Third Case Identified in Latest Measles Outbreak in Minnesota

A brief post to provide an update on the latest measles outbreak in Minnesota. On August 26, 2011, the Minnesota Department of Health announced that a third case has been identified. The latest is a 43-year-old woman who was exposed to the index case in a health care setting. She had unknown vaccination status and was identified through follow-up of people who had been exposed to the two initial cases.

As of this writing, the 12-month-old child, who had contracted the illness while in Kenya, is still in critical condition, but the second case, the 15-month-old, has been released from the hospital. Neither of the children had been vaccinated against measles.
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Related Posts:
New Measles Cases in Minnesota
Minnesota Measles Outbreak - A Recap
Acute Thrombocytopenic Purpura, the MMR and Natural Infection
"Soft" Hospitalizations in Minnesota Measles Outbreak?
Minnesota Measles Outbreak by the Numbers: A Timeline
Measles Outbreak in New South Wales, Australia
Climbing Numbers in Minnesota Measles Outbreak
More Cases of Measles in Minnesota, 3 of 4 Hospitalized
Minnesota Infant Contracts Measles - Why Immunization Is Important
Measles Outbreak in Boston

A Brief Note on Legal Thuggery and the Silencing of Others

A friend of mine, we'll call him Mr. T, was recently the target of the negative attentions of a bully, we'll call him Mr. BS. You see, Mr. BS said some defamatory things about some people on twitter. Mr. T didn't take kindly to it (after all, he pities the fool that bullies others) and called Mr. BS on it, going so far as to write up a blog post, stating facts about the exchange, as well as some additional information about Mr. BS. This ruffled Mr. BS's feathers, but rather than doing what a normal person would do and contacting Mr. T privately to work out the disagreement, Mr. BS published Mr. T's work address, phone and e-mail address on Twitter and in the comments of a news article, as well as blast e-mailing just about everyone at Mr. T's place of employment, threatening law suits if Mr. T didn't back down.

Imagine for a moment a purveyor of health and science information. The don that controls things on his street comes by and tells him to pay up or he's gonna break some kneecaps. In the situation with Mr. T, the "payment" is to cease all use of social media on topics of public health and instead of breaking kneecaps, he stands to lose his job. Why such a strong reaction? Because Mr. T's overseers viewed Mr. BS's sabre rattling as enough of a nuisance that they just wanted to avoid any legal issues altogether, thinking Mr. BS more of a tiger, when in reality he's closer to a gnat.

New Measles Cases in Minnesota

The Minnesota Department of Health reported on August 19, 2011 that there are two new cases of measles in that state. The index case is a 12-month-old infant who was infected while on a trip to Kenya. The second case is a 15-month-old child who acquired the measles virus after exposure to the first infant. Neither child, both residents of Dakota County, had been vaccinated against the disease. Both children have been hospitalized. The Shakopee Valley News and the Columbus, IN paper The Republic, as well as news station KARE11, report that the 12-month-old child is in critical condition. These cases are not connected with the measles outbreak in Hennepin County earlier this year, which resulted in 21 cases, almost all unvaccinated, with 14 hospitalizations.

Although both children were unvaccinated, it should be noted that they are right around the age when the first dose of MMR is recommended, according to the CDC schedule (PDF). Sources do not report any reason for the infants being unimmunized; it may be that the parents simply had not scheduled the appointment yet. It is also possible that the parents had avoided the MMR due to misinformation promulgated over the past several years in Minnesota by anti-vaccine activists which has negatively impacted herd immunity.

I will try to keep an eye on this situation, in case any further cases arise.

UPDATE: The 12-month old who has been hospitalized since August 10 appears to finally be recovering. Measles left Mahi Abdallah susceptible to a secondary pneumonia infection that very nearly killed him. He has been cared for in the pediatric ICU at Children's Hospital in Minneapolis. His mother, Nuria Koto, had planned to have him vaccinated against measles, but he was only 9 months old when the family left to visit Kenya. She thought he was too young to receive the MMR (typically recommended to first be given at 12 months) and was unaware of travel recommendations that allow for administration of the vaccine as young as 6 months old. I urge those considering whether or not to delay vaccinating against MMR to read his story. No parent should have to go through this, and my heart goes out to Nuria, Mahi and the rest of their family.
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Related Posts:
Minnesota Measles Outbreak - A Recap
Acute Thrombocytopenic Purpura, the MMR and Natural Infection
"Soft" Hospitalizations in Minnesota Measles Outbreak?
Minnesota Measles Outbreak by the Numbers: A Timeline
Measles Outbreak in New South Wales, Australia
Climbing Numbers in Minnesota Measles Outbreak
More Cases of Measles in Minnesota, 3 of 4 Hospitalized
Minnesota Infant Contracts Measles - Why Immunization Is Important
Measles Outbreak in Boston

Deception in Research

When is it okay to lie in a study? When someone volunteers to be a research subject, whether it is a psychological study or clinical trial for a new drug, a corporate study or student project, what are the limits on just how much you can deceive the person? What aspects of the deception should be disclosed, and which are okay to keep hidden from the subject? If you do disclose the deception, do you need to be up front about it? Can you wait until after the study is under way or even completed?

The easy answer is that researchers shouldn't lie or mislead study subjects. Lying is wrong, right? Besides, lying could have a very big impact on whether or not the subject participates. And then there are the psychological impacts of being lied to. Just look at the famous (infamous) Shocking Experiment by Stanley Milgram. Most people learn about this in high school social studies, but for those who may be a bit fuzzy or haven't heard about it, a quick summary.

