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Measles Outbreak In Europe, Especially France

Measles

By JOHN HEILPRIN   04/21/11 07:47 AM ET   AP

GENEVA -- Europe, especially France, has been hit by a major outbreak of measles, which the U.N. health agency is blaming on the failure to vaccinate all children.

The World Health Organization said Thursday that France had 4,937 reported cases of measles between January and March – compared with 5,090 cases during all of 2010. In all, more than 6,500 cases have been reported in 33 European nations.

"This is a lot of cases, to put it mildly. In past years we've had very few cases," said Rebecca Martin, head of WHO's office in Copenhagen for vaccine-preventable diseases and immunization.

"There's been a buildup of children who have not been immunized over the years," she said. "It's almost like a threshold. When you have enough people who have not been immunized, then outbreaks can occur."

WHO has found that young people between 10 and 19 have not been getting immunized as they should, she said.

To prevent measles outbreaks, officials need to vaccinate about 90 percent of the population. But vaccination rates across Europe have been patchy in recent years and have never fully recovered from a discredited 1998 British study linking the vaccine for measles, mumps and rubella to autism. Parents abandoned the vaccine in droves and vaccination rates for parts of the U.K. dropped to about 50 percent.

The disease has become so widespread in Europe in recent years that travelers have occasionally exported the disease to the U.S. and Africa.

Around Europe, Spain reported more than 600 cases in Andalusia in two outbreaks since October in Sevilla and Granada. Macedonia reported 400 cases this year with the capital, Skopje, most affected.

WHO said outbreaks and rising case numbers also were reported in Britain, Germany, the Netherlands, Norway, Romania, Russia and Switzerland.

"One of the problems is that people have fear of the vaccine more than the disease," Martin said. "People forget how severe measles can be."

WHO officials are examining immunization coverage data and plan a workshop with French, German, Belgian and Swiss officials later this month.

Measles symptoms include fever, cough, spots on the cheek and a rash. It is spread through close contact including coughing and sneezing and is especially serious in babies and people with weak immune systems. Health officials estimate complications affect one in every 15 children infected, including pneumonia, seizures and encephalitis.

___

AP Medical Writer Maria Cheng in London and Elaine Ganley in Paris contributed to this report.

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GENEVA -- Europe, especially France, has been hit by a major outbreak of measles, which the U.N. health agency is blaming on the failure to vaccinate all children. The World Health Organization said ...
GENEVA -- Europe, especially France, has been hit by a major outbreak of measles, which the U.N. health agency is blaming on the failure to vaccinate all children. The World Health Organization said ...
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Josephius
No, not microbio, molecular bio and biochemistry!
HUFFPOST SUPER USER
Taximom5
02:23 PM on 05/29/2011
So now they are recommending the MMR for infants 6-11 months old??? Where are the studies showing safety of the MMR for this age group?

And they are recommending TWO doses of MMR for anyone over one year of age before traveling abroad? Why are they not doing a titer check first? They should do a titer check before even ONE dose of MMR for anyone who has already had it, and they should routinely do a titer check before ANY second dose of MMR!

Oh, but they won't sell as many vaccines that way. Never mind, then...
01:11 PM on 06/01/2011
"Oh, but they won't sell as many vaccines that way. Never mind, then... "

The profit on a singe vaccination is about 10 to 25 cents. The cost of a single measles case can be thousands of dollars. If "big pharma" really was determined to make people sick to profit from it, they'd be doing everything they could to NOT vaccinate.

But hey, you stick with the naive belief that a merciless profit motive is driving them to turn away billions from treating measles, whooping cough and polio in order to scrape together a relative pittance from vaccination. I'm going to invest in "big pharma" stock. The anti-vax movement is going to be making money for them hand over fist in the next few years.
06:14 AM on 05/13/2011
Europe's measles outbreak has cast serious doubt on the continent's chances of meeting its WHO target for measles eradication in the coming years. Same goes for polio: it was meant to be wiped out in Europe next year but 2010 saw a major spike in new cases.

The figures from France are pretty shocking. I think if this were an epidemic of a new disease it would be all over the media but coverage has been relatively low-key, perhaps because measles is not currently seen as a major risk. Unfortunately this is probably about to change in the coming years if the number of cases continues to rise.

http://www.vaccinestoday.eu/diseases/measles-eradication-targets-under-threat-amid-epidemics/
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
08:21 AM on 05/13/2011
Glad they are not in charge of spaceship telemetry ...

"He pinned the blame primarily on declining public trust in vaccination, something which he said is a major concern, along with increased global travel. The surge in polio in Central Asia had originated in India."

Apparently the globe trotting Indian poor are to blame......

--------------------------------------------------------------------------------------

"The H1N1 pandemic has led to the very principle of vaccination being questioned, according to Ms Onkelinx..."

Wonder why ? .... "WHO failed to manage conflicts of interest among some of the members of its Emergency Committee which advised on the pandemic response."

---------------------------------------------------------------------------

...and the inevitable ....

"Reaching out to minorities and migrant populations will be particularly important"

--------------------------------------------------

One should be reminded that they have had 50 years to get the vaccination programme going and all you've done in that time is lost public confidence in the very system you say is so important to us all.

Through a variety of poor choices , strategies , lack of engagement , conflicts of interest, ......
09:31 AM on 05/13/2011
Some fair points Richard. Can I just ask: is your main gripe that authorities have done a poor job at managing the public health system, thus losing public confidence?
Or are you unhappy with vaccines in general?
Josephius
No, not microbio, molecular bio and biochemistry!
02:30 PM on 05/25/2011
"Apparently the globe trotting Indian poor are to blame.....­."

