Measles- not gone, not forgotten

After the measles vaccine was introduced in 1963 the number of reported cases was reduced by 99%. In 2000 measles was declared no longer endemic ( occurring routinely) in the United States. U.S. public health officials consider an outbreak a major setback in the control of infectious disease.

A “RASH” OF MEASLES CASES

Measles in the U.S. has climbed to its highest level in 25 years, closing in on 700 cases this year in a resurgence largely attributed to misinformation that is turning parents against vaccines.

“This is alarming,” said Dr. William Schaffner, a Vanderbilt University vaccine expert. Not only is measles dangerous in itself, but its return could mean other vaccine-preventable diseases seemingly consigned to the past may be coming back as well, he said.

APNEWS.COM, APRIL 24, 2019

The rash of measles, also known as rubeola, starts on the head and spreads to the trunk (chest and upper back) , arms, and legs over a few days .

What is measles?

At one time, measles was one of the “usual childhood diseases” that most of us over age 55 years contracted as children, prior to the use of the vaccine. It is caused by a virus in the Paramyxoviridae family and spread by person to person contact.

The other childhood diseases were

  • Rubella, or  German measles
  • Chicken pox, or  varicella
  • Roseola
  • Fifth Disease, or erythema infectiosum

These all cause a rash, called an exanthem.

Mumps was also a common childhood disease but does not usually cause a rash.

Symptoms of measles include cough, nasal drainage, reddened, inflamed eyes, and a rash as pictured below.

the rash of measles
image courtesy of the CDC- Centers for Disease Control , U.S. government

There is no specific treatment and it runs its course in about 1-2 weeks. Antibiotics are not effective .

Most of those infected recover uneventfully but there can be serious complications including pneumonia and encephalitis (inflammation of the brain).

Preventing measles and other exanthems

After the measles vaccine was introduced in 1963 the number of reported cases was reduced by 99%. In 2000 measles was declared no longer endemic ( occurring routinely) in the United States. U.S. public health officials consider an outbreak a major setback in the control of infectious disease.

Measles vaccine is usually administered as a “3 in 1” vaccine- the MMR, which has been vilified as a possible cause of autism, although that has been thoroughly discredited.

The other two letters in the mix stand for mumps and rubella (also known as German measles) both of which are also caused by viruses and for which no treatment exists.

No vaccine exists for roseola or Fifth Disease, but we have an effective vaccine for varicella, commonly called chickenpox.

MEASLES OUTBREAK ELSEWHERE

According to the World Health Organization, WHO, Europeans are also contracting the most measles cases in 30 years.

The WHO European Region comprises 53 countries, from Andorra to Ukraine. According to data from the WHO, 41,000 measles cases were reported from January to June 2018 across those countries, including 37 deaths — a record-high number of fatalities since the 1990s.

CBSNEWS.COM, JUNE 17, 2019

sharing the HEART of health

My family receives vaccines and believe any potential risk is worth the benefit. I urge you to think carefully and talk to a trusted physician before you decide to forgo vaccination for yourself and especially for your children.

Thanks for visiting this blog and considering this vital information as we explore the HEART of health together.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

Dr. Aletha 

2019 Women’s health update- hormones, the heart, and HPV

results of the Nurses Health Study over 18 years shows no increase in incidence of these complications in women who used vaginal estrogen, suggesting this is a safe option for women who elect to use estrogen. (from the journal Menopause)

Multiple health issues impact women exclusively or differently than men, so new and updated information is important to share. The issues we women face vary with our age, stage of life and health status.

Let’s look at some medical news about women’s health issues, information I picked up recently from several medical journals I follow.

This is current, general medical information that helps a doctor and patient make decisions about what is right for her. Medical recommendations and practice changes as we learn new things.
If you deal with any of these issues , please discuss with your doctor before  taking any action.

I’m illustrating this post with photos of art featuring women. I’ll tell you more about the source at the end.

statue of a woman holding an infant

Human papillomavirus and cancer 

Infection with the human papillomavirus, HPV, can cause  genital warts and cervical cancer.

The percentage of young women with confirmed HPV (human papillomavirus) infection  in the United States fell significantly from 2006 to 2012. Women who had received the HPV vaccine showed the greatest decline in infection rates, compared to those who had not. Even one dose was effective, even though 2 or 3 are recommended.

