Thanks to declining rates of vaccination, deadly diseases once thought vanquished are resurging in startling numbers.
In Durango, pertussis – a highly contagious bacterial respiratory disease that often is fatal to infants – is back, with 13 cases diagnosed in La Plata County between December 2013 and January 2014.
Twelve of the cases were children.
Meanwhile, measles – a lethal, highly contagious virus that doctors thought was all but eliminated in America – is having a deadly, nationwide resurrection. The Centers for Disease Control and Prevention reports there have been more measles outbreaks so far in 2014 than in any year since 1996.
Still, a minority of local parents is refusing to vaccinate their children.
Dr. Jack McManus, an emergency room doctor at Mercy Regional Medical Center, said the stakes are life and death.
“These are diseases we really thought we had beat. But if people don’t get vaccinated, even people who are vaccinated can be hurt,” he said.
Dangerous times
Last year, every school in Durango School District 9-R fell short of “herd immunity” for measles and pertussis, the safety standard long advocated by public health experts.
The logic behind “herd immunity” is simple: Most people develop immunity to measles and pertussis once they are vaccinated, but some don’t. Diseases die out if they can’t find anyone to infect.
Therefore, if 95 percent of a community is immunized to highly contagious, airborne diseases such as measles and pertussis, then everybody in the community is safe – even those who aren’t immune.
If, however, rates of vaccination fall below 95 percent, collective safety is lost: As soon as the disease infects one individual, it can spread through the community.
According to this rule, many Durango schoolchildren aren’t safe.
In fact, numbers compiled by Julie Popp, District 9-R spokeswoman, indicate no Durango schools achieved herd immunity last year. Even schools with the highest rates of vaccination – Durango High School, Big Picture and Needham Elementary (92 to 93 percent of children were vaccine-compliant) – fell just short of herd immunity for measles and pertussis.
Ninety to 91 percent of students at Sunnyside, Florida Mesa, Fort Lewis Mesa and Park elementary schools had received legally required vaccinations.
Only 89 percent of the children attending Animas Valley Elementary, 87 percent of Miller Middle School, 85 percent of Riverview Elementary and 84 percent of Escalante Middle School students were vaccinated.
Dr. Kicki Searfus, of Mountain View Family Medical, said herd immunity is especially vital to protecting the health of children in schools.
“That’s the thing: Schools are cesspools,” Searfus said. “I always tell people: ‘Your children are in a big petri dish teeming with germs for hours every day. Vaccinations keep everyone safe.’”
Personal exemptions
Overwhelmingly, Durango’s unvaccinated schoolchildren had parents who deliberately opted out of vaccinations through a loophole in Colorado law that permits kids to attend public school if their parents object to vaccinations on medical, religious or personal grounds.
Sixteen percent of Escalante’s student body and 15 percent of Riverview’s student body got such exemptions from parents.
Doctors say vaccines like MMR – which protects from measles, mumps and rubella – are appropriate for almost everyone except children younger than 1 and sick people whose immune systems – compromised by ailments such as leukemia, lung cancer or AIDS – can’t handle vaccinations.
While Colorado parents can refuse to vaccinate their children on medical and religious grounds, 94 percent invoke the “personal belief” exemption, according to the Keystone Center and the Colorado Department of Health and Environment.
This exemption, which allows parents who are philosophically opposed to vaccines to enroll their nonimmunized children in public school, is a lot broader than the narrow medical and religious exemptions in place in other states.
In Colorado, only 85 percent of kindergartners entering elementary school in fall 2012 were vaccinated for measles, mumps and rubella according to the CDC.
By comparison, nearly 100 percent of kindergartners in Mississippi and Maryland were vaccinated.
Sticking up for the herd
In La Plata County, some people are dismayed by the extent to which locals who oppose vaccinations are endangering children and public health, arguing Colorado law caters to parents who cavalierly reject science. In a March letter to the editor of The Durango Herald, Ignacio’s Yasmina Mickas urged Congress to require vaccinations.
“Decades ago, I almost lost my infant daughter to meningitis,” Mickas said. “It is stupid for us to go back to the 1950s when people died or became permanently disabled from diseases we can prevent now with just a shot in the arm.”
Mickas’ public pleading for tougher vaccination standards is a welcome development to many local doctors.
Mercy ER doctor McManus said the recent renaissance of contagious diseases in Durango and across the country places those without immunity – children whose parents refuse to vaccinate them, vaccinated people who didn’t develop immunity and babies and sick people who couldn’t be vaccinated for medical reasons – in direct peril.
Searfus attributed some Colorado parents’ opposition to vaccines to two phenomena:
First, she said, gullible Americans have fallen for the false theory that vaccinations cause totally unrelated conditions like autism. She said in the Internet age, this wrongheaded notion has been amplified by celebrities like Jenny McCarthy, a former Playboy model turned anti-vaccine crusader, who are only too happy to peddle panic in return for Twitter followers.
Second, Searfus said that for decades, high vaccination rates have allowed Americans to forget the horror, pain and destruction wrought by diseases like measles and polio.
“That’s the interesting thing about ‘herd immunity’ as a concept. When people are looking out for their own child, they’re very selfish, which is natural, in a way,” she said. “But when you put all this fear about autism in perspective, and the generalized fear about vaccines, they are benefiting from herd immunity and the fact that most Americans vaccinated their children.
“Go to India, or sub-Saharan Africa, and talk to someone who actually has these diseases: You’ll want a vaccination.”
cmcallister@durangoherald.com
Fort Lewis College takes immunizations seriously
Unlike Durango’s public schools, where a significant number of parents refuses to vaccinate their children for philosophical reasons, Fort Lewis College has nearly a 100 percent vaccination rate.
FLC spokesman Mitch Davis said the college achieved herd immunity in 2013: 3,974 students – 99.4 percent of the student body – immunized.
“We live and work in close proximity, something that can be said of most colleges and universities, so these kinds of issues are something that all institutions should be on the lookout for,” Davis said in an email.
Last year at Princeton University, a meningitis outbreak landed eight people in the hospital. According to The Daily Princetonian, university officials launched an information campaign. Posters advised students to avoid swapping saliva – by inadvertently sipping from someone else’s drink, for instance, and even through popular purposeful activities like kissing.
Davis said FLC employs similar strategies every flu season.
“We’ll send out healthy habits emails with tips like covering your mouth when you cough and washing your hands, along with hanging posters with similar messages,” he said. “The Health Center also offers flu shots and even services like immunizations and HIV testing. We also have a Student Wellness program that does work in a broad range of health areas.”
Davis said FLC had to be vigilant.
“We have students enrolled from 17 different countries, in addition to FLC students who travel abroad to places like Central and South America, Africa, Europe, the Middle East and Asia,” he said.
In the past, FLC has seen its share of terrifying diseases.
“We had a number of H1N1 cases back in 2009 when that flu hit hard,” he said. “ ... Our biggest incident was the measles in 1988. All told, we had about 80 students become infected. The measles incident lasted a couple of months.”
cmcallister@durangoherald.com
