Anatomy of a measles outbreak that began with an unvaccinated child
This article from MedicineNet on Monday provides a fascinating in-depth look at a 2008 measles outbreak in San Diego.
The outbreak began when a child who had not been vaccinated returned from Switzerland. Before symptoms appeared, he infected his siblings and his classmates, 11 percent of whom were unvaccinated.
In the end, 839 people were exposed to measles. Eleven were infected, and 48 exposed kids too young to be vaccinated were quarantined -- forbidden to leave their homes -- for 21 days. Jane Seward, MBBS, MPH, was the CDC's senior investigator for the outbreak.
"Even with the very high vaccine coverage that we saw in San Diego, if you have a community of vaccine refusers you can get an outbreak," Seward tells WebMD. "Had the local health department not been extremely aggressive in quarantining everyone who came in contact with a case who did not have immunity, the outbreak would have broadened."
Fortunately, nobody died or suffered neurological damage. But there was one very close call.
A 10-month-old boy who contracted the disease spent three days in the hospital, dropped from 18 to 12 pounds in five days, and took months to recover. His mother expressed frustration with non-vaxers.
Part of the investigation involved researchers reaching out to the anti-vaccination parents in the affected community and talking with them about the risks and benefits of immunizations. After these interviews, 40 percent of the parents chose to have their children immunized.
The State of Michigan (along with California and 18 other states) makes it very easy for parents to exempt their children from immunization requirements, by allowing philosophical and religious objections, along with medical exemptions. You just sign a form. I oversaw the health forms for my daughter's co-op preschool one year, and I was surprised at how many of the families claimed exemption from at least one immunization, and how easy the process was.
Some critics, including the American Medical Association, say the process should be more rigorous.
One plan, outlined in this article, would require parents to receive counseling about the risks and benefits of vaccines. They also would be required to present a signed, personal statement demonstrating how long they have held their beliefs and that they understand the risks and benefits of vaccines.
What do you think?
Jen Eyer is on the Community Team at AnnArbor.com. She oversees the Parenting and Home & Garden sections, and writes feature stories, blog posts and opinion pieces. She can be reached at 734-623-2577 or firstname.lastname@example.org.