I’m going to focus on just one story today. I wanted to try to understand something I’m curious about–what’s causing the rapid spread of measles in California?
The outbreak of measles that started at Disneyland in December is spreading rapidly across California, into other states, and even into Mexico. Five Disneyland employees have now been diagnosed with the disease (three have recovered and others are being tested), and the number of reported cases traced to Disneyland has passed 60.
Last week I wrote about an unvaccinated woman who contracted the measles virus in Disneyland and then took two airline flights to the Seattle area during the holidays before she was diagnosed. How many other people did she infect? Measles is highly infectious, airborne virus that can be spread by coughing and sneezing, like the common cold. From the CDC website:
Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It can spread to others through coughing and sneezing. Also, measles virus can live for up to two hours on a surface or in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected.
Infected people can spread measles to others from four days before to four days after the rash appears.
Another case was recently identified in Eugene, Oregon. The man is so sick that he hasn’t been able to talk to anyone, but his wife says he was in Disneyland and also went to the Rose Bowl game and then flew back home before he started showing symptoms. How many other people did he infect? UPDATE: It turns out the man did not go to the game–see story in comment thread.
Measles cases are also turning up in Northern California, according to SFGate: Disneyland measles outbreak spreads to Bay Area.
A large outbreak of measles that started at two adjacent Disney theme parks in December has now sickened people all over California, including a handful of Bay Area residents, and is prompting public health authorities to urge everyone to get vaccinated if they aren’t already.
California has reported 59 cases of measles since mid-December, the bulk of them in people who either visited or had close contact with someone who had been to Disneyland or California Adventure Park in Anaheim, public health officials said in a media conference call Wednesday. Seven measles cases have been reported in the Bay Area: in Alameda, San Mateo and Santa Clara counties.
Most of the people who have become infected were unvaccinated. Because of the threat of infection, public health officials said people who aren’t vaccinated — either because they can’t get the vaccine or they choose not to — should avoid public places where large groups of people, especially international travelers who may carry measles, congregate.
“We can expect to see many more cases of this vaccine-preventable disease unless people take precautionary measures,” said Dr. Gil Chavez, deputy director of the Center for Infectious Diseases with the California Department of Public Health. “I am asking unvaccinated Californians to consider getting immunized to protect themselves and family and community at large.”
I had measles as a child, and fortunately I didn’t develop any of the complications, such as blindness, severe ear infections, pneumonia, and encephalitis (rare). But now that we have a vaccine for measles, children don’t need to risk these possible dangerous consequences of getting the virus. Sadly, we have a lot of people in this country who believe conspiracy theories about vaccines.
How do the anti-vaxxers avoid the vaccines? Most states require vaccinations for children attending school, but most states also allow religious exemptions. Here’s a list of vaccine requirements in each state. Every state but Mississippi and West Virginia allows religious exemptions; a few states also allow “philosophical” exemptions. Only California allows “objections based on simply the parent(s) beliefs.” I’m guessing some parents avoid vaccinating their children by home-schooling them.
Bloomberg reports that Orange County has banned unvaccinated kids from attending school because of the measles outbreak.
Health officials in Orange County, Calif. have banned two dozen students who have no immunization records from attending high school in the wake of a measles outbreak that has been traced back to Disneyland.
Sixty-seven confirmed measles cases have been reported in California in the current outbreak. One student from Huntington Beach High School who was infected with the disease attended class following winter break, exposing fellow students to the highly contagious illness, especially those who did not receive a childhood vaccination against it.
“If there is a case in the school and their child is not immunized, they will be removed from the school for 21 days,” Dr. Eric Handler, the Orange County public health officer, told the Los Angeles Times. “From an epidemiological standpoint, in order to prevent spread of the disease, this is a necessary measure.”
Now check this out:
In Southern California…many schools now report that upwards of 10 percent of students have not received childhood vaccinations. In Northern California, the figures are even worse, with clusters of under-vaccinated children in the San Francisco Bay Area resulting in one out of every four children going without the recommended immunizations.
Most of the parents who opt out of having their kids vaccinated are relatively affluent and well-educated, according to science writer Tara Haelle at Forbes. She notes two reasons why measles is spreading so rapidly in California.
Those two things are the extreme infectiousness of the disease and the low levels of herd immunity, or community immunity, in pockets of southern California. Measles infects 9 out of every 10 non-immune individuals it finds. It’s airborne and hangs around up to two hours after an infected person leaves the area. It doesn’t take much for this disease to spread through a population that isn’t immune from previous exposure or through vaccination. Or, to put it another way, in an unvaccinated population, each person infected with the measles will transmit the disease to 12 to 18 other people. If no one were vaccinated against measles, we would be up to hundreds, perhaps thousands, of cases by now. We aren’t because there are some levels of herd immunity, but it’s because herd immunity has been weakened that we’re seeing additional cases at all.
She also debunks the notion that undocumented immigrants are spreading the virus.
Meanwhile, one of the biggest myths popping up in comment threads and on social media is that undocumented immigrants have something to do with this outbreak, or any other outbreak of a vaccine-preventable disease. We don’t yet know who Patient 0 – the first person with the disease – was at Disneyland, but we don’t really need to know. It’s not undocumented immigrants we should be pointing the finger at. It’s home-grown, upper-middle class, well-educated, mostly white southern California parents who have chosen not to vaccinate their children we should be giving the side-eye to. When vaccination rates in the region are below some developing countries’ rates, you don’t need undocumented immigrants to bring in the disease. Unvaccinated Americans do a fine job of that all on their own. A look at past cases makes this clear.
When the CDC tracked measles cases for the first half of 2013, they found that 159 cases resulted from 42 importations of the disease – but more than half those importations were U.S. residents returning to the States from abroad. Similarly, the outbreak of close to 400 cases in Ohio last year began with unvaccinated U.S. travelers returning from a visit to the Philippines. And the largest outbreak in San Diego since 1991 occurred in 2008 after an intentionally unvaccinated 7-year-old boy returned from a vacation in Switzerland with his family and brought back the measles. That last case is particularly of interest because the boy was a patient of Dr. Bob Sears, who has been spreading misleading information about measles in the midst of this outbreak.
Interestingly, she says that some people who have been vaccinated will still get the disease. But someone who hasn’t been vaccinated is 35 times more likely to get measles than someone who has had the vaccine.
Here’s some more information about Dr. Bob Sears, and Orange County pediatrician and author of “The Vaccine Book: Making the Right Decision for Your Child.” From the LA Times: Vaccination controversy swirls around O.C.’s ‘Dr. Bob.’
While the vast majority of physicians are troubled by the anti-vaccination movement, Sears, 45, lends a sympathetic ear. About half his patients forgo vaccines altogether. To others, he offers “Dr. Bob’s” alternative and selective vaccination schedules, which delay or eliminate certain immunizations.
At a conference this year in Rancho Mirage, Sears told a roomful of pregnant women, new mothers and healthcare professionals that vaccines work well and are responsible for the nation’s low disease rate, something parents who don’t want to immunize can take advantage of.
“I do think the disease danger is low enough where I think you can safely raise an unvaccinated child in today’s society,” he said. “It may not be good for the public health. But … for your individual child, I think it is a safe enough choice.”
That approach frustrates infectious-disease experts, who in recent years have found themselves combating some celebrities’ anti-vaccination beliefs.
“We eliminated endemic measles in the U.S. in 2000. It’s now 2014 and we’re at 400 cases. Why?” Dr. Paul Offit, chief of infectious diseases at Children’s Hospital of Philadelphia, said in an interview in June. The number of cases has since risen to nearly 600. “Because people listen to Bob Sears. And, frankly, I blame him far more than I do the Jenny McCarthys of this world. Because he’s a doctor. And he should know more.”
Here’s an interesting article from The New Republic, The Best Way to Combat Anti-Vaxxers Is to Understand Them A new study underlines the similarity between “neo-liberal” thinking and the anti-vaccination movement. Well The New Republic should certainly understand neo-liberal thinking–they practically invented it. An excerpt:
“Anti-vaxxers,” as they are often referred, are an easy group to stereotype and a difficult group to humor. In most thinking circles, they are cast as “the other”; people either too stupid to understand the science behind vaccination, or too selfish to care about the impact of their choices on those around them.
But vaccine skeptics aren’t as different from their critics as we might like to think. And their rise in number over the past decade has less to do with stupidity, or even selfishness, than it does with beliefs about knowledge, trust, and freedom of choice that are pervasive throughout our culture, whether you choose to vaccinate your kids or not.
Dr. Jennifer Reich, a sociologist at the University of Colorado Denver, has been researching the anti-vaccination movement since 2007, seeking to understand the processes by which people come to reject vaccines. Over the past seven years, she has conducted in-depth interviews with parents who refuse mainstream vaccine recommendations, along with doctors, alternative healers, and public policymakers.
Not all of the parents Reich spoke with were “anti-vaxxers” in the sense that we typically think of the term; only a small minority identified as activists in the Jenny McCarthy mold, campaigning other parents not to vaccinate or advocating for policy change. Nor did they necessarily abstain from vaccination completely.
Rather, what united them was a sense that vaccines were up for negotiation: to be administered or rejected depending on the convictions of the parent and the needs of the child. Reich’s interviewees saw themselves as critical consumers of information. They engaged with doctors not as authorities to be obeyed, but as another data point to be evaluated, embraced, or discarded. They continually assessed risk: How likely was it that their child would be exposed to Disease A? What would be the consequences if they contracted Disease B?
It seems to me that what these anti-vaxxers have in common with neo-liberals is that they have lost the sense that as Americans we are all in this together. They focus only on their own needs and ignore the ways in which their choices about whether to vaccinate their children could impact others and society as a whole.
Just one more article before I wrap this up.
Fifteen years after measles was declared eliminated in the United States, the recent outbreak traced to two Disney parks in California illustrates how quickly a resurgence can occur….
Experts explain the California outbreak simply.
“This outbreak is occurring because a critical number of people are choosing not to vaccinate their children,” said Dr. Paul Offit, director of the Vaccine Education Center and an attending physician at The Children’s Hospital of Philadelphia’s Division of Infectious Diseases.
“Parents are not scared of the disease” because they’ve never seen it, Offit said. “And, to a lesser extent, they have these unfounded concerns about vaccines. But the big reason is they don’t fear the disease.” ….
Researchers have found that past outbreaks of vaccine-preventable diseases are more likely in places where there are clusters of parents who refuse to have their children vaccinated, said Saad Omer, an associate professor of global health, epidemiology and pediatrics at Emory University School of Public Health and Emory Vaccine Center, in Atlanta.
“California is one of the states with some of the highest rates in the country in terms of exemptions, and also there’s a substantial clustering of refusals there,” Omer said….Other reasons include the belief that their children will not catch the disease, the disease is not very severe and the vaccine is not effective, Omer noted.
In California, vaccine exemptions have increased from 1.5 percent in 2007 to 3.1 percent in 2013, according to an analysis by the Los Angeles Times.
So, in a sense California is endangering people in other states. Omer says there’s recent legislation to make it more difficult to get exemptions, but “it is too soon to know the effects of the new law.”
So . . . comment on this issue if you wish; but feel free to treat this as an open thread. Have a great day Sky Dancers.
As many of you may have heard, S 510 the food safety bill, passed the Senate yesterday. I’ve discussed this bill once before. In that post I asked that people ask their Senators to vote for the Tester-Hagan amendment if they must vote for this poorly done bill. I’m happy to say the Tester-Hagan amendment passed with the bill, along with several other amendments that will make it a bit easier on small farmers. Thanks so much for writing and calling about this!
Even with bill’s passage all hope is not lost by any means. Because of Democrat foolishness, the Senate bill includes provisions about taxes, a House perogative. So the House Democrats will probably stop the Senate bill for a bit.
The bill has to be reconciled with the House version once all these mistakes are rectified, if they can be rectified. The House version of the bill is much, much harsher to small farmers. I might, therefore, be asking you all to write and call as the reconcilation process goes forward.
There are several other ways to stop the worst of this bill. One is when the UDSA/FDA/HSA (Why the heck is Homeland Security involved?) actually make up the rules. There will be hearings, committees, ‘listening’ sessions and more. Although the path to public involvement in these hearings is convoluted and arcane, it can be done.
