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"content": "\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Two unvaccinated Marin children have been confirmed to have measles, county health officials announced Thursday night \u003ca title=\"https://www.marinhhs.org/sites/default/files/files/public-health-updates/measles_health_advisory_01_29_2015.pdf\" href=\"https://www.marinhhs.org/sites/default/files/files/public-health-updates/measles_health_advisory_01_29_2015.pdf\" target=\"_blank\">in an advisory\u003c/a> sent to all Marin County clinicians.\u003c/p>\n\u003cp>Dr. Matt Willis, Marin Health Officer, told the Marin Independent Journal that the two children were members of the same family and that they had become infected outside the county. The children are of school age, Willis added, but no other unvaccinated children would be barred from attending school.\u003c/p>\n\u003cp>More from the \u003ca title=\"http://www.marinij.com/News/ci_27423424/Two-measles-cases-confirmed-in-Marin-Wednesday\" href=\"http://www.marinij.com/News/ci_27423424/Two-measles-cases-confirmed-in-Marin-Wednesday\" target=\"_blank\">Independent-Journal\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"These were two children who were out of school well before and throughout any infectious period,\" Willis said. \"The infectious period for measles is usually around eight days.\"\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>For this reason, the protocol of excluding unvaccinated children will not be observed, Willis said.\u003c/p>\n\u003cp>Willis said the two children \"have been safely isolated from the community, and will remain isolated for the next three weeks. The health department is in regular contact with the family.\"\u003c/p>\n\u003cp>The children were out of the county for part of that interval and were not in direct contact with anyone in the community, Willis said. \"We are taking appropriate measures to protect the community against further spread,\" he said.\u003c/p>\u003c/blockquote>\n\u003cp>Carl Krawitt, the Marin father of a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">child who cannot be vaccinated\u003c/a> because he is recovering from cancer treatment, said he is \"sorry for children who are sick and hope they heal fast.\" Krawitt has been advocating for changes in policy that would require schools to bar unvaccinated children from school, until they are immunized.\u003c/p>\n\u003cp>Marin is the 10th California county to see measles cases in the outbreak that started \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">in connection to Disneyland\u003c/a> in December. The new cases bring the statewide total in the current outbreak to 81.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>New Law to be Introduced\u003c/strong>\u003c/p>\n\u003cp>The new cases come against a backdrop of a \u003ca title=\"http://www.latimes.com/opinion/editorials/la-ed-exemption-20150128-story.html\" href=\"http://www.latimes.com/opinion/editorials/la-ed-exemption-20150128-story.html\" target=\"_blank\">growing debat\u003c/a>e about California's use of the \"personal belief exemption\" which allows parents to opt-out of vaccines on behalf of their children. The statewide PBE rate is 2.5 percent, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" target=\"_blank\">but in many areas \u003c/a>the rates are significantly higher. Marin county's PBE rate is 6.45 percent; some \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/2014-15%20CA%20Kindergarten%20Immunization%20Assessment.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2014-15%20CA%20Kindergarten%20Immunization%20Assessment.pdf\" target=\"_blank\">rural Northern California counties \u003c/a>are higher still. Nevada County's PBE rate is 21.55 percent.\u003c/p>\n\u003cp>Sen. Richard Pan (D-Sacramento) says he will \u003ca title=\"http://sd06.senate.ca.gov/news/2015-01-27-dr-richard-pan’s-2013-legislation-leads-more-vaccinated-children-schools-announces\" href=\"http://sd06.senate.ca.gov/news/2015-01-27-dr-richard-pan%E2%80%99s-2013-legislation-leads-more-vaccinated-children-schools-announces\" target=\"_blank\">introduce a bill \u003c/a>Friday that would require schools to notify parents of its immunization rates. They would also need to include a \"reference rate,\" he said, that would tell parents what public health officials say the rate of vaccination should be to protect people who cannot be vaccinated for medical reasons.\u003c/p>\n\u003cp>\"It's important to keep families informed of things their child may be at risk of at their school,\" Pan, who is also a pediatrician, said.\u003c/p>\n\u003cp>In addition, Pan said he wants to look at tightening the personal belief exemption. Only \u003ca title=\"http://www.vaccinesafety.edu/cc-exem.htm\" href=\"http://www.vaccinesafety.edu/cc-exem.htm\" target=\"_blank\">a minority of states\u003c/a> allow a personal belief exemption. \"Many other states have much stricter rules,\" Pan told me. \"There are \u003ca title=\"http://www.vaccinesafety.edu/cc-exem.htm\" href=\"http://www.vaccinesafety.edu/cc-exem.htm\" target=\"_blank\">many states \u003c/a>where you can only get exempted if you have a medical reason, or you can demonstrate a strong religious reason.\"\u003c/p>\n\u003cp>New York is one such state, and Pan said he plans to see if that approach might be a \"more appropriate model\" for California.\u003c/p>\n\u003cp>\"We need to look at what we need to do here in California,\" he said. \"We certainly understand people have different beliefs, but we also need children to be safe in their schools.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Krawitt, who has worried about the PBE rate in Marin and more broadly, was enthusiastic to hear of Pan's ideas. He said he and his wife would like to see a bill, but \"we would likely endorse it.\"\u003c/p>\n\n",
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"excerpt": "Two unvaccinated children with the measles are the first cases in Marin in the current outbreak.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Two unvaccinated Marin children have been confirmed to have measles, county health officials announced Thursday night \u003ca title=\"https://www.marinhhs.org/sites/default/files/files/public-health-updates/measles_health_advisory_01_29_2015.pdf\" href=\"https://www.marinhhs.org/sites/default/files/files/public-health-updates/measles_health_advisory_01_29_2015.pdf\" target=\"_blank\">in an advisory\u003c/a> sent to all Marin County clinicians.\u003c/p>\n\u003cp>Dr. Matt Willis, Marin Health Officer, told the Marin Independent Journal that the two children were members of the same family and that they had become infected outside the county. The children are of school age, Willis added, but no other unvaccinated children would be barred from attending school.\u003c/p>\n\u003cp>More from the \u003ca title=\"http://www.marinij.com/News/ci_27423424/Two-measles-cases-confirmed-in-Marin-Wednesday\" href=\"http://www.marinij.com/News/ci_27423424/Two-measles-cases-confirmed-in-Marin-Wednesday\" target=\"_blank\">Independent-Journal\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"These were two children who were out of school well before and throughout any infectious period,\" Willis said. \"The infectious period for measles is usually around eight days.\"\u003cbr>\n\u003c!--more-->\u003c/p>\n\u003cp>For this reason, the protocol of excluding unvaccinated children will not be observed, Willis said.\u003c/p>\n\u003cp>Willis said the two children \"have been safely isolated from the community, and will remain isolated for the next three weeks. The health department is in regular contact with the family.\"\u003c/p>\n\u003cp>The children were out of the county for part of that interval and were not in direct contact with anyone in the community, