Measles Outbreak: Reexamining Herd Immunity

The measles outbreak that started at Disneyland, in Anaheim, California, has resulted in more than 90 cases of measles in January alone. Most doctors are seeing this epidemic as a wake-up call to those parents who have refused to vaccinate their children. Parents who consider themselves part of the anti-vaccine movement, sometimes called “anti-vaxxers,” believe that vaccines are more dangerous than the childhood diseases they are meant to prevent.

In some places, the law backs them up. California, for instance, permits unvaccinated children to attend school. We’re not just talking about the measles vaccine but about vaccinations against ALL the childhood diseases including chicken pox, whooping cough, mumps, and Rubella. In Marin County, in which San Francisco is located, 7.8% of parents have consciously chosen not to vaccinate their children.

Vaccines do come with some risks and in 2000, the measles was declared eradicated in the United States. Therefore, argue the anti-vaccine people, there really is no good reason to vaccinate children. For one thing, they argue, vaccines can be deadly in a small percent of cases, while measles, on the other hand, has been wiped out.

Alas, this recent outburst of measles pretty much proves them wrong. Measles may have been eliminated in the United States, but it is still alive and kicking elsewhere in the world.  The Centers for Disease Control and Prevention (CDC) believes an international traveler, possibly a foreign worker, brought over the childhood disease from a different country. It is easy to understand how a contagious disease can spread among large,  happy-go-lucky amusement park crowds.

Unlike Ebola, which was thankfully not very contagious and turned out to be easily contained, measles is one of the most contagious diseases there is. Coming in contact with a carrier leaves the unvaccinated child or adult with a 90% chance of contracting the disease. For someone who isn’t vaccinated, just being in a room that was formerly occupied by a measles carrier, can mean catching the disease.

The recent outbreak was traced back to visits to the amusement park between December 15 and December 20. A handful of Disney workers were subsequently diagnosed with measles according to Disneyland officials. The typical incubation period for measles in 21 days, which means that a person exposed to the measles can take up to 21 days to exhibit symptoms. The risk of contagion begins four days before the onset of active measles symptoms and remains in effect until four days after the measles rash has gone.

Those parents against administering vaccines cite side effects as the main reason not to vaccinate though serious reactions such as severe allergic reaction, coma, permanent brain damage, deafness, and death are extremely rare. Severe allergic reactions occur in 4 children out of one million. The other serious side effects are so rare that experts are not sure whether they are at all connected to immunization.

Measles, on the other hand, is usually mild and clears up on its own within a few weeks. No big deal until one considers the fact that measles can lead to death in 1 or 2 children out of every one thousand who contract the disease. Now that is a scary statistic to contemplate, especially when one considers the highly contagious nature of measles.

If all we needed to consider as factors in the vaccination equation was the risk of side effects from immunization versus the risk of side effects from measles, vaccination would win out every time. But that isn’t the whole story by a long shot. There is the issue of herd immunity to consider.

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Community immunity or “herd immunity” is when most of the people in a community are protected against the disease, so that the few who are unprotected have a relatively small risk for contracting the disease. What this means is that those unable to receive the vaccination because of pregnancy or a weakened immune system are less vulnerable because the majority of people in their community are vaccinated. That means it is unlikely that the vulnerable will come in contact with carriers of the disease.

Once the measles was said to be eliminated in the United States, parents belonging to the anti-vaccine movement felt vindicated in refraining from immunizing their children. They felt that since the disease was said to be eliminated, there was a greater risk from the vaccine than from the disease, since the disease was no longer an issue, having been eliminated. What the anti-vaccine people seemed not to understand is that by not having their children vaccinated, they were destroying the herd immunity that had been created and which had protected society and their children over the past 15 years.

With fewer people vaccinated, there was every opportunity for an international traveler to spread the disease. Now some high schools are barring unvaccinated students from their halls while some pediatricians are no longer treating children whose parents decided against vaccinating them. With measles back in California and spreading daily, schools and doctors can’t afford to take the chance of infecting vulnerable students and patients.

And of course, measles is just one of the many diseases of childhood for which we have developed a vaccine. Things could get seriously nasty if, Heaven forfend, other diseases crop up that might have been prevented had most parents followed a proper immunization schedule for their children. Things are actually ALREADY nasty with the pro-vaccine people attacking the anti-Vaxxers for putting society at risk for what is presumed to be selfish reasons.

