Our First Job is to Protect Children. From Disease. From Ignorance.

LA SCHOOLS AND OTHER MUSINGS-It’s a word that appears more often in crossword puzzles than in everyday speech. Like ‘ere’, and ‘ante’ and ‘aria’.

The clues: Slight, Trifling, Paltry, Piddling, Insubstantial, Puny, Like a pittance, Ridiculously small, Contemptibly small, Pitifully small, Pathetically small, Like a 3 percent tip, Extremely slight, Contemptibly small, as an amount, Annoyingly small, Woefully small, Unsatisfactorily small, Like a 10-cent tip.

Measly. My clue would be “of or pertaining to Rubeola”; admittedly horrible crossword cluage … and grammatically incorrect.

Most of the content of this week’s 4LAKids is about the Measles Outbreak and the Lack of Vaccination issue. Measles presents an immediate, clear and present danger to schoolchildren and public education that dirty tricks in schoolboard politics, the impasse in labor negotiations, the impasse that is Washington DC and MiSiS+iPads (¡Oh Mi!) do not .

Let’s address and dismiss those right off:

1. PLEASE READ THIS: Steve Lopez: A NEW (if not lower…) LOW IN L.A. SCHOOL BOARD ELECTION GUTTER POLITICS | In which the California Charter Schools Association played the race card (at a cost of $28,575) in about as ugly a way as can be imagined. AND THIS: The Times pretends not to take sides while doing so here. 
2. TAKE A LOOK AT THIS: Wherein a schoolboard incumbent takes credit for something she really had very little to do with …unless we choose to hold her responsible for letting the schools in her district fall into such disrepair | FIVE LAUSD SAN FERNANDO VALLEY HIGH SCHOOLS FAST-TRACKED FOR RENOVATIONS + smf’s 2¢ | 
3. UTLA+LAUSD contract negotiations got public+ugly,  then seemed to stall as UTLA President Alex Caputo Pearl took his argument to KABC Talk Radio  …before negotiations resumed on Wednesday.
4. Congress is sorta/kinda pretending to start do something about Education Policy | NEWS FROM DC 
5. Here is the Superintendent’s Weekly MiSiS Update. It’s going to take two years to totally work it out; this is the 3rd week of the second semester of the first year.
6. We had a Bond Oversight Committee Meeting this week, the first in two years where the word ‘iPads” was not mentioned once. We talked about building and fixing-up schools instead. What a concept.
7. And, good news: Last week 128 LAUSD teachers earned the profession’s highest credential: National Board Certification - the most in the nation for the second year in a row.

In typical 4LAKids TMI fashion – but with more organization than usual – let me break down MEASLES INFO + CURRENT EVENTS into three categories: ●Things You and Everyone Needs To Know, ●Things You and Everyone Should Know, and ●More Than You Ever Wanted To Know.

► THINGS YOU AND EVERYONE NEEDS TO KNOW:

• Measles is a respiratory disease caused by a virus and is spread by sharing space and the air breathed by an infected person. 
• Measles is one of the most infectious+contagious diseases known to man – 90% of those susceptible who are exposed will become infected. Being in the same room for 15 minutes as someone who has measles, or having face-to-face contact with someone who has measles is all it takes.
• If you think your child has been exposed to the measles virus and hasn't been vaccinated, he can be treated with MMR vaccine to prevent it from developing. You NEED to take him to the doctor’s within three days of being exposed to it.

• Symptoms:

• The first symptoms are NOT the telltale rash – they are cold-or-flulike symptoms and a moderate to high fever and can take as long as ten days after exposure to develop. Not been to West Africa recently? It’s not Ebola …but it may be Measles. Call the doc.
• The second symptoms to appear are Koplick’s spots, small white spots that appear inside the mouth.
• Then the red spotty rash, which first appears on the back of the ears and then spreads to the head and neck and onto the body and extremities. THOSE INFECTED ARE CONTAGIOUS IN ALL

THREE PHASES AND REMAIN SO UNTIL THE RASH DARKENS AND DISAPPEARS – about 21 days after infection.

• The two-shot MMR (Measles, Mumps, Rubella) vaccination routine creates immunity in 90%-95% of those vaccinated. Actually having had measles creates 100% immunity. The MMR vaccine in not perfect – but herd immunity (see following) protects the outliers.
• California Law requires ALL students in public, charter, parochial and private schools be immunized against MMR, exception is made for those with certain medical conditions and/or religious or personal beliefs – but a new law requires that even those who opt-out through the religious/personal exemption consult with a doctor first.
• The law also requires that all students who are not immunized – even those with approved exemptions – MUST be immediately sent home for 21 days if exposed to measles.
• NO VACCINATION EVER CAUSED AUTISM. A British doctor first made that spurious claim in 1998 with bogus science and falsified proof – but his study has been declared to be a fraud, repudiated and retracted - and the British medical establishment (and the British courts - where libel and fraud are hardest to prove) have labeled his work fraudulent.
• Measles is rarely fatal in developed countries – but can be fatal or create dangerous complications in infants, pregnant women, older folks and those with compromised immune deficiency. The most frequent serious complication is pneumonia. About one in ten children with measles are admitted to hospital.
• The current outbreak of measles that started at the Disney theme parks in late December is just that: An outbreak. It will certainly spread a bit – but it is NOT an epidemic. And it’s our job to keep it that way.
• The treatment for measles is like the treatment for most viruses: Let it run its course. And because it’s so contagious, you let it run its course in quarantine. And because it’s itchy and infuriating and isolating it creates a certain crankiness among its victims. Probably the best advertisement for getting the vaccination is the fact that nobody in their right mind wants to be isolated in a household of bored measly rugrats!

► THINGS YOU AND EVERYONE SHOULD KNOW:

• HERD or COMMUNITY IMMUNITY describes a form of immunity that occurs when the vaccination of a significant portion of a population provides a measure of protection for individuals who have not developed immunity.
• Herd immunity theory proposes that, in contagious diseases that are transmitted from individual to individual, chains of infection are likely to be disrupted when large numbers of a population are immune or less susceptible to the disease. 
• The greater the proportion of individuals who are resistant, the smaller the probability that a susceptible individual will come into contact with an infectious individual.
• Measles has been eliminated as an endemic disease in the US since the 1980’s, in North, Central and South America since 2012 – protected by (almost) universal immunization and herd immunity. 
• The greater community no longer has the natural herd immunity gained from almost everyone having had the measles; the community relies on universal immunization for protection. We no longer need Smallpox vaccinations because that disease had been totally eradicated worldwide. Polio may be next. And hopefully/eventually M, M+R.
• LA and Orange Counties have an overall kindergarten immunization rate of about 97% - which is very good. But there are pockets of school populations out there where the kindergarten opt-out rate is much higher. 

Obviously the percentage protected by the herd immunity was not enough at the Disney theme parks last month when a foreign strain of measles was imported by a park visitor.

Arizona public health officials are concerned that the Disney outbreak might spread into the Super Bowl crowd this weekend.

We must be concerned that the immunity might be compromised in our schools and the most vulnerable members of the herd. Some schools have low vaccination rates – especially among middle class liberal White folks. My peeps - and a vexation to me. (See the article following about Sweden …maybe we should go to IKEA instead of Disneyland or the football game?)

► AND MORE THAN YOU EVER WANTED TO KNOW – with more following:

"We take vaccines so for granted in the United States," Melinda Gates explained during an appearance on HuffPost Live Thursday. "Women in the developing world know the power of [vaccines]. They will walk 10 kilometers in the heat with their child and line up to get a vaccine because they have seen death."

In detailing the struggle parents in the developing world endure to have their children vaccinated, Gates said Americans have simply "forgotten what measles death looks like."

A 2011 medical journal article described the VACCINE-AUTISM CONNECTION as "the most damaging medical hoax of the last 100 years.

A profile in a New York Times Magazine article noted: “Andrew Wakefield has become one of the most reviled doctors of his generation, blamed directly and indirectly, depending on the accuser, for irresponsibly starting a panic with tragic repercussions: vaccination rates so low that childhood diseases once all but eradicated here—whooping cough and measles, among them—have re-emerged, endangering young lives.” In 2010 Dr. Wakefield lost his license to practice medicine in the British Isles - he fled to Texas where wrongdoing is better tolerated.

Dr. Wakefield had a hypothesis back in the 1990’s: the MMR vaccine or the preservative in it caused autism. He did a study of 12 kids with autism and the initial results seemed to prove he might be right - the symptoms of autism appeared soon after the kids were vaccinated for MMR. He published his paper – but neither he nor anyone else was ever able to duplicate his first results. Irreproducible Results Disprove the Hypothesis - the replication and corroboration of research results is key to the scientific process …but apparently Wakefield falsified the results to his advantage. Five of the kids exhibited autism before they were vaccinated – three kids who were said to have autism didn't have it at all. An investigation published by the British medical journal BMJ concludes Wakefield misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study -- and that there was "no doubt" Wakefield was responsible. There were investigative reports and scandal and court cases and peer reviews. All discredited Wakefield.

Wakefield has his defenders. Good people like John McCain and Jenny McCarthy and Dr. Oz – good people who confuse correlation, causation and causality. But good people say and do wrong and bad and stupid things, especially when they are victims of falsehood and deception complicated by fraud, lies and doubt. Wakefield and the Anti-vaxxers won’t allow the facts to get in the way of what they choose to believe.

Urban legend has it that the noise ducks make doesn’t echo. Untrue. And this quack’s utterances reverberate endlessly: The Big Lie in an endless feedback loop. Senator McCain: "It’s indisputable that (autism) is on the rise amongst children, the question is what’s causing it. And we go back and forth and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines." Except that there isn’t any evidence. Senator McCain should get on his knees and pray: “We don't get fooled again!”

And they don’t use that preservative any more.

But Dr. Wakefield’s real victims aren’t Arizona Republicans or T.V. Doctors or 1994’s Playmate o’ th’ Year. They are those who are unprotected and get infected and go on to infect others. And those who are unprotected and miss three weeks of school without even getting the rash.

As parents and educators and a community our first job is to protect children. From disease. And ignorance. From things that go bump in the night and charlatans and quacks.

Transcript for Centers for Disease Control and Prevention (CDC) Telebriefing: MEASLES IN THE UNITED STATES, 2015 

¡Onward/Adelante!

 

(Scott Folsom is a parent and parent leader in LAUSD. He is the former President of Los Angeles 10th District PTSA and represents PTA as Vice-chair the LAUSD Construction Bond Citizen's Oversight Committee. Scott is a member of the California State PTA Board on Managers. He blogs at the excellent 4 LA Kids … where this perspective was originally posted.)

-cw