Saturday, February 22, 2014

KISS 2/22 : Mostly measles with a side of flu

Since both ScienceMom and I are strapped for time at the moment, I thought we'd try to do a series of short posts on current vaccine related themes - keeping it short and simple KISS.

1. Max is dead

Parents of children with SSPE, the always fatal measles complication, are getting more vocal in their support for vaccines, and therefore, we get to know the names of their children. Max caught measles in late 1994, when he was just half a year old, probably from older kids in his brother's daycare. He recovered seemingly well, but in 2004, 10 years later, he suddenly had memory lapses and was diagnosed with SSPE soon after. In 2006, Max fell into a wake coma - the family took care of him at home as long as possible, but in early January, Max was in such bad, intractable pain that his family placed him in hospice care. They write:

Maxi's condition has constantly worsened over the past weeks. He is barely reacting to his environment and if even he does, he would often start crying and screaming at things that definitely could not cause any pain such as music, wind or when you just caress him.

We are at the end. We cannot get the pain under control, we dare hardly just to touch him. For us parents it means a torture and for Maxi an absolutely intolerable situation. We have therefore decided to give Maxi in the care of a small hospice not far from here. It is a beautiful house, almost like a living community, located in a residential area. We very much hope that they will find the right pain management and that he no longer has to suffer. Today is the day.

Almost nine years of caring for Maxi within his family are coming to an end. We are very sad and it breaks our hearts, but we just can go on no more.

On the 12th of February 2014, Max passed away. Finally. He never had a chance.

2. Increase in measles cases in California

Really, this should not happen at all, however, unvaccinated adults and children are exposing Californians to measles. I wonder whether we'll ever learn whether the Temecula measles case was Dr. Bob's patient, like the patient who started the 2008 San Diego outbreak. As a reminder - check your immunity for measles. If you are not immune, get the MMR.

3. 2013/14 Flu vaccine effectiveness released

The CDC has released the preliminary vaccine effectiveness for this year's flu season (approximately 61%). Tara Haelle at Red Wine and Apple Sauce has summarized the situation in a thorough blog: Flu is really bad this year - and the vaccine's pretty good.


  1. What a tragedy for Max and his family; my deepest condolences to his family.

    There are two new cases of measles at the Temecula School, both cases were never vaccinated against measles and they were excluded from attending school, after the first case of measles was confirmed:

  2. Just so you know, SSPE can be contracted by having the MMR as well. In a study 40 out of 350 were fully vaccinated and had never had Measles, but had SSPE. In the study 46 % of the cases with SSPE had had Measles before age 2.

    1. Anon that is wrong - go away and read

      6.4. Only wild-type virus sequences have been found in SSPE

      Measles virus is a monotypic virus and the virus exists as a single serotype. Infection with one strain of measles appears to provide life-long protection from the disease. With the development of RT-PCR and DNA sequencing techniques it has become clear that virus isolates vary in their nucleotide sequences especially in those encoding the last 150 amino acids of the N protein and the entire H protein (Rima et al., 1997, Rota et al., 1992, Rota et al., 1994 and Taylor et al., 1991). During the last decade sequences of over 250 strains have been determined and these show that at least 21 genotypes exist which belong to eight different groups or clades. Although these viruses may once have been geographically restricted in their distribution, the increase in travel by children, who are the prime reservoir for virus replication, has now allowed worldwide distribution of most of the genotypes. Some of the clades appear to be extinct as no recent isolates have been made, but it is difficult to be certain about this as global measles surveillance is inadequate. In the USA and the UK, it has been possible to link the origin of the imported strain with travel by specific index cases (Rota et al., 2004). Thus the different genotypes have made it possible to establish transmission chains for a number of outbreaks.

      The description of specific clades and genotypes of MV has allowed the evaluation of mutations found in the MV RNA sequences from SSPE brain material against wild-type (clades B–G) viruses. All the vaccine viruses are derived from the Edmonston strain (clade A) but no clade A virus has been found in SSPE brain material. The sequences found in SSPE brain are related to the wild-type viruses circulating at the time of initial infection of the child and not to those circulating at the time of onset of symptoms. Hence, the virus which initially infected the child, appears to persist and SSPE is not due to a super-infection by viruses circulating during the onset of symptoms (Jin et al., 2002 and Rima et al., 1995; Rota, personal communication). To the best of the authors’ knowledge no vaccine virus, genotype A, sequences have been obtained from SSPE cases. SSPE has been vastly reduced in incidence after successful control of measles by vaccination (Dyken et al., 1989). In contrast, vaccine strains have been identified in MV infections in immuno-compromised patients who died from MIBE (Bitnun et al., 1999) and giant cell pneumonia (Mawhinney et al., 1971).

  3. What study would that be? How about a link to that study for your claim that the measles strain contained in a measles vaccine, caused childrens' cases of SSPE?

    You do know the difference between a strain of measles contained in vaccines and the wild strains of measles virus, don't you?

  4. The vaccine virus has never been implicated in SSPE. Always the wild virus. ""All of the genetic analyses of viral material derived from brain tissue of SSPE patients have revealed sequences of wild-type measles virus, never vaccine virus. There is no evidence that measles vaccine can cause SSPE." "Genetic studies have supported epidemiologic evidence that measles vaccine virus does not cause SSPE [6, 14, 15]"measles vaccine virus does not cause SSPE [6, 14, 15]"

    1. @justthevax There were 11 probable measles vaccine-associated cases (5.4%) three (1.5%) being vaccinated with a combined use of killed and live vaccine and eight (3.9%) with further attenuated live vaccine. There were nine cases (4.4%) Without a history of either measles illness or measles vaccination.

    2. Do, Thingy, tell us how good the technology was for analyzing DNA in 1989? Obviously, this is why you always bring up old studies. So each time I need to remind you of this, along with the 2005 article posted by Dr. Reiss: Review of the effect of measles vaccination on the epidemiology of SSPE.

      Which says: Cases of SSPE in which there is no known history of natural measles infection but measles vaccine has been administered should, therefore, not be attributed to vaccine; all available evidence points to such cases being due to undiagnosed or unrecorded natural infection, which can be very mild.

      Next time, Thingy present a paper from the 21st century,

  5. Is it really Thingy who posted a link to that paper from Japan, which reported on SSPE cases from 37 years ago...or another germ-phobic crazy troll?

    How about this 2012 retrospective epidemiology study of SSPE cases in Japan?

    Survey of Subacute Sclerosing Panencephalitis in Japan


    Investigators conducted a retrospective epidemiological study of subacute sclerosing panencephalitis, a fatal disease caused by measles infection, over the past few years in Japan. Data on 118 cases obtained from a questionnaire sent to attending physicians were analyzed. The annual incidence of subacute sclerosing panencephalitis was approximately 0.03 cases per million from 2001 to 2005. Children infected with measles at a young age (<12 months) showed a high incidence of subacute sclerosing panencephalitis, and those infected before 6 months of age showed earlier onset. Because a positive correlation was found between the prevalence of measles and the onset of subacute sclerosing panencephalitis, particularly among children infected at an early age, it is vital to eradicate measles infection by vaccination.