Map of Mark Geier Medical Licenses

UPDATE: I was recently informed that Dr. Geier also has a license in Texas. The map and list have been updated accordingly. He also appears to have a license application pending in Ohio, though the medical board of that state has noted the Maryland action against him and has issued a citation.(Added August 20, 2011)

With all of the various states that have licensed Dr. Mark Geier and the rising tide of suspensions of those license, I thought it may help to provide a map, visualizing which states have suspended Dr. Geier's license to practice medicine and which states still allow him to see and treat patients.

So here we go. Red states are those which have stopped Dr. Geier from misdiagnosing children with precocious puberty and subsequent treatment with the chemical castrator, Lupron, and the green states are those which have yet to take action to bar him from potentially harming any more children.

Mark Geier Medical Licenses by State - Click to Enlarge

Mark "Castrate 'Em" Geier's License Suspended - Part 5

Another brief update on the status of Dr. Mark Geier's licenses to practice medicine in various states. It has come to my attention that a fifth state, California, has now suspended Dr. Geier's license to practice in that state, effective August 3, 2011.

This comes following suspensions (in chronological order) in Maryland (PDF), Washington, Virginia and Indiana (PDF). He still has licenses to practice in Florida, Hawaii, Illinois, Kentucky, Missouri and New Jersey, although it has been reported that his license in Illinois is also under review for possible suspension. There have also been rumors that Missouri will follow suit.

Five dominoes have fallen, six remain.
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Related Posts:

• Mark "Castrate 'Em" Geier's License Suspended - Part 4
• Mark "Castrate 'Em" Geier's License Suspended - Part 3
• Mark "Castrate 'Em" Geier's License Suspended - Part 2
• Charges Levied Against Mark and David Geier
• URGENT: Please Call the Maryland State Board of Physicians About David Geier
• A Close Look at David Geier
• Mark "Castrate 'Em" Geier's License Suspended

A Parent's Story of Vaccine Reaction

Among the vocal anti-vaccine arm of the autism community, a very common story is that of a parent who brings their child to the pediatrician’s office for their routine shot, and then, BAM!, like a bolt of lightning, the light goes out of their child’s eyes and they regress into autism. Right then and there, the parent decides that no vaccine needle will ever touch their precious, “broken” child, nor indeed any of their children, ever again. Not only that, but they may be so affected by the experience that they encourage other parents to forgo immunizations for any child. At least, that’s how the story goes. More often, the timeline is more gradual, and the emergence of an anti-vaccine perspective slower, building as they read more and more material which plays on their fears and appears to confirm what they suspect: that each and every vaccine on the recommended schedule is nothing but a ticking time bomb waiting to steal children from their parents.

Well, this got me to thinking about those parents whose children had experienced an adverse event following a vaccine. What about those parents who, like many of those on the anti-vaccine side of things, have gone through similar emotions and fears, yet came out following science and reason and chose to continue to support vaccination as a means of protecting both individuals and society. They are not nearly as vocal, so their stories are seldom heard. Certainly, there must be some out there who were willing to tell their tales. Putting out the word that I was looking for these accounts, I received an email from one individual, who had been thinking about telling her story for some time. After careful thought and consideration, she agreed to let her narrative appear on Harpocrates Speaks. Without further ado, here is her story, in her words:

Mary Tocco, Is She Mistaken or Misrepresenting?

Something that has been noted here and elsewhere over the years is that anti-vaccine activists generally play rather loose and free with facts. They have this tendency to misrepresent reality in a way that suggests support for their opinions, and sometimes they even downright fabricate "facts" that have no basis in the real world. Take the long-debunked claim that vaccines contain anti-freeze. (They don't.) Because their goal is to stir up fears about vaccines, they latch onto scary-sounding chemical names and equate them with all manner of ills. Where nuance is called for, they resort to hyperbole. Their goal is fear, not truth.

Mary Tocco is no exception. I came across an article she wrote August 2 entitled "Seasonal Flu Vaccines, Are They Safe or Necessary?". Other than the poor word choice (I think they are generally safe and necessary in order to protect the greatest portion of the population; are they really only safe or only necessary?), I'll give you one guess as to what she thinks. In true anti-vaccine activist form, she jumps straight into getting things wrong in the very first paragraph:

Science-y Facts Bubble to the Surface

There are a lot of TV shows out there. No, really! Take a look. There's a lot of stuff that has been made, much of it short lived. Almost all of them, rather shockingly, have little bits and pieces that bear some passing resemblance to reality, and some even include topics that touch on science or scientific ideas. The good ones may stretch imagination a bit and force us to suspend disbelief, but we're okay with that; the story is intriguing, the logic internally consistent (mostly). Then there are those that make no sense whatsoever. They have plot holes big enough to sail a cruise ship through.

For whatever reason, I watched a show that fell into the latter category. It only lasted one season before being canceled, and I watched every single episode. Why do this to myself? Why put myself through such mind-boggling nonsense? Well, one, because I have Netflix and I could stream it; two, because there was an intriguing element to the storyline, wondering how things might end; and finally, because I just couldn't believe that they could get simple scientific ideas so completely wrong. The writers just had to redeem themselves.

So what is this show that threatened to cause my neurons to vaporize in a blaze of burning stupid? A 15-episode series called Surface: