Pandora Report 7.11.14

Highlights from this week include, vaccines, plague, ISIS, and smallpox. Oh my!

The Price of Prevention: Vaccine Costs are Soaring

For all the talk around here about anti-vaxxers, there might be a larger threat to vaccine preventable diseases in the United States…lack of vaccines or vaccines that are no longer affordable. In this insightful piece, the complicated story of vaccine necessity, vaccine scarcity, and vaccine cost is told through the doctors at the front lines. States require students to be vaccinated to attend school but the vaccines are hard to find. For doctors, keeping vaccines that may not be used or may not be reimbursed has become a grave financial burden.

The New York Times—“Old vaccines have been reformulated with higher costs. New ones have entered the market at once-unthinkable prices. Together, since 1986, they have pushed up the average cost to fully vaccinate a child with private insurance to the age of 18 to $2,192 from $100, according to data from the Centers for Disease Control and Prevention.”


Deadliest, Rarest Form of Plague Contracted Near Denver

It’s baaaaack. In the state’s first reported case since 2004, a Colorado man has been diagnosed with pneumonic plague. Pneumonic plague is the airborne version of the disease that can be transmitted through droplets from coughing or sneezing. In this case, the man has been treated with antibiotics while investigation of the source of the outbreak continues. Authorities think the man may have contracted it from his dog that had suddenly died and had been found to carry the disease. Many cases of plague in the U.S. come from contact with mammals and small rodents such as prairie dogs.

Bloomberg—“Plague in all of its forms infects only about seven people yearly in the U.S. The disease occurs when a bacteria named Yersinia pestis infects the body, according to the U.S. Centers for Disease Control and Prevention. The difference between the pneumonic and bubonic varieties is that the bacteria takes hold in the lungs in the first case, rather than underneath the skin through insect bites. Both types are treated with antibiotics.”


ISIS Seizes Former Chemical Weapons Plant in Iraq

As the Islamic State of Iraq and Syria (ISIS) tears through Iraq taking over cities, they have taken over some other things, too. These include a science lab at Mosul University, where they took 88 pounds of uranium components, and a former chemical weapons facility north-west of Baghdad. According to Iraq, in a letter circulated at the United Nations, the Muthanna facility held 2,500 degraded chemical rockets that were filled with sarin nerve agent or their remnants. The U.S. government has not expressed fear that these materials could be used to create a viable chemical or dirty bomb.

The Guardian—“A U.S. State Department spokeswoman, Jen Psaki, expressed concern on 20 June about Isis seizing the complex, but played down the importance of the two bunkers with “degraded chemical remnants”, saying the material dates back to the 1980s and was stored after being dismantled by UN inspectors in the 1990s.

She said the remnants “don’t include intact chemical weapons … and would be very difficult, if not impossible, to safely use this for military purposes or, frankly, to move it”.”


Smallpox Virus Found in Unsecured Government Lab

On the heels of accidental anthrax exposure at the CDC, reports this week highlight a concerning trend of lack of lab precautions when it comes to dangerous biological agents. Vials of smallpox, one of the most deadly viruses known to man, were discovered in an unused storage portion of a lab in Bethesda, MD.

Time—“The vials, which date from the 1950s, were discovered by National Institutes of Health workers on July 1, CDC said in a statement. The lab […] had been neither equipped nor authorized to store the pathogen, which was eradicated in 1978. Upon discovery, the vials were secured in a containment laboratory before being transported to another lab in Atlanta on July 7, where workers confirmed they contained DNA for the smallpox virus. There is no evidence the vials were breached, CDC said, and experts have not identified any danger to the public.”


Image Credit: U.S. Navy


Measles making a comeback through unvaccinated individuals

By Chris Healey

Unvaccinated individuals are promoting the spread of measles in the United States.

In a public statement on February 21, health officials said seven of fifteen confirmed measles cases in a 2014 California outbreak were reported in individuals who never received a measles vaccine. Health officials have not determined the vaccination status of 6 cases in the outbreak but it is known that in two cases the patients received the vaccine. Over 39,000 cases of measles were reported in California before the measles vaccine was licensed in 1963. In 2005, a record low of four cases were reported.

This outbreak in California is part of a measles resurgence facilitated by rising numbers of unvaccinated individuals. Similar measles trends have been reported across the U.S. According to the CDC, the average number of U.S. measles cases from 2001 to 2010 was 69.  In 2013, there were 189 cases.

Measles vaccines are delivered in one of two products produced by Merck– M-M-R II and ProQuad. Both are live-attenuated vaccines, which uses viruses incapable of replication as the pharmacologically-active ingredient. Health experts consider live-attenuated vaccines the most effective of all vaccine types. The measles vaccine schedule recommended by the CDC is 99% effective in conferring immunity.

Vaccination of children after measles vaccine licensure was credited with the elimination of measles in the U.S. in 2000. Measles occurs in the U.S. when individuals are exposed abroad and return to the country.  Health officials said three cases in the California outbreak recently traveled to the Philippines. Two traveled to India. Other cases had contact with individuals who traveled abroad.

A growing number of individuals are choosing not to vaccinate their children. Vaccination avoidance has been fueled by unsubstantiated claims of vaccines causing autism in children. The CDC maintains there is no evidence to support a relationship between vaccination and autism. In fact, a recent study published in The Journal of Pediatrics showed no causal link between vaccination and autism.

The CDC’s website states symptoms of measles include fever, cough, inflammation of the mucous membrane, conjunctivitis and a characteristic maculopapular rash. Symptomatic individuals have a chance of developing acute encephalitis and subacute sclerosing panencephalitis, or SSPE, a degenerative disease of the central nervous system. SSPE causes seizures, behavioral problems and intellectual deterioration.

Measles has a fatality rate ranging from one to three deaths for every 1000 cases in the U.S.

Unvaccinated individuals should consult their doctor about receiving a measles vaccine.


Photo Credit: CDC/ Amanda Mills