No. It's often brought back by the globe trotting non-poor business travelers who have it on them, or have been exposed to it (asymptomatic, thanks to immunization) and excreted in the stool when they return.

"all you've done in that time is lost public confidence in the very system you say is so important to us all. "

No, not really. It's reduced the incidence of these diseases to levels so low, for so long that people do not even know what these diseases are anymore. in fact, it has been so effective, we now have a portion of the population that has become complacent (at the least) or have become down-right denialists that they have the luxury of questioning the necessity of immunizations.

All it's going to take is more outbreaks and more exposure to the problems by the ignorant for them to get back on the program and realize how stupid they were.
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HUFFPOST SUPER USER
Dyson
debunking pseudoscience, one fallacy at a time.
07:06 AM on 05/04/2011
Vaccination rates for measles have remained suboptimal in France despite the introduction of effective vaccines. Rates peaked at just over 80% in the mid 1990s. If anything, the problem has got worse since the early 2000s, when publicity about Wakefield's fraudulent study peaked. The problem is one of encouraging the population to recognize the merits of vaccination, as well as ensuring the relevant health agencies continue promotion of immunization programs.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=322

During the current European Immunization Week, agencies may hopefully co-ordinate and implement better strategies to increase immunization, and hopefully this can bring an end to the outbreaks of measles cases and deaths across France and Europe.

Interesting commentary on communication about vaccination in the internet age:
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19849
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HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
01:12 AM on 05/05/2011
The vaccination enterprise is fragile. We are injecting substances into healthy infants to protect them against diseases which no one gets.

That's why the anti-vaccine movement is so dangerous. It doesn't take much to have parents move from vaccinating to not vaccinating.
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
02:09 AM on 05/05/2011
Public Health authorities in this situation should be more concerned with the fundamental errors made in health surveillance and containment they have made, then making some spurious and unevidenced attacks against religious groups, ethnic minorities and vaccine safety advocates.

What is needed is some clear objective reflection on the processes and campaigns they have waged over some forty years and the failure to engage these groups in positive health outcomes.

There are some clear and apparent areas that need to addressed inclusive of :

A health summit that contains all stakeholders including representatives of religious groups, ethnic minorities and vaccine safety advocates. to plan and implement a co-operative response that leads to positive health outcomes.

The investigation at a national and international level on more robust health strategies that protect particularly vulnerable groups within society including infants and unvaccinated populations. As well as the continuation of secondary strategies that can be made available if the first line 'fails".

Apparently doing the same thing over and over and over ..... is ....

"Insanity: doing the same thing over and over again and expecting different results."

Albert Einstein
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
04:10 AM on 05/05/2011
Here's an example of a positive engagement ...where medical authoritites worked together with a religious oragnisation to save a woman's life.

http://www.abc.net.au/worldtoday/content/2011/s3208571.htm

"Synthetic blood saves a life

A Melbourne doctor has saved a woman's life by using synthetic blood.

The product which is derived from cows' blood has largely been experimental until now and it's the first time it's been used in a life and death situation.

There are predictions synthetic blood will change the way doctors think about trauma medicine.

SIMON LAUDER: After a horrific car crash in October, Victorian woman Tamara Coakley ended up in Melbourne's Alfred Hospital.

She had massive blood loss but as a Jehovah's Witness she wasn't able to accept a regular blood transfusion.

When her condition started getting worse the head of trauma at the hospital Mark Fitzgerald had to find an alternative.

MARK FITZGERALD: She needed some blood but for religious reasons couldn't accept a blood transfusion. So we were able to get hold of some synthetic blood.

It has been used on other patients before but none of them have been at risk of absolute death if they hadn't received the product which she was."

-------------------------------------------------------------

This is where modern medicine should be opening research and working together for solutions .... not blame.
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John Richard Smith
Social Justice Advocacy
10:58 PM on 04/30/2011
There are many underlying questions in this debate that are either dismissed or avoided.

It is important that they are at least asked ...where the answers may lead us may well be an interesting journey.

It is a question of asking some robust and critical questions that leads to a solution rather than a continual "blame game", that stifles intellectual debate and much needed research for all children.

What has contributed to an outbreak on mainland Europe where the languages and culture are significantly different from the United Kingdom ?

Why were French doctors and medical students working with infants in critical care areas unvaccinated ?

How much did they as members of the medical community contribute to the spread of measles ?

What are the significant groups that are unvaccinated and do they contribute to disease outbreak or not ?

What strategies do medical authorities have in place to protect vulnerable infants that cannot be vaccinated ?

What alternative strategies have they planned ?

What research and development have they undertaken to improve vaccine safety over the last 15 years ?

What are the true and factual underlying reasons why people may not vaccinate ?

What statistical information or other studies have been undertaken by health authorities to answer this important question ?

What I clearly see from health authorities is an inability to engage and problem solve a solution for the benefit for all.

Hippocratic Oath
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Dyson
debunking pseudoscience, one fallacy at a time.
05:18 PM on 05/01/2011
Q: "What has contributed to an outbreak on mainland Europe where the languages and culture are significan­tly different from the United Kingdom?"

A: The UK is not a whole lot different - there have been outbreaks there in the last few years too. But there is rather a more "laissez faire" attitude in France to many things - part of continental culture.

Q: "Why were French doctors and medical students working with infants in critical care areas unvaccinated? and How much did they as members of the medical community contribute to the spread of measles?"

A: This refers to one study (Cotes de Rhone region) with 310 cases, 28 in health care staff. Normally these staff are required to show either evidence of vaccination or immunity (by serological tests). In this outbreak, a higher proportion of the HC worker cases had received full vaccination than had the index measles cases - this indicates that HC staff are susceptible to infection from their patients following more intensive exposure to infectious cases (and not necessarily that they act as vehicles for onward spread). Clearly France has some work to do in ensuring full vaccination of their HC staff to try and limit their infection.

