vaccines

unvaccinated-florida-kids-exposed-to-measles-can-skip-quarantine,-officials-say

Unvaccinated Florida kids exposed to measles can skip quarantine, officials say

Bad idea —

On Tuesday, nearly 20 percent of the school’s 1,067 students were reportedly absent.

Florida Surgeon General Dr. Joseph Ladapo speaks during a press conference at Neo City Academy in Kissimmee, Florida.

Enlarge / Florida Surgeon General Dr. Joseph Ladapo speaks during a press conference at Neo City Academy in Kissimmee, Florida.

Paul Hennessy/SOPA Images/LightRocket via Getty Images

A sixth student at Florida’s Manatee Bay Elementary School outside of Fort Lauderdale has a confirmed case of measles, health officials announced late Tuesday. However, health officials are not telling unvaccinated students who were potentially exposed to quarantine.

The school has a low vaccination rate, suggesting that the extremely contagious virus could spark a yet larger outbreak. But in a letter sent to parents late Tuesday, Florida Surgeon General Joseph Ladapo—known for spreading anti-vaccine rhetoric and vaccine misinformation—indicated that unvaccinated students can skip the normally recommended quarantine period.

The letter, signed by Ladapo, noted that people with measles can be contagious from four days before the rash develops through four days after the rash appears. And while symptoms often develop between 8 to 14 days after exposure, the disease can take 21 days to appear. As such, the normal quarantine period for exposed and unvaccinated people, who are highly susceptible to measles, is 21 days.

“Because of the high likelihood of infection, it is normally recommended that children stay home until the end of the infectious period, which is currently March 7, 2024,” Ladapo’s letter states, adding that the date could change as the situation develops. “However, due to the high immunity rate in the community, as well as the burden on families and educational costs of healthy children missing school, [the health department] is deferring to parents or guardians to make decisions about school attendance.”

Local media outlets reported that, on Tuesday, more than 200 of the school’s 1,067 students were absent.

The measles cluster began Friday when a third grader, who had not recently traveled, was diagnosed with the vaccine-preventable illness. Over the weekend, three additional cases were identified, leading the local health department to release a health advisory. Two additional cases were identified this week. It’s unclear if all six children are unvaccinated.

According to a county vaccine study, only 89.31 percent of the school’s students were vaccinated in the 2023/2024 school year, suggesting that around 114 students are susceptible due to their vaccination status.

The measles virus spreads easily through respiratory transmission and can linger in air space for up to two hours after an infected person has been in an area. Among people susceptible to the virus—those who are unvaccinated or have compromised immune systems—up to 90 percent will become infected upon exposure. People who are fully vaccinated, meanwhile, are considered protected. Two doses of the Measles, Mumps, and Rubella (MMR) vaccine are 97 percent effective at preventing the disease.

Measles symptoms include high fever, runny nose, red and watery eyes, and a cough, as well as a telltale rash that develops after initial symptoms. About 1 in 5 unvaccinated people with measles are hospitalized, according to the Centers for Disease Control and Prevention, while 1 in 20 infected children develop pneumonia and up to 3 in 1,000 children die of the infection.

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Measles is “growing global threat,” CDC tells doctors in alert message

Alert —

Since December, there have been 23 measles cases in the US, including two outbreaks.

A baby with measles.

Enlarge / A baby with measles.

The Centers for Disease Control and Prevention is putting clinicians on alert about the growing risk of measles cases and outbreaks amid a global surge in transmission.

In an outreach message sent Thursday, the CDC told clinicians to look out for patients who have a rash accompanied by a fever and other symptoms of measles, as well as patients who have recently traveled to countries with ongoing measles outbreaks.

Between December 1, 2023, and January 23, 2024, there have been 23 confirmed measles cases in the US, including seven direct importations by international travelers and two outbreaks with more than five cases each, the CDC noted. Most of the cases were in unvaccinated children and teens.

Measles outbreaks in the US are typically sparked by unvaccinated or undervaccinated US residents who pick up the infection abroad and then, when they return, transmit the disease to pockets of their communities that are also unvaccinated or undervaccinated.

Globally and in the US, vaccination rates against measles—via the measles, mumps, and rubella vaccine (MMR)—have fallen in recent years due to pandemic-related health care disruption and vaccine hesitancy fueled by misinformation.

“The increased number of measles importations seen in recent weeks is reflective of a rise in global measles cases and a growing global threat from the disease,” the CDC’s outreach message, titled “Stay Alert for Measles Cases,” read.

According to data from the World Health Organization, the European region saw an over 40-fold rise in measles cases in 2023 as compared with 2022. The region tallied over 42,200 measles cases last year, compared with just 941 in 2022.

