Saturday, September 15, 2012

Back to school for unvaccinated pupils after measles in Arkansas

Well, colour me surprised - pleasantly surprised. After two pupils came down with measles in Ozark Adventist Academy (Justthevax passim), the other (8?) unvaccinated pupils had to be sent home. After confirmation of those cases, I already had the headline for a blog about subsequent cases written in my head (it had something to do with bears and woods), but herd immunity and quarantine are miraculous things and apparently, no more cases have been reported (see Arkansas Department of Health), so OAA calls their pupils back to school from Monday:

Measles Update
September 13

The measles outbreak has been contained to the original family. All vaccine-exempt students may return to school September 17 if they have their annual filing for vaccine exemption up to date as required by the Arkansas Department of Health.
I am very pleased (it would even be better if those students kept at home had decided to catch up on their MMRs).


  1. Catherina...The things you find out when you visit the Ozark Adventist Academy website...

    The school is a combination boarding and day school. Boarding students' parents pony up $ 15 K/Year. for U.S. Students; international Students tuition is $ 16 K/ year; day students tuition is $ 9K/ year.

    I "forgot" that the school calendar in the Deep South is quite different than the school calendar "up North". The class year ends weeks earlier in the South...but also begins weeks earlier for the new school year. Classes began on August 13th. Those kids who were unimmunized, were excluded from class for one month.

  2. Well, not really lilady, since the measles did not become apparent until Monday 8/27 or Tuesday 8/28. So three weeks in all, which is "normal" for these kinds of outbreaks. And if the parents did not get their kids caught up, they'll miss another 3 weeks when the next family brings measles to school.

  3. Thanks for your correction Catherina..."only missed THREE WEEKS OF SCHOOL", heh, heh.

    How about this scenario Catherina? A late admission to their boarding school of a child coming from a "foreign European country" where measles is endemic, who is not immunized against measles. Ah, the complications there...notifying everyone on the airplane that the foreign student traveled to the USA releases issued to notify at least two airports.

    Those "foreigners"... :-)

  4. no - these are US students who went travelling to Europe, picked up measles, came back during the incubation period, went to school, got sick after a week, then everyone got sent home. They were exceptionally lucky that not more people got sick. As previously blogged - while middle class American problem.

  5. No Catherina these are white upper class kids (see my first post above, about the tuition their parents pay).

    "Those foreigners" Did you miss my smiley face and my post on your blog? (Drat I should have added /sarcasm, to that comment.)

    liladyAugust 30, 2012 3:54 PM

    Spot on Catherina: I am so sick of hearing the bogus claim that it is the "foreigners" who bring these vaccine-preventable diseases to the United States.

    A small part of my work experience as a public health nurse was seeing patients in several of our satellite clinics. Our pediatric patients were first generation Americans whose parents were born and immigrated from Latin America, Asia and Africa. Their moms and dads were exceptionally compliant with "well child" clinic appointments; these children were almost always immunized completely and in a timely manner. The parents always called for appointments to get their children "caught up" on their immunizations. Perhaps these parents *knew* a lot more about the benefits of having their kids immunized according to the Recommended Childhood Vaccine Schedule?

    When I returned to my office at the health department to do case surveillance on individual cases or outbreaks of vaccine-preventable diseases, I found with trace-back investigations that (white) upper middle class kids were the index cases. These kids were deliberately not vaccinated, traveled to endemic countries and brought back the diseases, to infect other kids in their "group".

    BTW, an infant who is 6 months of age and not yet one year old, should receive MMR vaccine in contemplation to visiting a measles endemic country. This immunization will not be "counted" and when the child is one year of age (s)he will require the 2-dose MMR series.

  6. The Foreigners? Puh-leaze. If anything, people in countries south of the United States have a really good immunization rate. Public Health authorities in those countries don't play around. One single case of measles in a little girl that arrived from France was enough to send Mexican epidemiologist into action. They vaccinated everyone associated with that plane, even if they already had their vaccine up to date. They weren't going to play around.

  7. The epidemiologists in the United States go into high gear as well, whenever a highly infectious disease, such as measles is reported in a traveler who was aboard a plane...domestic or foreign departure gate.

    Take a look at the August 2012 report from the European Centre For Disease Prevention And Control:

    • The 29 contributing EU and EEA countries reported 4 513 cases of measles from 1 January to 30 June 2012 and 10 427 cases during the last 12-month period from July 2011 to June 2012.
    • Reporting was complete for the 12-month period, with the exception of June 2012 data missing for Austria.
    • France, Italy, Romania, Spain and the United Kingdom accounted for 90% of the reported cases.
    • The majority (83%) of cases were unvaccinated, a group which includes those who should have been immunised according to recommendations and children too young to have received the first dose of MMR vaccine.
    • Romania’s notification rate over the last 12 months has been the highest in the EU and the increase in the number of measles cases reported in June compared to May indicates that the current outbreak is likely to continue through the low-transmission season.
    • Although ten cases were complicated by acute measles encephalitis, over the last 12 months there have been no measles-related deaths.
    • During the last 12 months, six countries have reported more than one case of measles per 100 000 population and the aggregated European incidence was 2.05 cases per 100 000 population.
    • Measles transmission continued to be slow at European level and no new large outbreaks have been reported since the last monitoring report.

    While the number of cases of measles YTD in Europe is slowly receding, the number of Rubella cases is huge:

    • 17 821 cases of rubella were reported from 1 January to 30 June 2012 by the 26 EU and EEA countries contributing to the enhanced surveillance for rubella.
    • 22 835 cases were reported in the last 12 months period from July 2011 to June 2012.
    • Poland and Romania accounted for 99% of all reported rubella cases.
    • Reporting has been complete, with the exception of data missing for Austria and Greece in relation to June 2012 and Italy for the first six months of 2012.
    • Sweden has reported its largest outbreak of rubella since 1996, associated with low MMR uptake in an anthroposophical community south of Stockholm.

  8. I feel a blog coming on (still working on two others, but the increase in rubella is frightening in a very pre-enlightening kind of way - Dr Jenner will know what I am talking about)