[NVIC] CDC Pushes Vaccines in New Orleans

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" Protecting the health and informed consent rights of children since 1982. "

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Extracted from the article:

" The CDC, meanwhile, is instructing health care workers to

vaccinate both children and adults when in doubt, saying there is no known

harm in repeated vaccinations. "

BL Fisher Note:

It is irresponsible and dangerous for CDC officials to be sending the

message to the public that repeated vaccinated is not harmful when they know

they cannot factually demonstrate the validity of that claim. Government

officials have never conducted research into the genetic and other

biological high risk factors which put some children and adults at higher

risk than others for suffering brain and immune system dysfunction following

repeated vaccination. The CDC's policy of pretending that being injected

with many vaccines carries no more risk than drinking many bottles of

purified water will result in some Hurricane Katrina survivors suffering

vaccine-related health problems. But, most likely, those health problems

will be blamed on the effects of the hurricane and not the effects of

one-size-fits-all vaccine policies which do not respect biodiversity.

Vaccination has become the only " cure " for every disaster that public health

officials attempt to manage.

http://www.washingtonpost.com/wp-dyn/content/article/2005/09/12/AR2005091201

409_pf.html

The Washington Post

Tuesday, September 13, 2005; HE01

Next Threat: Illness

Experts Anxious to Contain Disease Outbreaks, Rumors

By Agnvall

Special to The Washington Post

Loss, hunger and mass displacement aren't the only predictable elements of a

natural disaster. There's also disease. With tens of thousands of hurricane

survivors crowded into shelters around the country and others refusing or

unable to leave spots contaminated by floodwaters, public health officials

acted last week to try to control outbreaks of infectious disease -- and

quell unfounded rumors about others.

While concerns remained about possible cases of West Nile virus,

tuberculosis and leptospirosis, immediate efforts focused on treating and

containing common gastrointestinal viruses, vaccinating children against

measles and chickenpox, and getting survivors back onto drug regimens that

Katrina disrupted. These, of course, were on top of other critical health

concerns including dehydration, depression and a host of other medical

conditions.

We talked with health officials and infectious disease experts about the

biggest communicable disease concerns facing hurricane survivors.

· Is there any truth to reports of outbreaks of cholera and typhoid?

" It is extremely unlikely that cholera will be an issue. It just doesn't

exist in that region, " said S. Fauci, director of the National

Institute of Allergy and Infectious Diseases. " What has confused the picture

is that there have been seven case reports, with at least four deaths, of .

.. . vibrio vulnificus, " a cholera cousin that has caused pandemics in Africa

and Asia. The four vibrio deaths were evacuees--three in Mississippi and one

in Texas. The disease-causing bacteria, found in seawaters around the Gulf

and even in the Chesapeake Bay, pose little threat to healthy people. But

the elderly and the immune-compromised are more at risk.

Health officials say they don't anticipate a large outbreak of vibrio

infections, but have alerted first responders and directed them to treat it

with the antibiotic tetracycline or Cipro.

Fauci called a typhoid outbreak " extremely unlikely. "

· Are evacuees contagious?

If by this you mean, are they likely to spread disease to the community at

large, officials say the answer is no.

" We're starting to hear reports that some of the folks evacuated could cause

potential health risks to the cities they've gone into, " said Von Roebuck, a

spokesman for the Centers for Disease Control and Prevention (CDC), who

dismissed the idea. Roebuck said health care workers are assessing all

evacuees before they enter shelters and then vaccinating and separating them

if necessary.

" Just because someone has been evacuated and they are living in a shelter

doesn't mean they pose a health risk to others in the community. These folks

shouldn't be stigmatized with that, " said Roebuck.

Ultimately, however, disease control may be dependent on how well state and

local authorities carry out CDC recommendations.

· What about people leaving shelters or just moving straight into

communities?

The diseases health officials worry most about generally occur in crowded

conditions with poor hygiene. These include diarrhea caused by bacteria such

as E. coli, shigella and salmonella; viruses such as the norovirus (the bug

that sometimes causes outbreaks on cruise ships, also referred to as the

Norwalk-like virus) and rotavirus (the most common cause of acute diarrhea

in children); and common upper respiratory infections.

With the dispersal of people into homes or smaller shelters, risk of

widespread outbreaks plummets. Frequent hand-washing and good hygiene should

limit cases of diarrheal illnesses in health care workers and families who

take in evacuees.

" The best thing that can happen from a public health perspective is to get

people out of the Astrodome, " said Edelman, professor of medicine and

pediatrics at the University of land School of Medicine and an expert in

infectious diseases. " There's always potential for outbreak of disease when

you have 10,000 people together. "

· What types of diseases will likely affect evacuees?

The biggest immediate concerns are not exotic diseases but common diarrheal

illnesses caused by drinking or coming into contact with contaminated

floodwaters. Last week health officials closed a Biloxi, Miss., shelter with

400 people after some became ill with vomiting and diarrhea. Doctors

suspected dysentery, an intestinal disease that can be caused by many

organisms but is characterized by abdominal cramping and diarrhea.

Doctors in Houston reported Friday they had contained a viral outbreak that

caused diarrhea and vomiting in some 700 people at the Astrodome and Reliant

Arena, where 4,680 evacuees were still being housed; 40 were placed in

isolation. The outbreak was blamed on the norovirus.

