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The first peer-reviewed research into a promising coronavirus vaccine was published Thursday. Javier Zayas Photography / Moment / Getty Images
The world has reached a grim milestone with the number of confirmed coronavirus cases reported by the Johns Hopkins University tracker passing one million.
<p>But there is hope in the fight against the deadly pandemic as well: The first peer-reviewed research into a new <a href="https://www.ecowatch.com/tag/vaccines" target="_self">vaccine</a> was published in Lancet publication <a href="https://www.thelancet.com/pdfs/journals/ebiom/PIIS2352-3964(20)30118-3.pdf" target="_blank">eBioMedicine</a> Thursday, and it shows promise.</p><p>"Our ability to rapidly develop this vaccine was a result of <a href="https://www.ecowatch.com/tag/scientists" target="_self">scientists</a> with expertise in diverse areas of research working together with a common goal," co-senior author and dermatology chair at the University of Pittsburgh School of Medicine Louis Falo said in a <a href="https://www.pittwire.pitt.edu/news/covid-19-vaccine-candidate-shows-promise-first-peer-reviewed-research" target="_blank">press release</a>.</p>
<iframe width="100%" height="150" scrolling="no" id="twitter-embed-1245749335964467206" src="/res/community/twitter_embed/?iframe_id=twitter-embed-1245749335964467206&created_ts=1585844761.0&screen_name=PittTweet&text=%23ICYMI%3A+Scientists+from+%40PittDeptofMed%C2%A0announced+a+highly+scalable+potential+vaccine+for+the+new+coronavirus+behind%E2%80%A6+https%3A%2F%2Ft.co%2Fea2ACW4as2&id=1245749335964467206&name=University+of+Pittsburgh" frameborder="0" class="rm-shortcode" data-rm-shortcode-id="8aede4b627c69f3e0373670b9e3ceb06"></iframe>
<p>The University of Pittsburgh researchers said the new vaccine generated enough antibodies in mice to "neutralize" the virus that causes COVID-19 within two weeks of being administered, <a href="https://www.independent.co.uk/news/science/coronavirus-vaccine-pittsburgh-university-lancet-study-covid-pandemic-a9442536.html" target="_blank">The Independent reported</a>.</p><p>This isn't the first coronavirus vaccine in development. Another vaccine skipped animal testing and began human trials in Seattle in March. Dozens of other research teams are also working on vaccines. But this is the first of these vaccines to be peer reviewed, which means that the research behind it was published after scientists at other institutions looked it over.</p><p>The reason the Pittsburgh researchers were able to reach this step so quickly is that they had previously worked on two other deadly coronaviruses: the viruses that cause Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), <a href="https://in.reuters.com/article/us-health-coronavirus-vaccine-candidate/potential-covid-19-vaccine-shows-promise-in-mouse-study-idINKBN21K2BW" target="_blank">Reuters reported</a>.</p>
<p>Studying those viruses, which are closely related to the virus known as SARS-COV-2, taught the researchers that a certain protein called a "spike" protein was key to creating immunity against the disease.</p><p>"We knew exactly where to fight this new virus," co-senior author and associate professor of surgery at the Pitt School of Medicine Andrea Gambotto said in the press release.</p><p>Gambotto said the experience was an object lesson in the value of maintaining <a href="https://www.ecowatch.com/tag/public-health" target="_self">public health</a> research.</p>
<p>"That's why it's important to fund vaccine research," Gambotto said. "You never know where the next pandemic will come from."</p><p>It is too soon to know how long the SARS-COV-2 antibodies will last in mice, but the mice the researchers vaccinated for MERS retained their immunity for at least a year, and the mice injected with the new vaccine seem to be showing similar antibody levels. The researchers are now applying for permission from the Food and Drug Administration (FDA) to start human testing within a few months. Clinical testing typically takes a year or longer, but Falo said there was a chance they could speed the process up.</p><p>If the vaccine pans out, the researchers say it is scalable. It also might be less intimidating to anyone with a fear of needles.</p><p>That's because the researchers administer it via a small Band-Aid-like patch containing 400 tiny needles that dissolve into the skin as they deliver the spike protein.</p>"We developed this to build on the original scratch method used to deliver the smallpox vaccine to the skin, but as a high-tech version that is more efficient and reproducible patient to patient," Falo explained in the press release. "And it's actually pretty painless — it feels kind of like Velcro."
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Hospital employees wearing protection masks and gear tend to patients at a temporary emergency structure in Lombardy, Italy on March 13, 2020. MIGUEL MEDINA / AFP via Getty Images
By Alexander Freund
Sepsis is a life-threatening organ dysfunction caused by the body's immune system overreacting in response to an infection. This overactive, toxic response can lead to tissue damage, multiple organ failure and death.
<p>A <a href="https://www.thelancet.com/action/showPdf?pii=S0140-6736%2819%2933065-X" target="_blank">comprehensive study</a> on the frequency of sepsis and sepsis deaths was published in The Lancet in mid-January 2020. Nearly a quarter of all deaths worldwide are attributable to sepsis every year, according to the study.</p><p>In 2017 there were 48.9 million sepsis cases and 11 million sepsis deaths worldwide. In 2015, 75,000 sepsis deaths were documented in Germany alone — more deaths than from colon, breast, lung and prostate cancer combined. Around 15% of patients who died in hospital in Germany in 2015 died of sepsis.</p>
<p>Despite the high incidence of sepsis, knowledge about sepsis prevention and early detection in Germany is significantly lower than in comparable industrialized countries. For this reason, the <a href="https://www.sepsis-stiftung.eu/" target="_blank">German Sepsis Foundation</a> advises that "all patients at risk should follow the Robert Koch Institute's call to be vaccinated against the influenza virus and against pneumococcus."</p><p>That is especially the case for those with weakened immune systems: Newborns and <a href="https://www.dw.com/en/coronavirus-who-is-particularly-at-risk-and-why/a-52710881" target="_blank">elderly people with a history of illnesses</a> such as diabetes, cancer, chronic diseases or AIDS.</p>
<img lazy-loadable="true" src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjg3ODYwNC9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYxMTY5NzE0NH0.ONb6poa09nVjpQZ-UHgtGp7ZC-PTv0tYgswm_mt4TXg/img.png?width=980" id="ed5e7" class="rm-shortcode" data-rm-shortcode-id="b725e1788cb4055d14acb013185bc311" data-rm-shortcode-name="rebelmouse-image" />
<h3>How Does Sepsis Occur and How Do I Recognize It?</h3><p>Viruses, bacteria, fungi or parasites — sepsis can be triggered by a variety of pathogens. The causes of sepsis are usually pneumonia, wound infections, urinary tract infections or infections in the abdominal cavity.</p><p>In addition to the known seasonal influenza viruses, other viruses that are highly infectious, such as <a href="https://www.dw.com/en/coronavirus-symptoms/a-52233885" target="_blank">coronaviruses</a>, Ebola and yellow fever viruses, dengue, swine flu or bird flu viruses can also cause sepsis.</p><p>In addition to the typical signs of infection, there are several stand out symptoms that usually indicate possible sepsis — for example, a drop in blood pressure with a simultaneous rise in heart rate, fever, rapid, heavy breathing, an unusually strong feeling of illness and sudden confusion. Septic shock is the most severe stage and is diagnosed when your blood pressure drops to dangerous levels. In the event of such alarm signals, emergency care should be sought immediately.</p>