Q: "What are the significant groups that are unvaccinated and do they contribute to disease outbreak or not?"

A: As previously mentioned, anthroposophic communities and certain religious and travelling communities who object to vaccination are the ones mainly hit in European outbreaks, but there are others.
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HUFFPOST SUPER USER
Dyson
debunking pseudoscience, one fallacy at a time.
05:30 PM on 05/01/2011
Q: "What strategies do medical authorities have in place to protect vulnerable infants that cannot be vaccinated? What alternative strategies have they planned?”

A: The main strategy is to ensure herd immunity remains high enough to protect these infants, through universal vaccination. This works extremely well in countries with high immunization rates, but in Europe is compromised by the low uptake in many communities, which may spark off outbreaks. Authorities are aware of the problems and actively devising new approaches. These conference proceedings give some idea of what they are up to, but I am sure many expert minds are applying their efforts to solutions.
http://bit.ly/htWW3b

Q: “What research and development have they undertaken to improve vaccine safety over the last 15 years?”

A: Too broad a question, considering how many vaccines there are and how much work is ongoing. Google scholar is your friend. I know you feel enough is not being done, but recently with respect to MMR most of the crucial work was done between 15 and 30 years ago, and the vaccine has been tweaked and improved in terms of efficacy, immunogenicity and safety to a standard that is very high. Much of the recent safety work has gone into looking at MMR in combination with other vaccines – the experience of MMRV is quite instructive here – the combination led to a higher than expected number of febrile episodes, so it is not given now.
HUFFPOST SUPER USER
Taximom5
07:44 PM on 05/01/2011
Dyson: "Much of the recent safety work has gone into looking at MMR in combinatio n with other vaccines – the experience of MMRV is quite instructiv e here – the combinatio n led to a higher than expected number of febrile episodes, so it is not given now."

Yet according to www.cdc.gov" updated recommendations, May, 2010: "For the first dose of measles, mumps, rubella, and varicella vaccines at age 12--47 months, either MMR vaccine and varicella vaccine or MMRV vaccine may be used." And here in the US, pediatricians are giving the MMRV as standard, often telling parents that they don't even have MMR any more, or else they give separate MMR and Varicella on the same day, which kind of defeats the purpose of separating them.

So you are wrong to say that the MMRV is not given now.
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HUFFPOST SUPER USER
Dyson
debunking pseudoscience, one fallacy at a time.
03:17 AM on 05/02/2011
I was wrong about the MMRV advice. I see that it is still an option to give the combined vaccines.

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5903a1.htm?s_cid=rr5903a1_e

Safety studies indicated a higher risk of rash and fever as compared to individually dosed contemporaneous vaccines, so further studies were done (so, safety studies ARE still carried out).

"Use of MMRV vaccine has the benefit of requiring one less injection than the alternative of MMR vaccine and varicella vaccine. The risk for a febrile seizure after the first dose of MMRV vaccine, although low, is higher than after MMR vaccine and varicella vaccine administered as separate injections, and use of MMR vaccine and varicella vaccine avoids this increased risk. Children who have febrile seizures generally have an excellent prognosis. However, first febrile seizures often require a medical visit to an emergency department and are distressing for parents and caregivers. Therefore, parents might prefer to avoid the small increased risk for fever and febrile seizures after the first dose of MMRV vaccine compared with the first dose of MMR vaccine and varicella vaccine administered as separate injections. Given the balance of risks and benefits of a first dose of MMRV vaccine compared with a first dose of MMR vaccine and varicella vaccine, and the importance of individual values and preferences in weighing these risks and benefits, decisions should be made by providers and parents or caregivers on a case-by-case basis."
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HUFFPOST SUPER USER
Dyson
debunking pseudoscience, one fallacy at a time.
08:08 PM on 04/30/2011
It's really quite strange.

This discussion is ostensibly about the outbreaks of measles among (unvaccinated) children and people in Europe. There have been thousands of cases, and several deaths. Considering the declining levels of herd immunity, particularly in some pockets within the US, and the likelihood of outbreaks occuring here, this should be an important problem to discuss.

Yet some people posting here just want to talk about the "evils" of vaccines, and how they caused this reaction, or that side effect, or are linked (not) with autism. Worse still, when posters like me point out the acknowledged harms and risks that infections like measles can do, I am criticized for doing so, even though this information is clearly important and relevant to readers of the topic of "Measles outbreak in Europe".

On Huffpo, there is a vaccine-themed post every other week it seems, often highlighting some aspect such as whether there is a link to autism.

But somehow, the antivaccine posters never confine their debates about vaccine reactions or damage to these discussions, they have to infest just about every post on Huffpo that has even the remotest bearing on vaccines. One could almost be forgiven thinking they lie in readiness, waiting for any suitable topic to rear its head, and then they all pile in with their antivaccine propaganda, guns blazing, disguising their attacks on all vaccines as "concerns" about vaccine safety.
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
10:09 PM on 04/30/2011
First post on this topic ....

----------------------------------------------------------------------------------------------------
Pro Vaccine

09:07 AM on 4/21/2011
" . . . a discredite­d 1998 British study linking the vaccine for measles, mumps and rubella to autism."

The one responsibl­e for that has a lot to answer for.
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Pro vaccine

09:13 AM on 4/21/2011
Those truly responsibl­e, the stupid parents!

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Pro vaccine

09:13 AM on 4/21/2011
The British study linking vaccines to autism wasn't just discredite­d. It was proved to be fraudulent­.

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Pro Vaccine

09:18 AM on 4/21/2011
Fraudulent­? How so?
And, it's incredibly sad that people still use that an as excuse not to vaccinate their children. *shakes head*

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Pro safety

09:18 AM on 4/21/2011
i would really be interested to know the ages of the people infected. how many were adults? funny how the same people that give so much grief to those who question vaccine safety aren't even vaccinated themselves­. they have no problem giving their babies shot after shot after shot but are they fully vaccinated­?

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Pro vaccine

09:19 AM on 4/21/2011
JENNY MCARTHY IS DESTROYING THE WORLD.

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What reasonable people on this issue are trying to promote on Huffpost is that the reader should undertake a careful and critical reflection on what is being presented to them.

There is a story to be told and it has two sides, after the above post from a pro vaccination adherent you should seek an obvious balance.
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HUFFPOST SUPER USER
Dyson
debunking pseudoscience, one fallacy at a time.
05:52 PM on 05/01/2011
Supporters of vaccination may well have posted on this thread, however my point still stands.
11:22 PM on 04/30/2011
"This discussion is ostensibly about the outbreaks of measles among (unvaccinated) children and people in Europe."

I wonder why you wrote children and "people", instead of "adults" - children *are* people!

ADULTS in these reports are greatly affected by measles and yet it is the non-people (i.e. children) who are solely blamed for the outbreak and targeted for vaccination.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19443

Large measles epidemic in Switzerland from 2006 to 2009: consequences for the elimination of measles in Europe

"Adults aged 20 or over made up 19% of cases"

http://www.eurosurveillance.org/images/dynamic/EE/V15N36/art19656.pdf
Spotlight on measles 2010: Update on the ongoing measles outbreak in France

"The proportion of cases aged 20 years or older increased from 17% (n=100) in 2008 to 23% (n=360) in 2009 (p=0.002) and 38% (n=992) in 2010".

"50% (n=725) of the cases aged 20 years or older were hospitalised"

"the proportion of complications reported for the hospitalised cases was significantly higher among the cases aged 30 years or older (40%)"


http://www.eurosurveillance.org/images/dynamic/EE/V16N10/art19815.pdf

Ongoing Measles Outbreak Geneva Switzerland January to March 2011

"A total of 41 confirmed cases have been reported, the majority among young adults"

"No deaths were reported. All but one of the patients with complications or who were hospitalised were adults (median age: 36 years).
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
12:15 AM on 05/01/2011
That's some good data and work Alex007 .... getting a clear answer on what exactly is happening and what the true undistorted figures are, is a prerequisite for efficacious medical intervention.

"The proportion of cases aged 20 years or older increased from 17% (n=100) in 2008 to 23% (n=360) in 2009 (p=0.002) and 38% (n=992) in 2010".

This certainly seems to indicate that there is a real and significant problem in this population that cannot be 'blamed' on the so called "Wakefield" factor....

What are the factors involved in this ?

When children are involved once again it is intellectually disingenuous to point fingers at Wakefield it seems that the Health Authorities are not responding to an obvious problem in their strategy of vaccination.

"The vaccination coverage survey conducted in the
school year 2005-6 among six-year-old school children,
has shown a vaccination coverage of 93% for the first
dose of an MMR containing vaccine and 44% for the
second dose....."

http://www­.eurosurve­illance.or­g/images/d­ynamic/EE/­V15N36/art­19656.pdf

I think that data once again speaks for itself.... the system has some real difficulties to overcome.
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HUFFPOST SUPER USER
Dyson
debunking pseudoscience, one fallacy at a time.
03:54 PM on 05/01/2011
In Europe, about a fifth of those affected by this measles epidemic are adults.

Considering that many younger adults have fallen into the group who had been inadequately immunized, getting only one MMR shot instead of 2, this is hardly surprising. Their age-specific immunity is likely to be much lower than either yonger twice vaccinated people or older naturally infected people.

Stands to reason. But as JRS said, most cases are in completely unvaccinated kids and in infants under 1 yr old the severity is the highest.
08:13 AM on 04/29/2011
Was there any contributing factor for this???
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
07:52 PM on 04/29/2011
* Health care workers including Doctors and medical students were not vaccinated.

"In the PACA region, healthcare workers were particularly affected by measles, with 28 cases reported in 2010 (as of 30 November) through the mandatory notification system, representing 9% of all cases in the general population. Four cases were nurses, four were medical doctors, 11 were students (two nursing students and nine medical students) and seven were other types of healthcare workers; for two cases, their type of healthcare work was unspecified."

"The low measles immunisation coverage among the general population and healthcare workers, who can infect vulnerable persons who they treat, facilitates the expansion of the outbreak in the region"

"Insufficient implementation by healthcare workers and general practitioners of the current recommendations issued by the French health authorities [4] and unsuitable control measures in some healthcare facilities are the cause of measles transmission in healthcare workers and hospitalised patients"

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19754

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Four medical doctors and nine medical students. The obvious question then would be why not ?
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HUFFPOST SUPER USER
Dyson
debunking pseudoscience, one fallacy at a time.
06:49 PM on 04/30/2011
I want to know why people are so lax about immunization in France too.

At least you readily accept that unvaccinated people act as conduits and catalysts for outbreaks.

All the more important to keep people immunized then, something you clearly agree with since you highlighted this problem in your post.
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HUFFPOST SUPER USER
Dyson
debunking pseudoscience, one fallacy at a time.
06:45 PM on 04/30/2011
Well, vaccination against measles significantly reduces the risks of acquiring measles.

The overwhelming majority of cases in these outbreaks were in unvaccinated children/people.
Ensuring children are protected through vaccination, both directly and through herd immunity, would have averted these outbreaks.

