26 Aug 2008

Christians refuse mumps vaccine, fuel outbreak: Officials

Canwest News Service - Canada
August 25, 2008

by Pamela Fayerman

CHILLIWACK, B.C. - With the number of confirmed and suspected mumps cases in the Fraser Valley nearing 200, public health officials worry the disease will spread throughout the rest of the Lower Mainland.
Since the outbreak began in Chilliwack in February, cases have been spreading rapidly through the Fraser Valley, fuelled by a high rate of transmission among vaccine objectors from unnamed Christian fundamentalist groups that are against vaccines of all kinds.
About half of the 190 confirmed and suspected cases are individuals who have never been immunized, either on religious or philosophical grounds, said Dr. Elizabeth Brodkin.

She said another 25 per cent of cases involve people who are only partially immunized.
Public health officials have declined to disclose the church affiliations, saying that would violate confidentiality, but said the denominations' interpretation of the Bible dictates their aversion to vaccines.
"This outbreak is really taxing us, and we think a provincial consensus is needed to determine whether we should just resign ourselves to large numbers of cases, or (determine) what to do to mitigate the spread through some sort of immunization campaign," Brodkin said.
"After all, this is not a trivial disease. We've had many cases resulting in hospitalizations and complications," she added.
Because of the mobility of individuals, she said, "there's no guarantee it won't spread to the Vancouver region."
"At the moment, there is some evidence that it is moving out of the faith-based communities and into the broader communities," she said, noting that there are now cases as far west as Burnaby, B.C.
The BC Centre for Disease Control has convened a working group to decide if it is time to roll out a broad prevention strategy that would possibly involve vaccinating people in the 13-to-40-year age range, since they are the ones who either have no natural immunity through exposure to wild mumps virus, or who have not had two doses of the measles/mumps/rubella vaccine, which is about 95 per cent effective.
Even with the two-dose vaccine, immunity to mumps starts to wane after 15 to 20 years, cautioned provincial health officer Dr. Perry Kendall.
Brodkin said the mumps outbreak in the Fraser Valley involves intensive investigations because every case requires notifying dozens or even hundreds of contacts that they may contract mumps as a result of their contact with the infected individual.
Dr. John Carsley, a medical health officer in Vancouver, said it's difficult to predict if the outbreak will have a major impact on the city's residents. Since the beginning of the year, there have been only four cases, which is about typical.
"We're not planning any extraordinary vaccination efforts at this point, but we are keeping up with our surveillance efforts and when we have a meeting with other regions (in the next week or two) we will listen to the experience of other regions and go from there," Carsley said.
The mumps outbreak eclipses the previous one 12 years ago, when there were 83 confirmed cases.
Mumps is spread by saliva droplets. Kissing, coughing, sneezing, shouting, sharing drinks, toothbrushes and cigarettes and even singing are all activities that can transmit the virus.
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