A new study reported by the New England Journal of Medicine shows that women who become infected with the HPV strains 16 and 18 have a much higher risk of changes in their cervix called CIN-cervical intraepithelial neoplasia-which can be a precursor to cancer. These changes may not be picked up by a Papanicolaou (Pap) test.

Thus, protection against infection with HPV should also provide protection against cancers caused by HPV.

Human papillomavirus vaccine

Gardasil, a vaccine which targets the HPV has been available to females and males from 9 years old to 26 years old. Now the age has been extended through age 45 years for both genders.

Here is a link to detailed information about HPV vaccination from the National Cancer Institute.


Human Papillomavirus (HPV) Vaccines

statue of a pioneer woman with rifle and infant

Long-acting reversible contraception-LARC  

Two forms of long-acting reversible contraception are available to women in the United States.

Nexplanon, a contraceptive implant, slowly releases the hormone progestin and does not have estrogen. It can be used in women who cannot take estrogen, such as those with uterine fibroids or endometrial cancer.

Intrauterine devices, IUDs, containing copper only are appropriate for women with past or present breast cancer, ischemic heart disease, and women at risk for blood clots.

Use of LARCs accounts for 12% of all contraceptive use. Additional benefits include controlling excessive menstrual bleeding, potentially saving women from surgery.

Here is a link to Quick Fact about intrauterine devices and other forms of contraception from the Department of Health and Human Services

Intrauterine Device

statue of woman, holding infant, standing next to a child

Hormone therapy and prevention of heart disease

A 2015 Cochrane review of 40,410 postmenopausal women examined the use of oral hormone therapy (estrogen with or without progesterone) taken for at least six months, compared with placebo (no real drug), to determine the effect on death from any cause, and deaths caused by heart disease, stroke, and blood clot in a leg or lung.

The review found no benefits for preventing heart attack (fatal or nonfatal), or death due to any cause.

In women who took hormones they found

 
1 in 165 women had a stroke
1 in 118 women had a blood clot in the leg or lung
1 in 242 women had a blood clot in the lung

The women in this study were all older than 60 years old, so it is possible there might be benefit in younger women.

statue of woman with arm raised and holding an infant

Vaginal estrogen and heart health

While estrogen replacement after menopause is effective at controlling the undesirable effects of night sweats, hot flashes, and vaginal dryness, it potentially increases the risk of developing cardiovascular disease-heart attacks and stroke, and some cancers-breast and uterine.

However, results of the Nurses Health Study over 18 years shows no increase in incidence of these complications in women who used vaginal estrogen, suggesting this is a safe option for women who elect to use estrogen. (from the journal Menopause)

The photos- a tribute to women

I took these photos during a recent visit to Woolaroc ,a museum and wildlife preserve located in the Osage Hills of Northeastern Oklahoma. Woolaroc was established in 1925 as the ranch retreat of oilman Frank Phillips. 

These statues displayed there were all models considered for a larger project now known as the Pioneer Woman Statue in Ponca City, Oklahoma.

What do you think? Would you have chosen one of the other statues for the final version?

More women’s health info

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

a statue of a woman holding a child, "CROSSING THE PRAIRIE"
“CROSSING THE PRAIRIE” by Glenna Goodacre, Broken Arrow, Oklahoma
Shop To Fight Breast Cancer! Every Purchase Helps Give Free Hospital Mammograms To Women In Need!

(This post contains affiliate links which, by paying a commission if used for a purchase, help fund this blog. )

 

Vaccination prevents disease- part 1

 

Prevention is a focus in healthcare now  and immunization has  been one of the most effective ways to prevent disease ever developed.

The list of diseases that are “vaccine preventable” is long and continues to grow.

Vaccine recommendations may be based on a person’s

  •  age,
  • gender,
  • ethnicity and
  • concurrent conditions, especially diabetes mellitus, chronic lung diseases, heart disease and  immune suppressing disorders.

Vaccine administration may vary by

  • the number of doses recommended,
  • how far apart the doses should be given, and
  • which vaccines can be administered at the same time.

 

Immunization protocols have  become so complex that even physicians have difficulty keeping it straight without the use of paper or digital checklists. This is one area where the Internet and EMRs (electronic medical records) can be useful.

Create an immunization schedule for your child from birth to 6 years of age

2016 recommended immunizations for children
2016 recommended immunizations for children (the 2017 schedule is available on the CDC website)

 

Vaccines for infections caused by bacteria

I use the name of the disease and/or the bacteria, rather than the vaccine name, since there are different brand names for the vaccines depending on the manufacturer.

So successful have these vaccines been that most young doctors have never seen a patient with these diseases (unless perhaps they specialize in infectious disease, immunology, emergency medicine or critical care). And even I, who graduated medical school in 1978, have only seen a few, and none in recent years.

Diphtheria-primarily a respiratory tract illness in young persons

Pertussis, better know as whooping cough, also a respiratory illness, which has made a comeback in recent years, apparently due to a waning of immunity

Tetanus, also called “lockjaw”– due to a toxin which may contaminate a dirty wound

Menigococcal disease, which is one of many causes of meningitis (inflammation of the brain lining), but one of the most deadly, even with treatment

Streptococcal pneumoniae disease; the vaccine is often referred to as the “pneumonia vaccine”, but the bacteria can also cause ear infections, sinusitis, meningitis and sepsis (bloodstream infection)

Haemophilus disease is similar to pneumococcal, but more of a concern in infants and children

 

Six Things YOU Need to Know about Vaccines

 

 

 Pneumococcal Vaccination from JAMA

infections caused by Streptococcus pneumoniae

 

 

 Pandemic- a book review

Infection is still a major health issue worldwide

and epidemics are still a threat. This book explains why.                 Pandemic by Sonia Shah

Vaccination prevents disease, part 2

The rash that spreads- what you need to know about measles

Measles and mumps- 2 old diseases that are making a comeback #measles#mumps

You may continue reading here, but there is an updated version at this link

Measles, not gone, not forgotten

The rash of measles, also known as rubeola, starts on the head and spreads to the trunk (chest and upper back) , arms, and legs over a few days .

What is measles?

It used to be one of the “usual childhood diseases” that most of us over age 55 years contracted as children, prior to the use of the vaccine. It is caused by a virus in the Paramyxoviridae family and spread by person to person contact.

The other childhood diseases were

  • Rubella, or  German measles
  • Chicken pox, or  varicella
  • Roseola
  • Fifth Disease, or erythema infectiosum

These all cause a rash, called an exanthem.

Mumps was also a common childhood disease but does not usually cause a rash.

Symptoms of measles include cough, nasal drainage, reddened, inflamed eyes, and a rash as pictured below.

the rash of measles
image courtesy of the CDC- Centers for Disease Control , U.S. government

There is no specific treatment and it runs its course in about 1-2 weeks. Antibiotics are not effective .

Most of those infected recover uneventfully but there can be serious complications including pneumonia and encephalitis (inflammation of the brain).

Preventing measles and other exanthems

After the measles vaccine was introduced in 1963 the number of reported cases was reduced by 99%. In 2000 measles was declared no longer endemic ( occurring routinely) in the United States. Thus public health officials consider an outbreak a major setback in the control of infectious disease.

Measles vaccine is usually administered as a “3 in 1” vaccine- the MMR, which has been vilified as a possible cause of autism, although that has been thoroughly discredited.

The other two letters in the mix stand for mumps and rubella (also known as German measles) both of which are also caused by viruses and for which no treatment exists.

No vaccine exists for roseola or Fifth Disease, but we have an effective vaccine for chickenpox.

You can listen to  2 DOCS TALK  about mumps at this link or read the transcript.

Mumps – The Disease, the Vaccine, the Problem

“But recent increases in those who choose to have their children forego vaccines has led to a loss of herd immunity and an increase in these outbreaks.

To further complicate the issue, it seems that immunity wanes with time, which is why many college students (hello spring break!) find themselves falling ill eight to ten years after their last booster at age 12 to 15.”

My family receives vaccines and believe any potential risk is worth the benefit. I urge you to think carefully and talk to a trusted physician before you decide to forgo vaccination for yourself and especially for your children.

Thanks for visiting this blog and considering this vital information as we explore the HEART of health together.

Dr. Aletha