As to why there are so many unvaccinated in Europe...? Many loci of outbreaks are in schools and communities that traditionally avoid vaccination on anthroposophical or religious grounds. There should be far better education about the risks of measles and the importance of vaccination imo.
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
12:37 AM on 05/01/2011
Which inconveniently overlooks this fact ...

"In the PACA region, healthcare workers were particular­ly affected by measles, with 28 cases reported in 2010 (as of 30 November) through the mandatory notificati­on system, representi­ng 9% of all cases in the general population­."

Here's that highlight again - 9% of all cases in the general population.
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HUFFPOST SUPER USER
Dyson
debunking pseudoscience, one fallacy at a time.
03:45 PM on 05/01/2011
Health care workers are particularly vulnerable to acquiring infections from their patients.

Now who on earth would have imagined that in an infection outbreak?

In SARS, a high proportion of cases (and deaths) happened in the dedicated health care staff caring for patients.
It appears measles is little different in its propensity to infect medical staff.

In most other countries, mandatory vaccination of medical staff happens.
But in some countries libertarians object to that.
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HUFFPOST SUPER USER
Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
01:09 AM on 04/29/2011
Dr. Bob's Waiting Room
----------------------------------
I just came across this great blog entry: http://justthevax.blogspot.com/2011/04/2008-measles-in-dr-bob-sears-waiting.html

Dr. Bob, he of the relaxed vaccination schedules had a patient who had been intentionally not vaccinated against the measles. The kid ended up spreading the measles to 4 other kids in Dr. Bob's waiting room --- one kid ended up in hospital.

Measles is incredibly contagious. And we are going to see a lot more cases in the next few years. Hopefully, the death and disability toll will be small. We may see a new effort to catch up on measles vaccination in older children whose age means they are past the age of having their autism manifest itself, so that parents fooled by vaccination opponents will at least realize this.
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HUFFPOST SUPER USER
Sonic hedgehog
A true word needs no oath
10:46 PM on 04/29/2011
I think pretty soon we will be able to determine who specifically got the virus from who for every infectious viral disease (it is already possible for HIV). I wonder if the parents of the child will be prosecuted for putting both their kid and other kids in danger in case of a death. For HIV both intentional and non-intentional spread of the disease have been criminalized and people were punished. (I actually don't agree with those decisions because if you're gonna criminalize spreading diseases you cannot just limit it to one disease).
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HUFFPOST SUPER USER
John Richard Smith
Social Justice Advocacy
12:07 AM on 04/30/2011
sheldon

We can certainly juxtapose this against the following ...

"Insuffici­ent implementa­tion by healthcare workers and general practition­ers of the current recommenda­tions issued by the French health authoritie­s [4] and unsuitable control measures in some healthcare facilities are the cause of measles transmissi­on in healthcare workers and hospitalis­ed patients"

http://www­.eurosurve­illance.or­g/ViewArti­cle.aspx?A­rticleId=1­9754

------------------------------------------------------------------------------------------------

Dr Bob

"I believe that if more and more doctors offer parents such options, we will have better vaccination rates than we are seeing now."

Is it not true that the so called 'index' patient was in fact, as were the other patients to receive vaccination ?

Is it not true that the evidence you presented is from a militant pro vaccine site ?

Is it not a reasonable supposition then that the evidence then is biased ?

Do you reject the clear evidence that modern medicine is based on individual assessment of the patient involved and that there are clear contraindicators for some children to be vaccinated ?

Do you reject the supposition that health authorities have been unable to put forward clear medical strategies for the above group ?

Is it not a sound supposition that a single measles vaccination would be a viable alternative to those parents that seek safer alternatives for their children ?

Is it not a sound supposition then that a single vaccine would indeed reduce measles spread ?

Do you reject the clear evidence that health authorities were clearly evidenced to facilitate the spread of the disease ?
12:48 AM on 04/29/2011
Dyson,

@ Apr 28, 2011 at 18:22:19 you wrote:

"Unbelievable. You deny this happened?:

During the epidemic in the US between 1962–1965, Rubella virus infections during pregnancy were estimated to have caused 30,000 still births and 20,000 children to be born impaired or disabled as a result of CRS.[22][23]"
http://en.wikipedia.org/wiki/Rubella


I do not deny that babies were born with the triad of classic CRS symptoms after rubella infection during the early months of pregnancy.

What we do not know is exactly:

1) how many cases of rubella there were in the 1960s (when most childbearing women were naturally immune)

2) how many babies were stillborn because they had been infected by rubella ( Currently 1% of UK babies are either stillborn or die within the first few weeks)

3) how many were born with Classic CRS (the triad recognized at birth) and

4) how many were thought to be affected by rubella infection (recognized later) - hearing problems, developmental delay, autism

See if you can find out where these huge numbers from Wiki originated, Dyson because as far as I can see they came from estimates produced by Dr Stanley Plotkin, who happens to be the inventor of the rubella vaccine.
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HUFFPOST SUPER USER
Sonic hedgehog
A true word needs no oath
11:03 PM on 04/29/2011
Why do you keep bringing the discussions to the top of the comments? You could've replied to dyson in the same thread, he has other comments in the same thread. This attention seeking behavior makes your arguments weaker by the minute.
11:44 PM on 04/29/2011
Keep? I've top-posted twice.

I think you should take a look at that thread. There are more than 20 comments one after the other without reply buttons to them, except mine. If I had replied to Dyson's comment @ 05:56 PM on 4/24/2011, my reply to his comment @ 06:22 PM on 4/28/2011 wouldn't have appeared underneath his, and wouldn't have made sense, and I certainly didn't want him to miss my question by replying to myself.

