Measles Outbreak in Charlottesville

Lots of local media outlets are reporting on a local woman hospitalized with measles. Presumably unvaccinated, the woman had just returned from India, where she unknowingly contracted measles. Two of the people she came in contact with now also have the measles. The health department is trying to track down everybody who could have been exposed, so they’re releasing a list of the time and places of her travels around town. Those are the Charlottesville Waldorf School last Friday and the Downtown Mall between 4:30–9:00, specifically The Paramount, Marco & Luca, and Chaps Ice Cream. If you have cause to think that you or somebody who know was exposed, watch for flu-like symptoms that may or may not include a rash. As soon as they develop, isolate the patient and call—don’t visit—a doctor.

This is not an overreaction. Measles are mind-bogglingly contagious—it’s possible to contract it by simply breathing within dozens of yards of somebody who is infected. While the disease is often merely unpleasant, complications are common—pneumonia, encephalitis, partial blindness. Anybody who has had their MMR shots is immune.

Here’s hoping that Waldorf parents aren’t the sort who refuse to immunize their children—if they are, this outbreak could get a great deal worse. Measles were basically unknown in this country until the past few years, when well-meaning but ignorant parents started refusing to immunize their children (there’s a well-debunked urban legend that vaccines cause autism), leading to 118 cases in the U.S. so far this year—plus these three—some of which were among groups of children whose parents denied them immunization. Get your kids vaccinated, folks.

29 thoughts on “Measles Outbreak in Charlottesville”

  1. Since I’m older than this vaccine, I’ve actually had measles, but was immunizated against German measles. I was also immunizated against small pox, but I digress. I don’t see which variety of measles is currently zipping around the downtown mall. Anybody know?

  2. My money says that there’s a higher percentage of parents who don’t immunize among the Waldorf population than among most other schools.

  3. I worry that you’re right. Anecdotally, from the kids I know who went there and, now that I’m older, the parents I know who send their kids there, that seems right on a stereotypical level.

  4. You mean generating good karma isn’t going to protect my childern? I’m not composting anymore and taking my Prius back to the dealership!

  5. I too am of the generation when such as measles, mumps and chickenpox were almost like a childhood rite of passage,and I had my stint with all 3.
    Nothing serious from any of them, in fact with chickenpox in the first grade I recall my bewilderment at not being allowed to go to school.
    But with effective vaccines available now whats the point in taking risks with your kids health, not to mention loss of school time?

  6. The last reported case of measles locally was when I was in high school–and was a school mate of mine. They discovered at that time that either a round a vaccines were ineffective or we all needed another booster shot for full immunity(can’t remember which). I got mine in high school in the weeks following the case, but my college classmates were required to get another shot prior to college entrance.

    regardless, vaccines aren’t 100%–all women are tested for immunity for measles prior to or early in a pregnancy because immunity from vaccines is neither 100% nor lifelong.

    That being said, my son is fully vaccinated on the standard schedule. I feel it is a public service we do for those children who are unable to be vaccinated for medical reasons. Due to allergies as a young one, we initially thought he wouldn’t be able to be vaccinated on schedule.

  7. My child was given the ‘required’ vaccines, but not the optional ones. There is a certain body of evidence that indicates that the immune system needs to be challenged in order to train itself to protect you. So my child got chicken pox at five, but would have been immunized against it if she had not gotten it by about age ten. There are legitimate reasons for not immunizing; I charted a course that was part conventional wisdom (do it!) and part, well, common sense (of course the immune system needs to be sent to a gym to work out…).

    I really am interested to note how nearly universal the condemnation of the non-immunizers is. Most of us are just going to slide around on the back seat if we aren’t belted in: just as I did as a child in the pre-seatbelt days. Mostly, we’re not going through the windshield. Without immunization, we’re mostly going to train up our immune systems with an uncomfortable week or two. We are all required to belt our children into the car these days; we’re not all required to immunize our children. So why are we this offended by those who choose not to? The three reported cases are all (I believe) adults: why did the conversation immediately shift to children?

  8. Yep. My mom let me crawl around on the floor eating bugs and dirt back in the early 60s and ignoring the omnipresent sanitizers and the like. I vaguely recall getting a cold for a day back in 1986…

    My extremely unscientific thoughts, and my wifes serious belief, is that we often try and get science to do what nature will often do just as well.

