Tuesday, February 10, 2015

The Facts On Measles

Human Health

The Anti-Vaccine Lobby is not new, and is not above giving false information to engender
fear and paranoia in the public's mind. In this cartoon from June 12 1802, the British satirist
James Gillray caricatured a scene at the Smallpox and Inoculation Hospital at St. Pancras,
showing Edward Jenner administering cowpox vaccine to frightened young women, and cows
emerging from different parts of people’s bodies. The cartoon was inspired by the controversy
over inoculating against the dreaded disease, smallpox. The inoculation agent, cowpox vaccine,
was rumored to have the ability to sprout cow-like appendages. At least this image is amusing,
perhaps because its premise is so preposterous.

: U.S. Library of Congress Prints and Photograph Division: Washington

On Friday, February 6th, we received a letter from Toronto Public Health, which was sent to us from our two children’s schools; our two boys attend public schools (our oldest is in middle school in Grade 7, and our youngest is in elementary school, in Grade 1).

The letter, from Dr. Barbara Yaffe, director of communicable disease control and associate medical officer of health with Toronto Public Health, begins as follows:
Toronto Public Health is investigating a measles outbreak in the City of Toronto. Vaccination is the best defense against measles infection; and two doses of measles-containing vaccine (MMR or MMRV) are required for full protection.
Most Toronto schools have high vaccination rates.  However, if a measles exposure occurs in a school, students with incomplete vaccination, or an exemption from receiving the vaccine, will not be allowed to attend school until the outbreak is over.

If you are unsure of your child's immunization status, please check your child's yellow immunization card, or speak with your health care provider.  Once children are completely vaccinated they can return to school.
This is good public policy. There have been six confirmed cases of measles in Toronto; two children under the age of two and four adults. The individuals are unrelated, which causes some concern in public-health officials. And understandably so, since it is likely that there are more cases of measles in the city.

On social-media sites there has been a lot of debate and discussion on measles, a disease that has made a comeback in recent years in developed and advanced nations. What is not in doubt is that there are a cohort of persons, who, for various reasons, are against science and evidence-based medicine. They are part of the counter-culture movement, which is part of the larger counter-Enlightenment (anti-rational) group that views science and authority with suspicion and doubt.

Information is gathered and discarded based on its emotional appeal and whether others of similar minds are in agreement. They are found on both the right and left of the political spectrum, and in both secular and religious camps. What they have in common is that the scientific method is neither applied nor understood. This is a growing concern. A few days ago, I posted an article, citing National Geographic (“Why Do So Many Reasonable People Doubt Science? by Joel Achenbach), on science doubters.

A subset of this group are the anti-vaccine movement, or anti-vaxxers—militant and ill-informed— while also certain and firm in their decisions. They might have “good intentions,” and this is in doubt, but they are, however, responsible for the increase in incidences of measles; there is no other or softer way to present this information. A lack of scientific knowledge combined with magical thinking leads to such faulty and dangerous decision-making. Moreover, society is placed at risk because of it.

For those interested in facts, here is what the World Health Organization reports on measles; you will note a correlation between increased global vaccinations of children and decreased mortality. Even so, despite the availability of vaccines, 145,700 people, chiefly children, died from contacting measles.

On its website, the WHO reports the following relevant information in Fact sheet no. 286:
Measles is a highly contagious, serious disease caused by a virus. In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year.

The disease remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. Approximately 145 700 people died from measles in 2013 – mostly children under the age of 5.

Measles is caused by a virus in the paramyxovirus family and it is normally passed through direct contact and through the air. The virus infects the mucous membranes, then spreads throughout the body. Measles is a human disease and is not known to occur in animals.

Accelerated immunization activities have had a major impact on reducing measles deaths. During 2000-2013, measles vaccination prevented an estimated 15.6 million deaths. Global measles deaths have decreased by 75% from an estimated 544 200 in 2000 to 145 700 in 2013.
You do not need be a scientist or need a graduate science degree to understand these numbers, and what words like “correlation” and “causation” mean. It helps though if you have confidence in science (and not deny its validity and its efficacy), and admit openly on how medical advances, like vaccines, have improved our lives.

The measles vaccine, like all great discoveries, is an achievement in itself; it was developed by John Enders at Boston Children’s Hospital in 1963; and improved by Dr. Maurice Hilleman of Merck in 1971 to incorporate three vaccines into one dose— for measles, mumps and rubella (MMR). By combining the three into a single dose, six vaccines were reduced to two. Dr. Hilleman, The New York Times reports, “devised or substantially improved more than 25 vaccines, including 9 of the 14 now routinely recommended for children.”

Vaccinations are not only a great scientific advancement in human health, they are also a great public health benefit. My wife (a nurse) and I advocate and are a proponent for childhood vaccinations, and accordingly have vaccinated all of our children in accordance with the schedule set out by knowledgeable public-health agencies like Public Health Agency of Canada, the Canadian Paediatric Society and Ontario’s Ministry of Health. As a parent I cannot overemphasize to other parents to ensure that their (your) children are vaccinated. It’s the smart and reasonable thing to do. Or if you consider fashion important, it’s the fashionable thing to do.

For more, go to [WHO]

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