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. MMR woo-nauts and me, after the jump.
Last week we learned that a family of at least three children had come down with measles because their family didn't believe in vaccinating them:
Two children at a San Diego charter school and a sibling have contracted measles, prompting county health officials Monday to notify parents and students about possible exposure.
Two of the children attended the San Diego Cooperative Charter School, according to the San Diego County Health and Human Services Agency.
They did not have the measles vaccine, according to the HHSA.
Ten percent of the charter school's 380 students were not vaccinated. The figure for most schools in San Diego County is 1 percent to 2 percent, said Jennifer Gorman of the San Diego district's nursing and wellness program. The statewide average is about 1.5 percent, according to the California Department of Public Health.
Oh man. Are you really surprised that woo types might congregate?
SDCCS was started by a group of parents and educators from a variety of professions and backgrounds, who came together through a parent cooperative preschool. The experience of being a significant part of our children's education led us to feel that a school that emphasized parent involvement and respect for each child's learning style was an appropriate option for all children.
I'm not saying all charter school proponents are woo-nauts but you would think that woo-nauts might be charter proponents to a certain degree. Regardless, this place has a 5-fold increased rate of non-vaccination. Trouble ahead?
To all SDCCS families,
The County of San Diego Health and Human Services Agency (HHSA) has confirmed an additional case of measles at our school. The student is a classmate of one of the two children at school who recently contracted measles while traveling abroad. The newest case was a child who had not received the measles vaccination and has been at home since the first case was reported.
In case the above bulletin from the school doesn't remain on their splash page, the SD UnionTrib weighs in as well:
A fourth case of measles was reported Wednesday in connection with the measles incidence connected to a Linda Vista charter school earlier this week.
The infected student is a classmate of two other children attending the San Diego Cooperative Charter School. School principal Wendy Ranck-Buhr said the child was recovering at home.
That's right woo-nauts, you aren't going to be able to protect your unvaccinated kid from infection by removal, because there may be 4-12 days (Wikipedia) during which an infected child is asymptomatic and yet still infectious. And here lies the part where I start getting ticked off. First, these knuckleheads took one of their unvaccinated children to a region of the world that apparently fails to meet WHO targets for measles vaccination. Not to mention a country which seems to have had very recent measles "outbreaks". Seems like you might want an abundance of caution, right? Maybe not jump right back to school with a host of unvaccinated kids. But they did. And all of a sudden it is a public health nightmare. Which has very real consequences for a very large segment of your community.
Those of you with school age children and below, especially with three of them as this woo-family has, will understand. In the course of "4-12 days" of normal living, your kids interact with a LOT of other children. School is just the start and believe you me they do plenty of sneezing on each other and wrassling around on the playground. Then they have after-school care, activities, etc where they interact with kids from other schools and other parts of town. Did I mention the birthday party circuit? There's at least two per weekend if you have even just two kids, seems like. So that's a whole ton of kids exposed to your measles-child because you think, without any credible evidence, that it is a bad idea to vaccinate your children for measles. No problem, right? I mean, "most" kids are vaccinated. The above-reported stat suggests maybe 98% vaccination so no biggie, eh?
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. And guess what? Some of those kids your school-age kids interact with have infant siblings. Infant siblings that get dragged around to pick up their school aged brothers and sisters. Infant siblings that school aged kids show a remarkable (to me anyway) interest in at times. Infant siblings that are, in short, exposed to your measles-child.
And now it gets really fun. Because chances are decent that the now-exposed infant also spends some time in daycare with a big room of other under-12 month infants. Likewise unvaccinated. Remember that nifty asymptomatic-yet-infectious interval? And most sources insist, as does Wikipedia, that measles is highly infectious. So now we have the potential for a lot of little infants being exposed to an infectious agent which has some fairly nasty consequences.
Complications with measles are relatively common, ranging from relatively mild and less serious diarrhea, to pneumonia and encephalitis (subacute sclerosing panencephalitis), corneal ulceration leading to corneal scarring
Now, I exaggerated above about being "naked" to infection. The thought is that there is a degree of maternal immunity that lasts for the first year. This does nothing about the PIA aspects. Oh, yeah, the PIA aspects.
Layered on top of the worry about whether or not your particular infant will come down with measles given that s/he was exposed, the 4-12 day incubation period means...quarantine. For a long time. And if your infant does get sick, you can extend this quarantine at least another two weeks. Let's just suppose that it goes down like I have described. And just one daycare room of about 20 infants gets hit. That's twenty families who normally depend on some amount of daycare being disrupted fairly seriously for at least two weeks. Possibly for a month while they deal with an infant who actually gets measles. Quarantined. No going to parks, supermarket or anywhere else other infants might be exposed. If you were good about it, you might want to even avoid taking the infected infant along to daycare or school where you pick up his/her older sibling(s). Because who knows? You might be at one of those 10% woo-naut schools!
That, my anti-vaccine nutcase friends, is just one of the many things you are putting the community through because of your selfishness. Your theological belief in something that IS NOT TRUE is causing this. This is the sort of crap that should get you voted off the island.
Update 2/12/08: Aaaaand we're rolling. The SD paper is reporting an additional 5 patients awaiting probable confirmation of measles bringing us to 10 (yes, my scenario above was not just a 'scenario'). A total of 50 kids reported as under quarantine.
An idiot over at Tara's place says that "3 kids getting the measles is not a big deal". Well, it is getting to be a bigger deal as we're finding with each newspaper cycle.
Update 2/13/08: And as noted in the article linked by luna in the comments, my agent was correct in the rumor, now confirmed, that one kid with measles was on a plane to Hawai'i. So now we are turning from a mere curiosity and opportunity to bash the anti-vaccine people into some pretty interesting infectious disease epidemiology. Stay tuned, I guess. It'll be interesting to see first, how this breakout spreads and second how the public health system damps it down.