    Sadly, I watch the group of 20 somethings that work for me in a constant state of some sniffle or bug or the like all winter long.

  9. Barbara, one of the reported cases is a child. For me, “offended” is the wrong word to describe my reaction to those who choose not to vaccinate their children against a disease like measles or whooping cough — “pissed off” is more like it. They’re choosing to put other people’s children at greater risk; their unvaccinated child is much more likely to get one of those diseases and spread it in the community to vaccinated children (because vaccines reduce the likelihood of contracting the disease/the severity of the disease, but don’t eliminated the risk entirely). Whooping cough in an infant can be fatal; measles has some very scary possible complications. Your example of not vaccinating for chicken pox is a bit of red herring; if your unvaccinated child spreads chicken pox, the threat of complications is far less scary.

    Those who don’t use a car seat or seat belt on their child in the car are endangering their own child. Those who don’t vaccinate their child are endangering my child.

  10. Shingles: My 15 year old daughter got the chicken pox vaccine as a baby and last fall had an incredibly painful rash on her hand that I am pretty sure was shingles. Now one of her classmates has shingles. Getting the chicken pox vaccine does not protect you from shingles.

    I venture to say that not appropriately restraining a child in a car is far more likely to lead to death or injury than not vaccinating.

  11. Most of us are just going to slide around on the back seat if we aren’t belted in: just as I did as a child in the pre-seatbelt days. Mostly, we’re not going through the windshield.

    Easy for you to say—you’re alive. The people who died from not being buckled in cannot comment here to disagree with you. According to the National Highway Traffic Safety Administration, over 12,000 people in auto accidents in 2001 would have died if they hadn’t been wearing their seatbelts. That’s a lot of kids who wouldn’t have just been sliding around the back seat.

  12. I was going to correct myself this morning, having discovered that one of the infected is a 7th grader.

    I’m trying to ask broader questions. The incidence of autism & life threatening food allergies have sky-rocketed. Measles itself doesn’t kill people: it’s the secondary infections that do that. Administering vitamin A to measles victims reduces fatalities by 50%. Vitamin A. US measles deaths actually plummeted in the 30’s & 40’s due to improved nutrition and were statistically unchanged by the immunization programs instituted in the 1960s. Improved nutrition was the equivalent of the seatbelt. If we want to elimate car-deaths in children, we would have to make it illegal for them to be in cars. Isn’t that idea the equivalent of requiring vaccinations? If we’re serious about eliminating the risk of death for our children?

    But that’s the problem: we can’t eliminate risk. And we don’t evaluate risk very well. Most of the time we perceive it based on what is familiar, to us, at this particular snapshot of time and culture.

    Our environment is complicated & the changes we humans have made to it are astounding. We have impacted our water, food, and air with our factories, deforestation, and chemicals. We impact the micro-environment of our bodies with vaccines and processed foods and hair dye. I’m saying every complication introduces new risks. I’m saying asking if new risk ‘A’ is worse or no better than old risk ‘B’ isn’t a bad thing.

  13. Barbara, I don’t think anyone here is opposed to evaluating risk, and I don’t think anyone here believes that all risk can be eliminated. I am opposed, though, to off-loading risks to my child onto other people’s children, which is what happens if I decide, based on the junk science alleging a connection between vaccinations and autism, to leave my child unvaccinnated.

  14. Eat right, exercise, don’t smoke, practice safe sex, wear your seat belt, and get vaccinated. Those seem like pretty good rules to live by.

    Why anyone thinks they can debate the merits of any of those is astonishing to me.

  15. Parents who choose not to vaccinate their children are not only putting children who are medically ineligible for vaccinations at risk, they are also putting infants too young to be vaccinated at risk, as well as frail adults whose vaccine protection no longer exists. I do not understand how any private school can choose to admit children who are not vaccinated for non-medical reasons. Perhaps this outbreak will alert private school parents of children who can’t be vaccinated for medical reasons that they must check on their school’s policy on vaccinations.

  16. Virginia law allows for both a medical exemption and a religious one:

    My understanding is that schools are not allowed to question the religious beliefs of a parent or student using the exemption. I imagine that the 39 unvaccinated people at the Waldorf school all had exemptions on file, which is how they knew so quickly how many people were not vaccinated for measles.

