Why is measles making a comeback?

FROM THIS ARTICLE:

“There are two reasons for this year’s measles resurgence in the US, according to a recent paper in the New England Journal of Medicine.

The first is that the virus is still rampant in other countries, where it remains a leading cause of death in children. Globally, more than 20 million people still get measles each year, and about145,700 of those infected died in 2013 — an alarming increase from the previous year. Americans who travel can’t completely avoid contact with measles in many countries, but with high vaccination rates and effective infection control procedures in place, the disease can be kept at bay in the US.

That’s why the second reason for the resurgence is so troubling. “An increasing number of parents in this country are hesitant to have their children vaccinated,” the authors, from the Emory University School of Medicine, explain. “Such hesitancy has resulted in an accumulation of unvaccinated populations who can become infected and maintain transmission.”

There will always be a small number of unvaccinated people, namely babies who are too young for the vaccine and people whose immune systems are too compromised for a vaccine to be effective. Under the best circumstances, those people are protected by herd immunity: when the vast majority of a population is vaccinated, the virus cannot spread and will fail to reach the vulnerable few. But the “accumulation” the Emory researchers refer to is “non-medical exemptions” — parents who cite religious or philosophical objections to vaccination, artificially increasing the ranks of this vulnerable group and putting those who can’t make a choice, like infants, at unnecessary risk.

Source: forumblog.org

I think it’s going on three years that I have been posting this piece of public health news.

My review of the national population health statistics for "refusal to immunize children under 5" received a considerable amount of resistance from the medical profession. My matching posting on examples of diseases that are immunized and where they are noted as part of a patients medical history in this country, drew the criticisms of leaders in some of the grander leadership positions in the epidemiological field. But facts entered into EMRs don’t lie (some are rule outs, some are history, some are mistakes), and millions of accidental entries seems very much impossible.

This observation of avoiding the childhood immunization program I first made in 1986 when I was a researcher of taxol and several novel cancer drugs, in Portland State University’s chemistry department. At the time, I was also teaching classes on health and medical chemistry. My chemical specialty was and still is alkaloids and toxicology.

Friends in my age range in the late 1980s had kids who they refused to immunize. This was very much a by-product of the natural health movement going on around this time, but soon escalated into the vaccinations are unsafe ideology, due to the published claim that autism could be linked to certain vaccines.

(At one point in time, the mercury in the measles vaccine was claimed to be linked to autism, a claim since reversed and the supportive findings retracted by the researcher who performed this study; it was subsequently denounced in the medical journals and literature, but is still believed in by many people today).

Ten years later, when I had the opportunity to begin researching the health of the population using GIS and spatial data, this is one of the first topics I evaluated–the distribution of immunizable diseases in young children, and the EMR claims that included V-codes indicating a refusal to immunize you child.

Each of the immunizations that is refused has its own V-code. A single immunization can be in combination form, but there is an independent v-code for each line of combos or single vaccination products that is refused. A mother that refused to let her child be given an MMR for example was of course counted for each of the 3 vaccines refused. This allowed me to differentiate refusals by type of immunization, to determine if measles was the primary disease being avoided for its vaccine products.

When I first produced these maps, I was completely surprised about how universal these refusal patterns were, with parents preventing immunization of their children across all immunization products, both single and combination products, not just involving the individual measles vaccine or the MMR.

This behavior continues to day, and over the years the videos I produced of the maps of these behavioral pattern have remain unchanged in their spatial findings–the Pacific Northwest has the greatest numbers and density of children lacking the complete immunization profile by the age of 5, and the lower Hudson Valley into New York City has the greatest population density of children lacking a full immunization history.

This was also the first evidence I then publicized, for arguing that my very fast program for mapping national disease (nationalpopulationhealthgrid project – NPHG) is in need of further use and experimentation in a real life big data world. (Which I am still searching for, for my PhD dissertation project).

needless to say, there is a tremendous amount of resistance against my national population health mapping technique. I admit, it is not as standard and cut and paste as the other GIS systems everyone is heading towards. However, this is the only effective way to produce 15 to 20 thousand maps per day, or dozens to hundreds complex 3D maps, enough maps to quantify the health of the entire nature for hundreds of metrics per program run.

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Should the reader wish to explore my unique innovation, the child immunization presentations are at the following:

http://nationalpopulationhealthgrid.com/applications/01-childhoodimmunization/ 

https://brianaltonenmph.com/gis/population-health-surveillance/production-examples/childhood-immunization-refusals/ 

Immunizations and other childcare health issues demonstrated using the NPHG program are presented at this YouTube page: https://www.youtube.com/playlist?list=PLWrApErk5byaJjbbjS6TEAAChZ7apmbzg 

My Pacific Northwest Regional Health research report (1987-2006) also details this aspect of regional health, and more, at https://brianaltonenmph.com/gis/population-health-surveillance/production-examples/regions-and-health/ 

My criticism on much of the public health profession and managed care industry about its slow adoption of GIS in healthcare administration and management is reviewed–pointedly and in its entirety–at https://brianaltonenmph.com/about/surveillance-3d-modeling/ 

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IMMUNIZABLE DISEASES VIDEO(S)

For those with just a few minutes to check out this issue, I recommend my 3.5 minute video on where the diseases are noted in the medical records, and a series of videos on the refusal for each vaccine type. These videos very succinctly makes my point – – THE HERDING EFFECT IS AN OUTDATED IDEOLOGY OR PARADIGM that has to be put away when dealing the healthcare of a modern/post-modern society. See this at

https://www.youtube.com/watch?v=W1d8fBxz5V4&feature=youtu.be 

Or via (for the written text introduction page),

https://brianaltonenmph.com/gis/population-health-surveillance/production-examples/the-childhood-immunization-problem/part-i-immunizable-disease-rates/ 

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My general review from years ago of immunization refusals has the following YouTube index (links to an old YoutTube site, inactive, but most videos are still running):

IMMUNIZATION REFUSALS (CHILD AND A COUPLE ADULT)

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Other related pages/presentations/poster sessions/etc.:

https://brianaltonenmph.com/2014/02/14/population-density-immunization-refusal-potential-outbreak/ 

http://altonenb.tumblr.com/post/93111801851/the-immigration-problem-were-not-talking-about 

A third party information page supporting my postings: http://www.directrss.co.il/TextPage_EN.aspx?ID=6660655 

ScoopIt! on the new mapping algorithm I developed–NPHG: http://www.scoop.it/t/national-population-health-grid 

A NLM article on the pacific NW problem, particularly in Seattle – – http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1919709/ 

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“Great spirits have always encountered violent opposition from mediocrity.”

Albert Einstein, 1940

"All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident."

Arthur Schopenhauer

See on Scoop.it – Medical GIS Guide

Brian Altonen, MPH, MS