Seeing as my comment has been up since yesterday and Dyson hasn't responded yet, I'll ask you:

Can you find out where these huge numbers originated?
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Dyson
debunking pseudoscience, one fallacy at a time.
07:19 PM on 04/30/2011
I cannot comprehend your point, if you have one.

The fact is that there was a massive rubella epidemic in the early 1960s, and thousands of cases of congenital rubella syndrome resulted.
The epidemic did not happen merely because one doctor said it did.
The epidemic was not an "estimate", it was a frightening, widespread problem that greatly accelerated the search for a vaccine (successfully too). Pediatricians, public health physicians, epidemiologists, virologists, obgyns throughout the country had direct experience of the epidemic. The legacy of the epidemic cast a pall upon thousnads of kids, who if they survived, suffered cataracts, sensorineural deafness and heart problems. Google it - there are thousands of links to the information.

But you are now questioning some of this information. Why?
Would the fact that there were only half as many cases as there were reported make the disease any less awful? If there were only 10,000 CRS cases instead of 20,000 would that make rubella an OK thing for pregnant women to get?
Obviously no.

Thank heavens there is a great vaccine to prevent this problem ever recurring in the numbers it did 50 years ago.

But thanks to antivaccine campaigners, we may see it return, and see more and more women and children suffer. The risks that rubella in pregnancy imposes are serious, well documented and very quantifiable (and hardly speculative). I suggest you read the Pink Book, or check Mandell's book on infectious diseases from your local medical library for the details.
01:32 AM on 05/03/2011
I am questioning the source and reliability of these estimates:

12.5 million cases of rubella
30,000 stillbirths
20,000 cases of CRS in live-born infants

Since no one was counting cases until rubella become a notifiable disease in 1966, after the 1963-64 epidemic, and the CDC didn't establish the National Congenital Rubella Syndrome Registry until 1969, the year the rubella vaccine was licensed, what were these numbers based on?

Were there really 20,000 children born blind and deaf, who also had heart defects?

Here's an interesting article from 1965:
http://www.time.com/time/magazine/article/0,9171,842123,00.html
Gynecology: More Abortions: The Reasons Why

Note that the epidemic that was sweeping the US was "expected to leave more than 30,000 babies stillborn **or** crippled", not "30,000 stillborn **and** 20,000 crippled, and that "Doctors widely disagree as to what proportion of women who get the infection early in pregnancy will bear blind or deformed babies".

"A number of doctors argue that German measles is no valid reason for abortion. Says Tulane's Dr. Isadore Dyer, a chief of obstetrics at New Orleans' vast Charity Hospital: "If between 10% and 20% of the women who contract the disease in those first three months are going to have babies with anomalies, it seems rather drastic to destroy the other 80% or 90% to guard against this.""
01:35 AM on 05/03/2011
Continued

From this 1967 study:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1842984/pdf/brmedj02152-0025.pdf
Gammaglobulin in Prevention of Rubella and Congenital Defect: A Study of 30,000 Pregnancies

30,000 women exposed to rubella. Attack rate 1.95% in women treated with gammaglobulin rising to "3.25% at the height of the epidemic".


"Of 610 women who had rubella in pregnancy only 70% came to term. About a quarter of the children whose mothers had the disease in the first 12 weeks had heart or hearing defects; the proportion fell to about 10% for the next four weeks and then to about 5%"." (Notice that these children had **three** postnatal evaluations - complete physical examinations, careful auditory and ophthalmic assessment;and EEGs and chest x-rays.

"13% of the children, live-born or stillborn, were reported to have congenital defects, and in the light of the additional findings in the sample of children visited 18% is probably a better estimate. This high figure was largely accounted for by deafness and heart defects, both characteristic of rubella. **There were no cases of cataract**"

"There was no excess of cataract or heart disease and probably no excess of deafness in the children of the women who did not develop rubella though exposed to it. Subclinical rubella virus infection either carried little risk for the foetus or did not occur often enough for any adverse effect to be detected."

So NONE of the children in this study had classic CRS.
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Taximom5
04:58 PM on 04/28/2011
Well, well, what do we have here? Something from 1998 (and NOT associated with Wakefield) suggesting a causal relationship between measles vaccine and encephalopathy, even though we've been told over and over again that "vaccines don't DO that." Turns out, they've konwn all along that they DO do just that:

Pediatrics. 1998 Mar;101(3 Pt 1):383-7.

Weibel RE, Caserta V, Benor DE, Evans G.
Source

Division of Vaccine Injury Compensation, National Vaccine Injury Compensation Program, Health Resources and Services Administration, Public Health Service, Rockville, Maryland 20857, USA.
Abstract

OBJECTIVE:

To determine if there is evidence for a causal relationship between acute encephalopathy followed by permanent brain injury or death associated with the administration of further attenuated measles vaccines (Attenuvax or Lirugen, Hoechst Marion Roussel, Kansas City, MO), mumps vaccine (Mumpsvax, Merck and Co, Inc, West Point, PA), or rubella vaccines (Meruvax or Meruvax II, Merck and Co, Inc, West Point, PA), combined measles and rubella vaccine (M-R-Vax or M-R-Vax II, Merck and Co, Inc, West Point, PA), or combined measles, mumps, and rubella vaccine (M-M-R or M-M-R II, Merck and Co, Inc, West Point, PA), the lead author reviewed claims submitted to the National Vaccine Injury Compensation Program.

CONCLUSIONS:

This clustering suggests that a causal relationship between measles vaccine and encephalopathy may exist as a rare complication of measles immunization.
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Dyson
debunking pseudoscience, one fallacy at a time.
05:52 PM on 04/28/2011
Straw man alert!
Who has said "over and over again" that vaccines don't have side effects such as encephalopathy? Do you have a cite for those?

Measles vaccine is recognized as one of the many causes of ADEM (acute disseminated encephalomyelitis), a complication which may affect around one in a million vaccine recipients, and it is the problem that Bailey Banks developed and was compensated for through the vaccine courts.

(Natural measles causes it in 1 in 1000 cases of measles, by the way, approximately 1000 times more often than is seen with the vaccine)
09:56 PM on 04/28/2011
"Who has said "over and over again" that vaccines don't have side effects such as encephalopathy? Do you have a cite for those?"

The CDC's Vaccine Information Statements.

http://www.immunize.org/vis/

The MMR VIS doesn't list encephalopathy or ADEM as reactions to the MMR, and they are usually regarded as only temporally associated with vaccination - a coincidence.

"Severe Problems (Very Rare)

• Serious allergic reaction (less than 1 out of a million doses)
• Several other severe problems have been known to occur after a child gets MMR vaccine. But this happens so rarely, experts cannot be sure whether they are caused by the vaccine or not. These include:
- Deafness
- Long-term seizures, coma, or lowered consciousness
- Permanent brain damage"

Unfortunately, many pro-vaccination advocates assume that medical professionals spring into action when parents report symptoms of encephalitis/encephalopathy after vaccination. They don't.
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Taximom5
11:19 PM on 04/28/2011
Dyson: "Natural measles causes it in 1 in 1000 cases of measles, by the way, approximat ely 1000 times more often than is seen with the vaccine)"
And of course, this kind of mis-statement, made authoritatively and with utter conviction, in spite of the FACT that numbers aren't actually known, and in full contempt of the fact that very few vaccine reactions are even recognized, let alone reported...well, this kind of mis-statement is a huge part of the problem faced by those injured by vaccines.

And it's also a huge CAUSE of vaccine injuries that occur because people aren't aware that problems occur as often as they do. Statements like Dyson's have fooled parents into thinking vaccine reactions are rare. I was one of those parents. I know better now.

As a pre-emptive measure, I would request that Dyson et al refrain from trying to cloud the issue by trying to blame anyone calling for safer vaccines for any and all cases of illnesses that are supposedly prevented by those vaccines. We're tired of your games, and we're tired of pointing out that those vaccines don't work as advertised, and are clearly not as safe as advertised.

Our lives have been changed forever by vaccine reactions. Stop your silly games of attacking the messengers, and put your energy towards helping develop safer ways of preventing illnesses.
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John Richard Smith
Social Justice Advocacy
05:56 PM on 04/28/2011
Drilling deeper into the report

Acute encephalopathy followed by permanent brain injury or death associated with further attenuated measles vaccines: a review of claims submitted to the National Vaccine Injury Compensation Program.

"A total of 48 children, ages 10 to 49 months, met the inclusion criteria after receiving measles vaccine, alone or in combination.

Eight children died, and the remainder had mental regression and retardation, chronic seizures, motor and sensory deficits, and movement disorders.

The onset of neurologic signs or symptoms occurred with a nonrandom, statistically significant distribution of cases on days 8 and 9.

No cases were identified after the administration of monovalent mumps or rubella vaccine."

I'm going to see if any other posters on different forums have any thoughts on this. Thanks for the post it seems on my initial reading of it to be very valuable.
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Dyson
debunking pseudoscience, one fallacy at a time.
07:20 PM on 04/28/2011
48 possible cases, from a denominator of 75 million.
Don't forget to tell the people on those other forums that information as well, will you?
And also tell them that these cases may have been from the Edmonston strain of measles vaccine virus, which had a much higher rate of adverse reactions than the current measles vaccine strains.
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dbrett480
08:11 PM on 04/27/2011
This outbreak is ridiculous. This disease has all but been eradicated and the anti-vaccine nuts have brought it back. The same thing is happening with whooping cough in California.
04:12 AM on 04/26/2011
Top posting because I can't reply to Sonic on the thread.

06:36 PM on 4/24/2011
"Whenever I get a vaccine, they make me wait for at least 15 minutes to see if I get a reaction, and I think that's a common practice. So it's not the community's or the scientists' fault that your doctor dismissed the symptoms."


What makes doctors and you think that all vaccine reactions happen within 15 minutes of vaccination?

Doctors and their nurses dismiss vaccine reactions every day. Why should they take them seriously when they believe that they don't cause permanent harm? They're told by the CDC that they don't in their Vaccine Information Statements.
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onionboy
Blessed are the Cheese Makers
01:35 PM on 04/26/2011
I always love the "they" talk when talking about medical professionals.

MWAH-HA-HA-HA-HA!!! Do they where goatees and black rubber gloves?

Given the size of the medical field nowadays, I find it hard to believe that everyone in the country doesn't know at least one physician, nurse, MA, CNA...something. And I find it hard to believe that they're all in on this conspiracy of ignorance, all so they can injure you for some reason.
08:53 PM on 04/26/2011
It's not a conspiracy, onionboy.

They, that is to say, generally speaking, medical professionals ignore vaccine reactions because to them vaccines are safe and don't cause any long-term health problems such as long-term seizures or brain damage.

Earlier (Apr 24, 2011 at 13:06:35) DakkonA wrote:

"Reactions are known. You'll note that the handout you get whenever you get a vaccine lists them. From allergic reactions to Guillen-Barre Syndrome, they are listed. That's admitting them. We don't currently know what the risk factors are."

And I wrote:

"Who gets the handout? I didn't, and many other parents I know didn't.

What do parents who are given the Vaccine Information Statements learn from them?

