Question about the rise in measles cases in Wales

[Harry Phillips]

Does anyone know if the water and nutrition in Wales going down...the rise in measles cases is going up the anti-vaxers claim that these types of illnesses was reducing because of the increase in good clean water and better food.

That make s me wonder if the water and food quality is Wales is now going down.

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Regards,

Harry Phillips

[Greg Beattie]

"Does anyone know if the water and nutrition in Wales going down..."

No idea, Harry. But apparently the vaccination rates are at an all time high. Where did you want to go with this?

Greg

[Tasha David]

Hi Harry,

I found this information on Swansea in particular, and it seems that they do have problems with poverty, nutritious food intake, poor environmental conditions, poor housing, high rates of looked after children, substance and alcohol abuse etc. 

This Measles outbreak is being blamed on Wakefield and children that are supposedly unvaccinated yet, where is the proof?  How many cases of Measles are in the unvaccinated and how many are in the vaccinated?  Why did this outbreak occur when the rates of MMR vaccination in Swansea are higher than they have ever been, why not when they were at their lowest? Has the fact that Swansea has serious socioeconomic and environmental problems been even considered as a factor?

“Child poverty continues; Swansea has two of the top three ranked LSOAs in Wales for overall childhood poverty (both in Townhill) and a total of 18 LSOAs in Swansea fall into the top 10% most deprived areas in Wales (Child Multiple Deprivation Index 2008). Swansea has the highest proportion of children in Wales who live in a workless household 24.8% compared to 18% for the Wales average”

 

“Environment

Poor air quality due to traffic pollution, for example, traffic congestion in built up areas, has been shown to be linked to heart disease and stroke as well as respiratory problems. In Swansea, it does not correspond directly with socioeconomic status, and is getting worse in some areas. In fact there have been two additional areas nominated as air quality management areas since the last needs assessment. Indoor pollution from nitrogen oxides is related to certain gas appliances such as free standing liquid petroleum gas heaters or gas cookers in unventilated kitchens and appears to affect poorer sections of the community. Radon gas has an unpredictable exposure in certain parts of Swansea and Gower, with 10–20% of the buildings are believed to have a problem with radon. Climate change has become a greater consideration - heavy rainfall can cause untreated sewage overflows into rivers and coastal waters and it is anticipated that this may increase in the future. Climate change also has the potential to widen existing social inequalities, as the poorest sectors of society are not only more vulnerable to the impacts of climate change (including the increasing cost of fossil fuels) but are also likely to find it harder to recover when incidents occur.”

 

“Obesity, diet and exercise

Lower income families have less variety in their diet, eat fewer essential nutrients but eat more fat and sugar as processed foods (higher in salt, fat and sugar) are cheaper per unit of energy than fruit and vegetables. In Swansea over one half of the adult population (57%) is reported to be overweight or obese, which has increased by 5 percentage points since the last Needs Assessment in 2007. A particularly high prevalence in childhood obesity can be seen between Wales and the rest of the UK, with significant differences seen between managerial and professional occupations and those in routine and manual occupations. In Swansea only 36% of people are eating the recommended daily quantity of fruit and vegetables.”

 

 

“Within Swansea though there are areas which experience much higher rates of mortality, with an estimated 13 year age difference in experience of longevity between the east and west parts of Swansea.”

 

 

“The association between deprivation and health is clearly apparent. Many health outcomes are statistically significantly worse than Wales as a whole in the following areas of high deprivation: Swansea: Bonymaen, Penderry, Castle, Townhill.”

 

“The WIMD for Child Deprivation 2008 shows that Swansea has 5 LSOAs, which rank in the top 20 worst LSOAs across Wales for deprivation in the Education Domain - all of these are in Townhill and Penderry.”

 

“Substance Misuse – Alcohol, Drugs and Tobacco

Swansea experiences serious issues in relation to substance misuse and:

- is the joint second highest local authority in Wales for adults (50%) who drank alcohol above guidelines on at least one day in the past week.

- has the third highest level in Wales of adults (33%) who reported binge drinking on at least one day in the past week .

- is consistently the highest in the UK for positive testing for heroin and cocaine in individuals arrested for trigger offences.

- has the highest number of drug implicated deaths in Wales in 2009.

- has a high rate (43%) of evidence of infection amongst injecting drug users

- 100 adults died between 2006 and 2008 of alcohol related causes.

- has a much higher rate of hospital admission due to alcohol than the Wales average for both men and women”

 

“There are a wide range of issues affecting children in a number of areas in Swansea, demonstrating the inequalities which are experienced. Particularly these include the number of children on benefits, a high level of lone parents with dependent children, issues around levels of alcohol misuse, large increases in numbers of looked after children, high birth rate levels in certain areas, high levels of children and young people not in education, employment or training, and poor service provision for this group. In addition the risk (e.g. family conflict) and resilience (e.g. good parent child relationships) factors which can have an impact on children’s health and well being outcomes are seen to themselves vary greatly across Swansea.”

 

“Within Swansea there is a high number of Carers and Young Carers (10% more) compared to the rest of Wales. Young Carers are a particularly vulnerable group, and the proportion of children who provide 20 hours and more care per week is over 20% higher than the Wales average”

“They also experience difficulties in balancing caring for others with looking after their own health, often failing to make or keep appointments.”

http://www.healthchallengeswansea.org.uk/media/pdf/a/s/Executive_summary_final.pdf

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[Katie Brockie]

Tasha - rather than reaching out for some tenuous connection to hygiene, nutrition, etc, why not just face facts. South Wales had a huge drop in uptake of the MMR vaccine several years ago, and now they are having a huge outbreak of measles. According to the ABM University Health Board, 90% of the measles cases in Swansea are in unvaccinated people, and in the remaining 10%, some of them are only partially vaccinated. (Read the questions and replies here: https://www.facebook.com/ABM.healthboard)

To me, this makes it very obvious that it is the unvaccinated who are catching and spreading the disease.

K

[Tasha David]

Katie,

I was responding to Harry's question about living conditions in Wales, so I was not making tenuous connections, I was answering a question.  The poor living conditions in Swansea are a fact, it is also a fact that people who live in poor living conditions are more prone to health issues such as disease, so exactly what facts would you like me to face?

I have had a look at the ABM Facebook page but I am unable to see any official data about unvaccinated people/children being 90% of the outbreak, just a comment from one of the moderators from the page. So shouldn't we wait till we at least have the facts on that one? 
I will be interested in the official results, but considering how outbreaks can also occur in highly vaccinated populations I am wondering what that would actually tells us?

I did find it interesting that they are already talking about vaccinated people being infected with Measles though...

“It is inevitable that some children vaccinated in the last two weeks will already be incubating measles and vaccination will not prevent them from becoming unwell, but their illness is likely to be milder than if they had not received the vaccine.”

 

http://www.wales.nhs.uk/sitesplus/888/news/26881

And that they are not able to laboratory confirm all of the cases during an outbreak, so not all cases will be actual Measles infection.

“Notifications of measles in Wales

The data given on this page are of notifications of measles reported to Public Health Wales by doctors who have diagnosed a patient with having measles from clinical symptoms. Usually, a notification of measles is laboratory confirmed (or not) by sending a sample for virological testing. However, due to the high numbers of notifications reported during an outbreak, it is possible that not all clinically-diagnosed cases will undergo subsequent laboratory testing. It is probable that not all cases notified on the basis of clinical symptoms will be due to measles infection and this maybe true especially for notifications from outside the outbreak area.”

 

http://www.wales.nhs.uk/sitesplus/888/page/66389

Here is a study that shows how laboratory confirmation of Measles infection is essential as there are other infections that can be misdiagnosed as Measles such as HHV 6

"This study confirms the importance of human herpesvirus-6 as a cause of rashes in young children and shows that many cases of exanthem subitum are misdiagnosed on clinical grounds as measles or rubella. Laboratory confirmation is essential to ensure the effectiveness of measles and rubella surveillance programmes."

 

http://www.bmj.com/content/312/7023/101

“How is measles diagnosed?

 

Because measles can look like other diseases that cause a rash, a blood test is the only way to be sure it is measles.”

 

http://healthvermont.gov/prevent/measles/measles.aspx

[Katie Brockie]

The measles outbreak in Wales is a result of a drop in vaccination. Whether cases are clinically or laboratory diagnosed, I am certain that when it's all over, data will show that a far higher percentage of unimmunised or not fully immunised people will have caught measles.

You can obfuscate all you like, but basic facts are: measles is very contagious - among an unvaccinated community, 90% will catch it. If the vaccination rate for all ages is at 98%, measles will not spread. Looking at their data, in communities where the unvaxxed are higher than 8%, the disease will spread.

The reason the vaccination epidemic (which is now more than 1,000 cases) is spreading in South Wales is because of their low vaccination rate from a few years back.

K

[John Cunningham]

Drawing conclusions on the best available evidence, Tristan, is called evidenced based medicine.  If you can do better, using data, go right ahead, but we all know you cannot.

John

On 01/05/2013, at 9:25 AM, punter <trista...@hotmail.com> wrote:

So not seeing fit to draw conclusions from hopelessly incomplete and biased data is "obfuscation" is it?

 

OK.

[Tasha David]

“The measles outbreak in Wales is a result of a drop in vaccination.”

 

Once again the MMR vaccination rates in Wales are higher than they have ever been, so where is your evidence to back up your claims?  And when I say evidence I mean actual data not assumptions or rumours.

 

What are the reasons for the outbreaks in highly vaccinated populations then?  One dose of MMR is supposed to result in 95% immunity, two doses are supposed to give 99% immunity so how is this possible?  One of the articles I posted before had a pre outbreak rate of 99.7%, yet they still had an outbreak, even the CDC states that outbreaks can occur in 100% vaccinated communities.  This is really just a witch hunt, and it is being very effectively promoted around the world, inciting anger and resentment against non/selectively vaccinating parents, and the media are having a field day. 

I find this all very sad, are vaccine advocates so hungry to take away the rights of parents to make decisions for their own children’s health that they are willing to use this outbreak as an excuse to do this? 

 

 “You can obfuscate all you like”

 

So bringing up facts that question your assumptions is obfuscation is it? I thought it was discussing a differing point of a view?

 

“Measles outbreaks have been occurring worldwide since 2006 even in highly vaccinated countries.

 

In Saudi Arabia[19], where infants routinely receive a monovalent measles vaccine at age 9 months and two MMR vaccines, at age 1 and again at age 4-6 years and where vaccination rates with measles-containing vaccines have consistently been between 95 and 98% during the last 6 years, there were 4,648 cases of measles in 2007 compared to 373 cases in 2005, 807 in 2006, 157 in 2008 and 82 in 2009.

 

So in 2007, in spite of the superior vaccination rates in Saudi Arabia, there were 4,648 reported cases of measles in an estimated population of 27.6 million. In the same year, there were 3,670 reported cases of measles, of which 990 were confirmed, in the United Kingdom, estimated population 61 million.[20]

In Switzerland, the MMR vaccine has been licensed and used since 1985 when a catch-up vaccination was also recommended for teenagers aged 12 - 15 years. A second dose of MMR was recommended in 1996. Vaccination coverage for at least one dose by age 2 remained stable at around 82% during the decade of the nineties. It increased to around 87% in 2005 - 2007. For eight-year olds, the MMR vaccination rate was 90% while for adolescents, it was at 94%. Full vaccination with two doses of MMR reached 71 to 76% in Switzerland.

 

There were on average 50 notified cases of measles a year in Switzerland (population 7.5 million) from 1999 to 2006 except for 2003, when there was an outbreak of 612 cases.

 

From November 2006 to September 2009, Switzerland experienced a full scale epidemic with 4415 reported measles cases. The incidence rates of 15 per 100,000 in 2007 and 29 per 100,000 in 2008 were reportedly the highest in Europe.[21]

 

Switzerland and Saudi Arabia use serum and not saliva testing to confirm measles cases.”

http://www.vaccinationnews.com/measles-united-kingdom-wakefield-factor

 

[Katie Brockie]

Tasha,
In order to protect the community from epidemics of measles, the rate of vaccination of all ages needs to be around 98%.
The rates in all Wales Oct - Dec 2012 were:

1st dose MMR 2y 94.3%

2nd dose MMR 5y 89.9%

MMR coverage by age 16 (1 dose) 91%

MMR coverage by age 16 (2 doses) 82.4%
http://www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=54144

These are not high rates.

There is also a graph at the same link (http://www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=54144) showing vaccination uptake rates from 1997 - 2012. You can see that the MMR went below 80% in 2003/4. That is why so many teenagers are getting the measles in the current epidemic. The 10-18 age group are getting hardest hit.

These are not rumours. They are confirmed by the various Welsh Health Boards.

The vaccinations give full immunity to the vaccinated, but if people are not vaccinated or only partly vaccinated, the community protection effect breaks down, and the unvaxxed, the very young, and the immunocompromised are vulnerable to infection.

"I find this all very sad, are vaccine advocates so hungry to take away the rights of parents to make decisions for their own children’s health that they are willing to use this outbreak as an excuse to do this? "

Who is taking away anybody's rights? I don't see this happening either here or in Wales?

Katie

[Tasha David]

Katie,

 

You say that the Wales rates are not that high, but I must stress again (which was also stated in your link)” Although uptake rates for completed courses of MMR are higher than they have ever been in Wales, measles remains a concern.” 

 

Why didn’t the outbreaks occur when you said the MMR rates were at their lowest back in 2003, why now 10 years later when they are at their highest ever?  The 10-18yr olds are not the most affected age group the 1-4yr olds are, so once again what does this have to do with Wakefield?  The highest affected children were born way after the decrease in MMR rates?

 

“These are not rumours. They are confirmed by the various Welsh Health Boards.”

 

Their graphs do not match their statements, but I cover this in my reply to John.

 

“Who is taking away anybody's rights? I don't see this happening either here or in Wales?”

 

You are right it is not happening in Wales it is only happening here in Australia, where the only epidemic we have had lately was a Whooping Cough epidemic and that mainly affected the vaccinated, go figure?  I can only assume that you wrote this before the “Daily Telegraph” and “Sunday Telegraph” as well as the AMA started a campaign to pressure the government to ban our unvaccinated children from preschool, school and out of child care rebates.  I have to reiterate how sad it is to me to see this come to pass, my children are being treated like lepers by the Media and our Medical Association and I as a parent of unvaccinated children am being accused of being a child abuser yet I have committed no crime and my children are very healthy, where is the justice in this?  The only difference between me and a parent who vaccinates is that I believe that there is more than one way to raise healthy children, yet right now the media is openly inciting animosity towards us.  If we were any other minority this would not be allowed to happen,  yet there is a double standard when it comes to vaccination.   This is just plain wrong.

 

Tasha

[Tasha David]

John,

 

I can tell that you do not like my use of the words “assumptions” and “rumours” yet this whole “Wakefield Factor” is exactly this, and to make things worse you then you back up your statements with preliminary data that hasn’t even been released yet and is being compared to notifications which (the majority) are not even laboratory confirmed.

 

“The nice thing about Wales is that they have population numbers and vaccination rates well documented, so at the end of the day the figures will move around a little but I'm not expecting them to change all that much. Would you?”

 

From what I am seeing what their figures say and what health officials are saying are two different things, but you are right the Welsh data is well documented so it makes you wonder how the officials could get it so wrong?

 

“Although more than 33,000 non-routine vaccinations have been given across Wales during the outbreak, only just over 8,000 of those were in the 10 to 18 age group – the group hardest hit by the outbreak.”

http://www.wales.nhs.uk/sitesplus/888/news/27029

 

Yet when you look at the notifications by age in Wales, the 1-4yr olds have the highest rates not the 10-18yr olds as previously stated, the 0-9yr olds are harder hit by far than the 10-18yr olds yet the 0-9yr olds are the most vaccinated group out of them all?  Hmmm…that doesn’t really tie in with a Wakefield factor, now does it?

 

http://www.wales.nhs.uk/sitesplus/888/page/66389#d

 

Here are the notifications of Measles in Wales for 2012 and March 2013, and here are the laboratory confirmed cases of Measles in Wales for the same time periods.  As you can see there is only 14 laboratory confirmed cases in 2012, and 26 for Jan-Mar 2013, so is the 10 measles cases in vaccinated people from the 14 laboratory confirmed cases in 2012, or the 26 from 2013?

http://www2.nphs.wales.nhs.uk:8080/CommunitySurveillanceDocs.nsf/3dc04669c9e1eaa880257062003b246b/abefff808d75f76580257b41003cf988/$FILE/monthly%20notif%20201303.pdf

 

http://www2.nphs.wales.nhs.uk:8080/CommunitySurveillanceDocs.nsf/3dc04669c9e1eaa880257062003b246b/38c4ee86b5fd701e80257b41003cdc52/$FILE/monthly%20lab%20201303.pdf

 

So as I tried to say before the actual laboratory confirmations are significantly smaller than the notifications, which can be easily misdiagnosed (especially during a supposed epidemic) for other illnesses ie scarlet fever, rubella, human herpes virus 6, glandular fever, chicken pox etc.  Remember we are talking about a lot of doctors who haven’t seen these illnesses before so are much more likely to misdiagnose it.

 

Real hard data, publicly available. Vaccination protects?