For example, up until last year small farmers, and anyone who owned a horse, goat, sheep, cow, chicken, duck, or pig as a pet, had NAIS looming before them. NAIS, the National Animal Identification System, was to mandate an RFID for every ‘farm’ animal in this country. It was meant to facilitate disease outbreak tracing and enhance the ability for American meat producers to sell their products overseas.
NAIS mandated one RFID per ‘lot’ of animals. So a ‘lot’ of 10,000 chickens hatched, raised and slaughtered together would need one RFID tag. That’s great for a CAFO. But for a small farmer, who hatches maybe 100 chickens here, 100 there, or even less, it’s disaster. Each chicken or small lot would need a number. The system worked the same for horses, cattle, goats, etc. So I, with my
17 18 (keep forgetting the little one) goats, would pay 18 times what someone with 1,000 goats kidded at once would pay. Yea, that’s fair. The NAIS rules also meant a ton of other impositions. Farmers would be required to report any movement of animals within 24 to 48 hours. If you rode your horse down a trail, every farm you passed would have to report your movement into and off of their property. Take your pet goat to the vet in your car? Report that movement within 24 to 48 hours or face a fine. Animal die? Report it. Animal born? Report it. Animal moved to a different pasture through a common area? Report it. In order to facilitate all this reporting your property would be registered as a ‘premises’ and given a ‘premises number’. Legally, the owner of a premises has a different set of rights, lesser rights, than the owner of property.
When the particulars came out the government ignored the unrest. Then the listening sessions started, and they had to add more, and more. Comments on the Federal register grew long and loud. The listening sessions were attended by people 80% to 95% against NAIS. People dared the government to pass it, promising stubborn, non-violent resistance.
NAIS died last year, supposedly. Funding was dropped by Congress and the FDA/USDA stopped pushing it. However, elements of it are in the S 510 bills.
We can do this again with the Food Safety Act. We can make it palatable and workable for the little farmers. People power CAN fight against corporate ruled government if we are united. Unity is the key. With NAIS all sides came together to fight it. I was on mailing lists with people who became rabid tea-partiers. I didn’t agree with their solutions for everything, but I, and other liberals like me, did agree with how to fight NAIS. And so when someone made a political comment, the rest of us chastized them. ‘The list is only about NAIS, keep the rest out of it. We need everyone to fight it.’ This kind of unity is going to have to happen more and more, to fight against government take-over of our rights to privacy, freedom of speech, travel, and more. I welcome it.
Added the following to discuss the Washington Post article mentioned by BB in her great news roundup. These are my admittedly argumentative thoughts on the points in the article. I think the Food Safety bills could be good, but they need to be gone over very carefully and the wording needs reflect reality. It’s too vague right now.
Point 1: ‘ Would require farmers and food manufacturers to put in place controls to prevent bacteria and other pathogens from contaminating food.’
The bill requires ‘GAPS’ (Good Agricultural Practices) to be put in place for farmers. These are basically flow charts that are meant to identify problem areas and tell the farmer how to prevent them. They probably work ok for a farmer who grows 10000000000 acres of lettuce. However, I grow about 2 4 x 100 ft beds of lettuce, 4 4 x 100 ft beds of broccoli, 8 4 x 100 ft beds of potatoes… well you get the idea. I’d have to have a GAPS, generally designed by a food engineer ($$$$) for each vegetable and for how the growing of each vegetable impacts the other. I really resent this kind of linear, engineering thinking that is applied to everything. Learning about, and deciding to follow ‘good agricultural practices’ is something every farmer does. If they don’t, they go out of business.
Point 2: ‘Would require the Food and Drug Administration to regularly inspect all food facilities, with more frequent inspections in higher risk facilities. ‘
Who defines ‘higher risk’? Right now, it seems the FDA thinks little dairies and creameries are high risk. The factories that produced the 550 million egg recall had the equivalent of ‘GAPS’ in place. They had inspections, and got fined and written up, over and over again. Most of the HAACP (equivalent of GAPS) stuff requires them to self inspect and self report. The problems in these factories were ongoing over years. But a little cheese producer that has never tested positive for listeria is shut down because a California seized sample, held in improper conditions by the government, stripped of all the actual tracing lot numbers which are supposed to allow backtracing of food by that same government, ad nauseum, came back positive for listeria.
