TIME Infectious Disease

New Fears About Ebola Spread After Plane Scare

Sierra Leone West Africa Ebola
In this photo taken on Sunday, July 27, 2014, medical personnel inside a clinic take care of Ebola patients on the outskirts of Kenema, Sierra Leone Youssouf Bah—AP

It's an unprecedented public-health scenario: since 1976, when the virus was first discovered, Ebola outbreaks were limited to remote corners of Congo and Uganda

(DAKAR, Senegal) — No one knows for sure just how many people Patrick Sawyer came into contact with the day he boarded a flight in Liberia, had a stopover in Ghana, changed planes in Togo, and then arrived in Nigeria, where authorities say he died days later from Ebola, one of the deadliest diseases known to man.

Now health workers are scrambling to trace those who may have been exposed to Sawyer across West Africa, including flight attendants and fellow passengers.

Health experts say it is unlikely he could have infected others with the virus that can cause victims to bleed from the eyes, mouth and ears. Still, unsettling questions remain: How could a man whose sister recently died from Ebola manage to board a plane leaving the country? And worse: Could Ebola become the latest disease to be spread by international air travel?

Sawyer’s death on Friday has led to tighter screening of airline passengers in West Africa, where an unprecedented outbreak that emerged in March has killed more than 670 people in Guinea, Sierra Leone and Liberia. But some health authorities expressed little confidence in such precautions.

“The best thing would be if people did not travel when they were sick, but the problem is people won’t say when they’re sick. They will lie in order to travel, so it is doubtful travel recommendations would have a big impact,” said Dr. David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine.

“The important thing is for countries to be prepared when they get patients infected with Ebola, that they are isolated, family members are told what to do and health workers take the right steps.”

The World Health Organization is awaiting laboratory confirmation after Nigerian health authorities said Sawyer tested positive for Ebola, WHO spokesman Gregory Hartl said. The WHO has not recommended any travel restrictions since the outbreak came to light.

“We would have to consider any travel recommendations very carefully, but the best way to stop this outbreak is to put the necessary measures in place at the source of infection,” Hartl said. Closing borders “might help, but it won’t be exhaustive or foolproof.”

The risk of travelers contracting Ebola is considered low because it requires direct contact with bodily fluids or secretions such as urine, blood, sweat or saliva, experts say. Ebola can’t be spread like flu through casual contact or breathing in the same air.

Patients are contagious only once the disease has progressed to the point they show symptoms, according to the WHO. And the most vulnerable are health care workers and relatives who come in much closer contact with the sick.

Still, witnesses say Sawyer, a 40-year-old Liberian Finance Ministry employee en route to a conference in Nigeria, was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers aboard. Ebola can be contracted from traces of feces or vomit, experts say.

Sawyer was immediately quarantined upon arrival in Lagos — a city of 21 million people — and Nigerian authorities say his fellow travelers were advised of Ebola’s symptoms and then were allowed to leave. The incubation period can be as long as 21 days, meaning anyone infected may not fall ill for several weeks.

Health officials rely on “contact tracing” — locating anyone who may have been exposed, and then anyone who may have come into contact with that person. That may prove impossible, given that other passengers journeyed on to dozens of other cities.

Patrick Sawyer had planned to visit his family in Minnesota next month to attend two of his three daughters’ birthdays, his wife, Decontee Sawyer, told KSTP-TV in Minnesota.

“It’s a global problem because Patrick could have easily come home with Ebola, easy,” she said. The Associated Press left phone and email messages for her Monday.

International travel has made the spread of disease via airplanes almost routine. Outbreaks of measles, polio and cholera have been traced back to countries thousands of miles away. Even Ebola previously traveled the globe this way: During an outbreak in Ivory Coast in the 1990s, the virus infected a veterinarian who traveled to Switzerland, where the disease was snuffed out upon arrival and she ultimately survived, experts say.

Two American aid workers in Liberia have tested positive for the virus and are being treated there. U.S. health officials said Monday that the risk of the deadly germ spreading to the United States is remote.

The mere prospect of Ebola in Africa’s most populous nation has Nigerians on edge.

In Nigeria’s capital, Abuja, Alex Akinwale, a 35-year-old entrepreneur, said he is particularly concerned about taking the bus, which is the only affordable way to travel.

“It’s actually making me very nervous. If I had my own car, I would be safer,” he said. “The doctors are on strike, and that means they are not prepared for it. For now I’m trying to be very careful.”

It’s an unprecedented public health scenario: Since 1976, when the virus was first discovered, Ebola outbreaks were limited to remote corners of Congo and Uganda, far from urban centers, and stayed within the borders of a single country. This time, cases first emerged in Guinea, and before long hundreds of others were stricken in Liberia and Sierra Leone.

Those are some of the poorest countries in the world, with few doctors and nurses to treat sick patients let alone determine who is well enough to travel. In Sawyer’s case, it appears nothing was done to question him until he fell sick on his second flight with Asky Airlines. An airline spokesman would not comment on what precautions were being taken in the aftermath of Sawyer’s journey.

Liberian Assistant Health Minister Tolbert Nyenswah told The Associated Press last week that there had been no screening at Liberia’s Monrovia airport. That changed quickly over the weekend, when President Ellen Johnson Sirleaf said a new policy on inspecting and testing all outgoing and incoming passengers will be strictly observed. She also announced that some borders were being closed and communities with large numbers of Ebola cases would be quarantined.

International travelers departing from the capitals of Sierra Leone and Guinea are also being checked for signs of fever, airport officials said. Buckets of chlorine are also on hand at Sierra Leone’s airport in Freetown for disinfection, authorities said.

Still, detecting Ebola in departing passengers might be tricky, since its initial symptoms are similar to many other diseases, including malaria and typhoid fever.

“It will be very difficult now to contain this outbreak because it’s spread,” Heymann said. “The chance to stop it quickly was months ago before it crossed borders … but this can still be stopped if there is good hospital infection control, contact tracing and collaboration between countries.”

Nigerian authorities so far have identified 59 people who came into contact with Sawyer and have tested 20, said Lagos State Health Commissioner Jide Idris. Among them were officials from ECOWAS, a West African governing body, airline employees, health workers and the Nigerian ambassador to Liberia, he said. He said there have been no new cases of the disease.

___

Associated Press Medical Writer Maria Cheng reported from London. Jonathan Paye-Layleh in Monrovia, Liberia; Clarence Roy-Macaulay in Freetown, Sierra Leone; Erick Kaglan in Lome, Togo; and Heather Murdock in Abuja, Nigeria, also contributed to this report.

TIME Infectious Disease

Here’s What You Need to Know Now About the Ebola Crisis

After a passenger brought Ebola to Africa’s largest city, health officials are on alert for signs of the infection among passengers. Here's the latest

The Ebola outbreak has already led to more than 670 deaths in West Africa, but a man who became ill on a flight from Liberia to Lagos, Africa’s largest city, has raised alarms for public-health officials after he later died of the virus.

Liberia has closed most of its borders, and airports in Nigeria are now screening passengers arriving from foreign countries for Ebola’s symptoms, which include fever, headache, joint pain, lack of appetite, difficult breathing and sore throat. In its advanced stages, Ebola leads to diarrhea, vomiting and internal bleeding. While the airport screenings are meant to ease travelers’ minds, the reality is that the Ebola virus can’t be detected soon after infection — the first signs of the virus are red eyes and a rash, which could be caused by many different things. Plus, outgoing flyers are not being tested and its unclear at this point if over countries will follow suit. People have recovered from infection with the virus, but the mortality rate ranges from 50% to 90%.

(MORE: Here’s What It Will Take to Contain the Worst Ebola Outbreak in History)

Who can spread the virus?

The virus takes anywhere from two to 21 days to incubate and start causing symptoms, but Dr. Stephan Monroe, deputy director of the National Center for Emerging and Zoonotic Infectious Diseases at the U.S. Centers for Disease Control and Prevention (CDC), said during a telebriefing Monday that infected patients only spread the disease when they have symptoms. Because the virus is transmitted through direct contact with fluids like saliva or blood from infected patients, airport officials are essentially looking for passengers who might have severe vomiting, diarrhea or other bodily secretions that could reach other travelers.

Are Nigeria’s airport screenings enough?

Nigeria is screening incoming passengers for such symptoms and may also take passengers’ temperature. Nigerian officials have also created holding rooms to isolate patients or passengers who are suspected of being infected, so they can be triaged to further medical care.

But because some of the early symptoms of Ebola mirror those of other ailments, including malaria, CDC officials say the strongest way to contain spread of infectious diseases is by instituting travel restrictions at the source. That’s why Liberia has closed all its borders except for three land crossings where travelers can be screened and treatment services provided if needed.

Dr. Marty Cetrone, director of the division of global migration and quarantine at the CDC, said during the briefing that officials can also try to contain the outbreak by using questionnaires asking travelers at these checkpoints about their recent travel history as well as their potential exposure to the virus through friends or other close contacts.

How did this outbreak get so bad?

Health officials aren’t sure why this particular outbreak has led to a historic number of deaths, but note that social and cultural practices may be driving spread of the virus. In many of the communities where the virus remains active, there is still denial about the disease, and stigma associated with getting ill, which discourages patients from getting early hydration and nutrition that can help them to overcome the infection. While there is no treatment for the virus, these measures can lower the death rate for some. Funeral practices that involve touching the deceased may also help the virus move from host to host.

How at-risk are Americans?

Monroe says the risk of Ebola for U.S. citizens who haven’t traveled to West Africa remains low. There are no restrictions on travelers entering the U.S., but the CDC has issued a Level 2 travel advisory for people traveling to Guinea, Liberia or Sierra Leone, recommending that they avoid contact with blood or other bodily fluids that might contain the virus, and use the proper protective equipment to avoid infection. The advisory applies mostly to health care or humanitarian aid workers, who so far make up the largest group of people affected by Ebola. “[Transmission] involves not only touching the contaminated body fluid but introducing it through some mucous membrane or cut on the skin,” said Monroe.

For anyone who has recently traveled to those countries or might have been exposed to someone who was ill in that area, health officials are advising a 21-day fever watch to ensure that no active infection is occurring.

What if an infected person flies into the U.S.?

The CDC is also preparing for the remote possibility that a passenger from the region who is ill boards a plane and lands in the U.S. and starts infecting residents. The agency is informing its network of physicians in state and local public-health facilities about how to look for signs of Ebola. “We are sending Health Alert Network notices about the importance of taking steps to prevent spread of the virus,” said Monroe. That includes procedures on asking patients about their recent travel history, as well as using the proper personal protective equipment, such as masks, gloves and gowns if they suspect an Ebola infection.

They’re confident that these measures will be effective, since infection with a virus related to Ebola, Marburg, was successfully contained in the Netherlands with isolation and barrier procedures. No health care workers contracted the virus from that patient. Health officials hope that with the proper preparation and education, that record can apply to Ebola as well, if it makes it beyond the heavily affected countries in West Africa.

TIME Infectious Disease

There’s a Vaccine Against Cancer, But People Aren’t Using It

The only vaccine to protect against cancer, the HPV shot, isn't being used by young people who could benefit most

In a new report on immunization rates among young people, the Centers for Disease Control (CDC) reports relatively low numbers of adolescents getting the HPV vaccine, the only vaccine that can protect against cancers — in the cervix, anus and mouth — caused by the human papillomavirus virus.

The new data, published in the CDC’s Morbidity and Mortality Weekly Report, shows that only about one-third of adolescent girls between the ages 13 and 17 got all three doses of the HPV vaccine, which the CDC says is about the same as last year. The shot is recommended to protect adolescents before they become sexually active. Only about 57% of adolescent girls and 35% of adolescent boys for whom the shot is recommended received one or more doses.

The vaccine continues to face challenges from parents concerned that it would promote sexual activity among pre-teens and adolescents, despite data showing that immunized teens aren’t more promiscuous. The CDC data also shows that doctors can play a critical role in discussing the shot with parents and improving vaccination rates. Among parents whose daughters were vaccinated against HPV, 74% said their doctors recommended the vaccine. But the data also showed that among parents who did not vaccinate their girls, nearly half were never told by their doctor that they should consider it. The effect was even greater among boys, where only 26% of parents who did vaccinate their son received any advice from their doctor about it.

To boost vaccination rates, some researchers are investigating whether fewer doses of the vaccine could be effective, and so far those studies look promising.

TIME Infectious Disease

CDC Lab Director In Anthrax Incident Resigns

MED CDC Anthrax
A sign marks the entrance to the federal Centers for Disease Control and Prevention in Atlanta on Oct. 8, 2013. David Goldman—AP

The lab director is now permanently out of the job

The director of the bioterror lab involved in an incident which caused over 80 lab workers to be potentially exposed to anthrax has resigned.

Michael Farrell, head of the Centers for Disease Control’s Bioterror Rapid Response and Advanced Technology Laboratory had submitted his resignation on Tuesday. The resignation was first reported by Reuters and has been confirmed by TIME.

Last month, the CDC reported that procedures to deactivate anthrax when leaving a lab were not followed and that while the workers were protected, the bacteria was passed to other labs. When it was determined that anthrax had not been deactivated, the labs and CDC building were shut down and decontaminated. Lab workers have not contracted the disease.

Last month, Dr. Farrell was reassigned as the CDC conducted its investigation. Earlier this month, CDC Director Dr. Thomas Frieden said the incident was due to a lack of oversight, and that the CDC would increase safety precautions.

 

TIME Infectious Disease

Sierra Leone’s Chief Ebola Doctor Contracts the Deadly Virus

Sheik Umar Khan, head doctor fighting the deadly tropical virus Ebola in Sierra Leone, poses for a picture in Freetown, June 25, 2014.
Sheik Umar Khan, head doctor fighting the deadly tropical virus Ebola in Sierra Leone, poses for a picture in Freetown, June 25, 2014. Reuters Staff—REUTERS

Symptoms of Ebola include high fevers, diarrhea and vomiting

The top doctor fighting Sierra Leone’s deadly ebola outbreak has contracted the virus himself, the country’s government said Tuesday.

Sheik Umar Khan, 39, is leading an assault on the virus that the World Health Organization says has already claimed 632 lives—206 in Sierra Leone alone as of July 17.

The ebola virus is ruthless, with a mortality rate of 90%. Transmitted through direct contact with the body fluid, blood and infected tissue of victims, ebola can easily spread to the health workers working hard to fight it.

“Health workers are prone to the disease because we are the first port of call for somebody who is sickened by disease. Even with the full protective clothing you put on, you are at risk,” Khan said in an interview with Reuters, before displaying the illness.

Khan is credited with treating more than 100 Ebola victims, Reuters reports, and is considered a “national hero” by the nation’s health ministry. The doctor has been moved to a treatment facility run by the medical charity Doctors Without Borders, according to a statement released Tuesday from the president’s office.

The outbreak began in Guinea this February, but has quickly spread across West Africa.

[Reuters]

TIME Infectious Disease

MERS Could Be Airborne, Research Indicates

The disease has already claimed 288 lives

Findings from a scientific paper published Tuesday indicated that Middle East Respiratory Syndrome (MERS) may be able to spread through the air.

A research team in Saudi Arabia collected air samples from a camel barn that the virus had previously plagued. Their analysis of the air sample tested positive for a strain of MERS RNA, CNN reports.

The possibility of MERS as an airborne illness has been previously floated after reports said that some of those infected previously had close contact to fellow MERS patients. The disease has claimed at least 288 live, according to the World Health Organization.

However, scientists are hesitant to jump to conclusions from these findings. “What they say is that virus particles can be airborne, but it’s premature to conclude that MERS is transmitted through aerosols,” said Dr. Mark Denison, a Vanderbilt University School of Medicine professor.

“Do we still need to consider the possibility of airborne transmission?” Denison added. “Yes, of course.”

[CNN]

TIME Infectious Disease

HIV Diagnosis Rate Fell by a Third in U.S. Over a Decade

HIV DIAGNOSES
This graphic shows the annual number of HIV diagnoses in the U.S., which has dropped by one-third in the past decade F.duckett—AP

A government study finds that HIV infection rates in the U.S. fell by one-third in the past decade, but young gay and bisexual men remain at high risk for the infection

(NEW YORK) — The rate of HIV infections diagnosed in the United States each year fell by one-third over the past decade, a government study finds. Experts celebrated it as hopeful news that the AIDS epidemic may be slowing in the U.S.

“It’s encouraging,” said Patrick Sullivan, an Emory University AIDS researcher who was not involved in the study.

The reasons for the drop aren’t clear. It might mean fewer new infections are occurring. Or that most infected people already have been diagnosed so more testing won’t necessarily find many more cases.

“It could be we are approaching something of a ‘ceiling effect,'” said one study leader, David Holtgrave of Johns Hopkins University.

The study was released online Saturday by the Journal of the American Medical Association. It is part of the journal’s special report on HIV research, issued ahead of the International AIDS Conference that starts Sunday in Melbourne, Australia.

HIV is the virus that causes AIDS, which destroys the immune system. The World Health Organization estimates 35 million people globally have the virus. In the United States, 1.1 million people are thought to be infected, though many don’t know it.

The study is based on HIV diagnoses from all 50 states’ health departments, which get test results from doctors’ office, clinics, hospitals and laboratories. The data span a decade, making this a larger and longer look at these trends than any previous study, said another study author, Amy Lansky of the federal Centers for Disease Control and Prevention.

The findings: 16 out of every 100,000 people ages 13 and older were newly diagnosed with HIV in 2011, a steady decline from 24 out of 100,000 people in 2002.

Declines were seen in the rates for men, women, whites, blacks, Hispanics, heterosexuals, injection drug users and most age groups. The only group in which diagnoses increased was young gay and bisexual men, the study found.

The diagnosis rate is a direct measure of when people actually tested positive for the virus. The diagnoses may be identifying infections that happened recently or years before.

The study found diagnosis rates dropped even as the amount of testing rose. In 2006, the CDC recommended routine HIV testing for all Americans ages 13 to 64, saying an HIV test should be as common as a cholesterol check. The percentage of adults ever tested for HIV increased from 37 percent in 2000 to 45 percent in 2010, according to CDC data.

Lansky acknowledged that given the testing increases, the new findings may seem like a bit of a paradox. One might assume that “if more people get tested, you’re more likely to find more people who are infected,” she said.

But several factors could explain the decline.

One is Holgrave’s ‘ceiling effect’ theory. Another is a possible ebb in new infections.

The CDC has been estimating about 50,000 new infections occur each year and that number has been holding steady in the past decade. That estimate comes from reports from 25 city and state health departments, joined with statistical modeling.

Lansky said maybe new infections are waning. Or maybe not, she and other experts said.

How could new infections be holding steady when diagnoses are falling? Perhaps the infection count might be buoyed by the expanding epidemic in young gay and bisexual men, said Sullivan, the Emory researcher.

TIME

Chikungunya in Florida Man Is First Case Acquired in the U.S.

98736416
WS photography—Getty Images/Flickr RF

The Centers for Disease Control and Prevention (CDC) says that the first case of the mosquito-borne virus chikungunya infection picked up in the U.S. occurred in a Florida man who had not recently traveled abroad.

This year, 243 people in the U.S. became infected, but this is the first case of a disease believed to originate from a mosquito in the U.S.

Chikungunya is a disease caused by a virus that leads to fever, joint pain, headaches, swelling and rash. The infection is usually not fatal, but the pain can be debilitating.

“The arrival of chikungunya virus, first in the tropical Americas and now in the United States, underscores the risks posed by this and other exotic pathogens,” Roger Nasci, chief of CDC’s Arboviral Diseases Branch said in a statement.

The CDC is teaming up with the Florida Department of Health to confirm how the Florida man became infected and is monitoring the area for additional cases. The CDC believes that chikungunya in the U.S. will follow a similar pattern to that of the dengue virus, in which imported cases cause some local transmission, but did not cause a widespread outbreak. Public health officials are investigating how the mosquitoes were infected with the virus, including whether the insects acquired the virus by biting infected individuals. Since 2006, there have been an average of 28 cases a year of chikungunya infection; none of those cases have prompted an outbreak, however. Countries in Africa, Asia, Europe, India, the Middle East, and the French side of the Caribbean island of St. Martin have experienced outbreaks in the past and 23 countries have experienced local transmission of the virus in recent years.

The best way to stay protected from the virus is to keep mosquitoes at bay by wearing repellants and creating a physical barrier from being bitten, with long sleeves and pants when possible. Health officials also recommend getting rid of any standing water outside the home, where mosquitoes generally breed.

TIME Infectious Disease

Spacing Out Kids’ Vaccines Can Hurt Their Health, Experts Say

Girl getting immunization
Getty Images

All those shriek-inducing pokes may seem excessive but the rewards of following national vaccination guidelines far outweigh the risks, experts say

“Like any parent, I don’t like to see my child get a shot,” says Dr. Michael J. Smith, a pediatrician at the University of Louisville who has studied immunizations and developmental health outcomes among kids. “But these vaccine schedules are in place for a reason.” Smith compares skipping or postponing one of your child’s vaccinations to not buckling him or her in during a car ride. “You never know when you’re going to get hit. And if you delay or space out your child’s shots, not only are you putting your kids at risk, but you’re putting other people’s kids at risk too.”

The urgency of Smith’s warnings are borne out in the recent outbreaks of measles and pertussis, diseases that had been almost totally eradicated in the U.S. but have made a frightening comeback since the turn of the century—right around the time two now-discredited scientific papers suggested a possible link between vaccines and autism. Dozens of subsequent studies have demonstrated there are no links between vaccinations and autism. But while stats show most parents understand the importance of immunizing their kids, research from the University of Michigan indicates plenty of moms and dads—roughly 1 in 4—worry that current immunization guidelines may overburden their babies’ tiny immune systems.

The Centers for Disease Control and Prevention (CDC) currently recommend that all healthy babies be vaccinated against 12 different diseases or viruses during the first two years of life. That’s compared to eight back in the early 1990s. Recently added to the list are vaccinations against potentially deadly illnesses like hepatitis and chicken pox.

But while the number of vaccines (and needle pricks) has grown during the last two decades, the amount of antigen in those shots, which is the substance that triggers a response from your child’s immune system, has plummeted, Smith explains. “The actual burden on your child’s immune system is far lower that it was 10 or 20 years ago, even though kids now receive more shots,” he says. That’s credited to advances in protein science and a better understanding of the way diseases and children’s immune systems interact.

In an effort to provide some answers for concerned parents, Smith and his colleagues looked at kids’ scores on tests related to motor skill, verbal memory, attention span, and several other neuropsychological factor to see if vaccine timing had any impact—good or bad—on a child’s brain development. His research shows kids vaccinated on time score the same or better than children who receive their vaccinations late or not at all.

Related research from Canada looked specifically at the immunization decisions made by parents of children diagnosed with autism. “Our study found that roughly 60 percent of parents who had a child with autism delayed or declined vaccinations for a later-born child,” says Dr. Jessica Brian, a developmental psychologist at the University of Toronto. According to Brian’s research, those children who did not receive their shots on time or altogether were slightly more likely to develop autism. “I don’t want to suggest that vaccines offer some protection against autism,” she says. “But our data show that there’s no increased risk of autism among kids who are vaccinated on time.”

Brian, Smith and other vaccine researchers repeatedly point to the Internet as a source of misinformation and, in some cases, unsubstantiated fear mongering when it comes to vaccines. Not uncommon are conspiracy theories involving pharmaceutical companies and the CDC. But travel overseas, and the picture changes slightly.

In Europe, where some diseases were never eradicated as thoroughly as they were in the U.S., health officials say there isn’t as much “too much, too soon” concern among parents when it comes to immunizations. Still, European moms and dads do harbor fears about potential vaccine side effects, says Niklas Danielsson, deputy head of the vaccine-preventable diseases program for the European Centre for Disease Prevention and Control. Danielsson says the “unprecedented success” of vaccination programs has created a generation of young parents who aren’t familiar with the reality of something like a measles outbreak, so they’re focus is on a shot’s rare risks as opposed to its many proven benefits.

The lingering presence of diseases in other countries is one of the big reasons having your children vaccinated on time is so important, says Dr. Simon Hambidge, a professor of pediatrics and epidemiology at the University of Colorado. “We live in a world of international travel, and people are coming into our country all the time who may be carrying these diseases,” Hambidge says. “Unfortunately, the vast majority of the new outbreaks we’re seeing involve unvaccinated children.”

Hambidge has looked closely at one possible vaccine side effect that has parents worried: seizures. The CDC recommends that all healthy infants receive their first measles vaccination between the ages of 12 and 15 months, and some research has linked the measles vaccine to higher rates of febrile seizures. Though frightening for parents, seizures of this type are relatively common and almost never cause lasting damage, Hambidge explains. “About one in 2,000 to 4,000 kids will experience one of these febrile seizures after receiving the measles vaccine,” he says. “But we found that that seizure rate rises to one in 1,000 or 2,000 if the measles vaccine is given late, or between 16 and 23 months of age.” Hambidge says this is just one example of how a slight deviation from the CDC’s vaccination schedule can put your child’s health at risk.

“The risk of measles is far, far more serious than the risk for febrile seizures,” Hambidge says. “Even if your child is unlucky enough to have a seizure after a vaccination, these seizures are short-lived and don’t lead to any long-term issues, while measles is a life-threatening disease.”

Despite the overwhelming amount of research and real-world evidence that points to the reliable safety of vaccines, experts acknowledge that parents will continue to worry about the chemicals and additives in immunization shots. To those who have doubts, Dr. Smith says, “Vaccines are one of the most rigorously tested and effective health products on the planet. Nothing involving them is done lightly.”

And when it comes to the CDC’s recommendations regarding vaccination schedules, he adds, “As a pediatrician and as a parent, if my family’s on vacation and we have to put off my daughter’s doctor visit, I get anxious each day that she goes unvaccinated. I think the timing is that important.”

TIME Infectious Disease

Girl, 9, Killed by Brain-Eating Parasite in Water

Kansas and Florida officials issue health warnings about swimming in fresh water

+ READ ARTICLE

Kansas health and environment officials have issued a health warning after a 9-year-old girl died from a brain-eating amoeba that lives in fresh water.

Hally Yust is reported to have been a regular water-skier who frequently swam in freshwater areas. She died last week after encountering the parasite Naegleria fowleri which is found in warm, still water.

Florida officials have provided similar warnings following Yust’s death. Last summer Florida resident Zachary Reyna, 12, died after he picked up the parasite while playing in a ditch near his home.

The Department of Health and Environment in Kansas said that it’s not clear where Yust, a resident of Johnson County, contracted the parasite. This is the second such case in Kansas.

“We are very saddened to learn of this unfortunate circumstance, and our thoughts and prayers are with the family and friends during this difficult time,” said Robert Moser, Department Secretary and State Health Officer.

He added: “It is important for the public to know that infections like these are extremely rare and there are precautions one can take to lower their risk – such as nose plugs.”

From 1962 to 2013 there have been 132 similar cases reported in the U.S. The infection usually happens when the amoeba enters a person’s nose whilst they’re underwater and travels to the brain. Symptoms usually appear five days after exposure.

Officials recommend keeping your head above water when swimming in warm freshwater, wearing nose clips or avoiding freshwater activities altogether.

Your browser, Internet Explorer 8 or below, is out of date. It has known security flaws and may not display all features of this and other websites.

Learn how to update your browser