 

Tasha

 

On 6 May 2013 10:25, JC <jc_bi...@yahoo.com.au> wrote:

Tasha, 

Do you want actual data? Not rumours or assumptions? OK. http://www.wales.nhs.uk/sitesplus/888/page/66389 

In the health board area with the greatest number of cases so far, ABMUHB, they are having cases at a rate of 839 per 100,000 children (age<18). Only 84.3% are vaccinated in that region. The next highest region is Powys Teaching HB, with a rate of 339 per 100k and a vaccinated rate of 80.4%. 

They may be higher than they've ever been, but they're still not high, are they? 

Preliminary data is that the number of fully vaccinated people getting measles is about 10. Not 10%, but 10. That's all. 10 out of 1053 so far. Let's have a look at that. The overall rate of vaccination for MMR in Wales is 86.4%. If vaccination did nothing to protect against measles, then you would expect 86.4% of cases to be in the vaccinated. That is, you'd expect about 910 cases. But there's only been 10. So vaccination makes you about 90 times less likely to get measles. Now that's preliminary data, and will be confirmed when the patients notes are compiled. The nice thing about Wales is that they have population numbers and vaccination rates well documented, so at the end of the day the figures will move around a little but I'm not expecting them to change all that much. Would you? 

Real hard data, publicly available. Vaccination protects.

John

[John Cunningham]

Yes.

Yes it does.

John

[A MacDonald]

Sam,

I think the evidence that vaccines work, is wrapped up in the scientific evidence for herd immunity.

I have been looking for a while now, but sorry, I have not quite been able to put my finger on it.

Andrew.

From: SC <samcu...@yahoo.com>
To: vaccination-re...@googlegroups.com
Cc: ha...@tux.com.au
Sent: Friday, 10 May 2013 10:21 AM
Subject: [vaccination-respectful-debate] Re: Question about the rise in measles cases in Wales

So, I am reading a lot about % and numbers and how many children need to be vaccinated in order for people to be safe from a disease.  Just a clarification:

We allow part of a disease or a killed version of (once grown on a medium such as WI -38 diploid lung fibroblast or chick embryo culture ) to be added to a concoction of various chemicals (in a MMR vaccination are amino acids, bovine calf serum, sucrose, sodium phosphate, glutamate, recombinant human albumin, neomycin, sorbitol, hydrolysed gelatine), then injected that straight into the blood stream of our children. And it is repeated this twice.

Then the body produces a response and if the vaccination works (which obviously is the idea), My child now has an immunity to the disease.  

Therefore, my questions are:

If the vaccination has produced an immunity in my child why am I worried about whether there is a high percentage of up take by the rest of the population?  If it is my choice to vaccinate

and I believe that they protect my child then, I can obviously put my kid in with a bunch of unvaccinated kids who have measles and they will be safe?

If you believe then that your child isn't safe with a bunch of unvaccinated kids, Why? didn't the vaccine work? 

Also, how can an unvaccinated child, who contracts a disease by natural means be of any danger to a vaccinated child.  They have already had the disease, built up an immunity and are safe.  right?

In fact, would it not be fair to say that a vaccinated child who have just been injected with the disease, who now carries the disease, is of more  danger  and more contagious to the unvaccinated child who does not?  That must be the reason that they are asked to leave the school when there is an outbreak?

And then with that would it not be fair to say that it is actually the vaccinated children who are keeping the disease rife in a community due to being injected with the disease itself? And by the mere fact that the disease's are continually harvested in a laboratory, is keeping the disease alive? And maybe, Could it be that by not vaccinating our children the disease would have run its natural course and died out?????

My last Questions:  How will we ever know?  

Also, just out of curiosity, with Evidence based Medicine.....  Where is the Evidence that vaccinations work at all?  Where is the, longevity of a double or triple blind study that has shown, that fully vaccinated children are healthier than fully UNvaccinated children?  

[Katie Brockie]

Sam - I think you have got hold of some incorrect information. Immunisations are not injected directly into the bloodstream for a start.

Many of the questions you have raised are answered here:
http://www.ncirs.edu.au/immunisation/education/mmr-decision/faq-about.php
https://www.mja.com.au/journal/2006/184/4/vaccine-components-and-constituents-responding-consumer-concerns
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mmrv.pdf
http://www.cdc.gov/vaccinesafety/vaccines/mmr/mmr.html

Please read them. They are not very long, then if you have more questions - just ask!!

Katie

[Katie Brockie]

Andrew,

here is a good explanation about how herd immunity works:
http://science-at-home.org/how-herd-immunity-works/

cheers

katie