This week, the WHO reported a rapid escalation of measles cases in Kazakhstan (which the WHO considers part of the European region). Kazakhstan has recorded the highest incidence of measles cases in the region, with 13,677 cases in 2023. That corresponds to over 639 cases per million in the population. In the news release Tuesday, Kazakhstan’s health minister reported that there are “currently 2,167 children in hospital with measles, 27 of them in a serious condition.”

The outbreak is largely spurred by unvaccinated children who missed their routine immunizations during the pandemic. Sixty-five percent of the reported measles cases are in children under age 5, the WHO noted. The country is now trying to catch children up on their vaccines to curb the outbreak.

“Measles is highly infectious, but fortunately, can be effectively prevented through vaccination,” WHO’s Regional Director for Europe, Hans Henri P. Kluge, said in the news release. “I commend Kazakhstan for the urgent measures being taken to stop the spread of this dangerous disease.”

Meanwhile, measles is flaring up in many other places. Last week, the UK Health Security Agency warned of the potential for an ongoing measles outbreak to spread. As of January 18, there were 216 confirmed cases and 103 probable cases in the West Midlands region since October 2023. Authorities warned that any areas with low MMR vaccination rates are at risk of an outbreak.

The vast majority of Americans have received their MMR vaccines on schedule. In this case, the two standard, recommended doses are considered 97 percent effective against measles, and the protection is considered for life. But anyone who is unvaccinated or undervaccinated is at high risk of infection in the event of an exposure. The virus can linger in air space for up to two hours after an infected person leaves the area, the CDC notes, and is highly infectious—up to 90 percent of unvaccinated people exposed will fall ill. Once infected, people are infectious from four days before the telltale measles rash develops to four days afterward.

Measles is “growing global threat,” CDC tells doctors in alert message Read More »

cdc-reports-dips-in-flu,-covid-19,-and-rsv—though-levels-still-very-high

CDC reports dips in flu, COVID-19, and RSV—though levels still very high

a break? —

The dips may be due to holiday lulls and CDC is monitoring for post-holiday increase.

The influenza virus from an image produced from an image taken with transmission electron microscopy. Viral diameter ranges from around 80 to 120 nm.

Enlarge / The influenza virus from an image produced from an image taken with transmission electron microscopy. Viral diameter ranges from around 80 to 120 nm.

Key indicators of seasonal flu activity declined in the first week of the year, signaling a possible reprieve from the high levels of respiratory virus transmission this season—but the dip may only be temporary.

On Friday, the Centers for Disease Control and Prevention released its latest flu data for the week ending on January 6. Outpatient visits for influenza-like illnesses (ILI) were down that week, the first decline after weeks of rapid increases. Flu test positivity and hospitalizations were also down slightly.

Percent of outpatient visits for respiratory illnesses by week.

Enlarge / Percent of outpatient visits for respiratory illnesses by week.

But transmission is still elevated around the country. Fourteen states have ILI activity at the “very high” level in the current data, down from 22 the week before. And 23 states have “high” activity level, up from 19 the week before. (You can see the week-by-week progression of this year’s flu season in the US here.)

The CDC says it is monitoring for “a second period of increased influenza activity that often occurs after the winter holidays.”

Map of ILI activity by state.

Enlarge / Map of ILI activity by state.

Flu isn’t the only virus that seems to be letting up a little in the data, at least for now. COVID-19 data also showed some dips, with the CDC reporting that “Despite test positivity (percentage of tests conducted that were positive), emergency department visits, and hospitalizations remaining elevated nationally, the rates have stabilized, or in some instances decreased, after multiple weeks of continual increase.”

The CDC speculates that some of the declines in indicators could be due to people not seeking medical care during the holidays as they would otherwise. COVID-19 wastewater activity levels remain “very high,” with all regions showing high or increasing levels. The South and Midwest have the highest levels in the latest data, but there are some early indications that rises in the Midwest and Northeast may be slowing down.

Meanwhile, RSV activity remains elevated, though some areas are starting to see declines.

The CDC notes that it’s not too late to get vaccinated against COVID-19, flu, and (for those ages 60 and over) RSV. So far, 21 percent of adults have received the 2023–2024 COVID-19 vaccine, including 41.5 percent of people ages 65 and up. Around 363,000 people have died from COVID-19 in the US since September.

For flu, about 47 percent of adults have received their annual shot, including 74 percent of people ages 65 and up. On Thursday, researchers in Canada published the first estimates of flu vaccine effectiveness this season, finding the current annual shots are 61 percent effective against the most common strain of flu circulating in the US (influenza A(H1N1)pdm09) and 49 percent effective against the less common influenza A(H3N2) and 75 percent effective against influenza B.

The CDC estimates that there have been at least 14 million flu cases, 150,000 hospitalizations, and 9,400 deaths from flu so far this season so far, the agency reported. In the first week of this year, 13 children died of flu, bringing this season’s total to 40.

CDC reports dips in flu, COVID-19, and RSV—though levels still very high Read More »