The Far-Reaching Consequences of Bad Science
December 20, 2009 12:26 PM   Subscribe

Mumps has stricken New York, in the U.S.'s largest outbreak of the disease since 2006.

Infections have been largely contained to the Orthodox Jewish community. Although some reports have linked these infections to the refusal of vaccinations due to religious reasons, that doesn't seem to be the case here. Nor does there seem to be any particular reluctance to vaccinate with in the Jewish community.

However, the CDC has traced these infections back to an asymptomatic 11-year-old boy returning from the U.K., where "a mumps outbreak is ongoing with approximately 4,000 cases, primarily in unvaccinated young adults in the general population." Vaccine effectiveness isn't perfect, of course. But vaccination rates in the U.K. are relatively low, in part due to a now-debunked 1998 study over the safety of the MMR (measles, mumps, and rubella) vaccine; "[a]fter its publication, rates of inoculation fell from 92% to below 80%. Populations acquire 'herd immunity' from measles when more than 95% of people have been vaccinated." (previously)
posted by SpringAquifer (46 comments total) 4 users marked this as a favorite
 
Thanks, Andrew Wakefield and friends!
posted by inoculatedcities at 12:35 PM on December 20, 2009 [9 favorites]


Mumps always makes me think of vomiting muppets. Not muppets vomiting, but actually heaving up muppets.
posted by Cat Pie Hurts at 12:40 PM on December 20, 2009 [9 favorites]


Immunity doesn't necessarily last forever, either. I had to have some routine blood work done as an adult and discovered that my rubella immunity (the R in MMR) was no longer good. I had to get a booster shot at 27.

How many adults are at risk for so-called childhood diseases? I guess with a lack of herd immunity we're going to find out.
posted by sugarfish at 12:56 PM on December 20, 2009


Due to transferring schools, going to graduate school, and a bad habit of losing immunization records, I have received 5 MMR shots in the past 10 years, so I'm not too worried about the coming Great Mumps Plague of 2010. The rest of you are screwed, though.
posted by jedicus at 1:10 PM on December 20, 2009 [4 favorites]


How many adults are at risk for so-called childhood diseases?

The disease itself isn't a childhood disease, but diphtheria immunity fades after a few years if you aren't regularly exposed to the actual bacterium (and most people aren't). In fact the main reason tetanus boosters are pushed for adults is because it includes a diphtheria vaccine (and often pertussis too). Immunizing against tetanus is considerably less important; it's not contagious, it's extremely uncommon in the US, and immunity to it does not fade as much as with diphtheria.
posted by jedicus at 1:17 PM on December 20, 2009


Well, I should say that diphtheria does commonly affect children but it's pretty bad news in older adults as well.
posted by jedicus at 1:19 PM on December 20, 2009


How many adults are at risk for so-called childhood diseases?

I've never had chicken pox, but I have had the mumps so I guess it's a wash. Except the part about most chicken pox related deaths being adults that is.
posted by MikeMc at 1:57 PM on December 20, 2009


I think they have a Chicken Pox vaccine now.
posted by delmoi at 2:02 PM on December 20, 2009


All those anti-vaccine moms, who have been relying on others getting the MMR so their precious ones do not have the (infinitesimal) chance of a reaction.

So no enough of them have skipped the vaccination so now the disease is finding more people to infect.

The bottom line. . .everyone should bear the very slight risk of a reaction. . .then the population as a whole is at far far less risk from the disease.
posted by Danf at 2:12 PM on December 20, 2009 [3 favorites]


Immunity doesn't necessarily last forever, either. I had to have some routine blood work done as an adult and discovered that my rubella immunity (the R in MMR) was no longer good. I had to get a booster shot at 27.

I had the same issue with my measles titer coming back negative last year. It's my understanding, though, that a negative titer doesn't necessarily mean that you have no immunity. If you were to be exposed to the disease, your body would be able to produce the antibodies and fight the infection more quickly than if you'd never had the vaccine. It would be nice if someone who knows more about immunology and vaccines than I do could elaborate on this.
posted by lexicakes at 2:18 PM on December 20, 2009


the U.S.'s largest outbreak of the disease since 2006.