From the DaPT sheet, that fever, sleepiness, fussiness and vomiting are common problems, that high fever, seizures, non-stop crying for 3 hours or more are moderate problems, and that the severe problems that have been reported: "long-term seizures, coma, or lowered consciousness and permanent brain damage are so rare it is hard to tell if they are caused by the vaccine".

Let's say your child, an infant, is irritable and has high fever, and that he cries for more than three hours, vomits, sleeps for a long period - say 24 hours, and has a seizure. Would you be concerned, and more importantly would your doctor and his nurse be concerned? Under any other circumstance I'm sure they would be, but strangely, not after vaccination. "
08:54 PM on 04/26/2011
Continued

Parents of vaccine-injured children will tell you that medical professionals dismissed their children's vaccine reactions time and again regardless of their severity and encouraged them to keep to the schedule.

Here's the link to the VISs:

http://www.immunize.org/vis/
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DakkonA
www.DisentangledReality.com
02:19 PM on 04/26/2011
The most severe allergic reactions do happen that quickly after exposure to a substance. I apparently had a mild anaphylatic reaction (not shock) to either a Gardasil dose or Tdap (had them simultaneously) last month, within 15 minutes of getting the vaccines. Sometimes reactions can take longer to develop. All of these possibilities were in the Vaccine Information Statement I read prior to getting the vaccines. And guess what? I'm not scared away from taking vaccines. The benefits far outweigh the risks.
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John Richard Smith
Social Justice Advocacy
02:07 AM on 04/27/2011
Anaphyaltic reactions usually occur within a short time period but they may not be recognsed as such. Children with existing and known reactions have to wait for at least two hours after vaccination according to my paediatricians advise.

I have also been advised that these reactions although may look minor may 'come in waves' thus a child that may appear to have a non life threatening reaction should never be left alone and should be fully supervised for a further two hours.
08:22 PM on 04/25/2011
Horrifying that in developed countries like Western Europe there are so many unvaccinated kids and so many outbreaks of measles.

Thanks, Wakefield - I hope you are proud of your legacy. At least you can't be a doctor anymore, which is a small mercy. But just stop your whistle-stop tours around the country promoting your antivax message, would you?
11:02 PM on 04/25/2011
Oh get over it! Dr. Wakefield is not the reason so many people are not vaccinating. There are probably more and more people opting out of all sorts of "dreaded disease" vaccines. They just keep shoving more and more i onto the schedule. Just yesterday at our Easter party my young friend was telling me of her disappointment in going to get her child's MMR and it being combined now with chicken pox as well. She said she only wanted MMR and they told her it was no longer an option just to get that. So she said, no thanks! So much for blaming Dr. Wakefiled! Her child was there to get another vaccine and he actually suffered a rather serious reaction immediately and they backed off completely on the MMR-varicella plan. A friend today told me they knew someone whose kid got chicken pox yet they gave her the vaccine for it anyways (just to be cautious) and the kid developed encephalitis shortly thereafter. No thanks.
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cable1977
Against logic there is no armor like ignorance
09:23 AM on 04/26/2011
"Dr. Wakefield is not the reason so many people are not vaccinatin­g. "

Even Wakefield's lawyer during the GMC hearing conceeded that Wakefield was responsible for parents not vaccinating their children.

http://dl.dropbox.com/u/26719415/Daily/Day_130.pdf

On p.3 of the transcript Kieran Coonan, the lawyer representing Wakefield, said the following during his closing comment:

"Dr Wakefield was, as you know, a senior author of the Lancet paper, and publication of the paper, together with the commentary and the observations that he made at the press briefing, has led on the evidence that you have received to a downturn, or at least did turn to a downturn, in vaccination rates for the MMR vaccine. That is a fact. And it is a fact, even though Dr Wakefield may have been justified in publishing the paper; even though he held honest views about the safety of the MMR vaccine, and even though he advocated the use of a single vaccine. The fact of the linkage between the paper and the press briefing and the
downturn is a fact, and it is not difficult to imagine that in some quarters he would be heavily criticised for that fact."

Why is that it that if Wakefield's attorney, tasked with defending him and speaking on behalf of Wakefield himself, can acknowledge the fact that Wakefield's comments led to reduction in vaccination, his supporters cannot?
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DakkonA
www.DisentangledReality.com
02:16 PM on 04/26/2011
So people are spontaneously opting out of vaccines... why, exactly? The answer is that they wouldn't unless they had some reason to think there was going to be a serious problem.
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Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
07:19 PM on 04/25/2011
Consequences
--------------------
Steve Novella's written a great blog entry called consequences at his personal, non-commercial blog. http://theness.com/neurologicablog/?p=3160

The point he makes is that it is the work of vaccination opponents, such as those who comment here, that has been so successful in lowering the vaccination rate just enough to allow outbreaks to occur.

That is the natural consequence of the nonsense they push on the unwary. I hope they are happy with the result of their work.

My personal, non-commercial blog now features the transcripts of the man most responsible for this unhappy result. www.sheldon10blog.blogspot.com
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Dyson
debunking pseudoscience, one fallacy at a time.
07:44 PM on 04/25/2011
Is that the right url for your blog, sheldon? Doesn't work for me.
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Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
09:56 PM on 04/25/2011
www.sheldon101blog.blogspot.com
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Eric Mann
Do you want to be on the opposite side of Progress
06:58 PM on 04/25/2011
Note to Europeans:
You have a vastly better way of delivering health care than us US folk. So quit believing in the cra-cra "vaccinations are bad" and GET YOUR DARN CHILDREN VACCINATED!
Thanks!
08:11 PM on 04/26/2011
The Europeans do not have a better way of delivering health care. I have lived there.....glad to get care in the USA.
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01:09 PM on 04/25/2011
Whooping cough.