The recent measles outbreak is a stark reminder that diseases we once thought were conquered have the ability to reignite without proper precautions.
The Centers for Disease Control and prevention reported 141 cases in 17 states, including Texas, this year through Feb. 13. Most of the cases appear to be linked to people who contracted the disease after they visited Disneyland in Anaheim, Calif., in mid-December.
More than 38,000 students — about 0.75 percent of the state’s school-age population — had nonmedical exemptions to school immunization laws statewide in the 2013-14 school year, according to the Texas Department of State Health Services. The Texas rate compares favorably with the national average of 1.8 percent.
By contrast, some schools in Orange County, Calif., report that 50 to 60 percent of kindergartners are not fully vaccinated and up to 40 percent of parents have sought non-medical exemptions. The concept of “herd immunity” is that a target percentage of a population – ideally 85 to 95 percent depending on the disease – should be immunized to confer protection to the entire group.
Many call for public health officials to step in to underscore the dangers of measles, mumps and rubella to boost immunization rates. However, Dartmouth professor Brendan Nyhan wrote in The New York Times that his research shows that such efforts have no impact on parents’ intentions to vaccinate their children.
In the past century, nothing has done more for public health than immunizations. Around 1900, the infant mortality rate was 20 percent and another 20 percent died before the age of 5. Since then, vaccine-preventable diseases have decreased by at least 87 percent, to nearly wiping out, once-fatal diseases. According to the Association of State and Territorial Health Officials, every $1 spent on immunizations saves $16 in avoided costs, which is a significant public-health bargain.
William Sutker, MD, medical director of infectious disease and epidemiology at Baylor Scott & White Health North Texas division, said the controversy over whether to immunize children “certainly isn’t about personal choices. (Measles) is a serious illness that potentially can cause death. It is the most contagious disease, and anyone (not immunized) in the same room with someone who has the disease can be infected.”
Dr. Sutker noted a 1998 study that alleged a link between autism and vaccinations. The study has widely been discredited, the journal that published the article retracted it and the author lost his medical license.
“I think the most important part [of preparedness] is communication and education,” Dr. Sutker said. “We have to educate our physicians, we have to educate our staff and decrease the ‘fear-factor.’”
He pointed out that provider organizations already have plans in place to contend with disease outbreaks based on experience in dealing with other diseases such as H1N1, Ebola, SARS and avian influenza. He noted that measles is more common, and the best treatment is prevention.