    39 out of 200 in one school is a lot. I’ve actually found some stuff online about Waldorf/Steiner that implies that Steiner taught that vaccinations were disruptive to spiritual and physical development.

  17. The “measles” outbreak is rubeola, not rubella (“German” measles). Pregnant women do not routinely receive antibody titers for rubeola–they are checked for immunity to rubella, because it is teratogenic. Vaccination does not guarantee lifelong immunity: boosters are encouraged for individuals who have only had the initial series and are older. The woman who contracted the first case may have been vaccinated when she was much younger. We really shouldn’t speculate.
    For children, the vaccine is not 100%–but it’s close (I heard ‘99%’ which I assume corresponds to only one actual infection per 99 exposures) if the child has received both doses.
    Let’s hope no one else gets sick.
    I’d also like for us to stop blaming parents, who always do what they believe is best for their children, for not vaccinating. They don’t make up these notions themselves–there are individuals with vested financial interests who spread false information in order to sell books and alternative health products.

  18. What’s your definition of “blaming,” Adrienne? What I hear on this board, and what I’m doing myself, is critiquing the decision of a non-vaccinating parent, as I see believe it’s a decision to free-ride on the vaccinations that other kids are undergoing (i.e., take advantage of herd immunity) while increasing the risk facing kids who are unvaccinated for legitimate medical reasons. To call that “blaming” seems simplistic to me.

  19. Claire,
    No parent makes a decision he/she feels to be bad or dangerous. Parents who believe that vaccinations are dangerous for their children *also* believe that they are dangerous for all other children. They’re not abstaining so as to take advantage of your “free ride.” They don’t understand “herd immunity” and have made their decision based on bad information or lack of information. Raging at them will not change their behavior. Unfortunately, many of them have had very negative experiences with medications or healthcare, and they have come to distrust it all. It’s not hard to develop this viewpoint when your doctor won’t take the time to listen to your concerns, and the pharmaceutical companies engage in utterly immoral acts on a daily basis. It’s hard not to see the world as black-and-white. It *is* hard to have compassion for people who see things differently, especially when everyone is afraid–but it is also necessary.
    I support actions that will actually result in better public health. Refusing to understand why a problem exists and lashing out at people who are in fact also victims is not helpful. It’s vanity.
    Let’s start with debunking the people getting rich by encouraging parents to abstain from vaccination: high-profile doctors such as Mercola who sell books and “alternative” products to vaccines, Jenny McCarthy and Robert F. Kennedy, Jr. who will seize any opportunity to hurl themselves into the limelight, and local practitioners who practice ineffective “alternatives” such as homeopathy. Let’s take the time to explain how vaccines work and to listen. The current rates of vaccination should tell us that what we’re doing now isn’t working.

  20. @ Barbara: I would be interested in seeing the “body of evidence” which supports your notion that vaccination has a deleterious effect on the immune system. I am unaware of any scientific evidence that supports your “common sense” theories about the merits of contracting a vaccine-preventable disease.

    I believe there are several reasons why people reject vaccination. The misperceptions about risk which lead to such decisions are in part because they receive bad information, but that’s not because there is not enough good information available. It is in large part because they lack the ability to differentiate between good and bad information, but they do not recognize this fact. My common sense tells me that, because my knowledge of immunology and vaccine science is pretty limited, I should trust the recommendations of others who are well-educated about the subject. Like the folks at the CDC, or WHO, or the vast majority of medical professionals. But the people who reject vaccines and the science behind them, in my experience, generally believe themselves to be very “educated” on the subject. In fact, they frequently believe that their rejection of what is widely accepted as fact demonstrates both their intellectual superiority and their distinctiveness as those who reject authority. The rest of us are either sheeple or shills for Big Pharma.