Point 3: ‘Would allow the FDA to order a mandatory recall of any product it suspects may harm public health. ‘
This one sounds great. Of course, the FDA basically already has this ability. Note the wording ‘suspects may harm’. This could mean that a small farm or food producer is effectively destroyed while the FDA determines with the glacial slow movement of government facilities dragging their collective feet, that the farm/food producer did nothing wrong.
Point 4: ‘Would improve disease surveillance, so that outbreaks of food poisoning can be discovered more quickly’
I like this one. But how are they actually going to do it? More testing I suppose. Who pays? The consumer and the farmer. What about testing post slaughter, post canning, post wrapping, etc?
Point 5: ‘ Would require farmers and food-makers to maintain distribution records so that the FDA can more quickly trace an outbreak to its source. ‘
This is NAIS-like. At one time the government was talking about requiring every head of lettuce or broccoli to have an RFID. Interesting concept, and it may come to that. It would provide great tracing, until the RFID is removed. And even then, what if you return to the store with an RFID tag from lettuce that you said made you sick. You neglect to mention you ate that lettuce right after you cleaned the cat box… RFID tags won’t do anything about post-slaughter contamination, which is where MOST of the contamination of meat happens. The tag is removed from the animal when it’s slaughtered, of course.
Having said that, I don’t know of a farmer or food-maker that doesn’t maintain distribution, aka sales, records. Maybe it’s different in the big ag operations.
Point 6: ‘Would require foreign food suppliers to meet the same safety standards as domestic food-makers. ‘
I love this one. Could we reverse it and make it so that our food suppliers have to label GMO products and so on? That would rock.
Point 7: ‘Would exempt small farmers and food processors.’
This is good. I’ll believe it when I see it. Tester’s amendment says that small food producers have to abide by either the state regulations or the fed regulations. In practice, the fed usually tells the state how to regulate, or withholds money. So it’s all one in the same. I’m a bit worried about the part (they might have removed this in the final bill) that sends a farmer to jail for 10 years if they ‘distribute adulterated food’. The problem is the definition of distribute, adulterated and even food. Heh. Raw yogurt can be considered adulterated by some, because it’s still got the little raw beasties in it that make it so good.
Final point: ‘Would add 17,800 new FDA inspectors by 2014.’
I’ll believe that when I see it. Paid for by what? Are they going to be like the TSA? Who’s training them?
Note: I wanted to get this written up and posted yesterday, but family duties called me away and I spent all day at my parents’ house taking care of my sister.
Right now I am stressing about Senate Bill 510. The bill passed cloture today, and will come up for vote tomorrow or Friday, I believe. An important amendment, written by Senator Tester and Senator Hagen, would exempt small farms from many of the onerous provisions of this bill. Food experts, farm advocates, and consumer safety experts have debated the provisions of the bill over at Grist (see this article on if the bill will better provide food safety, this article on if the bill will harm small farmers, and this one on if we really have a food safety crisis), if you are interested in their arguments.
If S 510 passes without the Tester-Hagen amendment and then goes into reconciliation with the absolutely horrid (for small farms) House bill (HR 2749) which passed last year, I expect to be eventually regulated out of business. And I expect many, many other small farms to suffer the same fate. The law has no provisions in it to protect small farms; it simply urges the FDA and FEMA, yes, our food supply would come under FEMA, to consider small farms when making regulations. AHAHAHAHAHAHAHA. The Tester-Hagen amendment makes it law that they do so. The Bill is partly concerned with ‘terrorist’ scenarios, such as someone poisoning our food supply. If we were getting food from millions of small family farms, such a thing couldn’t occur. But the bill gives FEMA the power to intervene in cases of suspected terrorism, or food ‘adulteration’, however they end up defining it.
There’s some good parts in this bill. It does provide more oversight for Big Ag. I’m sure that’ll last until the regulations actually get written (cynical, cynical me). But as I see it, this bill and the House bill are just grandstanding so government people can say they ARE doing something about the supposed food safety crisis. If the USDA and the FDA had the funds to do the inspections they need and if our Senators and Representatives would seriously look into getting the lobbyists out of the regulatory mix, we’d not need these bills at all.