<h3>How Is Sepsis Treated?</h3><p>Although sepsis is common in hospitals, it's often detected very late. When diagnosed, sepsis is immediately treated as an emergency. The blood is examined, a broad-spectrum antibiotic is administered, and sufficient blood circulation and ventilation are ensured. As a precautionary measure, many sepsis patients are "protectionally incubated," i.e. put into an artificial coma.</p><p>Ventilation equipment and/or circulatory therapy, kidney replacement therapy or coagulation therapy are used to support the patient's organs in particular.</p><p>Such an intensive care treatment is highly complex and costly. In the <a href="https://www.sepsis.org/sepsis-basics/prevention/" target="_blank">U.S.</a> alone, around 24 billion dollars (€21.5 billion) are spent annually in hospitals for sepsis treatment.</p><p>More important than the costs, however, are the available capacities: existing intensive care beds should therefore primarily be available to those who are critically ill with the <a href="https://www.dw.com/en/how-does-testing-for-the-coronavirus-work/a-52633616" target="_blank">new coronavirus</a> or other pathogens and who urgently need respiratory care, for example due to sepsis.</p>
<h3>Long-Term Consequences</h3><p>In half of the patients, sepsis occurs without serious consequences. In the other half, infections, kidney failure or cardiovascular problems, i.e. cardiovascular diseases, can recur about three months after discharge.</p><p>In addition, many sepsis patients suffer severe, long-term functional, cognitive or psychological consequences such as paralysis, depression or anxiety disorders.</p><p>It is therefore of central importance that sepsis is prevented if possible or diagnosed as early as possible. The earlier the disease is diagnosed, the higher the chances of survival and therapy.</p>
<img lazy-loadable="true" src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjg3ODYxMS9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYzNzM5MzUxN30.YAJwQ9fN5JguNGfvy2WNbjVVJACXJAV_fQ8SpZm4DSc/img.png?width=980" id="8c43c" class="rm-shortcode" data-rm-shortcode-id="79678901507cf1ace29af0dfd2a88bc6" data-rm-shortcode-name="rebelmouse-image" />
<p><em>Reposted with permission from <a href="https://www.dw.com/en/sepsis-a-common-cause-of-death-from-coronavirus/a-52758193?maca=en-VAM_volltext_ecowatch-28485-html-copypaste,%20Possible%20title:%20Sepsis%20-%20A%20common%20Cause%20of%20Death%20from%20Coronavirus.%20What%20is%20Sepsis?" target="_blank">DW</a>.</em></p>
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A bat with white-nose syndrome in Great Smoky Mountains National Park on March 12, 2012. U.S. Fish and Wildlife Service
A deadly fungal disease responsible for the deaths of millions of bats across the U.S. has been confirmed in Texas for the first time.
<p>White-nose syndrome (WNS) is a disease in bats caused by a cold-loving fungus known as <a href="https://www.whitenosesyndrome.org/static-page/the-fungus" target="_blank"><em>Pseudogymnoascus destructans</em></a>, which infects the skin on the muzzle, ear and wings of hibernating bats. Infected bats have obvious fungal growth on their body, but may also behave erratically both inside and outside of caves during the winter when they should be hibernating, according to the <a href="https://www.whitenosesyndrome.org/static-page/what-is-white-nose-syndrome" target="_blank">White-Nose Syndrome Response Team</a>. The fungus that causes the disease was first detected in the state in 2017, but there were no signs of the WNS that it can cause, according to the Texas Parks and Wildlife Department (<a href="https://tpwd.texas.gov/newsmedia/releases/?req=20190508a" target="_blank">TPWD</a>). In the years since, the fungus has spread to dozens of sites in 21 counties. At the time, biologists said that it usually takes a few years after detecting the fungus for the disease to manifest.</p>
<p>The infected animal is a type of bat known as cave myotis (<em>Myotis velifer</em>) and was found in the central part of the state on Feb. 23. Analysis conducted by the USGS National Wildlife Health Center confirmed the presence of both the fungus and the disease that it causes.</p><p>"Finding WNS in Central Texas for the first time is definitely concerning," <a href="https://tpwd.texas.gov/newsmedia/releases/?req=20200305a" target="_blank">said</a> Nathan Fuller, bat specialist at TPWD. "Biologists had hoped that white-nose syndrome, a disease that thrives in cold conditions, might not occur in warmer parts of Texas. We're following up on several other reports to determine whether this was an isolated incident or if the impacts are more widespread. We recently received a report from a site in Bell County of five cave myotis that we suspect were infected as well. We should know more in the next few weeks."</p>
<p>WNS was first detected in New York more than a decade ago and has since spread from the northeastern part of the country to the southcentral states at what the USGS calls an "<a href="https://www.usgs.gov/faqs/what-white-nose-syndrome?qt-news_science_products=0#qt-news_science_products" target="_blank">alarming rate</a>." It is believed to have been introduced from Europe where bats appear to be resistant to the fungus. The fungus is largely transmitted between bats but can be brought into caves on the clothing and gear of humans.</p><p>As of this year, millions of bats in at least 33 states and seven Canadian provinces have died from the disease. In some parts of the U.S., normally long-lived winter bat populations have fallen by more than 90 percent. Because many species only produce one offspring each year, experts say it could take decades for some populations to recover.</p>
<p>Currently there is no cure for WNS but scientists are collaborating to study the disease and understand how it spreads to infect bats, as well as what can be done to control it. Lab tests have shown that oral vaccines may increase the chances of surviving an infection, <a href="https://www.sciencenews.org/article/vaccines-may-help-bats-fight-white-nose-syndrome" target="_blank">reports</a> Science News. Evidence suggests that WNS only occurs in bats and is not transmissible to humans as the fungus only grows at temperatures between 41 and 68 degrees Fahrenheit, which is much lower than the human body, according to the <a href="https://www.nps.gov/articles/what-is-white-nose-syndrome.htm" target="_blank">National Park Service</a>. No human infections have been documented after exposure to WNS-infected bats or caves.</p>
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A volunteer from Blue Sky Rescue wears a protective suit as she fumigates and disinfects outside an area of a local bus station on March 7, 2020 in Beijing, China. Kevin Frayer / Getty Images
By Rebecca S.B. Fischer
The coronavirus is on everyone's minds. As an epidemiologist, I find it interesting to hear people using technical terms – like quarantine or super spreader or reproductive number – that my colleagues and I use in our work every day.