Other early reports of diarrheal illnesses were being investigated late last

week by CDC, said the agency's director, Gerberding. Because these

illnesses can be easily transmitted by hand, health officials were urging

frequent hand-washing in shelters. In the Astrodome, officials were urging

people to use alcohol-based hand sanitizers, which is generally regarded as

superior to hand-washing.

Respiratory illnesses, like diarrheal illnesses, pose a particular threat to

small children, the elderly and the immune-compromised living in crowded

conditions; these groups, said Gerberding, are at greater risk of

dehydration or other complications. Risks are also exacerbated for people

who have been living for a week or more without their usual medications.

Katrina's survivors are also considered at increased risk for hepatitis A (a

liver inflammation spread by contaminated food or water or contact with an

infected person) and tetanus (a neuromuscular disease that can follow a

contaminated puncture injury). Fauci said the Department of Health and Human

Services has shipped 90,000 doses of tetanus vaccine.

· Is vaccination part of the disease containment strategy?

Yes, a key part. The CDC is advising that adults and most children in

shelters receive vaccines for influenza, varicella (chickenpox), MMR

(measles, mumps, rubella) and hepatitis A unless they have a documented

record of immunization.

The CDC is advising that all evacuees receive vaccinations against tetanus

and influenza and that those over 65 or with a high-risk condition get a

pneumonia vaccine. The agency also recommends that children 10 and under who

are without medical records and are not living in shelters be " forward

vaccinated " -- that is, considered up-to-date on immunizations. Children 11

to 18 should receive the following vaccinations: DTaP (against diptheria,

tetanus, whooping cough), MCV (against meningitis) and flu.

Health care workers and emergency responders should get shots for tetanus

and diphtheria, and those working directly with sick patients should get

hepatitis B shots.

· What about tuberculosis?

Levels of tuberculosis -- a potentially fatal and transmissible bacterial

illness -- are higher in inner cities, among minorities and among people

with HIV virus -- " all three ingredients that would fit in this case, " Fauci

said.

Gerberding said some people in the shelters are known to have tuberculosis

and were on medication for the disease, which keeps it from being

contagious. There have also been investigations of potential new cases.

However, prolonged contact with a highly infectious patient is needed for

the disease to spread -- one reason health officials say this is not one of

their most pressing concerns.

· Could children entering schools from shelters spread illnesses?

They are no more likely than any other children to spread illness, assuming

their vaccinations are up-to-date.

The CDC has said if a child is well and was attending school before the

hurricane, he or she should be allowed to attend school without further

screening or quarantine. In Texas, some shelters are setting up vaccination

centers; the state has issued a 30-day waiver on its requirement that

children be fully vaccinated before they enter school.

Doug McBride, spokesman for the Texas Department of State Health Services,

said displaced students enrolling in schools pose no increased health risk

to Texas students. The CDC, meanwhile, is instructing health care workers to

vaccinate both children and adults when in doubt, saying there is no known

harm in repeated vaccinations.

" Immunization rates in some of these areas [that the children come from] are

lower than they should be, " said Trish Perl, an associate professor of

medicine in the division of infectious disease at s Hopkins University

School of Medicine. But officials say high immunization rates elsewhere

around the country should protect children.

" It would be unusual for measles or rubella or the other

childhood-vaccine-preventable diseases to emerge, but many of the people in

these shelters are among the people in our country who already experience

health disparities, and we're erring on the side of immunizing anyone for

whom we have any reason to suspect their vaccination status is not

up-to-date, " Gerberding said in a press conference last week.

· How big a disease threat are the floating bodies we see in those horrific

news images?

Corpses, while they make a disturbing sight, do not pose an infectious

disease threat. " That's a myth, " said Edelman. " No mosquito is going to bite

a decaying body. Decaying bodies don't defecate. "

Raw sewage poses a far greater threat. " It's the people who are going about

their daily business who are contaminating the environment, " said

Fraser, an infectious disease physician at the Cleveland Clinic.

· I've also heard mention of diseases with icky names like trench foot and

leptospirosis. What are those?

These are just two of the many reasons why officials want all residents to

leave New Orleans and avoid continued exposure to contaminated floodwaters.

Trench foot is a painful ailment that can occur when feet are immersed for a

long period. Leptospirosis, initially marked by fever and aches, comes from

exposure to infected animals or water that contains their urine. In worst

cases, kidney or liver failure may result. The CDC has placed updates on

these and other diseases on this Web page:

http://www.bt.cdc.gov/disasters/hurricanes/infectiousdisease.asp.

· What about West Nile and other mosquito-borne illnesses?

" It's possible you could have a significant outbreak of West Nile, " a virus

that can be dangerous or fatal to the elderly and the immune-compromised,

Fauci said. But we won't likely know for weeks. Edelman recalled that when

Hurricane Camille barreled into the Eastern United States in 1969, heavy

rains and the storm surge wiped out mosquitoes for about a month. Katrina is

expected to have a similar effect.

Once the mosquitoes' breeding cycle is restored and eggs begin to hatch in

standing water, residents in the Gulf area could be at greater risk for both

West Nile and St. Louis encephalitis, another mosquito-borne illness.

Widespread spraying of the area might curtail an outbreak. Whether toxic

chemicals and oil in the water might hamper mosquito breeding is not known.

Neither West Nile nor encephalitis is passed from person to person. ·

Agnvall wrote recently for the Health section about women's heart

health.

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