#APIC2013: Driven by misplaced fears and misinformation, measles outbreaks continue

January 12th, 2015

Fort Lauderdale: Infection preventionists must raise a “common voice” in support of the measles/mumps/rubella (MMR) vaccine to overcome the misplaced fears and false information that have led to recurrent outbreaks in unvaccinated populations, an IP urged Sunday at the annual meeting of the Association for Professionals in Infection Control and Epidemiology.

“You can’t undo fear very well,” said Patricia Stinchfield, MS, RN, CPNP, director of infection prevention and control at Children’s Hospital and Clinics of Minnesota.

In describing the massive disruption and chaos her hospital faced after a measles outbreak began among an unvaccinated group of people from Somalia in 2011, Stinchfield warned that similar unvaccinated groups are only one exposure away from infection.

“It’s sort of like the perfect storm,” she said. “You get a group of people and they choose not to be vaccinated for whatever reason. They live closely together, [but] they’re out in the world and the community. If they have one single exposure it goes through that community like a match on tinder.”

Indeed, a recent measles outbreak among an unvaccinated Jewish community in New York City resulted in some cases of pneumonia, hospitalizations and one miscarriage, according to published reports. Interestingly, the index case in the New York outbreak was a visitor from the United Kingdom, where a large measles outbreak in Swansea, Wales has caused UK officials to urge mass vaccinations.

In 1998 the British journal Lancet infamously published a since retracted “study” implying that the MMR vaccine may cause autism. The paper by Andrew Jeremy Wakefield, a former surgeon and medical researcher in the UK, was retracted by the journal in 2010 after years of protest and criticism from the medical community.(1) However, the damage done continues to echo on the Internet, where concerned parents may find a wealth of misinformation circulated by anti-vaccine groups. The fear continues, though there are “two dozen great studies” showing no link between MMR vaccine and autism, Stinchfield says.

“[The Wakefied study] has been retracted and is known to be false information, but that myth really still prevails. A lot of people still believe it, they’re worried about it” she said. “Sometimes people say: ‘I see autism all over the place, and I don’t want a child with autism. I really don’t ever see measles and how bad can it be? It’s a rash, they have a runny nose, they have a fever -- it’s going to end, whereas autism is for their whole life. But there is no relationship [between MMR vaccination and autism.]”

Thus, hospitals and public health officials must remain vigilant for outbreaks of a highly contagious airborne disease that had already been declared eradicated in the U.S. A single case entering one of these susceptible groups can set off an outbreak that can lead to emergency room exposures, and time-consuming and disruptive follow-up of patients and health care workers.

Reference

1. Wakefield AJ, et al. RETRACTED: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998; 351:637-641.