De Blasio declares health emergency in Brooklyn; mandates measles vaccinations

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jserraglio
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De Blasio declares health emergency in Brooklyn; mandates measles vaccinations

Post by jserraglio » Tue Apr 09, 2019 11:38 am

NEW YORK POST

Mayor de Blasio on Tuesday declared a public health emergency in the Williamsburg section of Brooklyn to stem an outbreak of measles.
As part of the emergency order, unvaccinated individuals living in selected ZIP codes in the heavily Orthodox Jewish community who may have been exposed to measles will be required to receive the measles-mumps-rubella (MMR) vaccine to help curtail the ongoing outbreak.
“We don’t take these steps lightly,” de Blasio said of the mandatory edict to get vaccinated. “It’s time to protect your family and your community.”
Those who have not received the measles vaccine — or do not have evidence of immunity — could be slapped with a violation and fined $1,000.
Under mandatory vaccinations, members of the city’s Department of Health and Mental Hygiene will check the vaccination records of any individual who may have been in contact with infected patients.
“There’s no question that vaccines are safe, effective and life-saving,” de Blasio said. “I urge everyone, especially those in affected areas, to get their MMR vaccines to protect their children, families and communities.”
To date, 285 cases have been confirmed since the beginning of the outbreak in October, with many of these new cases being confirmed in the last two months.
The vast majority of cases are children under the age of 18 — 246 cases — and 39 cases involve adults.
There have been no deaths associated with this outbreak, although there have been complications, including 21 hospitalizations and five admissions to the intensive care unit.
In 2017, there were two measles cases in the city, the mayor said.
His deputy mayor for Health and Human Services, Dr. Herminia Palacio, also warned about the risk to others, and mentioned “measles parties” where parents purposely take their uninfected kids to be near infected children.
“When people choose not to get their children vaccinated, they are putting their children and others – such as pregnant women, people on chemotherapy, and the elderly – at risk of contracting measles,” Palacio said.

John F
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Re: De Blasio declares health emergency in Brooklyn; mandates measles vaccinations

Post by John F » Tue Apr 09, 2019 12:56 pm

The Center for Disease Control considers you protected from measles if you have written documentation showing at least one of the following:

You received two doses of measles-containing vaccine, and you are a(n)—
school-aged child (grades K-12)
adult who will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers.


You received one dose of measles-containing vaccine, and you are a(n)—
preschool-aged child
adult who will not be in a high-risk setting for measles transmission.

A laboratory confirmed that you had measles at some point in your life.

A laboratory confirmed that you are immune to measles.

You were born before 1957.

We used to hear about measles and German measles. According to the Mayo Clinic we site they're two different diseases. German measles is somewhat milder but it's the kind of measles that can cause birth defects. Today's vaccine protects against both types of measles and the mumps.
John Francis

jserraglio
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Re: De Blasio declares health emergency in Brooklyn; mandates measles vaccinations

Post by jserraglio » Tue Apr 09, 2019 4:20 pm

And on the horizon lurk superbugs, which are likely to become even more of a long-term threat than the bugs we already know how to defeat. Here's why.

NYT

Superbugs are spreading. We need doctors trained to treat them.

Many have heard of the rise of drug-resistant infections. But few know about an issue that’s making this threat even scarier in the United States: the shortage of specialists capable of diagnosing and treating those infections. Infectious diseases is one of just two medicine subspecialties that routinely do not fill all of their training spots every year in the National Resident Matching Program (the other is nephrology). Between 2009 and 2017, the number of programs filling all of their adult-infectious-disease training positions dropped by more than 40 percent.
This could not be happening at a worse time. Antibiotic-resistant microbes, known as superbugs, are pinballing around the world, killing hundreds of thousands of people every year. The Times recently reported on Candida auris, a deadly new fungus that has infected hospital patients in Illinois, New Jersey and New York.
Everyone who works in health care agrees that we need more infectious-disease doctors, yet very few actually want the job. What’s going on?
The problem is that infectious-disease specialists care for some of the most complicated patients in the health care system, yet they are among the lowest paid. It is one of the only specialties in medicine that sometimes pays worse than being a general practitioner. At many medical centers, a board-certified internist accepts a pay cut of 30 percent to 40 percent to become an infectious-disease specialist.
This has to do with the way our insurance system reimburses doctors. Medicare assigns relative value units to the thousands of services that doctors provide, and these units largely determine how much physicians are paid. The formula prioritizes invasive procedures over intellectual expertise.
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The problem is that infectious-disease doctors don’t really do procedures. It is a cognitive specialty, providing expert consultation, and insurance doesn’t pay much for that.
For example, I recently diagnosed a case of fungal pneumonia. To arrive at this diagnosis took hours: first, speaking with the patient’s primary care doctor and pulmonologist, followed by a long stretch reviewing chest X-rays and other imaging studies with a radiologist, before examining the cells in the patient’s lung tissue under a microscope to confirm the diagnosis and report back to the anxious patient and family. Most of this work was done free.
A generation ago, most well-rounded doctors knew what to do when a patient developed a fever. Not anymore. New threats like Candida auris pop up all the time, and to identify a deadly pathogen, we often have to use a sophisticated technique called matrix-assisted laser desorption ionization time-of-flight mass spectrometry. As the name suggests, it requires a bit of expertise.
Back in the day, there were only a handful of reliable antibiotics to choose from. But as more bugs have emerged, and more have become resistant to standard treatments, we’ve had to develop new drugs to fight them. The good news is that in 2018, the Food and Drug Administration approved a cadre of new antibiotics to confront the rising threat of superbugs, including eravacycline, plazomicin and omadacycline, and we can expect even more this year. But very few physicians know how to use these powerful new drugs. Many don’t even know how to pronounce them.
Infectious-disease specialists are often the only health care providers in a hospital — or an entire town — who know when to use all of the new antibiotics (and when to withhold them). These experts serve as an indispensable cog in the health care machine, but if trends continue, we won’t have enough of them to go around. The terrifying part is that most patients won’t even know about the deficit. Your doctor won’t ask a specialist for help because in some parts of the country, the service simply won’t be available. She’ll just have to wing it.
My family got a taste of how much this matters in 2017, when my father-in-law, Bill, learned he had an aggressive form of pancreatic cancer, a disease that kills many patients within a year. Not long after he was started on chemotherapy, Bill developed a fever. A potentially lethal bacterium, Staphylococcus aureus, had entered his blood and soon leapt to his spine, leaving him partially paralyzed. His cancer treatments were put on hold to address the more immediate threat of an infection. But stopping chemotherapy gave the tumor a chance to grow, causing Bill’s chances of survival to plummet.
Death appeared imminent until he was transferred to NewYork-Presbyterian Hospital and put under the care of an infectious-disease specialist, who quickly devised a treatment plan that cured the infection and ultimately saved his life. Studies show that patients with Bill’s infection are more likely to survive hospitalization if an infectious- disease specialist is consulted. Others with his condition may not be so fortunate.
The Infectious Diseases Society of America and other professional organizations have devised aggressive recruitment and advocacy strategies, but there is far more work to be done. It begins with the recognition that infectious-disease doctors are overworked and underpaid. Our insurance system needs a better way to measure the value of diagnoses and treatments so that we can fairly reimburse doctors in cognitive specialties.
We must hurry. Superbugs are coming for us. We need experts who know how to treat them.
Matt McCarthy, an infectious-disease doctor at Weil Cornell, is the author of the forthcoming “Superbugs: The Race to Stop an Epidemic.”
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Modernistfan
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Re: De Blasio declares health emergency in Brooklyn; mandates measles vaccinations

Post by Modernistfan » Tue Apr 09, 2019 5:19 pm

For political reasons, DeBlasio has sucked up to the medievalist, backward-thinking Hasidic community for years. He has fought efforts to force the yeshivas to follow New York state Department of Education standards on education, with the result that many students, particularly boys, are graduating with, at best, a fourth-grade education by normal standards in English, math, history, and the sciences. Even creepier, he backtracked on the prior Bloomberg administration's efforts to stamp out the practice of "oral suction" ("metzitzah b'peh") during circumcision, a practice that has led to some serious herpesvirus infections among infants; at least a couple of those infections have proven fatal. (If I had my way, any mohel (the religious functionary who performs the circumcision rite) who employed this dangerous and unsanitary method would be prosecuted as a sex offender.) Now we have this dangerous measles epidemic. If this community wants to live in New York, they will have to follow community norms. There is a phrase in the Talmud that states: "dina d'malkuta dina" (the law of the kingdom (i.e., the civil authority) is the law). The Hasidic community has seemingly forgotten this maxim.

John F
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Re: De Blasio declares health emergency in Brooklyn; mandates measles vaccinations

Post by John F » Wed Apr 10, 2019 2:00 am

Williamsburg has been gentrifying at a rapid pace. Rents are going up, restaurants and stores are opening, and accordingly the demographics are diversifying. It may be that nonetheless, the measles outbreak is entirely or mainly in the orthodox Jewish community, but that's not clear. The zip codes specified in the order are 11205, 11206, 11211 and 11249. I live in zip code 11205 which is in Clinton Hill (east of Williamsburg); its demographics are 42.2% African-American, though not in my building. Since I was born before 1957, well before, the order doesn't affect me, but I suppose it does affect my neighbors.
John Francis

lennygoran
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Re: De Blasio declares health emergency in Brooklyn; mandates measles vaccinations

Post by lennygoran » Wed Apr 10, 2019 5:06 am

jserraglio wrote:
Tue Apr 09, 2019 4:20 pm
And on the horizon lurk superbugs, which are likely to become even more of a long-term threat than the bugs we already know how to defeat. Here's why.

NYT

Superbugs are spreading. We need doctors trained to treat them.
I learned from 60 Minutes just the other day that NYU Medical has become tuition free-maybe that could help get more doctors. Thank you Home Depot! Regards, Len

https://www.cbsnews.com/news/tuition-fr ... 0-minutes/

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