our control; for most people in the United States, these vaccines are just around the corner. “If the case fatality were 50 percent, you can be sure measles would be eradicated quickly,” Kretsinger says. “There are some places where that fear still exists, because measles was recently one of the childhood killers.” Perhaps a little fear would do us some good.


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  #544  
Old 05-06-2019, 01:12 PM
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MEASLES
NEW YORK

https://www.wsj.com/articles/what-ca...ls-11557077101
Quote:
What Can Stop the Measles Outbreak? Officials Lean on an Unlikely Band of Locals
Public-health officials are counting on community insiders for help, including a nurse who has taken a personal approach

Spoiler:
To fight the biggest measles outbreak in the U.S. in more than a quarter-century, public-health officials have tried robocalls, vaccination audits, vaccination orders and $1,000 fines. This is the standard playbook and it hasn't worked to stop the disease's spread.

Now, officials are increasingly counting on an informal network of community groups, religious leaders and local medical practitioners.

Blima Marcus, a 34-year-old oncology nurse practitioner, is working to counter antivaccination messages that have taken root in New York City's insular ultra-Orthodox Jewish communities where measles has spread. Dr. Marcus, herself a member of an ultra-Orthodox community in Brooklyn, has gathered mothers in living rooms and written and printed booklets that challenge antivaccination assertions line by line. She wants to set up a hotline to explain the science behind vaccines and take questions.

"Simple education in a respectful, hand-holding manner really is going a lot further than anything else so far," said Dr. Marcus, who has a doctorate of nursing practice.

It's a tactic that is hard to replicate, is time intensive and relies heavily on the goodwill of volunteers with other jobs. But these days, it's one of the best resources available to public-health officials who have struggled to contain the disease.

Standard public-health tools, which have been deployed successfully for years, are falling short in the face of an aggressive antivaccination campaign, growing exposure to measles in countries such as Israel, and a longstanding distrust of government or other outside sources of information. Since October, 423 cases have been reported in New York City.

Public-health authorities have had similar difficulties fighting measles in other close-knit communities in the U.S., including among the Amish in Ohio, Eastern Europeans in Washington state, and Somalis in Minnesota.

Grassroots approaches are becoming more important in public health, with infectious-disease outbreaks around the world -- including Ebola in Democratic Republic of Congo -- increasingly erupting in remote or insular communities, conflict zones and other areas where disease fighters have to grapple with economic, cultural or security challenges.

The Centers for Disease Control and Prevention has formed a work group to seek new ways to counter an increasingly vocal antivaccine movement. Trusted sources within a community's own networks "can be more effective than we can" in educating people about vaccination, said Nancy Messonnier, an expert on immunization and respiratory diseases at the agency.

Vaccination rates among children have now reached a record high in the Williamsburg neighborhood of Brooklyn, the epicenter of the outbreak, officials say, due in part to outreach and a mandatory vaccination order implemented last month. Roughly 14% of young children in Williamsburg remain unvaccinated, the city's health commissioner, Oxiris Barbot, said on April 17.

New public-health tools are needed, said Herminia Palacio, New York City's deputy mayor for health and human services, including an "aggressive counter-messaging campaign to really counteract the very intentional misinformation and disinformation that is being dangerously propagated by a small, but well-organized coalition of groups across the country."

The stakes are high. Measles may be on a path to gain a foothold once again in the U.S., CDC officials warn.

New York City's measles outbreak began when an unvaccinated child was infected on a trip to Israel. It wasn't huge at first, with fewer than 10 new cases every week. Early on, the city health department ordered more than 100 schools and day-care centers to exclude students who didn't have the measles, mumps and rubella (MMR) vaccine.

In February, an unvaccinated, infected child at a Jewish school that didn't enforce the health department's exclusion order infected other unvaccinated children, resulting in 28 new cases. That led to 17 secondary transmissions outside the school, fueling a surge in cases that continues.

Dr. Marcus, who works at Memorial Sloan Kettering Cancer Center, learned in October that antivaccination messages had taken root in ultra-Orthodox communities when a cousin invited her to join a text group. Many women weren't vaccinating their children, she said.

Alarmed by what she read, she did some research and began challenging claims that vaccines cause autism and cancer and that they can cause measles, citing scientific studies. "I hate liars," she said of her reasons for taking on the antivaccination campaign.

Skepticism about vaccines has quietly grown over the past few years, spread through written materials, conference calls and face-to-face conversations, according to city officials and local pediatricians. Some families have received religious exemptions to vaccination -- a pathway some New York state legislators are trying to close.

A group called Parents Educating and Advocating for Children's Health, or Peach, circulated a 40-page document titled "The Vaccine Safety Handbook: An Informed Parent's Guide." It mixed antivaccination claims with first-person stories and Jewish "points of interest."