These sentiments against the anti-Vaxxers spawned, for instance, a satire piece that appeared in The Onion, entitled, I Don’t Vaccinate My Child Because It’s My Right To Decide What Eliminated Diseases Come Roaring Back:

As a mother, I put my parenting decisions above all else. Nobody knows my son better than me, and the choices I make about how to care for him are no one’s business but my own. So, when other people tell me how they think I should be raising my child, I simply can’t tolerate it. Regardless of what anyone else thinks, I fully stand behind my choices as a mom, including my choice not to vaccinate my son, because it is my fundamental right as a parent to decide which eradicated diseases come roaring back.

The decision to cause a full-blown, multi-state pandemic of a virus that was effectively eliminated from the national population generations ago is my choice alone, and regardless of your personal convictions, that right should never be taken away from a child’s parent. Never.

Say what you will about me, but I’ve read the information out there and weighed every option, so I am confident in my choice to revive a debilitating illness that was long ago declared dead and let it spread like wildfire from school to school, town to town, and state to state, until it reaches every corner of the country. Leaving such a momentous decision to someone you haven’t even met and who doesn’t care about your child personally—now that’s absurd! Maybe I choose to bring back the mumps. Or maybe it’s diphtheria. Or maybe it’s some other potentially fatal disease that can easily pass among those too young or too medically unfit to be vaccinated themselves. But whichever highly communicable and formerly wiped-out disease that I opt to resurrect with a vengeance, it is a highly personal decision that only I and my family have the liberty to make.

Last but not least, one cannot bring up the controversy surrounding immunization without bringing up the now thoroughly discredited link between vaccinations and autism. A man named Andrew Wakefield along with 12 colleagues, had a study published in 1998 in the distinguished medical journal, The Lancet, which suggested that the MMR (measles, mumps, rubella) vaccine had directly caused autism. Though the study was small in size, parents in droves stopped vaccinating their children for fear vaccination would result in autism.

Even after the fraud was exposed, parents were afraid to vaccinate their children. As a result, many children suffered not only from the effects of measles, mumps, and rubella, but from the serious complications that in rare cases arise from these diseases. There were measles outbreaks in the UK in 2008 and 2009, along with outbreaks in the U.S. and Canada. A great deal of time and money was spent in an effort to debunk Wakefield’s fraudulent claims and to convince parents the vaccine is relatively safe.

An Associated Press piece from 2011 described the Wakefield hoax and its result:

Wakefield made international waves following the publication in 1998 in the Lancet, a prestigious medical journal, that he and his colleagues had linked measles-mumps-rubella vaccine with autism in most of a dozen children they had studied.

It was a small series of observations, wrapped in a hypothesis — not even a full medical study. But it exploded in the media, prompting a wave of parental concerns in England as well as the United States.

Immunization rates in Britain dropped from 92 percent to 73 percent, and were as low as 50 percent in some parts of London. The effect was not nearly as dramatic in the United States, but researchers have estimated that as many as 125,000 U.S. children born in the late 1990s did not get the MMR vaccine because of the Wakefield splash.

And now we see that a well-educated pocket of people in California,  who truly believe they are doing the right thing by not vaccinating their children, have contributed to the destruction of the herd immunity that had mostly protected American children for the past decade and a half. I would posit that every parent has the right to study the issue of vaccination but that parents do not have the right to endanger their own children based on inaccurate or fraudulent data and misconceptions. Please study the subject at length and do the right thing. Don’t let fear drive your decision, let reality drive your decision.

Kars4Kids has no choice but to come to the firm conclusion that vaccination is a gift and that we have a responsibility to our children and our community at large to immunize those capable of receiving immunization. Discuss the matter with a doctor you trust. Do your independent study, too. But ultimately, choose to do the right thing.

Vaccinate your child, for everyone’s sake.

Childhood Obesity in the Land of Supersize Me

Childhood obesity in the Land of Supersize Me, also known as the United States, should surprise no one. You only need a pair of working eyes to see kids getting chubbier (their parents, too). Still, the statistics put out by the Centers for Disease Control (CDC) can make you suck in your breath every bit as much as those size 12 jeans.

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Fact #1

Childhood obesity has more than doubled in children and has risen four times in adolescents over the past 3 decades.

Fact #2

In 1980, 7% of children in the U.S. age 6-11 were obese. In 2012, 18% of U.S. children were obese.

Fact #3

Of U.S. adolescents age 12-19, 5% were obese in 1980 and that figure rose to 21% by 2012.

Fact #4

In 2012, over one-third of children and adolescents were found to be either overweight or obese.

Part of the problem is that kids no longer use their bodies for play. They’re digital natives. They use devices. Maybe their FINGERS are slim, but their bodies aren’t getting any exercise whatsoever. Not to mention that using devices generally requires one hand only. The other hand can be, um, gainfully employed in shoving snack food into one’s mouth.

The combination of no exercise and a surplus of snack food translate to overweight or obese children. Not to mention our culture in which large portions are considered a virtue. Think about what happens when you order a supersized portion. Most of us don’t like to waste food, so even if our bodies are sending our brains signals of satiation, if we see there’s still food remaining on our plates, we try our best to finish up. The result is overeating, which again, leads to packing on the pounds.

Is your child overweight or obese?

Not sure what’s the difference? Here’s the deal:

Overweight means having too much body weight for one’s height. The excess weight may be from fat, muscle, bone, water, or any combination of these elements.

Obesity is excess body fat.

In either case, both overweight and obesity result from “caloric imbalance” or when more calories are taken in (through eating) than are expended (through activity). That is the simple explanation for something that can be complicated by a variety of factors (genetic, behavioral, and environmental).

Overweight and obesity are a vicious cycle for children. In the past, peer pressure might have led to a greater desire to refrain from overeating. Kids would be teased for being overweight. But now, with one in three children overweight or obese, it’s easy enough to fit in whether one is chunky or slim. Today, excess weight more likely goes unremarked by friends.

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That’s a major headache for parents, the lack of peer pressure, because without peer pressure, what incentive do children have to lose weight? Adults understand that health is a gift and that overweight and obesity in children can lead to long-term ill health effects. Kids, on the other hand, think only of the present. If they feel good, they don’t think about how extra poundage will harm them later. And while 70% of obese children were found to have a minimum of one risk factor for cardiovascular disease, that’s meaningless to a child who feels just fine.

Meantime, in addition to risking cardiovascular disease as a result of such factors as high blood pressure or high cholesterol levels, obese teens also tend toward pre-diabetes in which blood sugar is high enough to presage the later development of diabetes. The extra weight also puts a strain on bones and joints and may leave to aches and pains, not to mention actual deterioration of these crucial body parts.

Then too, overweight young people are more likely to become overweight adults. The health risks at this point are undeniable and include stroke, heart disease, osteoarthritis, type 2 diabetes, and many types of cancer. One research trial found that children who were already obese at the age of 2 were at greater risk for being obese as adults. Overweight and obesity are associated with a heightened risk for such cancers as cancer of the colon, breast, esophagus, endometrium, pancreas, kidney, thyroid, gallbladder, cervix, ovary, and prostate as well as for Hodgkin’s lymphoma and multiple myeloma.

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What Can Parents Do?

  • Make it a priority to educate your child about nutrition
  • Ban high-fat and high-sugar treats
  • Make exercise a family value
  • Take vacations that include hiking and other physical activities
  • Limit time on electronic devices or make it tit for tat: 30 minutes of computer time is earned through 30 minutes of exercise
  • Organize your community and create a walking school bus in which kids walk to school instead of riding the bus
  • Enroll your child in a Zumba class
  • Take walks as a family
  • Aim for a nutrition-dense diet in which only foods that have high nutrition levels are purchased and consumed
  • Put out a bowl of fresh fruit or a tray of crudités (raw veggies) for snacking

 

Amie Valpone: Clean Food Healthier Children

Amie Valpone was sick—really sick. And the doctors couldn’t figure out what was wrong with her.

In the end, treatment by integrative physicians along with extensive research and the adoption of a “clean” lifestyle, led to Valpone’s complete recovery (read more about Amie’s story here). Now she wants to help you get well, too.

Kars4Kids writer Varda Epstein stumbled on Amie’s blog after seeing a lot of mommy/healthy nutrition blogs with truly dreadful looking photographs and descriptions. But Amie’s blog, thehealthyapple.com, was a horse of a different color. The photos were GORGEOUS and the food, healthy as it was, looked absolutely delicious. We thought Amie might offer our readers some guidance on how to foster better, more nutritious eating habits in our children so we reached out to her for an interview. As it turns out she had a lot to say on the subject and much helpful advice to dispense.

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K4K: So many children have learning disabilities these days. According to a collaborative study by the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA), the rate of ADHD alone, went up 33% from 1997 to 2008. From your perspective, as someone involved in clean eating, could there be a connection between diet and learning disabilities? Is this rising rate of learning difficulties a sign that children have nutritional needs we’re not meeting as parents?

Now tell me--what kid would turn down THIS snack? Recipe HERE (photo credit: Amie Valpone)
Now tell us–what kid would turn down THIS snack? Recipe HERE (photo credit: Amie Valpone)

Amie Valpone: Who knows if food is at play here because so many things have changed—it’s hard to extrapolate what’s at play with such a large sample and so many variables—but also awareness is so much higher. It’s possible that we are just diagnosing better, or possibly over-diagnosing. 

K4K: How should a child’s diet differ from an adult’s diet?

Amie Valpone: Less sugar. Avoid the crash and cravings. Less carbs, take the opportunity to introduce foods they don’t/can’t get at home and let them run around and breathe. Too much sitting is detrimental to concentration and sugar only makes it worse by spiking their blood sugar and leading to so many other awful issues including gut issues.

K4K: Are there items we should include in a child’s diet to aid in concentration in the classroom—to relieve the stress that comes during exams and tests? Are there dietary changes we might try before putting children on medication for ADHD, such as Ritalin?

This recipe is listed as "Kid Friendly" on thehealthyapple.com. We concur. (photo credit: Amie Valpone)
This recipe is listed as “Kid Friendly” on thehealthyapple.com. We concur. Recipe HERE. (photo credit: Amie Valpone)

Amie Valpone: Less sugar and more organic lean proteins like beans, legumes, poultry and low-mercury seafood but also a more regular schedule in general. ADHD is definitely real but it can’t be an excuse for behavior if the behavior can be changed without drugs.

K4K: You speak a lot about clean eating. Is it more difficult for city children to get clean food in their diets? Are they exposed to more toxins than children who live in rural areas and if so, can we address this from a dietary standpoint?

Amie Valpone: Some cities are “food deserts.” Some inner-city kids don’t know what fruits and vegetables look like in their natural form—only what’s cut up and soaked in preservatives on their lunch trays or in packaged processed food. Current government assistance does not provide enough money for fresh fruits and veggies to feed full families (ask yourself what you would do if you’re trying to fill your babies’ empty bellies and you can buy a few pieces of rotten fruit or a ton of cheap cereal and chips and soda), and so the grocers don’t stock fresh produce.  

School breakfasts, snacks and lunches are the number one way we can help these kids experience new foods and good nutrition, which is the number one way to prevent disorders and illnesses like asthma that are exacerbated by toxins in their neighborhoods. From lead paint to secondhand smoke to cheap toys to factories/pollution that wealthier communities can contest, these kids are definitely exposed to more. Children can become obese and malnourished and they can’t concentrate.

K4K: How do you ease children into a clean diet from one that is heavy in refined carbohydrates and sugars? How do we make such food appealing to them? Do we ban junk food altogether?

This will make a salad-eater out of even the pickiest child. (photo credit: Amie Valopone)
This will make a salad-eater out of even the pickiest child. Recipe HERE. (photo credit: Amie Valopone)

Amie Valpone: Banning things at home just causes children to binge and leads to cravings for these processed foods. It doesn’t teach anything and costs money. Have kids help more in the preparation of their food. They’re more likely to try it. Don’t go cold turkey. Transition. Allow treats. Talk about it, and make it fun but not an obsession. Arm them with the tools to make their own healthy decisions because the real world isn’t devoid of junk, but kids can make the right choices if you give them the opportunity. 

K4K: How much should we regulate a child’s diet?

Amie Valpone: I think that exposure is a better word than regulate. Expose children to more and they’ll want more. Regulate them and they’ll binge on junk food as soon as they’re out of their parents’ sight or develop food-related hang-ups (I’ve seen both). Just be mindful that they are always thinking and watching and so lead by example. Teach them how to take care of themselves through food –through exposure. Make it a positive thing versus a negative thing.

Amie Valpone, HHC, AADP is the Editor-in-Chief of www.TheHealthyApple.com; she is a Manhattan based Personal Chef, Culinary Nutritionist, Professional Recipe Developer, Food Photographer, Writer and Motivational Speaker specializing in simple gluten-free, soy-free and dairy-free ‘Clean’ recipes.  Amie recently healed herself from a decade of chronic pain including Lyme Disease, Polycystic Ovarian Syndrome, Hypothyroidism, Heavy Metals and much more exhausting every doctor in the country and Mayo Clinic; she shares her story of how Clean Eating  and Detox saved her life and inspires you to Clean up your food, too.  Amie lives in Manhattan, NYC where she cooks for a variety of clients including celebrities and people with busy lifestyles who enjoy healthy, organic, whole foods. Amie’s work appears on Martha Stewart, Fox News Health, WebMD, The Huffington Post, The Food Network, Glamour Magazine, Clean Eating Magazine, SHAPE Magazine, Prevention Magazine, PBS and many others. Visit Amie on Facebook, Twitter, Instagram, Google Plus and Pinterest @TheHealthyApple.