Few alive still remember.
posted by DU at 2:26 PM on December 20, 2009 [13 favorites]


Funny, all the Orthodox Jews I know are research scientists working on things like vaccines.
posted by Kid Charlemagne at 2:44 PM on December 20, 2009 [4 favorites]


not to be dismissive of mumps, but it is a little silly to say "the U.S.'s largest outbreak of the disease since 2006. "
posted by edgeways at 2:53 PM on December 20, 2009 [1 favorite]


I think they have a Chicken Pox vaccine now.

I don't have a reference handy but the first varicella vaccines were created in the early 1970's in Japan and the US. The US vaccine was developed by the late, great Maurice Hilleman, who also created the first vaccines for measles, mumps, hepatitis A and B, meningitis, streptococcal pneumonia, and Haemophilus influenzae (Hib B) bacteria, and effectively saved the lives of and preventing permanent disability in hundreds of millions of human beings.

You can read about Hilleman's extraordinary contributions in Paul Offit's excellent book Vaccinated: One Man's Quest to Defeat the World's Deadliest Diseases.
posted by inoculatedcities at 2:58 PM on December 20, 2009 [1 favorite]


and we have political power because we vote in blocs

Didn't you mean to write 'and we have political power because we own all the banks and the media' here?
posted by PeterMcDermott at 3:02 PM on December 20, 2009 [1 favorite]



and we have political power because we vote in blocs

Didn't you mean to write 'and we have political power because we own all the banks and the media' here?


No, silly, that's the rootless cosmopolitan secular jews.

The orthodox jews own the diamond district and atavistic oppressive sexist politics and culture.
posted by lalochezia at 3:09 PM on December 20, 2009


What we need now, more than ever, is Dr. Miracles.
posted by Blazecock Pileon at 3:36 PM on December 20, 2009 [4 favorites]


Anyway, on topic...

I was impressed how little of a ruckus the recent h1n1 vaccine recall caused. Maybe we are making progress?

Probably not though, as I have had to convince fellow health care workers recently that there is no verifiable link between autism and MMR.
posted by rosswald at 4:10 PM on December 20, 2009


edgeways: not to be dismissive of mumps, but it is a little silly to say "the U.S.'s largest outbreak of the disease since 2006. "

Why? It is, isn't it? That's how the CDC puts it, too: "Mumps Outbreak --- New York, New Jersey, Quebec, 2009."

It's quite significant, statistically. In the U.S., we saw fewer than 20 cases in 2007 and 2008. Now we're looking at 179 in the U.S. and 15 in Canada, most if not all based from a single index case. That's something.
posted by SpringAquifer at 4:10 PM on December 20, 2009


"How many adults are at risk for so-called childhood diseases?"

Me! I had very bad reactions to most childhood shots. I ended up in the hospital from the first & only MMR shot I had. Unfortunately, I had a near exposure to measles two years ago. Herd immunity works out well for some people. There an iffy religious angle to this one, the link to autism is kinda shot, why do people still do this? Is it a matter of forgetting the bad times of polio, measles and the like?
posted by kellyblah at 4:58 PM on December 20, 2009


I think they have a Chicken Pox vaccine now.

Both of my kids have been vaccinated against Chicken Pox but oddly enough it never occurred to me that I, as an adult, could get the same vaccination. I guess I've always associated these vaccines (like MMR) with children.
posted by MikeMc at 5:33 PM on December 20, 2009


fullofragiere since this thread is jumping a gorge right now and dang if Jewish people ain't some of the best people around, but one Hasidic community does want bike lanes removed because "Williamsburg's Hasidic community to bike lanes that pass through their neighborhood, the main beef was supposedly about the "immodest" dress of female cyclists". See here.

Says Simon Weiser,
"The issue with modesty, it's a problem, but we live in New York, you know what I mean?" said Simon Weiser, a community board member who represents the Hasidim.