Authors of the Peach document didn't respond to emails and calls for comment. Jennifer Margulis, a writer in Ashland, Ore., said the authors -- parents in New York City's ultra-Orthodox community -- asked her to speak for them because they are afraid to respond, believing they face a "double hate" of being Jewish and against vaccination.

Parents do not become skeptical about vaccines over any one document, said Ms. Margulis, who described herself as a children's health advocate who thinks parents should be able to choose whether they vaccinate their children. Instead, they start questioning vaccines when a child has a bad reaction to one. She said the parent authors don't understand why a magazine distributed five years ago has anything to do with the measles outbreak now.

Sholom Laine, who lives in the Crown Heights neighborhood of Brooklyn, hasn't vaccinated his six daughters and two sons, who range from preschool age to teenagers. He and his wife, Esther, filed a lawsuit last year against a local yeshiva over the school's reluctance to accept a religious exemption for their youngest, whom they had planned to enroll in fall 2018.

The child's enrollment is still pending for the next school year, said Mr. Laine, who declined to specify the basis of the request for a religious exemption. He said the decision to vaccinate should be a personal choice. "In the 1950s they had the measles. And everybody had the measles at a point in time, or whatever, and it was all good," he said.

Chaim Greenfeld, the father of two young sons in Williamsburg, takes issue with vaccine skeptics. "The people who don't want to get vaccinated, it's not acceptable to me. Totally not," he said. "They don't even have any Jewish reason that's telling them not to do it."

Several women in the text group Dr. Marcus had joined started messaging her privately after she responded to their concerns with scientific research, she said. They thanked her for her answers, saying they felt someone was taking their concerns seriously, Dr. Marcus said.

"It's the first time someone is giving us actual information, and doing it respectfully and not making them feel stupid," she said they told her.

Sensing a thirst for information, Dr. Marcus organized three workshops, gathering 10 to 20 people at a time and leading them through slideshow presentations explaining vaccine science.

In January, she stopped leading the workshops after starting her job at Memorial Sloan Kettering, with longer hours than a previous position. She began putting together a book to counter the antivaccination assertions in the Peach handbook and training more nurses to run workshops.

Other nurses in the Orthodox Jewish Nurses Association, of which Dr. Marcus was president at the time, wanted to help, too. She and a team spent weeks researching and compiling a 110-page manuscript, calling it PIE, for "Parents Informed & Educated."

The women at the workshops and in the text group had very detailed questions, so Dr. Marcus insisted on detailed responses. "The antivax movement has done a really good job," Dr. Marcus said. Her audience members "need to have real data. They need to have really good answers."

The nurses listed each claim they had found in the Peach handbook, followed by their findings and sources. Under "Having the measles will build my children's immune systems and make them stronger," they wrote, "False & Dangerous!" in big red letters, citing a 2015 study.

A section titled "Autism 101" featured a chart from a landmark Japanese study that showed autism rates continuing to rise even after the MMR vaccination rate declined significantly among children in one city.

Aware of Dr. Marcus's work and with measles cases surging, the city health department asked her to distribute a version of the manuscript for Passover. They were concerned that the virus would spread further with holiday travel.

Dr. Marcus and her team rushed to prepare and print 10,000 copies of a 20-page version, called "A Slice of PIE." The cover read: "Making PIEs Out of PEACH."

One afternoon during Passover week, Dr. Marcus scrambled for helpers to distribute 7,000 copies of the booklet that were sitting in a friend's garage, asking everyone she knew for help. Within a few hours, she found someone with a car, and another group with a shopping cart, to drop booklets into door slots, mailboxes and offices for $20 an hour.

The health department has asked Dr. Marcus to print 29,000 more copies of the PIE booklet to distribute to households.

Dr. Marcus and the group of nurses working with her have spent just under $12,000 of their own money covering costs so far. The organization she formed, called the EMES Initiative ("Engaging in Medical Education with Sensitivity"), has now secured funding from private donors to cover their costs, she said.

Dr. Marcus said it's too early to know whether her approach is working. A little anecdotal evidence "shows we're on the right path," she said. After one workshop, a woman got the MMR shot for her four children, she said. Another woman called a Google phone line Dr. Marcus's group had set up, asking questions about the flu shot. She later got the shot for herself and her family, Dr. Marcus said.

Another group, the recently-formed Jewish Orthodox Women's Medical Association, is launching a confidential hotline that families in the Orthodox Jewish communities can call to request vaccinations in their homes, for convenience and privacy. The group has formed a cadre of volunteer physicians to provide the service, said Eliana Fine, founder and CEO and a medical student at the Renaissance School of Medicine at Stony Brook University.

Steven Goldstein, a pediatrician in Williamsburg, found a handful of copies of the "A Slice of PIE" booklet when he returned to his office after Passover. He has asked for more copies to hand out to his patient families who questioned vaccines. "This is a little bit more approachable to the families in the community" than another booklet he has, he said.

Many parents still aren't heeding a health-department recommendation that babies between 6 and 11 months get an MMR dose, he said.

"I'm hoping it will get a lot of traction," he said of the booklet. "We're not making as much progress as we'd like to make."


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  #545  
Old 05-13-2019, 02:07 PM
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MEASLES
UNITED STATES

https://www.governing.com/topics/hea...s.html#new_tab

Quote:
Where the Next Big Measles Outbreak Could Happen

Spoiler:
Researchers who in 2015 correctly predicted where the Zika outbreak would strike in the U.S. say they think the country's next big measles outbreak is most likely to happen in Cook County.

A research project spearheaded by Sahotra Sarkar, a University of Chicago-educated professor at the University of Texas at Austin, revealed the 25 counties most at-risk for a widespread measles outbreak, like those seen in Washington, Oregon and New York. Sarkar and his former student, Lauren Gardner of Johns Hopkins University, determined Cook County was the most at-risk for an outbreak. That's based largely on the number of airplane flights to Chicago from global destinations where parents increasingly don't have their children vaccinated, he said.

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"Cook County turns out to be as important as it is, mainly because of the presence of O'Hare Airport," Sarkar said.

The study was published Thursday in The Lancet Infectious Diseases. The research took about six months to complete, using risk assessment models similar to one Sarkar and Gardner used when they determined Zika, a mosquito-carried virus that can cause serious birth defects, would first affect Texas and Florida when it emerged as a global threat to pregnant women.

Rachel Rubin, a senior medical officer with the Cook County Health Department, wasn't surprised by the study's findings. The seven measles cases reported in Illinois this year likely stemmed from one person who was infected overseas and traveled back to Illinois, she said.

"As we know O'Hare is a huge transfer point for travel within the United States, not to mention all of the international flights," she said. "I'm not surprised that their modeling would've predicted that Cook County and the city of Chicago would be such a hot spot."

Rounding out the top 10 counties identified in the study as most at-risk for a measles outbreak are: Los Angeles; Miami-Dade; Queens, N.Y.; King, Wash.; Maricopa, Ariz.; Broward, Fla.; Clark, Nev.; Harris, Texas; and Honolulu.

Since the 2015 work on Zika, Sarkar learned that a widely discredited former physician who claimed the vaccine for measles, mumps and rubella can cause autism has relocated to Austin and gained a following. Sarkar did the measles study to warn people what could happen if they choose "conspiracy theories" over science.

"It occurred to me that perhaps besides the vaccine resistance from people who bought into this false notion that the MMR vaccine has a link to autism ... the other crucial factor would be the volume of travel from countries outside the U.S. where there have been epidemics," including in European countries and the Philippines, Sarkar said.

Sarkar points to what happened in Brooklyn in October, after unvaccinated children visited Israel during a monthslong measles outbreak. They returned to their community, made up mainly of ultra-Orthodox Jews, many of whom have chosen not to vaccinate their children with MMR because they believe the vaccine is not kosher. What followed was one of the nation's largest outbreaks, prompting New York's Rockland County to declare a state of emergency, banning unvaccinated children from visiting public places.

The Illinois Department of Health recently announced it is working with the Illinois State Board of Education to conduct an in-depth analysis focusing on schools at risk for outbreaks. It also is taking steps to increase vaccination rates across the state.

Despite that, the state health department does not make public statistics on "vaccine avoidance," Sarkar said. It isn't clear whether there are enclaves of families who refuse to vaccinate based on religious beliefs or because they distrust vaccine safety.

"Estimated vaccination rates are low even though vaccination is mandatory and there are no nonmedical, nonreligious exemptions (allowed) in Illinois," Sarkar said.

"If there are pockets of resistance in Cook County like there were in Brooklyn with the ultra-Orthodox Jewish community, then there's a very serious worry."

Rubin doesn't know of any particular enclaves where people avoid vaccines because of religious edicts. But she does sometimes encounter objections to vaccines. When that happens, she tries to be diplomatic in explaining their safety and efficacy.

"It's a bad choice to refuse vaccination just because you feel that you don't want it, based on your own philosophical reasons," she said.

Rubin and Dr. Tina Tan, an infectious disease specialist at Lurie Children's Hospital, said having a high vaccination rate is most important for people who are allergic to vaccines or suffer from an ailment that suppresses the immune system, making it impossible for those children to receive a vaccine. For measles, more than 95 percent of the population needs to be vaccinated to guard against measles ourbreaks.

Sarkar said he now recommends infants get their first MMR vaccination at 6 months because of how many children remain unvaccinated in his area. The dose at 6 months may not be as effective as a dose given at 12 months, but when there's an outbreak, something is better than nothing, Sarkar said.

Countries that are particularly dangerous, Sarkar said, include India, China, Mexico, Japan, Thailand, the Philippines and a number of European countries. Those include Ukraine, the United Kingdom, France and Italy.


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