    It’s comforting to believe that the risks that you can control, like rejecting vaccination and the potential side effects, are much bigger than the risks that you have no control over, like those posed by the actual disease. That’s why people don’t vaccinate, in spite of the fact that the risk of harm from the disease is about 1000x that of the vaccine. Or why a smoker might choose not to fly because of the risk that the plane will crash. This is human nature. Its also human nature to believe what seems to be true, even when your experiences related to that belief are extremely limited. I can’t really fault anyone for that, but at the same time I think there is a social contract which is violated when parents choose not vaccinate. In the US, it is possible for a minority to refuse vaccination but remain relatively safe from the risk of disease simply because most of us vaccinate. When the herd immunity decreases to a level that the disease is able to gain a foothold, those that choose not to vaccinate will, as Barbara said, probably have a few days or weeks of minor inconvenience if they get sick, and will acquire immunity to the disease along the way. But the most vulnerable among us, those too young or too sick to be vaccinated, will be at risk because of their choices.

    I have kids, and I am not overjoyed about the tiny but real risks associated with vaccinating them. I do recognize that the real disease is much riskier, just as the Waldorf parents who are rushing their children to be vaccinated now that the risk is real and imminent do. They always understood it, and they selfishly decided not to take the small risks because the rest of us who did made it safe for them to do so. They are freeloading of the rest of us, just like a tax evader who enjoys the resources financed by tax dollars does. It’s unethical and I have every right to be angry about it.

  21. I find it very hard to believe, Adrienne, that the parents of Waldorf kids as a rule don’t understand the concept of herd immunity. I think they’re very well aware of what it means, and how it benefits them if they don’t vaccinate their kids.

  22. The non-vaccinating parents I know *don’t* understand, so I’m speaking from my own experience, not my imagination. The parents I know believe that vaccinations don’t work and that they are dangerous. For example, they think that some other mysterious factor resulted in the extinction of polio and that the idea that the vaccination was the cause to be “hype” or “propaganda.” They cite misleading “research” by parties who have a lot to gain from the creation of a vaccine controversy. Again, just my own experience.

  23. Adrienne writes, “The non-vaccinating parents I know *don’t* understand, so I’m speaking from my own experience.” That’s a helpful clarification that corrects your earlier blanket assertion that “Parents [no qualifier, implying “all”] who believe that vaccinations are dangerous for their children *also* believe that they are dangerous for all other children. They’re not abstaining so as to take advantage of your ‘free ride.’ They don’t understand ‘herd immunity’ and have made their decision based on bad information or lack of information.” It’s helpful now to see that you really meant “the parents I know” rather than all parents. If you had said that at the outset, the back-and-forth would have gone differently.

    You seem familiar with a subset of nonvaccinators who think very, very differently than the typical Waldorf parent (and here I’m speaking from *my* own experience, not my imagination). The kind of parents who send their kids to Waldorf understand that vaccinations eradicate diseases. They understand what herd immunity means; they’re banking on it. They simply don’t want to expose their own child to either the scientifically accepted risks of immunization (the very low incidence of seizures, etc. that they always warn you about) OR to the alleged risk of autism. If they were living abroad, in a country where these diseases still raged, they’d vaccinate, because they don’t want their child to get polio. They just figure the US is a safe place to run around unvaccinated.

  24. Claire, so you’re saying that the parents you know with this mindset are worried about autism? If so, they must believe that vaccines are dangerous for everyone, if they have been duped into believing that they cause autism. The difference in the two viewpoints is that the parents you know seem to believe that vaccines cause autism, and they *also* protect against disease. The parents I know may or may not buy the autism thing, but they definitely believe that vaccines don’t do what they are supposed to do.

    Unfortunately, the autism misinformation is still raging, despite the doctor behind the initial study’s having been discredited. I saw a link posted on FB only yesterday about a “regression analysis” on cases of autism and incidence of vaccination. Supposedly, the researchers had also corrected for ethnicity and SES, but naming these variables is just a smoke screen to fool the public into thinking that a causal relationship can actually be substantiated. It’s a correlation at best–but we may as well run a regression on average global temperature and vaccine numbers and claim that global warming causes autism. They looked at raw numbers–they’re going up, because the population is increasing. They didn’t look at rates per capita. And even if they had, a correlation never corresponds magically to a cause.
    This is the sort of “research” that healthcare providers need to address with their patients. Ignoring it is not working.
    I do understand why you’re angry, I think. It is a very frustrating situation.

  25. “Most of us are just going to slide around on the back seat if we aren’t belted in: just as I did as a child in the pre-seatbelt days.”

    This reasoning is rather disturbing.

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