The Centers for Disease Control reported a higher number of measles cases in the US for first quarter 2008 in a recent report [h/t: occasional commenter ddt].
However, during January 1--April 25, 2008, a total of 64 confirmed measles cases were preliminarily reported to CDC, the most reported by this date for any year since 2001. Of the 64 cases, 54 were associated with importation of measles from other countries into the United States, and 63 of the 64 patients were unvaccinated or had unknown or undocumented vaccination status.
The CDC also took the opportunity for directly addressing idiot anti-vaccination parents such as the ones causing the San Diego measles scare. Bravo.
Idiot anti-vaccination parents are gently informed by the CDC overview:
These cases remind us that it is important to vaccinate children and adults to protect them against measles. Even though the ongoing transmission of measles was declared eliminated in the U.S. in 2000, the disease is still common in other parts of the world and can be imported into the U.S. from many countries, including countries in Europe. Worldwide, 20 million cases of measles still occur each year, and the disease is a significant cause of vaccine-preventable death among children. In 2005, 311,000 children under age 5 died from the disease.
The Editorial Note at the end of the original report is a little more direct:
Before introduction of measles vaccination in 1963, approximately 3 to 4 million persons had measles annually in the United States; approximately 400--500 died, 48,000 were hospitalized, and 1,000 developed chronic disability from measles encephalitis (1). Even after elimination of endemic transmission in 2000, imported measles has continued to create a substantial U.S. public health burden; of the 501 measles cases reported during 2000--2007, one in four patients was hospitalized, and one in 250 died (1).
Right. Get it people? Measles can be a nasty disease. While you may have nice bucolic childhood memories of being pampered by Mommy through your measles and chicken pox without lasting effects, your personal anecdote doesn't mean that there aren't people who died!
The limited size of recent measles outbreaks in the United States has resulted from highly effective measles and MMR vaccines, preexisting high vaccination coverage levels in preschool and school-aged children, and a rapid and effective public health response.
I think I failed to mention this before when I noted the Today Show piece on measles but the perspective expressed by the anti-vaccination parent was just horrifying. Her position seemed to be essentially "Why should I risk my precious darling for public health goals?". I imagine this attitude is common to the anti-vaccination position. It is a SELFISH position people! You live in a society, like it or not, although frankly you give every evidence of enjoying many fruits of this society. One of the things you do when joining societies is that you give up some personal liberties in the pursuit of greater benefits. If you can't understand this you are a selfish idiot jerkwad. I think the rest of society should seriously consider voting you off the island for certain of these selfish behaviors, but that's just me.
Many of the measles cases in children in 2008 have occurred among children whose parents claimed exemption from vaccination because of religious or personal beliefs and in infants too young to be vaccinated. Forty-eight states currently allow religious exemptions to school vaccination requirements, and 21 states allow exemptions based on personal beliefs.*** During 2002 and 2003, nonmedical exemption rates were higher in states that easily granted exemptions than states with medium or difficult exemption processes (7); in such states, the process of claiming a nonmedical exemption might require less effort than fulfilling vaccination requirements (8).
Although national vaccination levels are high, unvaccinated children tend to be clustered geographically or socially, increasing their risk for outbreaks (6,9). An upward trend in the mean proportion of school children who were not vaccinated because of personal belief exemptions was observed from 1991 to 2004 (7). Increases in the proportion of persons declining vaccination for themselves or their children might lead to large-scale outbreaks in the United States, such as those that have occurred in other countries (e.g., United Kingdom and Netherlands) (10).
Right. So when you associate with fellow anti-vaccination idiot parents you make the situation even worse (the SD measles scare involved a charter school with lower than city-average vaccination rates). When you promote your anti-vaccination woo to parents in families with which you plan to associate your non-vaccinated disease-breeder children, ditto.
You. Are. Bad. Fellow.Citizens!
(1) Orenstein WA, Papania MJ, Wharton ME. Measles elimination in the United States. J Infect Dis 2004;189(Suppl 1):S1--3.
(6) Parker AA, Staggs W, Dayan GH, et al. Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States. N Engl J Med 2006;355:447--55.
(7) Omer SB, Pan WK, Halsey NA, et al. Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence. JAMA 2006;296:1757--63.
(8) Rota JS, Salmon DA, Rodewald LE, Chen RT, Hibbs BF, Gangarosa EJ. Processes for obtaining nonmedical exemptions to state immunization laws. Am J Public Health 2001;91:645--8.
(9) Smith PJ, Chu SY, Barker LE. Children who have received no vaccines: who are they and where do they live? Pediatrics 2004;114:187--95.