<p>But I'm also hearing newscasters and neighbors alike mixing up three important words: outbreak, epidemic and pandemic.</p><p>Simply put, the difference between these three scenarios of disease spread is a matter of scale.</p>
<h3>Outbreak</h3><p>Small, but unusual.</p><p>By tracking diseases over time and geography, epidemiologists learn to predict how many cases of an illness should normally happen within a defined period of time, place and population. <a href="https://www.who.int/emergencies/diseases/en/" target="_blank">An outbreak</a> is a noticeable, often small, increase over the expected number of cases.</p><p>Imagine an unusual spike in the number of children with diarrhea at a daycare. One or two sick kids might be normal in a typical week, but if 15 children in a daycare come down with diarrhea all at once, that is an outbreak.</p><p>When a new disease emerges, outbreaks are more noticeable since the anticipated number of illnesses caused by that disease was zero. An example is the cluster of pneumonia cases that sprung up <a href="https://www.ucsf.edu/news/2020/01/416511/mysterious-coronavirus-spreads-infectious-disease-expert-explains-what-you" target="_blank">unexpectedly among market-goers in Wuhan, China</a>. Public health officials now know the spike in pneumonia cases there constituted an outbreak of a new type of coronavirus, now named SARS-CoV-2.</p><p>As soon as local health authorities detect an outbreak, they start an investigation to determine exactly who is affected and how many have the disease. They use that information to figure out how best to contain the outbreak and prevent additional illness.</p>
<h3>Epidemic</h3><p>Bigger and spreading.</p><p>An epidemic is an outbreak over a larger geographic area. When people in places outside of Wuhan began testing positive for infection with SARS-CoV-2 (which causes the disease known as COVID-19), epidemiologists knew the outbreak was spreading, a likely sign that containment efforts were insufficient or came too late. This was not unexpected, given that no treatment or vaccine is yet available. But widespread cases of COVID-19 across China meant that <a href="https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200122-sitrep-2-2019-ncov.pdf?sfvrsn=4d5bcbca_2" target="_blank">the Wuhan outbreak had grown to an epidemic</a>.</p>
<h3>Pandemic</h3><p>International and out of control.</p><p>In the most classical sense, once an epidemic spreads to multiple countries or regions of the world, it is considered <a href="https://www.who.int/bulletin/volumes/89/7/11-088815/en/" target="_blank">a pandemic</a>. However, some epidemiologists classify a situation as a pandemic only once the disease is sustained in some of the <a href="https://www.ncbi.nlm.nih.gov/books/NBK143061/" target="_blank">newly affected regions through local transmission</a>.</p><p>To illustrate, a sick traveler with COVID-19 who returns to the U.S. from China doesn't make a pandemic, but once they infect a few family members or friends, there's some debate. If new local outbreaks ensue, epidemiologists will agree that efforts to control global spread have failed and refer to the emerging situation as a pandemic.</p>
<h3>Terms Are Political, Not Just Medical</h3><p>Epidemiologists are principally concerned with preventing disease, which may be fundamentally different than the broader <a href="https://theconversation.com/coronavirus-unites-a-divided-china-in-fear-grief-and-anger-at-government-131549" target="_blank">concerns of governments</a> or <a href="https://theconversation.com/who-declares-global-health-emergency-over-coronavirus-4-questions-answered-130940" target="_blank">international health organizations</a>.</p><p>As of this writing, the World Health Organization classifies the risk of global COVID-19 spread as "<a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen" target="_blank">very high</a>," the highest level in their risk classification scheme and one step below an official pandemic declaration. This means that the <a href="https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200305-sitrep-45-covid-19.pdf?sfvrsn=ed2ba78b_2" target="_blank">WHO remains hopeful</a> that, by taking aggressive steps now, containment of localized outbreaks may still be possible.</p><p>But I and other scientists and public health officials are already calling this a pandemic. The official numbers count an excess of 100,000 cases in almost 100 countries, and community spread has been <a href="https://www.cdc.gov/coronavirus/2019-ncov/summary.html" target="_blank">documented in the U.S.</a> and elsewhere. By the classical definition, it's a pandemic.</p><p>A formal declaration of COVID-19 or any other infectious disease as pandemic tells governments, agencies and aid organizations worldwide to shift efforts from containment to mitigation. It has economic, political and societal impacts on a global scale.</p><p>Formal declaration needn't incite fear or cause you to stockpile surgical masks. It doesn't mean the virus has become more infectious or more deadly, nor that your personal risk of getting the disease is greater. But it will be a historical event.</p>
<p>
<em>Reposted with permission from <a href="https://theconversation.com/whats-the-difference-between-pandemic-epidemic-and-outbreak-133048" target="_blank">The Conversation</a>.</em>
</p><script async="async" data-counter="https://counter.theconversation.com/content/133048/count?distributor=republish-lightbox-advanced" id="theconversation_tracker_hook" src="https://theconversation.com/javascripts/lib/content_tracker_hook.js" type="text/javascript"></script>From Your Site Articles
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The Director of the Chinese Center for Disease Control and Prevention, Gao Fu speaks on Jan. 26 during a press briefing on studying the 2019-nCoV coronavirus and developing a vaccine to prevent it. Roman Balandin / TASS / Getty Images
Editor's note: The coronavirus that started in Wuhan has sickened more than 4,000 people and killed at least 100 in China as of Jan. 27, 2020. Thailand and Hong Kong each have reported eight confirmed cases, and five people in the U.S. have been diagnosed with the illness. People are hoping for a vaccine to slow the spread of the disease.
Is there a vaccine under development for the coronavirus?
<p>Work has begun at <a href="https://www.niaid.nih.gov/diseases-conditions/mers-sars-therapeutics-vaccines" target="_blank">multiple organizations</a>, including the National Institutes of Health, to develop a <a href="https://www.ecowatch.com/tag/vaccines" rel="noopener noreferrer">vaccine</a> for this new strain of coronavirus, known among scientists as <a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html" target="_blank">2019-nCoV</a>.</p><p>Scientists are just getting started working, but their vaccine development strategy will benefit both from work that has been done on closely related viruses, such as <a href="https://www.niaid.nih.gov/news-events/niaid-officials-discuss-novel-coronavirus-recently-emerged-china" target="_blank">SARS and MERS</a>, as well as advances that have been made in vaccine technologies, such as <a href="https://doi.org/10.2147/IJN.S39810" target="_blank">nucleic acid vaccines</a>, which are DNA- and RNA-based vaccines that produce the vaccine antigen in your own body.</p>Was work underway on this particular strain?
<p>No, but work was ongoing for other closely related coronaviruses that have caused severe disease in humans, namely MERS and SARS. Scientists had not been concerned about this particular strain, as we did not know that it existed and could cause disease in humans until it started causing this outbreak.</p>How do scientists know when to work on a vaccine for a coronavirus?
<p>Work on vaccines for severe coronaviruses has historically begun once the viruses start infecting humans.</p><p>Given that this is the third major outbreak of a new coronavirus that we have had in the past two decades and also given the severity of disease caused by these viruses, we should consider investing in the development of a vaccine that would be broadly protective against these viruses.</p>What does this work involve, and when might we actually have a vaccine?
<p>This work involves designing the vaccine constructs – for example, producing the right target <a href="https://www.britannica.com/science/antigen" target="_blank">antigens</a>, viral proteins that are targeted by the immune system, followed by testing in animal models to show that they are protective and safe.</p><p>Once safety and efficacy are established, vaccines can advance into clinical trials in humans. If the vaccines induce the expected immune response and protection and are found safe, they can be mass produced for vaccination of the population.</p><p>Currently, we lack virus isolates – or samples of the virus – to test the vaccines against. We also lack antibodies to make sure the vaccine is in good shape. We need the virus in order to test if the immune response induced by the vaccine works. Also, we need to establish what animals to test the vaccine on. That potentially could include mice and nonhuman primates.</p><p>Vaccine development will likely take months.</p>Can humans ever be safe from these types of outbreaks?
<p>We expect that these types of outbreaks will occur for the foreseeable future in irregular intervals.</p><p>To try to prevent large outbreaks and pandemics, we need to improve surveillance in both humans and animals worldwide as well as invest in risk assessment, allowing scientists to evaluate the potential threat to human health from the virus, for detected viruses.</p><p>We believe that global action is needed to invest in novel vaccine approaches that can be employed quickly whenever a new virus like the current coronavirus – and also viruses similar to Zika, Ebola or influenza – emerges. Currently, responses to emerging pathogens are mostly reactive, meaning they start after the outbreak happens. We need a more proactive approach supported by continuous funding.</p>From Your Site Articles
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Medicare, Obamacare, vaping, vaccines and virtual healthcare are expected to be among the top health-related issues in 2020. Ani Kolleshi / Unsplash
By Roz Plater
It's 2020 and another year of health-related topics awaits us.
<p>What health issues will take priority? What buzzwords will we all be talking about? How might technology change healthcare?</p>
<p><em>Reposted with permission from </em><a href="https://www.healthline.com/" target="_blank"><em>Healthline</em></a><em>. For detailed source information, please view the original article on <a href="https://www.healthline.com/health-news/what-will-be-the-top-health-issues-for-2020#Vaping" target="_blank">Healthline</a></em><em>.</em></p>
<p>We asked some experts to peek into their crystal balls and make a few predictions.</p><p>They tell us that how you get access to healthcare and how you pay for it will both be hot topics this presidential election year.</p><p>In fact, one expert says healthcare could help decide political winners and losers.</p><p>"Whoever comes up with a plan that will work, is affordable, and something people can understand, that will push them ahead," said <a href="https://www.merritthawkins.com/why-merritt-hawkins/who-we-are/leadership/" target="_blank">Kurt Mosley</a>, vice president of strategic alliances for Merritt Hawkins, a physician search, consulting, and research firm.</p>
Medicare
<p>Medicare is front and center as we kick off 2020.</p><p>That's in part because "<a href="https://www.healthline.com/health/what-medicare-for-all-would-look-like-in-america" target="_blank">Medicare for All</a>" is the single payer option health plan being touted by two of the top Democratic presidential candidates.</p><p><a href="https://www.forrester.com/Jeff-Becker" target="_blank">Jeff Becker</a>, the senior analyst for healthcare strategy at Forrester Research says there are also a number of bills in Congress looking to expand access to Medicare as a public option.</p><p>"When you look at the polling numbers, our call is that Medicare for All will die in the court of public opinion and become Medicare Advantage for more," Becker told Healthline.</p>Affordable Care Act
<p>The <a href="https://www.healthline.com/health/consumer-healthcare-guide/pros-and-cons-obamacare" target="_blank">Affordable Care Act (ACA)</a>, often referred to as Obamacare, will be in the courts again this year.</p><p>In December, a federal appeals court <a href="https://www.cnbc.com/2019/12/18/-.html" target="_blank">ruled</a> that the health insurance law's individual mandate provision was unconstitutional.</p><p>However, the justices sent back to a federal district court in Texas the issue of whether other parts of the law could continue to exist without the mandate that requires everyone to have health insurance.</p><p>Look for some sort of Obamacare case to wind up in the U.S. Supreme Court this year.</p><p>"Our call is whether or not it goes to the Supreme Court, the ACA will survive because the individual mandate is severable," Becker told Healthline.</p>Price Transparency
<p>Experts say you'll hear a lot of debate about price transparency, a move designed to increase competition and lower costs.</p><p>President Trump <a href="https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html?amp" target="_blank">signed an executive order</a> in November that requires hospitals and insurers to publish their confidential, negotiated rates for treatments.</p><p>"The reason this would be important is you'd be able to figure out what your out-of-pocket expenses would be" said Becker.</p><p>But a coalition of hospital groups has <a href="https://www.reuters.com/article/us-us-hospitals/hospital-groups-file-lawsuit-to-block-trumps-price-transparency-rule-idUSKBN1Y81YY" target="_blank">filed a lawsuit</a> to block the rule. They argue that the public disclosure of negotiated charges would create confusion about consumers' out-of-pocket costs.</p><p>The order is scheduled to go into effect January 1, 2021.</p>Lower Prescription Drug Prices
<p>"The thing about pharmaceuticals is, if you can't afford them, they don't work," Mosley said.</p><p>He predicts the move to lower the costs of prescription drugs will again be on the front burner of the healthcare debate in 2020.</p><p>"The problem is Medicare and Medicaid can't negotiate prices with these drug companies," Mosley told Healthline.</p><p>The House of Representatives has <a href="https://www.aarp.org/politics-society/advocacy/info-2019/house-passes-drug-price-bill.html" target="_blank">approved a bill</a> that would do just that. The legislation also caps out-of-pocket expenses for people enrolled in Medicare Part D.</p><p>However, the prognosis for this bill becoming law isn't good.</p><p>Political observers say the legislation won't go anywhere in the Senate, and the White House has indicated the president would veto it.</p><p>Republicans in the Senate have <a href="https://www.usatoday.com/story/news/health/2019/11/11/mcconnell-pelosi-clash-over-drug-price-bill-congress-act/2558426001/" target="_blank">crafted</a> their own prescription drug price plan. The president has indicated he would sign this bill, but it would need to be approved by the Democrat-controlled House.</p>Access to Health Services
<p>"One of the cross-cutting issues we see as a priority in 2020 is the social determinants in health disparities in our patients," said <a href="https://www.aafp.org/media-center/releases-statements/all/2013/amy-mullins-medical-director.html" target="_blank">Amy Mullins</a>, MD, FAAFP, medical director for quality improvement for the American Academy of Family Physicians.</p><p>"Patients need more than just access to a physician," she told Healthline. "They need access to good food, safe places to live, to exercise, transportation, community resources, access to medication."</p><p>"If you don't address those, it's really difficult to treat your patients effectively," she added.</p><p>Mullins says her group has an internal division called the Center for Diversity and Health Equity whose mission is to look at healthcare through that lens.</p>Vaccine Hesitancy
<p>Mullins also says the issue of vaccine myths is one you'll continue to hear about in 2020.</p><p>"We want to do more to counter the misinformation that's out there around vaccines that may be holding some people back from getting what they need," said Mullins.</p><p>A <a href="https://www.sciencedirect.com/science/article/pii/S0264410X1931446X?via%3Dihub" target="_blank">recent study</a> concluded that a lot of the false information is being spread on social media by a handful of anti-vaccine ad buyers.</p><p>"We're promoting vaccine education to physicians, their healthcare teams, patients, and communities" Mullins said.</p><p>A <a href="https://www.healthaffairs.org/do/10.1377/hblog20191212.484779/full/" target="_blank">2020 National Vaccine Plan</a> is currently being developed by the Department of Health and Human Services' Office of Infectious Disease and HIV/AIDS Policy.</p>Vaping
<p>"Another of the big priorities for health providers in 2020 is vaping and e-cigarettes," Mullins said.</p><p>"We really applaud and support the work the Centers for Disease Control and Prevention and the Food and Drug Administration is doing to try and get a handle on this crisis," she said. "But these products target adolescents and we think the marketing needs more regulation."</p><p>A <a href="https://www.drugabuse.gov/news-events/news-releases/2019/12/vaping-marijuana-rise-among-teens" target="_blank">study</a> released last month from the National Institute on Drug Abuse reported that more teens are vaping marijuana.</p><p>That's despite a lung illness linked to vaping that's killed <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html" target="_blank">more than 50 people</a> nationwide.</p>Virtual Care Visits
<p>On the digital front, Becker predicts there will be aggressive growth in virtual care visits.</p><p>That's where you interact with your doctor via text, video, or phone call.</p><p>Becker's group crunched the numbers after looking at outpatient visit data as well as talking to virtual vendors and tracking healthcare investments.</p><p>"The result was 36 million net new virtual care visits in 2020," he said.</p><p>He points to how employers and insurers are already embracing the concept. Amazon recently launched a pilot program called "<a href="https://www.cnbc.com/amp/2019/09/24/amazon-launches-employee-health-clinic-amazon-care.html" target="_blank">Amazon Care</a>," a virtual clinic for its employees in Seattle.</p><p>Walmart recently expanded its <a href="https://mhealthintelligence.com/news/walmart-expands-telehealth-services-for-employees-in-3-states" target="_blank">telehealth services</a> to workers in Colorado, Minnesota, and Wisconsin with $4 online or video care visits.</p><p>Humana has <a href="https://medcitynews.com/2019/04/humana-and-doctor-on-demand-launch-new-virtual-primary-care-health-plan/" target="_blank">teamed up</a> with "Doctor on Demand" to offer a virtual primary care plan at significantly lower monthly premiums.</p><p>"Everybody is moving toward a model where we're not using high-cost care centers like emergency rooms," Becker said.</p><p>"And consumers are demanding more cost effective services, too," he added. "In 2018, consumers took out <a href="http://nymag.com/intelligencer/2019/04/americans-borrowed-usd88-billion-for-health-expenses-in-2018.html" target="_blank">$88 billion</a> in personal loans just to pay for out-of-pocket medical costs."</p>From Your Site Articles
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Ebola virus seen under a microscope. Studio_3321 / iStock / Getty Images Plus
The U.S. Food and Drug Administration (FDA) announced Thursday that it has approved a vaccine for Ebola manufactured by Merck, according to Reuters.
<p>Merck's vaccine, Ervebo, was also approved by the European Commission in November, as <a href="https://www.statnews.com/2019/12/19/fda-approves-an-ebola-vaccine-long-in-development-for-the-first-time/" target="_blank">STAT</a> reported.</p><p>The vaccine was used widely by the World Health Organization and the Democratic Republic of Congo to help reduce the spread of the Ebola virus in a few West African countries from 2014 to 2016, according to <a href="https://www.reuters.com/article/us-health-ebola-merck-co/merck-receives-fda-approval-for-ebola-vaccine-idUSKBN1YO06U" target="_blank">Reuters</a>. Ebola Zaire is the strain of the virus responsible for the ongoing outbreak in the Democratic Republic of the Congo, according to <a href="https://www.statnews.com/2019/12/19/fda-approves-an-ebola-vaccine-long-in-development-for-the-first-time/" target="_blank">STAT</a>.</p><p>The Ebola virus is extremely rare in the U.S. The only cases that have ever existed are from people infected in other countries who traveled to the U.S. or from healthcare workers who treated people infected with the virus, according to <a href="https://abcnews.go.com/Health/fda-approves-1st-ebola-vaccine-us/story?id=67845280" target="_blank">ABC News</a>.</p>
<p>"Ebola virus disease is a rare but severe and often deadly disease that knows no borders," said Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, in a statement reported by <a href="https://www.statnews.com/2019/12/19/fda-approves-an-ebola-vaccine-long-in-development-for-the-first-time/" target="_blank">STAT</a>. "Vaccination is essential to help prevent outbreaks and to stop the Ebola virus from spreading when outbreaks do occur."</p><p>Secretary of Health and Human Services Alex Azar touted the vaccine, which is a single-dose injection that works within 10 days of injection, as "a triumph of American global health leadership," according to <a href="https://www.cnn.com/2019/12/20/health/fda-approves-first-ever-vaccine-ebola-virus/index.html" target="_blank">CNN</a>.</p><p>The Ebola Zaire virus has claimed thousands of life in West Africa and set off widespread panic during an outbreak in 2014. The current outbreak has claimed 2,000 lives in the Democratic Republic of Congo, while the outbreak in 2014 led to more than 11,000 deaths in West Africa, according to <a href="https://www.cnn.com/2019/12/20/health/fda-approves-first-ever-vaccine-ebola-virus/index.html" target="_blank">CNN</a>.</p><p>The Ebola virus causes hemorrhagic fever, which can quickly shut down bodily functions. It spreads when a person makes direct contact with the bodily fluids of an infected person, as <a href="https://abcnews.go.com/Health/fda-approves-1st-ebola-vaccine-us/story?id=67845280" target="_blank">ABC News</a> reported.</p><p>The vaccine is approved for patients 18 and older. It will make up a large portion of the vaccine stockpile held by the Gavi, the Vaccine Alliance, to have readily available at the next sign of an outbreak, according to <a href="https://www.statnews.com/2019/12/19/fda-approves-an-ebola-vaccine-long-in-development-for-the-first-time/" target="_blank">STAT</a>. Gavi recently said it planned to stockpile half a million doses of the vaccine. Ervebo is attractive to Gavi for its simplicity since it is just a single-dose and has a fairly quick immune response time of just 10 days, as <a href="https://www.statnews.com/2019/12/19/fda-approves-an-ebola-vaccine-long-in-development-for-the-first-time/" target="_blank">STAT</a> reported.</p><p>"While the risk of Ebola virus disease in the U.S. remains low, the U.S. government remains deeply committed to fighting devastating Ebola outbreaks in Africa, including the current outbreak in the Democratic Republic of the Congo," said Anna Abram, FDA deputy commissioner for policy, legislation and international affairs, in a statement Thursday, as <a href="https://abcnews.go.com/Health/fda-approves-1st-ebola-vaccine-us/story?id=67845280" target="_blank">ABC News</a> reported. "Today's approval is an important step in our continuing efforts to fight Ebola in close coordination with our partners across the U.S. Department of Health and Human Services, as well as our international partners, such as the World Health Organization."</p><p>The vaccine has been in the works for decades, starting in the 90s. However, the dearth of commercial interest in an Ebola vaccine kept large pharmaceutical companies from partnering in the research and development of the drug. The outbreak in 2014 triggered a change in attitude and the drug was rapidly developed.</p><p>It underwent extensive testing, culminating in a clinical trail in Guinea, which was effected by the outbreak. Ervebo proved effective in stopping the spread of the virus, as <a href="https://www.statnews.com/2019/12/19/fda-approves-an-ebola-vaccine-long-in-development-for-the-first-time/" target="_blank">STAT</a> reported.</p>More than 258,000 people have been vaccinated in the current outbreak, according to <a href="https://www.statnews.com/2019/12/19/fda-approves-an-ebola-vaccine-long-in-development-for-the-first-time/" target="_blank">STAT</a>.
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Measles Killed More Than 140,000 People in 2018, Mostly Young Children, Despite a Safe Vaccine
06 December 2019
Science
A child receives a measles vaccine. DFID - UK Department for International Development / CC BY 2.0
Measles infected nearly 10 million people in 2018 and killed more than 140,000, according to new estimates from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). Most of the people who died were children under five years old.
<p>The figures come as vaccination rates have stalled in the last ten years. WHO and the <a href="https://www.unicef.org/" target="_blank">United Nations Children's Fund</a> (UNICEF) estimate that 86 percent of children received the first dose of the measles vaccine in 2018 and fewer than 70 percent received the second dose, but WHO says a vaccination rate of 95 percent is necessary to protect communities from disease outbreaks.</p><p>"The fact that any child dies from a vaccine-preventable disease like measles is frankly an outrage and a collective failure to protect the world's most vulnerable children," WHO Director-General Dr. Tedros Adhanom Ghebreysus said in a press release. "To save lives, we must ensure everyone can benefit from vaccines — which means investing in immunization and quality health care as a right for all."</p>
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<p>In poorer countries, vaccination rates are low because of problems with or interruptions in health services, <a href="https://www.theguardian.com/society/2019/dec/05/142000-died-from-measles-last-year-who-estimates" target="_blank">The Guardian explained</a>. In the Democratic Republic of the Congo (DRC), one of the five countries most affected by measles in 2018, conflict and an inadequate health care system have prevented children from receiving the vaccine. Measles has killed more than 4,500 people in the country this year, claiming a higher death toll than an Ebola outbreak.</p><p>Along with the DRC, the other most impacted countries were Liberia, Madagascar, Somalia and Ukraine, which together saw almost half of the global measles cases this year.</p><p>Dr. Peter Hotez, dean of the National School of Tropical Medicine at the <a href="https://www.bcm.edu/people/view/peter-hotez-m-d-ph-d/b1846a47-ffed-11e2-be68-080027880ca6" target="_blank">Baylor College of Medicine</a> in Houston, who was not part of the WHO and CDC study, told <a href="https://edition.cnn.com/2019/12/05/health/measles-deaths-worldwide-who-cdc-report/index.html" target="_blank">CNN</a> that measles is the first disease to return when vaccinations are interrupted because it is so contagious. He said measles could make a comeback anywhere because of war, political conflict, the <a href="https://www.ecowatch.com/climate-change/" target="_self">climate crisis</a> or anti-vaccination movements.</p><p>"So the fact that measles is now returning in some areas is an indication that our vaccine ecosystem is fragile and in some areas breaking down despite general gains," he said.</p><p>Worries about the safety of vaccines helped spark a deadly outbreak in Samoa after two children died from an incorrectly-mixed vaccine in 2018, according to The Guardian. Anti-vaccination activist Robert F. Kennedy Jr. then visited the island in June, apparently fanning the flames of fear. In the past weeks, 62 deaths and more than 4,200 cases have been reported on the island, according to CNN, and the government <a href="https://www.ecowatch.com/samoa-measles-vaccine-2641506808.html" target="_self">shut down its offices Thursday and Friday</a> so public employees could focus on a mass vaccination campaign.</p><p>Anti-vaccination messages have also led to an increase in measles cases in wealthier countries. In 2018, the U.S. recorded its highest number of cases in 25 years, and the European countries of Albania, Czechia, Greece and the UK lost their measles elimination status.</p>
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<p>WHO's immunization director Dr. Kate O'Brien told The Guardian that anti-vaccination messages were able to spread more easily now because of the internet.</p><p>"Anti-vaccine messages are not new," she said. "But what is new is the tools with which and the opportunity for these messages even from a small fringe group of people to disseminate very widely and to portray themselves as if they are accurate pieces of information, which they are not."</p><p>Measles is more contagious than either the flu or Ebola, <a href="https://uk.reuters.com/article/uk-health-measles-who/who-decries-collective-failure-as-measles-kills-140000-idUKKBN1Y92CC" target="_blank">according to Reuters</a>. It can be fatal, or cause long-lasting complications like pneumonia, brain-damage, blindness or deafness. An October study found that it can also damage survivors' immune memory, making them more vulnerable to other infectious diseases.</p>
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<p>The world has made progress in battling measles since 2000, when there were 28,219,100 cases and 535,600 deaths, according to the WHO. However, measles cases have begun to climb since 2016, increasing 167 percent worldwide in the last two years, CNN reported.</p><p>The trend does not look to be improving in 2019, according to WHO. As of November, there were three times the number of reported cases than had been documented by the same time last year.</p><p>"It is a tragedy that the world is seeing a rapid increase in cases and deaths from a disease that is easily preventable with a vaccine," Dr. Seth Berkley, CEO of <a href="https://www.gavi.org/" target="_blank">Gavi, the Vaccine Alliance</a>, said in the press release.</p>
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Samoan Government Shuts Down Offices After Measles Kills 55, Infects 2% of Population
03 December 2019
Health + Wellness
Prime Minister Tuilaepa Sailele Malielegaoi asked for the public's help in making sure that people get vaccinated during the two days that government offices are closed. DANIEL LEAL-OLIVAS / AFP / Getty Images
The government of Samoa will shut down its offices for two days this week so civil servants can focus on a nationwide immunization drive after almost 4,000 confirmed cases of measles have swept across the small Pacific nation of just 200,000 people, as NPR reported. So far 55 people have died, 50 of them are children under four, according to The Guardian.
<p>198 new cases were confirmed on Sunday and Monday, according to the <a href="https://www.bbc.com/news/world-asia-50625680" target="_blank">BBC</a>.</p>
<p>The government started a mass vaccination campaign on Nov. 20 and successfully vaccinated over 58,000 people, or one-fourth of the country's population, as it announced on <a href="https://twitter.com/samoagovt/status/1201285534368190464" target="_blank">Twitter</a> yesterday.</p><p>Prime Minister Tuilaepa Sailele Malielegaoi asked for the public's help in making sure that people get vaccinated during the two days that government offices are closed on Dec. 5 and 6. He asked for "village councils, faith-based organizations, and church leaders, village mayors and government women representatives" to persuade the public to get vaccinated, according to <a href="https://www.npr.org/2019/12/02/784179707/samoan-government-to-close-its-offices-amid-measles-crisis-that-has-left-53-dead" target="_blank">NPR</a>.</p><p>He also cautioned against alternative medicine and homeopathy.</p><p>"Let us work together to ... convince those that do not believe that vaccinations are the only answer to the epidemic. Let us not be distracted by the promise of alternative cures," Tuilaepa said, as <a href="https://www.npr.org/2019/12/02/784179707/samoan-government-to-close-its-offices-amid-measles-crisis-that-has-left-53-dead" target="_blank">NPR</a> reported. He warned people to avoid traditional healers, saying that vaccinations are the only cure.</p><p>Schools and universities have been closed since Nov. 17. Public gatherings have been banned and a state of emergency was declared on Nov. 15. While an immunization campaign has vaccinated tens of thousands people successfully, the outbreak has continued to spread, as the <a href="https://www.bbc.com/news/world-asia-50625680" target="_blank">BBC</a> reported.</p>
<p>"The situation has a tremendous impact on everybody," Sheldon Yett, Unicef representative to the Pacific, told the <a href="https://www.bbc.com/news/world-asia-50625680" target="_blank">BBC</a>. "People are nervous, people are seeing the impact of this disease. Samoa is a very small country and everybody knows somebody who's been affected by this."</p><p>Samoa has one of the lowest vaccination rates in the world. The World Health Organization (WHO) and UNICEF estimated that Samoa's measles vaccination rate for infants was <a href="https://www.who.int/immunization/monitoring_surveillance/data/wsm.pdf" target="_blank">31 percent in 2018</a>, according to <a href="https://arstechnica.com/science/2019/12/measles-outbreak-spurred-by-anti-vaxxers-shuts-down-samoan-government/" target="_blank">Ars Technica</a>. That's a steep decline from a rate as high as 90 percent in 2013. By comparison, the nearby islands of Nauru, Niue and Cook Islands have immunization rates of 99 percent, according to the <a href="https://www.bbc.com/news/world-asia-50625680" target="_blank">BBC</a>.</p><p>The low vaccination rate is often attributed to a medical mishap in July 2018 when two infants died after nurses mistakenly mixed vaccines with muscle relaxant instead of water. The nurses pleaded guilty to manslaughter and are serving five years in prison, according to the <a href="https://www.bbc.com/news/world-asia-50625680" target="_blank">BBC</a>.</p><p>"As a result of that, the vaccination program was halted while they investigated the cause," Keni Lesa, editor of the Samoa Observer <a href="https://www.npr.org/2019/12/01/783932628/measles-outbreak-kills-dozens-of-kids-on-samoa-and-infects-thousands-more" target="_blank">told </a><a href="https://www.npr.org/2019/12/02/784179707/samoan-government-to-close-its-offices-amid-measles-crisis-that-has-left-53-dead" target="_blank">NPR</a>.</p>
<p>During the temporary postponement of the immunizations, the anti-vaccine movement picked up steam and sowed the seeds of distrust. "They really found a gap there to really hammer home their message. And a lot of parents became scared to take their kids to get vaccinated," said Lesa to <a href="https://www.npr.org/2019/12/02/784179707/samoan-government-to-close-its-offices-amid-measles-crisis-that-has-left-53-dead" target="_blank">NPR</a>.</p><p>Medical teams from Australia, New Zealand, France, China, Norway, Japan the United Kingdom, the U.S. and the United Nations have flown in to help stem the crisis in Samoa, according to <a href="https://www.npr.org/2019/12/02/784179707/samoan-government-to-close-its-offices-amid-measles-crisis-that-has-left-53-dead" target="_blank">NPR</a></p><p>The WHO has pointed to an insidious rise in vaccine skepticism for the uptick, <a href="https://www.who.int/emergencies/ten-threats-to-global-health-in-2019" target="_blank">saying earlier this year</a> that vaccine hesitancy is one of the 10 largest threats to global health, according to <a href="https://time.com/5742417/samoa-measles-outbreak/" target="_blank">Time</a>.</p><p>"People who are spreading lies and misinformation about vaccinations are killing children," said Yett to the <a href="https://www.bbc.com/news/world-asia-50625680" target="_blank">BBC</a>. "The best way to keep children safe is to make sure they're immunised. Preventing vaccination and presenting false information kills children. That is clear - the evidence speaks for itself."</p>
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Measles Outbreak in Samoa Kills 6. Schools Closed. State of Emergency Declared
18 November 2019
Health + Wellness
(L) 3D graphical representation of a spherical-shaped, measles virus particle that is studded with glycoprotein tubercles.
(R) The measles virus pictured under a microscope. PHIL / CDC
(R) The measles virus pictured under a microscope. PHIL / CDC
The Pacific Island nation of Samoa declared a state of emergency this week, closed all of its schools and limited the number of public gatherings allowed after a measles outbreak has swept across the country of just 200,000 people, according to Reuters.
<p>In declaring the health emergency, officials said they were anticipating the worst to come, according to a <a href="https://www.facebook.com/samoagovt/" target="_blank">post on Facebook</a>, as the <a href="https://www.nytimes.com/2019/11/18/world/australia/samoa-measles-deaths-vaccination.html" target="_blank">New York Times reported</a>.</p>
<p>The tiny country that is just south of the equator in the Pacific ocean, half way between New Zealand and Hawaii, has seen at least 716 suspected cases of measles, over 40 percent have required hospitalization. The six deaths were mostly infants under two, according to <a href="https://www.reuters.com/article/us-health-measles-samoa/samoa-declares-state-of-emergency-as-measles-spreads-across-pacific-idUSKBN1XR02C" target="_blank">Reuters</a>.</p><p>Nearly 100 people remain hospitalized with 15 in intensive care. The National University of Samoa, the island's only university, told students to stay home and indefinitely postponed exams, according to the <a href="https://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=12286228" target="_blank">New Zealand Herald</a>.</p><p>The government announced that official plans for compulsory measles, mumps and rubella (MMR) immunizations would be published on Monday, according to <a href="https://www.dw.com/en/measles-outbreak-samoa-declares-state-of-emergency-after-6-fatalities/a-51290095" target="_blank">Deutsche Welle</a>.</p><p>"MMR vaccinations for members of the public who have not yet received a vaccination injection is now a mandatory legal requirement for all of Samoa," it said.</p><p>Also, on Friday, the <a href="https://www.facebook.com/samoagovt/photos/a.900118486685841/2752844521413219/?type=3&theater" target="_blank">Samoan government declared</a> that measles vaccinations would be mandatory. It also planned to limit exposure by prohibiting children under 17 gathering in public or entering medical centers unless they are sick, according to the <a href="https://www.nytimes.com/2019/11/18/world/australia/samoa-measles-deaths-vaccination.html" target="_blank">New York Times</a>.</p>
<p>However, vaccinations rates in Samoa are extremely low. The numbers plummeted after two nurses incorrectly mixed a vaccine with an anesthetic, which killed two infants, the <a href="https://www.abc.net.au/news/2019-08-02/samoa-nurses-sentenced-manslaughter-infant-vaccination-deaths/11378494" target="_blank">Australian Broadcasting Corporation reported</a>. The immunization rate fell to as low as 30 percent last year from about 60 percent in 2016, according to figures from the <a href="https://www.who.int/immunization/monitoring_surveillance/data/wsm.pdf" target="_blank">World Health Organization</a>, as <a href="https://www.nytimes.com/2019/11/18/world/australia/samoa-measles-deaths-vaccination.html" target="_blank" rel="noopener noreferrer">The New York Times reported</a>.</p><p>Those numbers stand in stark contrast to the nearby islands of Fiji, Tonga and American Samoa where outbreaks have been reported, but nearly 90 percent of children have been immunized, which is near the requisite number needed to prevent an epidemic, as the <a href="https://www.nytimes.com/2019/11/18/world/australia/samoa-measles-deaths-vaccination.html" target="_blank">New York Times reported</a>.</p><p>"The way it is going now and the poor (immunization) coverage, we are anticipating the worst to come," said Samoa's Director General of Health Leausa Take Naseri, as <a href="https://www.reuters.com/article/us-health-measles-samoa/samoa-declares-state-of-emergency-as-measles-spreads-across-pacific-idUSKBN1XR02C" target="_blank">Reuters reported</a>. He added that the children who died had not been vaccinated.</p>
<p>Experts have criticized the Samoan government for a slow and inadequate response to the outbreak.</p><p>"It's as bad as you're seeing and probably worse," said Dr. Helen Petousis-Harris, a vaccinologist at the University of Auckland in New Zealand, as the <a href="https://www.nytimes.com/2019/11/18/world/australia/samoa-measles-deaths-vaccination.html" target="_blank">New York Times reported</a>. "This is very much out of control."</p><p>Nearby countries have offered nurses and vaccinations to help stop the outbreak. Winston Peters, the New Zealand foreign affairs minister, said today that his country would send 18 more vaccination nurses, upping their total to 30, along with 3,000 units of the vaccine.</p><p>"Measles is highly contagious, and the outbreak has taken lives in Samoa," Peters said in a statement, as <a href="https://www.reuters.com/article/us-health-measles-samoa/samoa-declares-state-of-emergency-as-measles-spreads-across-pacific-idUSKBN1XR02C" target="_blank">Reuters reported</a>. "It is in everybody's interests that we work together to stop its spread."</p><p>Australia also sent medical aid and 26 practitioners with supplies and a portable intensive care unit. American Samoa announced that travelers coming from Samoa must provide proof of measles vaccination or they will be denied entry, <a href="https://www.nytimes.com/2019/11/18/world/australia/samoa-measles-deaths-vaccination.html" target="_blank">according to the New York Times</a>.</p>
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Female doctor pediatrician with baby patient. Lordn / iStock / Getty Images
By Julia Ries
- The measles virus was declared eliminated in the United States in 2000.
- But if more cases of the measles virus are detected next month, it could mean an end of that elimination status.
- There have been more than 1,200 measles cases this year so far. That's the largest number of cases since 1992.
<p><br></p></div>
<p>The United States was declared to have eliminated the measles virus in 2000, meaning it was no longer endemic to the country.</p><p>But now ongoing outbreaks of the measles virus threaten that elimination status. There have been <a href="https://www.cdc.gov/measles/cases-outbreaks.html" target="_blank">1,241 cases</a> of the measles in the United States since January.</p><p>The last time there was well over a thousand cases of measles was 27 years ago, in <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00020688.htm" target="_blank">1992</a>. At least 2,200 people reported having the measles that year, and, while that may seem steep, it was a 77 percent drop in the number of measles cases the United States saw the year prior.</p><p>After 1992, the measles finally started to lose steam — all the way until 2000, when a vaccination program was declared successful. Health officials were able to officially declare the United States to have eliminated measles.</p><p>This year, as measles cases continue to climb, the country may lose its elimination status by early October if the disease continues to appear.</p><p>"That loss would be a huge blow for the nation and erase the hard work done by all levels of public health," Kristen Nordlund, a spokesperson for the Centers for Disease Control and Prevention (CDC), told Healthline.</p><p>According to Nordlund, the measles elimination goal — which was first announced in 1996 — was a monumental task.</p><p>Before the vaccine came around, which successfully wiped out measles, about 3 to 4 million people contracted the virus each year, with nearly 48,000 of them being hospitalized and around 500 dying.</p>
New York State’s Measles Outbreak
<p>Just last week, New York City <a href="https://www1.nyc.gov/office-of-the-mayor/news/409-19/mayor-de-blasio-health-officials-declare-end-measles-outbreak-new-york-city" target="_blank">announced</a> their 11-month <a href="https://www1.nyc.gov/site/doh/health/health-topics/measles.page" target="_blank">outbreak</a> — which infected 654 and led to the controversial <a href="https://www.nejm.org/doi/full/10.1056/NEJMp1905941" target="_blank">mandatory vaccinations</a> in Brooklyn — came to a close.</p><p>Though promising, it's not enough to keep elimination status.</p><p>"Measles elimination status is lost immediately if a chain of transmission in a given outbreak is greater than 12 months," Nordlund explained.</p><p>If transmission continues in New York state — specifically, <a href="http://rocklandgov.com/departments/health/measles-information/" target="_blank">Rockland</a> and <a href="https://www.health.ny.gov/press/releases/2019/2019-08-08_doh_wyoming_county_measles_joint_release.htm" target="_blank">Wyoming</a> counties, where there've been a combined 317 cases of the measles since October 2018 — elimination status will end.</p><p>It would just take one case to be reported in the area on or after Oct. 2, Nordlund says.</p>Measles Is on Its Way to Becoming Endemic Again
<p>Aside from being a disappointing blow to the United States, losing elimination status means measles could become endemic again.</p><p>"We can, if this continues, go back in time to before the 1960s era when 3 to 4 million cases occurred every year. So many died and developed serious consequences from this disease," said <a href="https://www.yalemedicine.org/doctors/marietta_vazquez/" target="_blank">Dr. Marietta Vazquez</a>, a pediatrician and infectious disease expert with Yale Medicine.</p><p>Granted, the virus wouldn't be quite as destructive as it was decades ago. Since many people do get the measles, mumps, and rubella (MMR) vaccine, the level of cases, hospitalizations, and deaths would likely be nowhere near what the country saw pre-vaccine, according to Nordlund.</p><p>The virus, however, is extremely contagious. It infects about <a href="https://www.cdc.gov/measles/transmission.html?CDC_AA_refVal=https://www.cdc.gov/measles/about/transmission.html" target="_blank">90 percent</a> of nonimmune people who come into contact with it.</p><p>"While many germs require skin-to-skin contact, or that someone sneezes or coughs on you, or that you consume contaminated food or water, measles is broadcast into the air so easily that merely being in the same room with an infected person — or even where that person recently spent time — is enough to cause transmission," said <a href="https://www.northwell.edu/find-care/find-a-doctor/pediatrics/dr-michael-b-grosso-md-11314712" target="_blank">Dr. Michael Grosso</a>, the chief medical officer and chair of pediatrics at Northwell Health's Huntington Hospital.</p><p>It also doesn't take many virus particles for someone to get sick. Infected people typically start spreading the virus about four days before they even begin to notice symptoms.</p><p>Because of this, the measles virus is perfectly suited to cause an epidemic, Grosso says.</p>Here’s What It Will Take to Reclaim Elimination Status
<p>If the United States loses elimination status, the country will have to restart all over again to achieve elimination status yet again. And it might not be as easy this time around.</p><p>"Honestly, it would be even harder than when [the] original measles campaign started in the U.S., given globalization and how easy it is to move from country to country," Vazquez said.</p><p>To reclaim the status, the United States will need to keep measles at bay for another year.</p><p>"Just like elimination loss is defined as greater than 12 months of endemic transmission, gaining elimination status back would be the inverse — showing that we didn't have endemic transmission for more than 12 months," Nordlund said.</p><p>Healthcare officials have made it extremely clear that to beat measles, the <a href="http://ecowatch.com/tag/vaccines" rel="noopener noreferrer">vaccination</a> rate must increase — and quickly.</p><p>"Getting control of measles again involves nothing more or less than what our nation did the first time around: Immunize enough persons to prevent the chain of transmission," Grosso said.</p><p>Right now, approximately <a href="https://www.cdc.gov/nchs/fastats/immunize.htm" target="_blank">91 percent of infants</a> are receiving the MMR vaccine. In certain close-knit communities, though, this vaccination rate is much, much lower.</p><p>About 93 to 95 percent of the population needs to be immune to prevent transmission. The big question is, how do we get there?</p><p>The anti-vaccine movement, which circulates inaccurate information and false theories about vaccines, has prevented thousands of people from getting the MMR vaccine.</p><p>For the country's immunization rate to go up and for the outbreaks to stop, these myths need to be broken down, and community attitudes need to change.</p><p>For now, all eyes are on New York. Sure, we may still have new importations or other outbreaks, Nordlund notes, but it's really that long, consistent outbreak in New York that must be stopped.</p>The Bottom Line
<p>If the New York state measles outbreak continues, the United States could lose its measles elimination status by early October.</p><p>The loss of elimination status would be a huge disappointment for the country, which fought to immunize people and wipe out the virus in 2000.</p><p>To get control of measles, vaccination rates across the country need to increase. Otherwise, measles could easily become endemic again.</p>
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