"My concern is that there are three bike lanes right next to each other and so many children, so many schools, in a very small area. Everyone understands and knows a bike lane is a nuisance."
So a Hasidic representative is on record saying bike lanes are apparently a danger to schoolkids and a nuisance in general. Or because they bring immodest woment into the neighborhood.

Ortho's comment may not be relevant or warranted, but it ain't quite anti-semitic from where I'm standing. A curt and snippy summary presented snidely, but it's a long way from vileness.
posted by boo_radley at 6:19 PM on December 20, 2009 [1 favorite]


Wow, this thread took a weird turn. Shouldn't we leave the Jews out of this and concentrate on ridiculing the Jehovah's Witnesses for refusing vaccinations for religious reasons?
posted by MikeMc at 6:23 PM on December 20, 2009


I had mumps, which led to meningitis, which led to the loss of most of my hearing. It changed my life irrevocably. I don't think most people take the disease as seriously as polio, but for the people who get it, the results can be really tragic.

Also, if ortho had used exactly the same words to describe Christians (as he could have, were this Colorado Springs), you'd have heard not a peep about bigotry. Amazing, really.
posted by klanawa at 6:29 PM on December 20, 2009 [2 favorites]


Also, if ortho had used exactly the same words to describe Christians (as he could have, were this Colorado Springs), you'd have heard not a peep about bigotry.

Nonsense. Some of the most frequent posters on this site (St. Alia, Miko, PaterAletheias, me, others) self-identify as Christians.

The strawman of "MEFI! IT'S LOLXIANS!" don't fly.
posted by Sidhedevil at 6:36 PM on December 20, 2009 [1 favorite]


Hey, what do bike lane disputes have to do with vaccines??? And using the words "shiksa sluts" in the voice of a supposed Orthodox Jew -- is that a rational rhetorical device, even if we WERE discussing bike lanes, which we're not?
Plus he uses standard racist rhetoric that would be called out immeditately in any of its more obvious forms towards other minorities. Recognize this attack?: "They have too many kids and they're on welfare and get food stamps." Excuse me? Imputing this to the majority of Orthodox Jews is just as heinous as when rabid white racists spew it viciously about people of color. And please, what does that old racist device, "they have too many babies and they take welfare," have to do with vaccine beliefs either?
And s/he put it into the first person of a supposed Orthodox Jew -- which makes the entire tone even more awful.
Yes, I believe this is vicious, and I am pretty dismayed and shocked.
posted by fullofragerie at 6:41 PM on December 20, 2009 [1 favorite]


No, Peter, because I'm not dealing in baseless antisemitic slurs, but a pretty well-documented aspect of New York politics.

A little googling produces:
...

http://www.vosizneias.com/41273/2009/11/03/kiryas-joel-ny-voting-bloc-shifts-allegiances-outcome-uncertain-in-monroe-town-race/


Not to keep this whole thing going but...am I the only one who always wants to call this community "Curious Joel"?
posted by MikeMc at 6:49 PM on December 20, 2009


Mod note: few comments removed if you can't make your argument without being over the top offensive, you don't get to make it here - metatalk for this. sorry for the chopped up thread everyone else.
posted by jessamyn (staff) at 7:17 PM on December 20, 2009


Despite being vaccinated, I got the mumps as a kid.

It was pretty hilarious, but only because I didn't get any of the complications, and only got the ridiculously swollen cheeks that made me have to eat through a straw for a week.
posted by Dr.Enormous at 7:48 PM on December 20, 2009


Nonsense. Some of the most frequent posters on this site (St. Alia, Miko, PaterAletheias, me, others) self-identify as Christians.

Hey, whatever! I'm an atheist and I think all religion is silly. But there's only one religion that, when you criticize its ludicrous doctrine, you get branded as a racist. That reverse-Godwin shit never accompanies criticism of any other religion. In the context of this discussion its (tangentially, at least) relevant.
posted by klanawa at 8:44 PM on December 20, 2009 [2 favorites]


There an iffy religious angle to this one...

No, no there isn't. Vaccination rates in the Hasidic and Orthodox communities are high.

Orthodox Jews generally view inoculations as important to the health of their communities. There have been a number of Orthodox halachic rulings (since the 1800's,) which have clearly stated that an individual does not have the right to refuse a vaccination because this puts the entire community at risk. Therefore, the community must mandate vaccinations for all of its members.

Years ago, the argument was raised that Tamudic law is a bit iffy on vaccination because of the whole "a doctor is giving someone a disease" thing. Is it "kosher" for a physician to give someone a non-life threatening disease to protect them from potentially being afflicted by one that is life-threatening? Rulings on the subject have pretty much unequivocally said that vaccination is a mitzvah, and the doctor is performing a good deed by inoculating people.
posted by zarq at 9:02 PM on December 20, 2009 [9 favorites]


In the context of this discussion its (tangentially, at least) relevant.

If you read the linked articles, it really seems like religion is not relevant at all. Except for the existence of jewish summer camps, and the fact that some poor people were attending (and these people tend to be less likely to be vaccinated). It really looks like bad luck.
posted by Monday, stony Monday at 9:03 PM on December 20, 2009


Both of my kids have been vaccinated against Chicken Pox but oddly enough it never occurred to me that I, as an adult, could get the same vaccination.

Most adults with prior exposure don't need it. Varicella immunity from a bout with chickenpox is sufficient throughout your adult life. Chickenpox is, however, dangerous to adults who do not have immunity.

After age 60, though, anyone who has had chickenpox (generally) should get the shingles vaccine.
posted by dhartung at 9:06 PM on December 20, 2009


As far as the Orthodox angle goes, is it not completely fucking obvious that it's a close-knit community with lots and lots of events, activities and organisations? I imagine it's random chance that a member of this particular subculture happened to be infected rather than another in the same city, and that the spread has very little to do with the community's beliefs or practices other than its general habit of spending a lot of time with each other.
posted by i_am_joe's_spleen at 9:17 PM on December 20, 2009 [1 favorite]


Is this the thread where I get to yell at anti-vaxers?

GOOD. Because Jenny McCarthy has been trying to sell me some damn wii fitness game every time I turn on the TV. She says "oooh lets be "healthy" and I just scream back "I won't be very healthy when I have the goddamn mumps or other entirely preventable disease in a first world country in the 21st-goddamned-century!"

Yelling this also usually takes care of the kids on my lawn.
posted by fontophilic at 9:36 PM on December 20, 2009 [10 favorites]


Is this the thread where I get to yell at anti-vaxers?

Yup. This is MetaFilter. We don't tolerate people badmouthing the VAX.
posted by Monday, stony Monday at 10:13 PM on December 20, 2009


It is extremely, extremely unlikely that the cause of this outbreak is due to anti-vaccination sentiment.

The only group I know that might be anti-vax are the Satmars. The Satmars tend to cluster in, yes, Monsey, but also in Williamsburg. This article says that the camp that the index case attended was in Sullivan County--this alone implies no Satmar connection--but that the camp was mainly Borough/Boro Park kids. Most Boro Park people don't have anything to do with Satmars, and which some Satmars live there because of bleed-through from Williamsburg, I really doubt they're at fault.

An on preview, looky what I found about this very outbreak:
But perhaps the most frustrating news to some parents is that most of the affected patients had received their proper two-dose vaccination as children — 83 percent, according to the CDC.

[...]

“These communities tend to have social contact with themselves and tend to be a bit isolated from the outside community,” she said. “In New York City especially it’s going through their schools.”
That said,
And while statistics show that an overwhelming majority of the kids in these neighborhoods are in fact properly vaccinated, the few outliers are probably the ones perpetuating the disease spread, he added.
“Overall, immunization coverage is good, but this is a community that has had resistance to MMR vaccines — their parents have claimed religious exemptions,” Zimmerman said.
So no, you can't scream about this being a "Jewish Problem" when 83% of people who are actually getting sick are fully vaccinated, when the national average is 80%. That's right: the Jews are doing better at vaccinations than average! Not worse! In fact, given that the figure of 83% is only those getting sick, there's probably an even higher proportion of Monsey Jews who are vaccinated, but whose vaccination has 'held up.'
posted by flibbertigibbet at 1:35 AM on December 21, 2009


Who vaccinationS HAVE 'held up.'

And WHILE some Satmars live there.

Sorry guys, it's exam season. I'm sleep-deprived.
posted by flibbertigibbet at 1:36 AM on December 21, 2009


It sounds like this is clustering in the jewish community because that just happens to be who caught this in the U.K.

But it is the case that anti-vaxxers tend to be well educated and these outbreak clusters tend to be in high-income, high-educated areas. Which is kind of fascinating.
posted by delmoi at 1:59 AM on December 21, 2009


But there's only one religion that, when you criticize its ludicrous doctrine, you get branded as a racist. That reverse-Godwin shit never accompanies criticism of any other religion.

Your wrong. When did orthag ever criticize doctrine? It was racist spew any way you slice it. The "wellfare queen" criticism wasn't racist? Decrying the power of Jews in NYC because "they vote in blocs" (which is an old trope about Jews "controlling" NYC) wasn't racist?

There was no evidence or facts provided for his wellfare comment. And, in NYC there are political organizations and govt. reps for almost every racial/religious/ethnic subgroup. This is also an old racist trope, and has been used against the Irish/Italians/African Americans etc. He wasn't attacking Ortho Jewish beliefs.

If this thread was about Hispanic immigrant health practices in the US, and someone complained that they just abuse their voting power and live off wellfare... well Ill let you figure it out.
posted by rosswald at 5:18 AM on December 21, 2009


Wow, this thread took a weird turn. Shouldn't we leave the Jews out of this and concentrate on ridiculing the Jehovah's Witnesses for refusing vaccinations for religious reasons?
posted by MikeMc at 9:23 PM on December 20 [+] [!]


This is not true. I was raised as a Jehovah's Witness (I'm not one now) and my siblings and I received all of the recommended vaccinations as children. If you want to ridicule the Jehovah's Witnesses for a medical practice, ridicule them for not allowing blood transfusions.
posted by Maisie at 5:48 AM on December 21, 2009 [2 favorites]


I'm half-deaf because I got mumps in 1967, when I was three, ironically the first year that three-year-olds were vaccinated routinely for it. I may also be sterile as a result.

If the rabid anti-vax types want a piece of that action, they're free to blow out one of their own eardrums and have themselves sterilized, but they have no right to force that onto their kids. None.
posted by Halloween Jack at 8:36 AM on December 21, 2009 [4 favorites]


not to be dismissive of mumps, but it is a little silly to say "biggest outbreak ince 2006. "
----

Why? It is, isn't it?



Yes, no one is disputing the factually accuracy of it, but at least to me when you are going to use a term like "biggest X since Y" it loses its potency if Y is the immediate past. As it stands in this post it is almost a meaningless phrase. Biggest outbreak in 3 years? Near akin to saying biggest snowfall since last year.

Again, I want to stress this, I am in no way being dismissive of the disease just how it's reporting is done here. You know, kind of how everyone flipped out about H1N1 early this year?
posted by edgeways at 10:06 AM on December 21, 2009


You know, kind of how everyone flipped out about H1N1 early this year?

You mean, the disease that has infected 50 million people and caused approximately 10,000 deaths, just in the United States, since last spring? (Remember, that's in addition to the regular seasonal flu.)
posted by Halloween Jack at 3:36 PM on December 21, 2009


yeah I mean the thing that has .02% mortality rate, that has killed 1/3 to 1/4 less than the regular seasonal flu. I am not being dismissive of it despite what you may think, I am saying the "OMFG the swine flu will kill us all".... "It's gonna be 1918 all over again" disaster-porn was not helpful.
posted by edgeways at 4:58 PM on December 21, 2009


Says who? People came in to get treatment for any and every flu-like symptom, whereas before they might have rode it out. And I imagine that the millions of vaccinations given may have had a wee bit to do with the low mortality numbers, as well.
posted by Halloween Jack at 7:21 PM on December 21, 2009


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