Measles

https://www.newyorker.com/magazine/2019/09/02/the-message-of-measles

This is a really, really good article. More bits and pieces as I work my way through it:

«It wasn’t hard to determine where the measles had come from. The boy had caught it in Israel. The theory was that he’d got it from another Israeli, who had travelled to the city of Uman, in Ukraine, for the Rosh Hashanah pilgrimage known as the Hasidic Burning Man. Because of a low vaccination rate, there have been more than FIFTY THOUSAND CASES OF MEASLES [emphasis mine — John.] in Ukraine in the past year. Patient Zero had not been fully vaccinated, but not because of any objection on his parents’ part. In Israel, which is experiencing a measles outbreak of its own, vaccinations are administered in school, and, according to a patient advocate at Refuah, on the day the boy’s classmates had received their shots for measles, mumps, and rubella (known as M.M.R.) he was home sick. The boy’s twin brother, and the rest of his family, had been vaccinated.

….

The rate of hospitalization is about one in five, mostly owing to pneumonia, and the mortality rate is about one in a thousand. (In developing countries, it is more like one in a hundred.) Measles may also have a suppressive effect on the immune system for two years—“the shadow of measles,” as I heard one doctor describe it. The disease can cause hearing loss [reminds me — I saw a deaf orphan (from illness) on my recent trip to Rwanda. Forgot that this is a thing that happens with measles.] and, in rare cases, five to ten years later, a usually fatal form of encephalitis. Its prevalence, before the development of the vaccine, made it a scourge. Pretty much everyone got it. Its virtual disappearance since has made it seem like an abstraction, one of those common experiences of yesteryear that old-timers think kids today are too coddled to abide, like schoolyard fistfights, helmetless cycling, and child labor.
“Some people seem to think measles is some happy Norman Rockwell rite of passage for American youth,” 

….

Parents who might agree sometimes throw so-called measles parties, to get it over with for as many kids as possible, as soon as possible. What was once a folksy response to inevitable exposure now carries a hint of Munchausen by proxy.»

Do these people really (still) exist, or is this just a straw man now? Whew, “Munchausen by proxy”.

«For public-health officials like Zucker, measles was a clear and present concern on its own, but, more significant, it was a leading indicator of a societal failure. Mark Mulligan, the director of the Vaccine Center at N.Y.U. Langone, said, “This outbreak is the eyes of the hippopotamus.”

….

The measles outbreak has helped clarify for many public-health professionals that the virus they’re fighting isn’t so much measles as it is vaccine hesitancy and refusal. With the spread of mass shootings and conspiracy theories like QAnon, we are becoming more comfortable with the concept that ideas behave like viruses.»

Alexandria Ocasio-Cortez said something along this line earlier, that many Trump followers are like virus victims.

«Needless to say, the anti-vaccination ethos is by no means exclusive to the New York tristate-area Orthodox community. It thrives in certain pockets—affluent boho-yoga moms, evangelical Christians, Area 51 insurgents. The vaccination rates are about the same in Monsey and in Malibu. Before New Square, the three most recent big outbreaks of measles occurred among Somali immigrants, in Minnesota; Amish farmers, in Ohio; and a hodgepodge of visitors to Disneyland.

“It’s shocking how strong the anti-vax movement is,” Zucker said. “What surprises me is the really educated people who are passionately against vaccinations. I see this as part of a larger war against science-based reality. We need to study vaccine hesitancy as a disease.”

….

Elisa Sobo, a medical anthropologist at San Diego State University, has advanced the idea that saying no to vaccinations is as much an opting in as it is an opting out—“like getting a gang tattoo, slipping on a wedding ring, or binge-watching a popular streamed TV show,” she writes, in a recent paper, “Theorizing (Vaccine) Refusal.” “This kind of refusal is more about who one is and with whom one identifies than who one isn’t or whom one opposes.

….

The Hollywood Reporter found that the rates of vaccination in some of the private schools in Santa Monica and Beverly Hills—Marianne Williamson country—are roughly the same as in Chad and South Sudan.

….

In May, there was an ultra-Orthodox anti-vaccination “symposium” in a ballroom in Monsey—men and women separated by a makeshift wall, Wakefield present via Skype. A Satmar rabbi, Hillel Handler, stood and suggested that the measles outbreak was an anti-Hasidic conspiracy concocted by Mayor Bill de Blasio, as a cover for diseases imported by Central American immigrants. Others equated what they called “forced vaccination” with the Holocaust.

A representative of the Church of Scientology offered logistical help.

….

In the health establishment, it is now standard practice to differentiate between diehard refuseniks and the vaccine-hesitant, and even to acknowledge that the former aren’t really persuadable. Chanie Sternberg, the Refuah C.E.O., said, “Those who don’t want to learn do not.” The latter are the softer target: the yes-but set, whose heads are aswirl with contradictory information, and who really want nothing more than for their children to be healthy and safe.»

Seems to me this applies in the political realm, also.

«Patricia Ruppert, the Rockland County health commissioner, told me, of the vaccine-hesitant mothers she’d encountered, “They’re not as interested in the science as they are in the stories.”»

Story, again. One of my favorite topics.

«When a mother protests that her child has a cold and that the vaccine shot might just make things worse, Sternberg says, “The baby’s cranky anyway, so you might as well get it over with.”

….

Zucker’s C.V. is forty-two pages long, single-spaced.

….

…asked him, with some delicacy, about how the counsellors and the adults at the camp observe and ultimately pass along indicators of mental or emotional distress. It seemed to Zucker that here, away from parents and schoolmates and the routines and pressures of regular life, a boy who might be suffering from some difficulty, pain, or trauma might reveal things that he might not at home, and that it might be of some benefit, to the boys and even to society, to keep a benevolent, watchful eye. “Maybe you have an opportunity here, know what I mean?” Zucker said. This was a tricky line of inquiry, fraught on all sides, and yet for me, as a civilian who knows the damage that damaged men do in the world, an unexpectedly enlightened one. Another virus, but one yet without a vaccine.

….

Zucker asked Newfield what his greatest challenges were. Newfield and the camp pediatrician gave each other a knowing look, and Newfield said, “The volume of prescribed medication.” He painted a familiar picture of a teen and preteen pharmacopoeia. “It’s mind-boggling and sad for us.”

….

There was one fatality: an El Al flight attendant who went into a coma and died this month after falling ill on a flight from New York. One in a thousand.»

Ah. Another connection. I’ve mentioned her in a couple of other posts.

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