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Friday, February 8, 2019

Measles Wildfire

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  Antivax sentiment has been strong in the Pacific Northwest.

Kirk Johnson at NYT:
Measles, declared eliminated as a major public health threat in the United States almost 20 years ago, has re-emerged this winter in the Pacific Northwest and other states where parents have relatively broad leeway over whether to vaccinate their children.
Seventy-nine cases of measles have been reported by the Centers for Disease Control and Prevention since the start of this year. Fifty cases of the highly contagious disease were in Washington State.
An outbreak of measles has also occurred in the Orthodox Jewish community in Brooklyn, where 64 confirmed cases of measles were reported, mostly late last year. That outbreak began, the C.D.C. said, when a child who had not had a measles vaccination caught the virus on a visit to Israel, where a large outbreak of the disease was occurring.
Lena H. Sun and Maureen O'Hagan at Wash. Post:
The Pacific Northwest is home to some of the nation’s most vocal and organized anti-vaccination activists. That movement has helped drive down child immunizations in Washington, as well as in neighboring Oregon and Idaho, to some of the lowest rates in the country, with as many as 10.5 percent of kindergartnersstatewide in Idaho unvaccinated for measles. That is almost double the median rate nationally.
Libertarian-leaning lawmakers, meanwhile, have bowed to public pressure to relax state laws to exempt virtually any child from state vaccination requirements whose parents object. Three states allow only medical exemptions; most others also permit religious exemptions. And 17, including Washington, Oregon and Idaho, allow what they call “philosophical” exemptions, meaning virtually anyone can opt out of the requirements.
All those elements combine into a dangerous mix, spurring concern about the resurgence of a deadly diseasethat once sent tens of thousands of Americans to hospitals each year and killed an estimated 400 to 500 people, many of them young children.

“You know what keeps me up at night?” said Clark County Public Health Director Alan Melnick. “Measles is exquisitely contagious. If you have an under-vaccinated population, and you introduce a measles case into that population, it will take off like a wildfire.
Dr. Haider Warraich at Vox:
If they are effective, preventive therapies treat events that a person will never witness. So a patient who takes a statin might never experience the heart attack it prevented but might experience side effects, or simply the inconvenience of taking a medication sometimes with no perceived benefit. This is unlike treatments that are therapeutic for symptoms or obvious physical manifestations of diseases after they have developed. For example, while many patients may overstate the risks of statins, the benefits of treatments such as coronary stents, which are used to increase blood flow in blocked or narrowed arteries supplying the heart to manage heart attacks and chest pain, are frequently inflated.

Outbreaks of measles in the US, largely driven by refusal of a critical mass of parents in a community to have their children vaccinated, could be a result of this phenomenon. Rumors and fears that have taken hold of largely well-educated, concerned, and well-meaning parents, connected through online networks, are fueling the anti-vaxxer movement.
Yet perhaps the answer to this modern disease that appears to have landed straight out of a Black Mirrorepisode might also lie in the online networks that have helped foment this in the first place. A team of scientists successfully predicted the measles outbreak at Disney World in 2014 using machine learning to analyze social media posts and search engine behaviors two years in advance.