Anyway, I ask you to call or email your Senators and ask them, if they must vote for this bill, that they also vote for the Tester-Hagen amendment. It’s probable that every Dem Senator will vote for it, so let’s do what we can to make it more palatable to the small food producers that hope to feed us all.
More links of possible interest:
I’m trying to look on the bright side. If the bill passes, is reconciled with the House bill and becomes the pile of ummhmmm I suspect it will, it can still be fought during the formation of regulations phase. Oh joy.
Sometimes it seems like the world I think I know is just a falsehood, a play put on by the Powers That Be to keep me pacified, dumbed down, and walking the way they want me to walk.
Take, for example, farming in the United States. This has always been, in my estimation, an honorable profession. The nation was founded by farmers wealthy and dirt-scrabble poor. Farming helped drive the expansion and eventual rise of the nation. Farming has fed us all.
But when I speak of farming, I have in my mind a certain kind of farm. It’s not too big; not more than a family can manage. Maybe it’s several hundred acres or more if it’s a ranch out west running cattle. If it’s dairy, it’s only got 200 or less cows. If it’s vegetables it’s growing a main crop and then lots of little crops for the farmers’ family. Or maybe it’s like my farm, with lots of different vegetables in small amounts, and some goats for milk, cheese and manure. The animals on the family farm are healthy, happy and living under the warmth of the sunshine in deep green pastures, or roaming semi-free over hot western plains. You know, the farm looks like all the commercials we see.
A farm is not a CAFO (‘Concentrated Animal Feeding Operation’). It is not 10,000 chickens or 2,000 pigs, or 5,000 cattle all under the same roof. These animals never see the light of day. They are given only square feet to live in. They are dealt with as though they were pieces of plastic running down an assembly line belt. That is not farming. And yet, CAFOs have become the source of much of the meat we eat, much to our shame.
A small farm does not have a ‘manure lagoon‘ which is full of liquid that can be so deadly it will kill you if you fall into it.
The farmer (read manager) of a huge agri-business farm uses satellite positioning and GPS to determine when and where to fertilize and harvest. The manager ‘drives’ a tractor which can be self-steering (pdf). Computer monitors sense the condition of the soil, the air, the plants. These give feedback that tells the manager when to plant, fertilize, harvest. Anyone can do it, as long as they can read a computer screen.
A farmer walks her acres, strand of grass in mouth, feeling the condition of her plants and soil.
Small farms, traditional farms, don’t grow patented seed. They don’t grow seed which has been bio-engineered with e. coli (yes, e. coli!) to carry resistance to herbicides.
A true farmer plants traditionally hybridized or open pollinated seed. She tries to find organic seed if possible. She uses seed catalogs which source from places other than huge seed houses which are trying to lock up all the genetic potential in plants through patents on common seed genomes.
Small farming is under attack from every side in our world. It is almost impossible to make a decent living from a family sized farm. For several generations now often one part of the family has to work off the farm to make it viable. In my own family, the men worked off the farm and the women farmed. We are so used to subsidized food, subsidies started in part by FDR to help even out the ups and downs of farming but quickly taken over by big business, that we don’t know what it really costs to grow it. Believe me, it costs more than 79 cents a pound cabbage.
Dairy farms are under attack. Recently official prices for milk were lowered to below break even point for farmers. Thousands left the business, closing up family farms (note that in this article, even 1000 cow dairies, BIG dairies are closing) . What is left? Big Agribusiness, of course.
The government, in a scramble to prove to voters that it really does care that food be safe, is legislating and regulating small farming out of existence. Dairy farms, cheese making operations with actual ties to farms (not Kraft, thank you), CSAs and even backyard vegetable patches are coming under increased regulatory scrutiny. The amount of food borne illness attributable to these operations is infinitesimal, and yet, that is what is regulated. Only 1% of food shipments into the country will be inspected, only written warnings, blown off by the egg factories which then recall 1/2 a billion eggs, will be issued. But you’ll be safe from your neighbors’ eggplant!
Below is the trailer for a new documentary: Farmageddon