lornajarrettblanchard

–72  CDC Wonder. Compressed Mortality, 1979-1998 Results, Meningococcal Meningitis. 1992.

 

Narrative Information

 

Meningococcal Meningitis (ICD-9 Code 036.0)[1]: “Meningococcal disease can refer to any illness caused by the type of bacteria called Neisseria meningitidis, also known as meningococcus… These illnesses are often severe and can be deadly. They include infections of the lining of the brain and spinal cord (meningitis) and bloodstream infections (bacteremia or septicemia). These bacteria spread through the exchange of respiratory and throat secretions like spit (e.g., by living in close quarters, kissing). Doctors treat meningococcal disease with antibiotics, but quick medical attention is extremely important. Keeping up to date with recommended vaccines is the best defense against meningococcal disease.” (Centers for Disease Control and Prevention. Meningococcal Disease. 4-9-2018 update.)

 

Sources

 

Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1979-1998 on CDC WONDER Online Database, released 2003. ICD-9 code 036.0, Meningococcal Meningitis, 1990. Accessed 6-10-2019 at: https://wonder.cdc.gov/

 

Centers for Disease Control and Prevention. Meningococcal Disease. 4-9-2018 update. Accessed 10-3-2018 at: https://www.cdc.gov/meningococcal/index.html

 

 

 

 

 

[1] ICD-9 is the 9^th revision of the International Statistical Classification of Diseases and Related Health Problems, a medical classification list by the World Health Organization. 036.0 is the code for meningococcal meningitis.

–2,098  CDC Wonder. Compressed Mortality File 1979-1998. ICD-9 code[1] 487[2] influenza.

 

Alabama                     26        0.64     (Yellow highlight denotes higher than average death rate.)

Arizona                       21        0.57

Arkansas                     20        0.85

California                 156        0.52

Colorado                     24        0.73

Connecticut                42        1.28

Florida                        40        0.31

Georgia                       49        0.76

Idaho                           23        2.28

Illinois                        87        0.76

Indiana                                    36        0.65

Iowa                            86        3.10

Kansas                        56        2.26

Kentucky                    24        0.65

Louisiana                    38        0.90

Maine                          22        1.79

Maryland                    14        0.29

Massachusetts            44        0.73

Michigan                    66        0.71

Minnesota                   78        1.78

Mississippi                 33        1.28

Missouri                     79        1.54

Montana                      14        1.75

Nebraska                     55        3.49

New Hampshire          14        1.26

New Jersey                 29        0.37

New Mexico               11        0.73

New York                   62        0.34

North Carolina            55        0.83

Ohio                            96        0.88

Oklahoma                   31        0.99

Oregon                                    39        1.37

Pennsylvania              61        0.51

South Carolina            15        0.43

South Dakota              16        2.30

Tennessee                   39        0.80

Texas                        256        1.51

Utah                            19        1.10

Virginia                      36        0.58

Washington                61        1.25

West Virginia             16        0.89

Wisconsin                   70        1.43     US population size utilized: 248,922,111

 

States and DC not shown indicate that there were fewer than 10 deaths. Puerto Rico not included.

 

Influenza (CDC): “The flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. It can cause mild to severe illness, and at times can lead to death. The best way to prevent the flu is by getting a flu vaccine each year.” (CDC. Influenza (Flu). “Key Facts About Influenza (Flu).” 10-3-2017 update.

 

Sources

 

Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1979-1998 on CDC Wonder Online Database, 2003. ICD-9 code 487.0, Influenza, 1990. Accessed 1-24-2019 at: https://wonder.cdc.gov

 

Centers for Disease Control and Prevention. Influenza (Flu). “Key Facts About Influenza (Flu).” 10-3-2017 update. Accessed 6-17-2018 at: https://www.cdc.gov/flu/keyfacts.htm

 

 

 

 

[1] ICD-9 is the 9^th revision of the International Statistical Classification of Diseases and Related Health Problems, a medical classification list by the World Health Organization.

[2] 487.0 (influenza with pneumonia), 487.1 (with other respiratory manifestations), 487.8 (with other manifestations).

–120  CDC Wonder. Compressed Mortality File 1979-1998. ICD-9 code 052 (Chickenpox).

 

California      26        0.09

New York       14        0.08

Texas              10        0.06

 

Narrative Information

 

CDC: “Chickenpox is a very contagious disease caused by the varicella-zoster virus (VZV). It causes a blister-like rash, itching, tiredness, and fever. The rash appears first on the stomach, back and face and can spread over the entire body causing between 250 and 500 itchy blisters. Chickenpox can be serious, especially in babies, adults, and people with weakened immune systems. The best way to prevent chickenpox is to get the chickenpox vaccine.” (Centers for Disease Control and Prevention. “Chickenpox (Varicella).” 7-1-2016 update.)

 

Blanchard note: States and DC not shown indicate that the “total” function was “disabled” because there were fewer than 10 deaths. Puerto Rico is not included in CDC Wonder.

 

Sources

 

Centers for Disease Control and Prevention. “Chickenpox (Varicella).” 7-1-2016 update. Accessed 11-26-2018 at: https://www.cdc.gov/chickenpox/about/index.html

 

Centers for Disease Control and Prevention. CDC Wonder On-line Database. Compressed Mortality File 1979-1998. ICD-9 code 052 (Chickenpox), 1990. Published 2003. Accessed 1-23-2019 at: https://wonder.cdc.gov/

 

 

 

–1,810  CDC Wonder. Compressed Mortality File, 1979-1998. ICD-9[1] code 010-018.[2]

 

Alabama                      47      1.26     (Yellow highlighting denotes above average death rate.)

Arizona                         27      0.74

Arkansas                       22      0.94

California                   211      0.71

District of Columbia     12      1.97

Florida                        137      1.06

Georgia                        63      0.97

Illinois                          85      0.74

Indiana                                      19      0.34

Kentucky                      24      0.65

Louisiana                      40      0.95

Maryland                      22      0.46

Massachusetts              31      0.52

Michigan                      43      0.46

Mississippi                   38      1.48

Missouri                       35      0.68

New Jersey                   64      0.83

New Mexico                 12      0.79

New York                   293      1.63

North Carolina              61      0.92

Ohio                              53      0.49

Oklahoma                     29      0.92

Oregon                                      14      0.49

Pennsylvania                76      0.64

South Carolina              37      1.06

Tennessee                     44      0.90

Texas                          131      0.77

Virginia                        26      0.42

Washington                  12      0.25

West Virginia               11      0.61

Wisconsin                     12      0.25                 US population size used — 248,922,111

 

Narrative Information

 

Tuberculosis: “Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection (LTBI) and TB disease. If not treated properly, TB disease can be fatal.

 

“TB bacteria are spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, speaks, or sings. People nearby may breathe in these bacteria and become infected.

 

“TB is NOT spread by:           Shaking someone’s hand.

Sharing food or drink.

Touching bed lines or toilet seats.

Sharing toothbrushes.

Kissing.

 

“When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body, such as the kidney, spine, and brain.

 

“TB disease in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious.

 

“People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers or schoolmates.” (CDC. Tuberculosis (TB). 3-20-2016 update.)

 

Tuberculosis:  “Tuberculosis (TB) is an infectious disease and was greatly feared well into the 20th century. Frequently called “consumption,” TB was often fatal. By 1943 it was the No. 3 cause of death in Tennessee. The “White Plague,” so named because of its strikingly pale victims, carried a social stigma similar to that of AIDS in recent years. …residents fought the location of a TB hospital in their neighborhood, claiming that property values would plummet.

 

“Tuberculosis is a contagious lung disease (though it can attack other parts of the body) spread through the air. It is highly controlled today with early detection and antibiotics. Around 1900, the average hospital stay for a TB patient was three years….”  (Tennessee State Library and Archives. Disasters in Tennessee. “Epidemic Scourges in Tennessee.” Nashville.)

 

Sources

 

Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1979-1998. CDC Wonder Online Database, released 2003. ICD-9 Codes 010-018, Tuberculosis (1990). Accessed 1-22-2019 via: https://wonder.cdc.gov

 

Centers for Disease Control and Prevention. Tuberculosis (TB). 3-20-2016 update. Accessed 10-16-2018 at: https://www.cdc.gov/tb/topic/basics/default.htm

 

Tennessee State Library and Archives. Disasters in Tennessee. “Epidemic Scourges in Tennessee.” Nashville. Accessed 10-18-2013 at: http://www.tennessee.gov/tsla/exhibits/disasters/epidemics.htm

 

[1] ICD-9 is the 9^th revision of the International Statistical Classification of Diseases and Related Health Problems, a medical classification list by the World Health Organization — International Classification of Diseases for short.

[2] States not listed indicates deaths were under ten and thus not noted by the CDC. Puerto Rico not included by CDC.

–596 CDC Wonder. (Average hypothermia death rate was 0.24 per 100,000 population.)

Death rate for hypothermia per 100,000 population, where noted.

Alabama 17 0.42
Alaska 24 4.36 Highest loss of life per 100,000 population of any State.
Arizona 23 0.63
California 42 0.14
Colorado 10 0.30
Illinois 45 0.39 Highest loss of life of any State.
Indiana 10 0.18
Kentucky 10 0.27
Massachusetts 13 0.22
Michigan 30 0.32
Minnesota 13 0.30
Missouri 15 0.29
New Mexico 18 1.19
New York 30 0.17
North Carolina 27 0.41
Ohio 23 0.21
Oklahoma 23 0.73
Pennsylvania 17 0.14
South Carolina 12 0.34
Tennessee 11 0.23
Texas 25 0.15
Virginia 12 0.19
Wisconsin 10 0.20

Source

Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1979-1998. CDC WONDER On-line Database, compiled from Compressed Mortality File CMF 1968-1988, Series 20, No. 2A, 2000 and CMF 1989-1998, Series 20, No. 2E, 2003. Accessed at http://wonder.cdc.gov/cmf-icd9.html on Sep 6, 2021 7:13:41 PM

–108  Hinman, et al. using “capture-recapture methodology.”[1]

—  97  Daily Reporter, Spencer, IA. “Immunizations prevent many diseases.” 4-16-1994, p. 5.

—  95  NIP[2] surveillance database; in Hinman, et al. “Acute Measles…” JID, 2004.

—  89  CDC. “Current Trends Measles – United States, 1990.” MMWR, 40/22, 6-7-1991, p. 369.

—  79  Blanchard tally of State breakouts below.

—  75  NCHS[3] multiple-cause mortality database; in Hinman, et al. “Acute Measles…” JID, 2004

—  64  CDC. Epidemiology…Prevention of Vaccine-Preventable Diseases. Ch. 12, 2012, p. 179.

—  35  Jan-May.[4]

 

Alaska            (  ?)

— ?  Outbreak. LA Times. “Measles Outbreak Plagues 23 States; Funds Run Short.” 4-14-1990.

 

Arizona          (  ?)

— ?  Navajo Reservation, Dec; preschool children.[5]

 

California       (56)

–56  Statewide. Lan Sing, Humboldt County, CA, Health Officer.[6]

–47  Statewide, out of more than 10,000 cases in first two-thirds of the year.[7]

—  ?  Alameda County outbreak.[8]

—  ?  Bakersfield/Kern County outbreak. (noted by CDC)

—  6  Los Angeles County, by end of May, from 1,407 cases.[9]

—  2  Orange County (children).[10]

–1  Anaheim, Feb. Baby girl, 10-months.[11]

–1  Santa Ana, Jan 17. Jose Herrera, 7-months.[12]

—  5  San Bernardino County, by end of May, from 910 cases.[13]

—  ?  San Joaquin Valley outbreak.[14]

—  ?  San Diego outbreak. AP. “Measles reaches epidemic level.” Ukiah Daily Journal, 4-1-1990, A10.

 

Florida            (  ?)

— ?  Outbreak. LA Times. “Measles Outbreak Plagues 23 States; Funds Run Short.” 4-14-1990.

 

Illinois             (  ?)

–?  Cook County outbreak (203 cases through May).[15]

 

Indiana           (  ?)

— 0  Adams County outbreak.[16]

— 0  Allen County, Fort Wayne. Sixth case confirmed; measles emergency declared.[17]

— ?  LaGrange County. Over 30 cases reported by Jan 31.[18]

— 0  Monroe Co., Indiana Univ., Bloomington campus, early April. Six confirmed cases.[19]

 

Iowa                (>1)

—>1  Daily Reporter, Spencer, IA. “Immunizations prevent many diseases.” 4-16-1994, p. 5.[20]

— ?  21 cases reported by March 16. AP. “Measles on rise…” Cedar Rapids Gazette, 3-16-1990, 10A.

 

Kansas            (  1)

— 1  Out of 316 cases by May 19. St. Marys Academy and College; boy, 13.[21]

 

Maine             (  ?)

— ?  30 cases for the year, 26 at University of Maine.[22]

— ?  5 cases in Orono in Feb (four at Univ. of Maine, and one in public school system).[23]

 

Maryland       (  ?)

— ?  Anne Arundel County, four cases first week of May.[24]

 

Minnesota      (  3)

— 3  State. Hmong babies, 9-months, 11-months, 14-months; too young for vaccination.[25]

— ?  St. Paul Outbreak. 117 cases Jan to April 14.[26]

 

Montana         (  0)

— 0  6 cases reported.[27]

 

Nevada           (  ?)

— ?  Outbreak. LA Times. “Measles Outbreak Plagues 23 States; Funds Run Short.” 4-14-1990.

 

New Mexico   (  ?)

–~90  State cases. NMDOH. Health Status of NM. Chart “Measles, New Mexico, 1985-2013.”[28]

—    0  Alamogordo case reported, Feb.[29]

—    0  Anthony cases reported, Feb.[30]

—    0  Artesia, two cases reported, Feb.[31]

—    0  Roswell. 2 cases, late March. Roswell Daily Record, NM. “Roswell scene.” 3-28-1990, p. 10.

 

New York       (  9)

— 9  NYC. CDC. “Measles Outbreak – New York City, 1990-1991.” MMWR, 40/18, 5-10-1991.

 

Pennsylvania  (  ?)

— 0  Dubois, Clearfield County, Feb. 7-8 cases confirmed.[32]

— 1  Philadelphia outbreak, starts in Oct.[33] Boy, 18-months (1^st measles death there 20 years).[34]

— 0  Titusville area school district outbreak of 40-50 cases, Feb.[35]

 

Texas              (>7)

— 7  Dallas, by May 7. Five Dallas Co. residents (four children); two out-of-co. in Dallas hosp.[36]

–1  Jan 30. Female, 26; probably not immunized (1^st county measles death since 1979).[37]

–1  Feb 16. Girl, 15-months; hand not been immunized.[38]

–1  Feb 20. Girl, 18 months.[39]

— ?  El Paso, Feb. 110 cases confirmed.[40]

— 0  Lamar, May (14 cases). Paris News, TX. “1990 Year in review.” 12-30-1990, p. 6A.

–?  Laredo. 39 cases by Feb 14; School district sends 250 unvaccinated students home.[41]

 

Virginia          (  0)

— 0  86 cases during year in state.[42]

— 0  Virginia Peninsula outbreak of 12 cases primarily among unvaccinated preschoolers.[43]

 

Washington    (>2)

— 2  Out of 266 cases. CDC. “Epidemiologic Notes…Measles – Washington, 1990.” MMWR.

— 0  But 266 cases reported by mid-July, described as an epidemic imported by unvaccinated.[44]

— 0  Yakima County outbreak (22 cases of 46 in the State in Spring).[45]

 

Narrative Information

 

CDC MMWR: “As of May 10, 1991, local and state health departments reported a provisional total of 27,672 measles cases in the United States for 1990[46] — a 52.1% increase over the 18,193 cases reported for 1989[47]…and 89 suspected measles-associated deaths. Cases were reported from 49 states and the District of Columbia. The overall incidence rate in 1990 was 11.1 cases per 100,000 population. This report summarizes epidemiologic features of measles cases reported for 1990 and compares findings with cases reported for 1989.

 

“In 1990, children less than 5 years of age accounted for 48.1% of measles cases, compared with 36.6% of cases in 1989… Persons greater than or equal to 20 years of age accounted for 22.5% of all reported cases in 1990, compared with 17.0% in 1989.

 

Estimated incidence rates were higher in 1990 than in 1989 for all age groups, except 15- to 19-year-olds. The largest increases in incidence rates were among children less than 1 year of age (137.6%) and adults greater than or equal to 25 years of age (130.0%). The highest incidence rates were among children aged less than 1 year (119.3 per 100,000) and 1–4 years (58.3 per 100,000).

 

“Information on race/ethnicity was available for 11,083 (40.1%) cases reported from 34 states and the District of Columbia (no race/ethnicity information was available for cases reported from the other 15 states, including California). Of these, 6192 (55.9%) occurred among non-Hispanic whites; 2472 (22.3%), non-Hispanic blacks; 2082 (18.8%), Hispanics; and 337 (3.0%), other racial or ethnic groups. Incidence rates were highest for Hispanics (29.5 cases per 100,000 population) and blacks (12.3 per 100,000) and lowest for non-Hispanic whites (5.2 per 100,000).

 

“Importations from other countries accounted for 377 (1.4%) cases; an additional 188 (0.7%) cases were epidemiologically linked within two generations of transmission to imported cases. Of the 377 cases, 249 (66.0%) were acquired in Mexico, and 95 (25.2%) in other Central American, South American, or Caribbean countries.

 

“A total of 240 outbreaks, involving from five to 7514 persons, accounted for 87.0% of the cases. Outbreaks affecting predominantly preschool-aged children involved 19,827 (71.7%) cases; school-aged persons, 2842 (10.3%) cases; and postschool-aged persons, 1376 (5.0%) cases. The largest outbreaks involved predominantly preschool-aged children and occurred in Los Angeles (7514 cases); Dallas (2331); New York City (1108); San Diego (1049); and Bakersfield/Kern County, California (1011). These outbreaks accounted for 47.0% of all cases reported for 1990.

 

“Vaccination status was known for 27,632 (99.9%) patients. Of these, 5100 (18.4%) were known to have been vaccinated on or after their first birthday…; approximately 71.4% of these persons were 5-19 years of age. Of the 22,532 (81.4%) persons who were unvaccinated or inadequately vaccinated (i.e., vaccinated before their first birthday), routine vaccination was indicated for 12,268 (54.4%… Almost 40% of these vaccine-eligible persons were children 16 months to 4 years of age. Measles occurred in 8,698 (31.4% of total) persons for whom routine vaccination was not indicated, of whom 7,257 (83.4%) were children less than 16 months of age. Of the 1,566 persons (5.7% of total) who were unvaccinated for other reasons, 1,424 (90.9%) were persons with religious or philosophic exemption to vaccination….

 

“A provisional total of 89 measles-associated deaths were reported, for a death-to-case ratio of 3.2 deaths per 1000 reported cases. Deaths were reported from 15 states. Forty-nine (55.1%) deaths occurred among children less than 5 years of age, including 15 (16.9%) children less than 12 months of age and 13 (14.6%) children 5–19 years of age. The other 27 (30.3%) deaths occurred among adults greater than or equal to 20 years of age. Eighty-one (91.0%) suspected measles-associated deaths occurred among unvaccinated persons. Reported by: Div of Immunization, Center for Prevention Svcs, CDC….

 

Editorial Note…. Failure to vaccinate children at the appropriate age was the major factor contributing to the resurgence of measles in the United States in 1989–1990 (National Vaccine Advisory Committee, unpublished data, 1991). Surveys in areas experiencing measles outbreaks indicate that as few as 50% of children have been vaccinated against measles by their second birthday (5), and that black and Hispanic children are less likely to be age-appropriately vaccinated than are white children.”[48]

 

Background

 

CDC, Epidemiology…: “Measles is an acute viral infectious disease. References to measles can be found from as early as the 7th century. The disease was described by the Persian physician Rhazes in the 10th century as “more dreaded than smallpox.”

 

“In 1846, Peter Panum described the incubation period of measles and lifelong immunity after recovery from the disease. Enders and Peebles isolated the virus in human and monkey kidney tissue culture in 1954. The first live attenuated vaccine was licensed for use in the United States in 1963 (Edmonston B strain).

 

“Before a vaccine was available, infection with measles virus was nearly universal during child-hood, and more than 90% of persons were immune by age 15 years. Measles is still a common and often fatal disease in developing countries. The World Health Organization estimates there were 164,000 deaths globally from measles in 2008….

 

“Measles transmission is primarily person to person via large respiratory droplets. Airborne transmission via aerosolized droplet nuclei has been documented in closed areas (e.g., office examination room) for up to 2 hours after a person with measles occupied the area….

 

“Measles is highly communicable, with greater than 90% secondary attack rates among susceptible persons. Measles may be transmitted from 4 days before to 4 days after rash onset. Maximum communicability occurs from onset of prodrome through the first 3–4 days of rash.

 

“Before 1963 approximately 500,000 cases and 500 deaths were reported annually, with epidemic cycles every 2–3 years. However, the actual number of cases was estimated at 3–4 million annually. More than 50% of persons had measles by age 6, and more than 90% had measles by age 15. The highest incidence was among 5–9-year-olds, who generally accounted for more than 50% of reported cases.

 

“Following licensure of vaccine in 1963, the incidence of measles decreased by more than 98%, and 2-3-year epidemic cycles no longer occurred. Because of this success, a 1978 Measles Elimination Program set a goal to eliminate indigenous measles by October 1, 1982 (26,871 cases were reported in 1978). The 1982 elimination goal was not met, but in 1983, only 1,497 cases were reported (0.6 cases per 100,000 population), the lowest annual total ever reported up to that time.

 

“During 1980-1988, a median of 57% of reported cases were among school-aged persons (5-19 years of age), and a median of 29% were among children younger than 5 years of age. A median of 8% of cases were among infants younger than 1 year of age.

 

“From 1985 through 1988, 42% of cases occurred in persons who were vaccinated on or after their first birthday. During these years, 68% of cases in school-aged children (5–19 years) occurred among those who had been appropriately vaccinated. The occurrence of measles among previously vaccinated children (i.e., vaccine failure) led to the recommendation for a second dose in this age group.

 

“From 1989 through 1991, a dramatic increase in cases occurred. During these 3 years a total of 55,622 cases were reported (18,193 in 1989; 27,786 in 1990; 9,643 in 1991). In addition to the increased number of cases, a change occurred in their age distribution. Prior to the resurgence, school-aged children had accounted for the largest proportion of reported cases. During the resurgence, 45% of all reported cases were in children younger than 5 years of age. In 1990, 48% of patients were in this age group, the first time that the proportion of cases in children younger than 5 years of age exceeded the proportion of cases in 5–19-year-olds (35%).

 

“Overall incidence rates were highest for Hispanics and blacks and lowest for non-Hispanic whites. Among children younger than 5 years of age, the incidence of measles among blacks and Hispanics was four to seven times higher than among non-Hispanic whites.

 

“A total of 123 measles-associated deaths were reported (death-to-case ratio of 2.2 per 1,000 cases). Forty-nine percent of deaths were among children younger than 5 years of age. Ninety percent of fatal cases occurred among persons with no history of vaccination. Sixty-four deaths were reported in 1990, the largest annual number of deaths from measles since 1971.

 

“The most important cause of the measles resurgence of 1989-1991 was low vaccination coverage. Measles vaccine coverage was low in many cities, including some that experienced large outbreaks among preschool-aged children throughout the early to mid-1980s. Surveys in areas experiencing outbreaks among preschool-aged children indicated that as few as 50% of children had been vaccinated against measles by their second birthday, and that black and Hispanic children were less likely to be age-appropriately vaccinated than were white children.

 

“In addition, measles susceptibility of infants younger than 1 year of age may have increased. During the 1989-1991 measles resurgence, incidence rates for infants were more than twice as high as those in any other age group. The mothers of many infants who developed measles were young, and their measles immunity was most often due to vaccination rather than infection with wild virus. As a result, a smaller amount of antibody was transferred across the placenta to the fetus, compared with antibody transfer from mothers who had higher antibody titers resulting from wild-virus infection. The lower quantity of antibody resulted in immunity that waned more rapidly, making infants susceptible at a younger age than in the past.

 

“The increase in measles in 1989-1991 was not limited to the United States. Large outbreaks of measles were reported by many other countries of North and Central America, including Canada, El Salvador, Guatemala, Honduras, Jamaica, Mexico, and Nicaragua.

 

“Reported cases of measles declined rapidly after the 1989–1991 resurgence. This decline was due primarily to intensive efforts to vaccinate preschool-aged children. Measles vaccination levels among 2-year-old children increased from 70% in 1990 to 91% in 1997.

 

“Since 1993, fewer than 500 cases have been reported annually, and fewer than 200 cases per year have been reported since 1997. A record low annual total of 37 cases was reported in 2004. Available epidemiologic and virologic data indicate that measles transmission in the United States has been interrupted. The majority of cases are now imported from other countries or linked to imported cases. Most imported cases originate in Asia and Europe and occur both among U.S. citizens traveling abroad and persons visiting the United States from other countries. An aggressive measles vaccination program by the Pan American Health Organization has resulted in record low measles incidence in Latin America and the Caribbean, and the interruption of indigenous measles transmission in the Americas. Measles elimination from the Americas was achieved in 2002 and has been sustained since then, with only imported and importation-related measles cases occurring in the region….

 

“In 2008 a total of 140 measles cases was reported, the largest annual total since 1996. Eighty nine percent of these cases were imported from or associated with importations from other countries, particularly countries in Europe where several outbreaks are ongoing. Persons younger than 20 years of age accounted for 76% of the cases; 91% were in persons who were unvaccinated (most because of personal or religious beliefs) or of unknown vaccination status. The increase in the number of cases of measles in 2008 was not a result of a greater number of imported measles cases. It was the result of more measles transmission after the virus was imported. The importation-associated cases occurred largely among school-aged children who were eligible for vaccination but whose parents chose not to have them vaccinated. Many of these children were home-schooled and not subject to school entry vaccination requirements….

 

“To date there is no convincing evidence that any vaccine causes autism or autism spectrum disorder. Concern has been raised about a possible relation between MMR vaccine and autism by some parents of children with autism. Symptoms of autism are often noticed by parents during the second year of life, and may follow administration of MMR by weeks or months. Two independent nongovernmental groups, the Institute of Medicine (IOM) and the American Academy of Pediatrics (AAP), have reviewed the evidence regarding a potential link between autism and MMR vaccine. Both groups independently concluded that available evidence does not support an association, and that the United States should continue its current MMR vaccination policy. Additional research on the cause of autism is needed….” (CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. Chap. 12, 2012, p. 179.)

 

California

 

Oct 14, AP: “San Jose (AP) – A shortfall of immunized children has created ‘a toddler gap’ between both rich and poor in California, according to researchers. ‘Young children, especially 7-month-old and 2-year-old children, have disturbingly low immunization levels,’ researchers wrote in this month’s issue of the Western Journal of Medicine. The state, they reported, lags behind national immunization patterns. Barely one-third of children using public clinics were adequately immunized from 1979 to 1987, and only two-thirds of the youngsters attended by private physicians met state requirements, according to findings by Dr. Michael Scheiber, of the University of California at Berkeley, and Dr. Neal Halfon, of Children’s Hospital Medical Center in Oakland.

 

“More than half the 550,000 children born in California every year will not be properly vaccinated by their second birthday, health officials estimate. ‘The vaccines are poison,’ said Shannon Lenz, who has nursed her three children through concurrent bouts of whooping cough. ‘I’d rather take my chances with the measles,’ said Lenz, who refuses to have her 20-month-old daughter immunized for measles, mumps, rubella and diphtheria.

 

“Lenz’ attitude is part of what health officials call a growing national health epidemic. Parents who distrust – or don’t know about – the country’s immunization program are contributing to rising outbreaks of major and deadly diseases. Even programs that offer free hamburgers have failed to make a dent in the immunization shortfall.

 

“The measles outbreak in the state is the worst in 20 years, with more than 10,000 cases and 47 deaths reported in the first two-thirds of 1990. Whooping cough is also up, with more than 400 incidents reported yearly.

 

“Inadequate immunization causes the outbreaks, according to state and local officials. Despite increasing medical evidence that vaccines rarely produce long-term illness or deaths, millions of parents refuse to immunize their children. ‘We’ve tried everything, and nothing has worked,’ said Dr. Loring Dales, chief of immunization for the California Department of Health Services, which spends $1.5 million a year on outreach programs.” (Associated Press, San Jose. “`Toddler gap’ of immunized children in state.” Ukiah Daily Journal, CA, 10-14-1990, p. 6.)

 

New York City

 

CDC: “In March 1990, a large measles outbreak began in New York City. Through December 1990, approximately 2500 cases and eight measles-associated deaths were reported.

 

Texas

 

May 7, AP: “Dallas (AP) – Health experts say the measles outbreak that has claimed five lives in Dallas County was a disaster waiting to happen because tens of thousands of preschool children never received immunization shots. ‘Anytime you’ve got that many children not vaccinated, the situation is right for measles, and the fuel is there to start a rather substantial outbreak,’ said Dr. William Atkinson, a medical epidemiologist with the federal Centers for Disease Control in Atlanta.

 

“Dallas has reported more cases of measles than any other place in the country, Dr. Atkinson said. More than 2,040 cases have been reported in Dallas since the local outbreak began in December. Of the five resident who died of measles, four were children. Two out-of-county residents also have died of measles in Dallas hospitals.

 

“Los Angeles has reported 3,000 cases and 25 deaths since 1987, but Dallas has a higher per capita rate, Dr. Atkinson said. Dallas’ measles cases, like those nationwide, have been concentrated among preschool children who live in poverty, said Dr. Charles Haley, chief epidemiologist for Dallas County.” (Associated Press, Dallas. “Dallas measles program faulted.” Big Spring Herald, TX, 5-7-1990, p. 2-A.)

 

Source

 

Associated Press, Yakima, WA. “5 more measles cases reported in Yakima County.” Walla Walla Union-Bulletin, 4-1-1990, 5. Accessed 5-4-2016 at: http://newspaperarchive.com/us/washington/walla-walla/walla-walla-union-bulletin/1990/04-01/page-5?tag

 

Associated Press, Bloomington, IN. “6th measles case is confirmed at IU.” Kokomo (Ind.) Tribune. 4-15-1990, p. 11. Accessed 5-4-2016 at: http://newspaperarchive.com/us/indiana/kokomo/kokomo-tribune/1990/04-15/page-11?tag=measles+death+dead+die+kill&rtserp=tags

 

Associated Press, Fort Wayne, IN. “Another measles case reported.” Kokomo Tribune, IN, 3-8-1990, p. 22. Accessed 5-4-2016 at: http://newspaperarchive.com/us/indiana/kokomo/kokomo-tribune/1990/03-08/page-22?tag

 

Associated Press, Dallas. “Dallas measles program faulted.” Big Spring Herald, TX, 5-7-1990, p. 2-A. Accessed 5-4-2016 at: http://newspaperarchive.com/us/texas/big-spring/big-spring-herald/1990/05-07/page-2?tag

 

Associated Press, Laredo, TX. “Laredo officials tackle measles.” Kerrville Daily Times, TX, 2-16-1990, 3A. Accessed 5-5-2016 at: http://newspaperarchive.com/us/texas/kerrville/kerrville-daily-times/1990/02-16/page-3?tag

 

Associated Press, Dallas. “Measles claims 3 lives.” Herald-Zeitung, New Braunfels, TX, 2-22-1990, p. 3. Accessed 5-5-2016 at: http://newspaperarchive.com/us/texas/new-braunfels/new-braunfels-herald-zeitung/1990/02-22/page-13?tag

 

Associated Press, Dallas. “Measles control.” Big Spring Herald, TX, 3-8-1990, 2-A. Accessed 5-5-2016 at: http://newspaperarchive.com/us/texas/big-spring/big-spring-herald/1990/03-08/page-2?tag

 

Associated Press, Des Moines. “Measles on rise; immunization urged.” Cedar Rapids Gazette, IA. 3-16-1990, 10A. Accessed 5-4-2016 at: http://newspaperarchive.com/us/iowa/cedar-rapids/cedar-rapids-gazette/1990/03-16/page-19?tag

 

Associated Press, Los Angeles. “Measles reaches epidemic level.” Ukiah Daily Journal, 4-1-1990, A10. Accessed 5-4-2016 at: http://newspaperarchive.com/us/california/ukiah/ukiah-daily-journal/1990/04-01/page-10?tag

 

Associated Press, Topeka, KS. “Officials hope outbreak ends by fall.” Iola Register, KS, 5-19-1990, p. 2. Accessed 5-4-2016 at: http://newspaperarchive.com/us/kansas/iola/iola-register/1990/05-19/page-2?tag

 

Associated Press, Newport News. “Officials warn parents of red measles danger.” Bluefield Daily Telegraph, WV. 8-23-1999, A3. Accessed 5-4-2016 at: http://newspaperarchive.com/us/west-virginia/bluefield/bluefield-daily-telegraph/1990/08-31/page-5?tag

 

Associated Press, Indianapolis. “Second measles emergency declared.” Kokomo Tribune, IN, 1-31-1990, p. 11. Accessed 5-5-2016 at: http://newspaperarchive.com/us/indiana/kokomo/kokomo-tribune/1990/01-31/page-11?tag

 

Associated Press, San Jose. “`Toddler gap’ of immunized children in state.” Ukiah Daily Journal, CA, 10-14-1990, p. 6. Accessed 5-4-2016 at: http://newspaperarchive.com/us/california/ukiah/ukiah-daily-journal/1990/10-14/page-6?tag

 

Associated Press, Orono. “UMO immunizing against measles.” Journal Tribune, Biddeford, ME, 2-16-1990, p. 6. Accessed 5-5-2016 at: http://newspaperarchive.com/us/maine/biddeford/biddeford-journal-tribune/1990/02-16/page-6?tag

 

Atkinson, William L., et al. “Measles Surveillance – United States, 1991.” MMWR (Morbidity and Mortality Weekly Report) CDC Surveillance Summaries, Vol. 41, No. SS-6, pp. 1-12. Atlanta, GA: Centers for Disease Control and Prevention, 11-20-1992. Accessed 5-5-2016 at: https://books.google.com/books?id=lnCt01e4gKcC&printsec=frontcover#v=onepage&q&f=false

 

Bangor Daily News. “Maine reportedly measles free despite outbreaks nationwide.” 4-25-1991. Accessed 5-5-2016 at: http://archive.bangordailynews.com/1991/04/25/maine-reportedly-measles-free-despite-outbreaks-nationwide/

 

Centers for Disease Control and Prevention. “Current Trends Measles – United States, 1990.” MMWR (Morbidity and Mortality Weekly Report), Vol. 40, No. 22, 6-7-1991, pp. 369-372. Accessed 5-2-2016 at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00001999.htm

 

Centers for Disease Control and Prevention. “Epidemiologic Notes and Reports Measles – Washington, 1990.” MMWR (Morbidity and Mortality Weekly Report), Vol. 39, No. 28, pp. 473-476. Atlanta, GA: CDC, U.S. Department of Health and Human Services, 7-20-1999. Accessed 5-5-2016 at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00001675.htm

 

Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases (W. Atkinson, S. Wolfe, and J. Hamborsky, editors, 12^th ed.). Chapter 12: Measles. Washington, DC: Public Health Foundation, 2012. [Known as The Pink Book.] Accessed 2-3-2015 at: http://www.cdc.gov/vaccines/pubs/pinkbook/table-of-contents.html#toc

 

Centers for Disease Control and Prevention. “Measles Outbreak – New York City, 1990-1991.” MMWR (Morbidity and Mortality Weekly Report), Vol. 40, No. 18, 5-10-1991, pp. 305-306. Accessed 5-2-2016 at: http://www.cdc.gov/mmwr/preview/mmwrhtml/00001980.htm

 

Daily Press, Hampton Roads, VA. “Fight Measles With Prevention.” 8-15-1991. Accessed 5-5-2016 at: http://articles.dailypress.com/1991-08-15/news/9108150186_1_measles-vaccine-measles-outbreaks-proper-immunization

 

Daily Reporter, Spencer, IA. “Immunizations prevent many diseases.” 4-16-1994, p. 5. Accessed 5-5-2016 at: https://news.google.com/newspapers?nid=1926&dat=19930416&id=FVkrAAAAIBAJ&sjid=0tkEAAAAIBAJ&pg=2752,6024531&hl=en

 

Gazette Telegraph, Colorado Springs, CO. “Immigrants propelled epidemic, center says.” 7-20-1990, p. 5. Accessed 5-4-2016 at: http://newspaperarchive.com/us/colorado/colorado-springs/colorado-springs-gazette-telegraph/1990/07-20/page-5?tag

 

Hinman, Alan R., et al. “Acute Measles Mortality in the United States, 1987-2002.” Journal of Infectious Diseases, Vol. 189 (Supplement 1), 2004, pp. S69-S77. Accessed 5-2-2016 at: http://jid.oxfordjournals.org/content/189/Supplement_1/S69.long

 

KRTV 3, Great Falls, MT (Zack Briggs). “No measles cases in Montana yet, officials watching neighboring states.” 2-7-2015. Accessed 5-5-2016 at: http://www.krtv.com/story/28051578/no-measles-cases-in-mt-yet-officials-watching-neighboring-states

 

Los Angeles Times (Ron Harris) “Measles Outbreak Plagues 23 States; Funds Run Short.” 4-14-1990. Accessed 5-5-2016 at: http://articles.latimes.com/1990-04-14/news/mn-967_1_nation-s-measles-outbreak

 

“Minnesota reported measles deaths 1981-2000.” Accessed 5-5-2016 at: http://www.whale.to/vaccine/measles3.html

 

New Mexico Department of Health. Health Status of New Mexico. Chart: “Measles, New Mexico, 1985-2013.” January 2015. Accessed 5-5-2016 at: https://nmhealth.org/data/view/general/1632/

 

Offit, Paul A. MD (Children’s Hospital of Philadelphia). The Philadelphia Measles Outbreak; Lessons From the Past. Accessed 5-5-2016 at: http://mchc.net/wp-content/uploads/2015/01/Philadelphia-Measles-Outbreak-Paul-Offit.pdf

 

Orange County Register (Susan Peterson), Santa Ana, CA. “Measles complications suspected as cause of Anaheim baby’s death.” 3-8-1990, B7. Accessed 5-5-2016 at: http://newspaperarchive.com/us/california/santa-ana/santa-ana-orange-county-register/1990/03-08/page-29?tag

 

Paris News, TX. “1990 Year in review.” 12-30-1990, p. 6A. Accessed 5-3-2016 at: http://newspaperarchive.com/us/texas/paris/paris-news/1990/12-30/page-8?tag

 

Roswell Daily Record, NM. “Measles cases reported.” 2-23-1990, p. 9. Accessed 5-5-2016 at: http://newspaperarchive.com/us/new-mexico/roswell/roswell-daily-record/1990/02-23/page-9?tag

 

Roswell Daily Record, NM. “Roswell scene.” 3-28-1990, p. 10. Accessed 5-4-2016 at: http://newspaperarchive.com/us/new-mexico/roswell/roswell-daily-record/1990/03-28/page-10?tag

 

Santa Ana Orange County Register, CA. “How Life Changed in 1990: Orange County.” 12-30-1990, p. J5. Accessed 5-3-2016 at: http://newspaperarchive.com/us/california/santa-ana/santa-ana-orange-county-register/1990/12-30/page-191?tag

 

Sing, Lan. “Immunization can prevent disease” (Letter to Editor). Times-Standard, Eureka, CA. 9-25-1991, p. 4. Accessed 5-7-2016 at: http://newspaperarchive.com/us/california/eureka/eureka-times-standard/1991/09-25/page-4?tag

 

Syracuse Herald-Journal, NY. “Vaccinations may prevent measles epidemic here,” 6-4-1990, B3. Accessed 5-4-2016. Accessed 5-4-2016 at: http://newspaperarchive.com/us/new-york/syracuse/syracuse-herald-journal/1990/06-04/page-16?tag

 

The Capital, Annapolis, MD. “Measles cases reported,” 5-5-1990, p. 8. Accessed 5-4-2016 at: http://newspaperarchive.com/us/maryland/annapolis/annapolis-capital/1990/05-05/page-8?tag

 

The Star, Orland Park, IL. “Fewer measles cases spotted, but officials still concerned.” 12-6-1990, p. 6. Accessed 5-3-2016 at: http://newspaperarchive.com/us/illinois/orland-park/orland-park-star/1990/12-06/page-6?tag

 

Titusville Herald, PA. “City, Region News of `90 Reviewed.” 12-31-1990, p. 8. Accessed 5-3-2016 at: http://newspaperarchive.com/us/pennsylvania/titusville/titusville-herald/1990/12-31/page-8?tag

 

Titusville Herald, PA. “Measles Confirmed at DuBois..” 3-1-1990, p. 3. Accessed 5-5-2016 at: http://newspaperarchive.com/us/pennsylvania/titusville/titusville-herald/1990/03-01/page-3?tag

 

WCCO-TV, Minneapolis. “MN Health Officials Worried Over Possible Measles Outbreak.” 3-31-2011. Accessed 5-5-2016 at: http://minnesota.cbslocal.com/2011/03/31/mn-health-officials-worried-over-possible-measles-outbreak/

 

Additional Reading:

 

Dales, Loring G. et al. “Measles Epidemic From Failure to Immunize.” Western Journal of Medicine, Vol. 159, No. 4, October 1993, pp. 455-464. Accessed 5-2-2016 at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1022280/pdf/westjmed00074-0031.pdf

[1] Authors argue there are inefficiencies in CDC NIP and NCHS data collection which capture-recapture corrects for. See Hinman, et al. for discussion.

[2] National Immunization Program, U.S. Department of Health & Human Services. See Hinman on differences between NIP and NCHS.

[3] National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.

[4] Syracuse Herald-Journal, NY. “Vaccinations may prevent measles epidemic here,” 6-4-1990, B3.

[5] Atkinson, William L., et al. “Measles Surveillance – United States, 1991.” MMWR, 41/SS-6, 11-20-1992, p. 6.

[6] Letter to Editor by Sing, titled “Immunization can prevent disease.” Times-Standard, Eureka, CA. 9-25-1991, p. 4.

[7] AP, San Jose. “`Toddler gap’ of immunized children in state.” Ukiah Daily Journal, CA, 10-14-1990, p. 6.

[8] Associated Press, Los Angeles. “Measles reaches epidemic level.” Ukiah Daily Journal, 4-1-1990, A10.

[9] Associated Press, Los Angeles. “Measles reaches epidemic level.” Ukiah Daily Journal, 4-1-1990, A10.

[10] Orange County Register, Santa Ana, CA. “How Life Changed in 1990: Orange County.” 12-30-1990, p. J5. An earlier report noted 37 cases were confirmed in Jan, 11 in Feb, and 30 others in March, prompting Orange County epidemiologist Thomas Prendergast to state “That just indicates that measles is going full tilt in 1990 after slowing down in 1989.” Orange Co. Register. “Measles complications suspected as cause of Anaheim…” 3-8-1990, B7.

[11] Orange County Register. “Measles complications suspected as cause of Anaheim baby’s death.” 3-8-1990, B7.

[12] Orange County Register. “Measles complications suspected as cause of Anaheim baby’s death.” 3-8-1990, B7.

[13] Associated Press, Los Angeles. “Measles reaches epidemic level.” Ukiah Daily Journal, 4-1-1990, A10.

[14] Associated Press, Los Angeles. “Measles reaches epidemic level.” Ukiah Daily Journal, 4-1-1990, A10.

[15] The Star, Orland Park, IL. “Fewer measles cases spotted, but officials still concerned.” 12-6-1990, p. 6.

[16] Associated Press, Fort Wayne, IN. “Another measles case reported.” Kokomo Tribune, IN, 3-8-1990, p. 22.

[17] Associated Press, Fort Wayne, IN. “Another measles case reported.” Kokomo Tribune, IN, 3-8-1990, p. 22.

[18] Associated Press, Indianapolis. “Second measles emergency declared.” Kokomo Tribune, IN, 1-31-1990, p. 11.

[19] Assoc. Press, Bloomington, IN. “6^th measles case is confirmed at IU.” Kokomo (Ind.) Tribune. 4-15-1990, p. 11.

[20] “Vaccine-preventable deaths have been reported in Iowa every year since 1981.”

[21] AP, Topeka, KS. “Officials hope outbreak ends by fall.” Iola Register, KS, 5-19-1990, p. 2.

[22] Bangor Daily News. “Maine reportedly measles free despite outbreaks nationwide.” 4-25-1991.

[23] Associated Press, Orono. “UMO immunizing against measles.” Journal Tribune, Biddeford, ME, 2-16-1990, p. 6.

[24] The Capital, Annapolis, MD. “Measles cases reported,” 5-5-1990, p. 8.

[25] “Minnesota reported measles deaths 1981-2000.” Another source notes there were more than 500 cases and that the outbreak began in the emerging Hmong community ‘Where immigrants didn’t immediately access health care or understand the value of vaccines.” (WCCO-TV, Minneapolis. “MN Health Officials Worried Over Possible Measles Outbreak.” 3-31-2011.)

[26] Los Angeles Times. “Measles Outbreak Plagues 23 States; Funds Run Short.” 4-14-1990.

[27] KRTV 3, Great Falls, MT. “No measles cases in Montana yet, officials watching neighboring states.” 2-7-2015.

[28] Notes source as Ne Mexico Dept. of Health, Infectious Disease Epidemiology Bureau.

[29] Roswell Daily Record, NM. “Measles cases reported.” 2-23-1990, p. 9.

[30] Roswell Daily Record, NM. “Measles cases reported.” 2-23-1990, p. 9.

[31] Roswell Daily Record, NM. “Measles cases reported.” 2-23-1990, p. 9.

[32] Titusville Herald, PA. “Measles Confirmed at DuBois..” 3-1-1990, p. 3.

[33] Atkinson. “Measles Surveillance – US, 1991.” MMWR CDC Surveillance Summaries, 41/SS-6, 11-20-1992, p. 6.

[34] Offit, P. A. MD (Children’s Hosp. of Philly). The Philadelphia Measles Outbreak; Lessons From…Past. Slide 7. Notes there had been 258 cases by end of month.

[35] Titusville Herald, PA. “City, Region News of `90 Reviewed.” 12-31-1990, p. 8.

[36]  Associated Press, Dallas. “Dallas measles program faulted.” Big Spring Herald, TX, 5-7-1990, p. 2-A. Another source notes that as of March 5 there had been 1,013 reported cases in the county – “more than half were preschoolers and most of them hadn’t been vaccinated.” Notes the CDC was sending personnel to Dallas. (AP, Dallas. “Measles control.” Big Spring Herald, TX, 3-8-1990, 2-A.)

[37] Associated Press, Dallas. “Measles claims 3 lives.” Herald-Zeitung, New Braunfels, TX, 2-22-1990, p. 3.

[38] Associated Press, Dallas. “Measles claims 3 lives.” Herald-Zeitung, New Braunfels, TX, 2-22-1990, p. 3.

[39] Associated Press, Dallas. “Measles claims 3 lives.” Herald-Zeitung, New Braunfels, TX, 2-22-1990, p. 3.

[40] Roswell Daily Record, NM. “Measles cases reported.” 2-23-1990, p. 9.

[41] Associated Press, Laredo, TX. “Laredo officials tackle measles.” Kerrville Daily Times, TX, 2-16-1990, 3A.

[42] Daily Press, Hampton Roads, VA. “Fight Measles With Prevention.” 8-15-1991.

[43] Associated Press. “Officials warn parents of red measles danger.” Bluefield Daily Telegraph, WV. 8-23-1999, A3. One of the twelve was an adult. Writes “The original case on the Peninsula involved a child who had been overseas for a month and came back infected…”

[44] Gazette Telegraph, Colorado Springs, CO. “Immigrants propelled epidemic, center says.” 7-20-1990, p. 5.

[45] AP, Yakima, WA. “5 more measles cases reported in Yakima County.” Walla Walla Union-Bulletin, 4-1-1990, 5.

[46] An original footnote states that “As of December 31, 1990, a total of 26,520 cases had between officially reported to CDC.” An Editorial note writes: “The provisional total of 27,672 measles cases in 1990 is the largest number reported since 1977. Cases were reported from every state except North Dakota; however, 61% of all cases were reported by two states, California (12,479 cases) and Texas (4,403 cases).”

[47] CDC footnote 1: CDC. “Summary of notifiable diseases, United States, 1989.” MMWR 1989; 38(54).

[48] Original footnote: CDC. “Update: measles outbreak–Chicago, 1989.” MMWR 1990;39:317–9,325-6.

 

–12  CDC WONDER. Compressed Mortality, 1979-1998. ICD-9 code 033.0, Whooping Cough.

 

Narrative Information

 

Sep 15: “Back to school means crayons and fuzzy-bear backpacks and polka-dot dresses. Also immunizations against infectious diseases. Only some parents think the prevention is worse than the disease. They’re wrong. And they not only endanger their own children, by refusing to have them vaccinated; they put everybody’s children at risk.

 

“The poor don’t get immunized because they can’t afford a private doctor and can’t get it together to find out when the public clinic is doing free vaccinations and get there and stand in line and then come back and do it again for booster shots.

 

(In Wisconsin, students from kindergarten through 12^th grade must provide evidence that they have received required immunizations for their grade level within 30 days of admission to school. Public health departments provide immunization shots free to children of families who can’t afford them…)

 

“Only 77 percent of 2-year-olds are fully immunized, the federal Centers for Disease Control estimate. In inner cities, half the preschoolers are unprotected. As immunization rates fall, cases of mumps pertussis [whooping cough] and measles are rising….

 

“Arizona, Idaho, Washington and other states have been hit by large outbreaks of pertussis, also known as whooping cough, said Dr. Loring Dales, chief of Immunization for the California health department….

 

“Upper-middle-class kids don’t get immunized because their parents have heard horror stories of children who died or became brain-damaged after DPT[1] shots that include the pertussis vaccine. They’ve heard the federal government has set up a program to compensate ‘victims’ of immunization reactions. They haven’t heard about the babies who die and suffer brain damage because they weren’t vaccinated. Nobody goes on Donahue and says: ‘My child got a DPT shot, and he cried a lot but he didn’t get diphtheria or pertussis or tetanus.’

 

“Doctors agree that the polio vaccine causes about one case of polio in 500,000 inoculations, sometimes leading to permanent paralysis. The pertussis vaccine is more controversial. Researchers used to think the pertussis vaccine caused one case of brain damage in 310,000 vaccinations, one case of brain disease in 140,000. Now they think that’s way too high. The real number may be zero.

 

“In the March 23-30 issue of the Journal of the American Medical Association, James Cherry, of the University of California, Los Angeles pediatrics department, summarized three major studies involving 230,000 children and 713,000 vaccinations and reported: ‘No evience of a causal relationship between pertussis vaccine and permanent neurological illness was found.’

 

“There was a link when English parents turned against the DPT vaccination in the late ‘70s. Immunization rates dropped by more than half, to 30 percent. Whooping cough became epidemic: 104,000 cases over six years;; 400 deaths.

 

“Whooping cough causes convulsions in one of 40 cases, brain disease or permanent brain damage in one of 240. Babies cough so hard they can’t get enough oxygen to the brain. Some suffer permanent lung damage. It causes death in one of 100 babies less than 6 months old.

 

“The disease becomes milder with age; for children over 10, and adults, it’s just a nasty cough that won’t go away and is rarely diagnosed.

 

“Whooping cough was the No. 1 baby killer in the 20’s and ‘30s, killing thousands of children. Vaccination cut that to 1,218 cases and six deaths in 1981. Last year, there were 3,745 cases of whooping cough in the United States. This year, the toll is up 38 percent.

 

“Because of pressure from parents, the National Vaccine Injury Compensation Program now offers no-questions-asked pay-outs to children who show symptoms of neurological problems after receiving a vaccination. As many as 80 children a year are expected to qualify for payments, which will come from a surcharge on the DPT, MMR (measles, mumps, rebella) and polio vaccine.

 

“In addition to making vaccines more expensive, the program encourages parents to think vaccines are dangerous and that every child who shows symptoms of a problem in the week after a shot did so because of the shot.

 

“Babies get DPT shots at 2, 4 and 6 months of age, just the period when an epileptic baby will have its first convulsion, the period when crib death is most common, Dales said.

 

“The baby of one of his staffers was going to be the star of a state health department videotape on immunization. The tape was never made; the baby died of Sudden Infant Death Syndrome. A reaction to the DPT vaccine? No. The baby died the day before the vaccination was to have been given. But what if the shot had been scheduled a day earlier? Dales wonders. The devastated parents would have looked for a reason for their inexplicable loss, and blamed the vaccine.

 

“Parents need to know that immunization saves children’s lives. Your child, somebody else’s child.” (Jacobs, Joanne (San Jose Mercury News). “There’s no good reason to miss immunizations.” Wisconsin State Journal, Madison. 9-15-1990, pp. 1C and 3C.)

 

Sources

 

Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality, 1979-1998. ICD-9 code 033.0, Whooping Cough (1990). 2003. Accessed 7-19-2018 at: http://wonder.cdc.gov/cmf-icd9.htm

 

Jacobs, Joanne (San Jose Mercury News). “There’s no good reason to miss immunizations.” Wisconsin State Journal, Madison. 9-15-1990, pp. 1C and 3C. Accessed 7-19-2018 at: https://newspaperarchive.com/madison-wisconsin-state-journal-sep-15-1990-p-17/

[1] Diphtheria, pertussis, and tetanus.

–16  NFPA. Fire Investigation Rpt., Elderly Housing Fire, Johnson City, TN, 24 Dec 1989. 1990

–16  NFPA. Home Fires with Ten or More Fatalities. Sep 15, 2008 update.

–16  National Fire Sprinkler Association. F.Y.I.  1999, 6.

–16  USFA. Sixteen-Fatality Fire in High-rise Residence for…Elderly Johnson City, TN.  1999.

 

Narrative Information

 

NFPA: “At approximately 5:10 p.m, an accidental fire occurred at the 11-story John Sevier Center in Johnson City, Tennessee. The fire damage was limited to the first floor and two second floor areas. However, smoke travelled throughout the entire building. Sixteen occupants died in this Christmas Eve fire, and at least 40 others were injured.

 

“At the time of the fire, the center was a mixed occupancy with residential apartments on all eleven floors and supporting business facilities on the first floor only. In 1924, the building was constructed as a fire-resistive structure, and its original use was as a hotel. But, as the building was converted to its current use, the fire resistance was reduced by the use of light-weight noncombustible and combustible materials in areas on the lower floors and by unprotected penetrations for pipes and other utilities. On the other hand, some renovations were made to improve fire-safety features of the building such as new enclosed stairways and detection alarm systems.

 

“The fire, which started in a first floor apartment, was apparently caused by smoking materials. Once ignited, the fire spread into a combustible concealed space above the apartment or origin’s suspended ceiling, and this fire spread horizontally over most of the first floor. In addition, the fire spread horizontally from the apartment of origin through an open apartment door. The fire also spread vertically into two areas of the second floor. The vertical fire spread occurred through unprotected utility penetrations made during a renovation. Unlike the fire damage that was limited to the lower floors, smoke spread to and caused damage on all floors.

 

The following factors appear to have contributed to the loss of life and property:

 

• Rapid fire spread in a combustible concealed space.
• Loss of compartmentation due to open doors, walls that did not extend slab to slab, and voids that were not sealed against smoke penetration.
• Smoke spread into the high-rise residential tower through various vertical openings.
• The lack of automatic sprinkler protection….”

 

(NFPA. Fire Investigation Rpt., Elderly Housing Fire, Johnson City, TN, 24Dec1989. 1990, 1-2)

 

USFA: “A Christmas Eve fire that caused the death of 14 residents and two visitors occurred at the John Sevier Center, a high-rise residence for the elderly, in Johnson City, Tennessee. It also injured about 50 other people including 15 firefighters. One victim was found in the elevator lobby on the sixth floor, one in Room 107, and the rest, 14 victims, on higher level floors in living units.

 

“The fire started in Apt. #102 shortly after 1700 hours and traveled out of the apartment and across the ceiling above the main hallway smoke detectors (which would have activated the 911 fire alarm system) across to the main lobby. Swirling smoke trapped many of the occupants on the upper floors of the 11-story building before any notification or alarm was heard by them.

 

“The alarm was received at 1711 by the dispatcher of the Johnson City Fire Department. The first units were on the scene within four minutes. Upon arrival, flames were observed on the first floor and additional calls were made for backup units to respond. More than five hours later, firefighters were still breaking windows and heavy smoke continued to hamper their rescue efforts. Johnson City firefighters, public safety officers, and hundreds of volunteer firefighters and civilians who had responded to the call assisted in the rescue and treatment of the injured. Almost every available emergency unit and crew from as far as 70 miles away answered the call. Helicopters from as far away as Virginia helped to move the injured from the fire scene to nearby hospitals. Sub-freezing temperatures hampered rescue efforts and made some of the occupants resistant to leaving the building. The freezing conditions caused firefighters to have to force open exit doors. The building had a history of “false alarms,” which may have caused some of the occupants not to be too concerned even if the alarm was heard.

 

“Many of those who were able to make it out on their own in the early stages of the fire simply wandered off, or were treated and released by rescue workers. Others were assisted by their families and friends. Red Cross workers tried desperately to determine who and how many occupants were still left in the building….

 

“…the building was approximately 65 years old. It was originally a high-rise hotel that had been converted to a “residential high-rise” in the late 1970s. At the time of conversion and renovation the building was periodically inspected to insure compliance with the building codes in effect at that time. The last time a major inspection was conducted by building officials was in 1980….

 

“While thick smoke filtered up through elevator shafts and pipe chases, residents using crutches, walkers, and canes attempted to exit through narrow stairways from as high up as the tenth floor. Others, too frightened, too old, or too confused simply stayed in their apartments and waited for the rescue teams to arrive. Not all were fortunate enough to be found, however, before they succumbed to the deadly gases. Reportedly, one couple, found dead, had been sitting in their chairs reading the Bible. Because of the frequency of seemingly minor fires or false smoke alarms, some residents may have simply ignored the alarm. Others, because of poor hearing, may not have even heard the alarm. This situation may have added to the already confused atmosphere that seemed to prevail, as many residents left their apartments to go into a hallway already filled with smoke. Fire resistant doors had been installed at the entrance of each apartment. However, the automatic door closers were removed in many of them due to resident complaints the doors were too hard to open….

 

“Presumably the John Sevier Center met code requirements at the time it was renovated as a “high-rise residential” property in 1980. There is no question, however, that a properly installed sprinkler system could have prevented the rapid spread of fire on the first two floors. Nor is there any question that heavy smoke traveled rapidly up elevator shafts and pipe chases causing most of the victims to die of smoke inhalation, even though the fire was contained to the first two floors. Questions remain in the minds of some residents, family members, building owners, elected and appointed city officials as to whether or not the building was properly classified at the time it was renovated and if it were properly inspected by building and fire officials before, during, and after completion of the renovation process. While many documents provided by code enforcement authorities to attest to the fact the building had been inspected during this phase of the changeover, questions still prevail as to how thorough these inspections were and on how closely the existing codes were compiled with. Were building permits obtained for all interior constructions since renovation? Even as late as the previous fatal fire in October 1989 code violations were observed yet left uncorrected because time and the inspectors workload did not permit more thorough preliminary inspections or more frequent follow-up inspection. The October fire had similar consequences due to rising smoke in the pipe chase areas. Even though a person died, the fire was not deemed to be “important enough” to have a sprinkler system installed at the time. The owners and managers of the building have said they planned to install a sprinkler system in the building in the Spring of 1990. Yet, large holes were left open between floors where smoke passed freely to the floors above….

 

“Investigators believe the fire ignited a loveseat in the immediate area of origin in Apt. #102 and then traveled in a vertical path until reaching a dropped ceiling supported by wooden joists. The fire quickly traveled across the ceiling, gaining in intensity as it consumed combustible materials above the dropped ceiling.” (United States Fire Administration. Sixteen-Fatality Fire in High-rise Residence for…Elderly Johnson City, TN.  1999.)

 

Sources

 

National Fire Protection Association. Fire Investigation Report, Elderly Housing Fire, Johnson City, Tennessee, December 24, 1989. Quincy, MA:  NFPA. 1990.

 

National Fire Protection Association. Home Fires with Ten or More Fatalities. Quincy, MA:  NFPA, 9-15-2008 update. Accessed 5-9-2016 at:  http://www.nfpa.org:80/itemDetail.asp?categoryID=953&itemID=30981&URL=Research%20&%20Reports/Fire%20statistics/The%20U.S.%20fire%20problem

 

National Fire Sprinkler Association, Inc. F.Y.I. – Fire Sprinkler Facts. Patterson, NY: NFSA, November 1999, 8 pages. Accessed 2007 at: http://www.firemarshals.org/data/File/docs/College%20Dorm/Administrators/F1%20-%20FIRE%20SPRINKLER%20FACTS.pdf

Note: This is now an inactive page.

 

United States Fire Administration. Sixteen-Fatality Fire in High-rise Residence for the Elderly

Johnson City, Tennessee. Emmitsburg, MD: National Fire Data Center, USFA, FEMA, June 28, 1999, 39 pages. Accessed 5-9-2016 at: http://www.interfire.org/res_file/pdf/Tr-039.pdf

 

 

— 16  National Climatic Data Center. Storm Data, Vol. 31, No. 12, Dec 1989, p. 12.

 

Narrative Information

 

NCDC Storm Data: “Michigan. Upper Peninsula and Northwest and Southwest Lower Michigan. [Dec] 02…Heavy Snow. Heavy snow fell from the morning of December 2^nd through the evening of the 3^rd. Strong winds caused near-blizzard conditions and resulted in 150 auto accidents. Twenty-two people were injured and 16 people died in the accidents. Drifts up to four feet deep were reported in many areas.”

 

Source

 

National Climatic Data Center. Storm Data, Vol. 31, No. 12, Dec 1989. Asheville, NC: NCDC, NOAA, U.S. Dept. of Commerce. Accessed 5-9-2016 at: http://www1.ncdc.noaa.gov/pub/orders/IPS/IPS-0435ED3A-B7DC-4990-AAA1-16E2CBAF8EA6.pdf

 

–5  ASN. Accident descrip. USA CASA C-212 Aviocar 200, Dec 1989, Patuxent Riv. NAS MD

–5  Baugher, Joseph F. 1988 USAF Serial Numbers. 11-26-2011 revision.

–5  NTSB. Safety Recommendation letter to Federal Aviation Administration. 12-19-1990.

 

Narrative Information

 

ASN:

“Time:                         ca 09:30….

“First flight:                1983-02-18 (6 years 10 months)

“Crew:                         Fatalities:  5 / Occupants: 5….

“Total:                         Fatalities:  5 / Occupants: 5….

“Departure airport:      Fort Belvoir-Davison AAF, VA…

“Destination airport:   Patuxent River NAS, MD…

“Narrative:

 

“The crash occurred shortly before as the plane was preparing to land at Patuxent River Naval Air Station. The crew had been conducting tests of tracking equipment during the short flight from Davison Army Air Field at Fort Belvoir. The plane crashed sank into the water about 50 yards off shore from the Naval Air Station, in 45 feet deep water.

 

“Reportedly, this aircraft crashed because the flight crew inadvertently selected “beta range” on the propellers at 800 feet. The aircraft then stalled and crashed into the river. The CASA aircraft was owned by the US Army Intelligence and Security Command (INSCOM) and carried both a military (88-0320) as well as civilian (N296CA) registration marks.”[1] (Aviation Safety Network.  Accident Description. United States Army, CASA C-212 Aviocar 200, 1989, Dec 1, Patuxent River Naval Air Station, MD.)

 

Baugher: “CASA 212 Spanish registry EC-DHO. Operated as N296CA by US Army for special electronic reconnaissance  project – w/o Dec 1,  1989, at Patuxent River NAS.  Five crew killed.”  (Baugher, Joseph F.  1988 USAF Serial Numbers. 11-26-2011 revision.)

 

NTSB: “On December 1, 1989, a Construcciones Aeronauticas, S. A. (CASA) C-212 operated by the U.S. Army crashed while on approach to Patuxent River Naval Air Station, Maryland. The five crewmembers were fatally injured. The U.S. Army Safety Center investigation of the accident is continuing. Preliminary indications by the Army Safety Center team are that the airplane’s propellers may have been placed in the beta mode[2] before impact.

 

“The Safety Board has investigated two similar fatal accidents involving the CASA C-212:

 

On March 4, 1987, a Northwest Airlink flight crashed at the Detroit-Wayne County Airport in Romulus, Michigan. Of the 19 persons on board, 9 were killed. The Safety Board determined that the probable cause of the accident was ‘the captain’s inability to control the airplane in an attempt to recover from an asymmetric power condition at low speed following his intentional use of the beta mode of propeller operation to descend and slow the airplane rapidly on final approach for landing.’…. [page 1]

 

“….the National Transportation Safety Board recommends that the Federal Aviation Administration:

 

Issue an Airworthiness Directive applicable to the CASA C-212, to require the design and installation of a system that provides a positive means of preventing the power levers from being placed below the flight idle position while the airplane is airborne…. [page 3]

 

(NTSB. Safety Recommendation letter to Federal Aviation Administration. 12-19-1990, 4 pages.

 

Sources

 

Aviation Safety Network. Accident Description. United States Army, CASA C-212 Aviocar 200, 1989, Dec 1, Patuxent River Naval Air Station, MD. Accessed 3-14-2012 at:

http://aviation-safety.net/database/record.php?id=19891201-0

 

Baugher, Joseph F. 1988 USAF Serial Numbers. 11-26-2011 revision. Accessed 3-14-2012 at:  http://www.joebaugher.com/usaf_serials/1988.html

 

National Transportation Safety Board. Safety Recommendation letter to Federal Aviation Administration (re. CASA crash, Patuxent River NAS MD, 12-1-1989). Washington, DC: NTSB, 12-19-1990, 4 pages. Accessed 5-9-2016 at: http://www.ntsb.gov/safety/safety-recs/recletters/A90_181_182.pdf

 

 

 

[1] Cites:  Scramble, Vol. 11, No. 7, p. 34 [does not note the year].

[2] “The beta range is used for ground operations inclusive of slowing the aircraft after landing.” (SKYbrary, “Beta Range,” 10-5-2014, accessed 5-9-2016.)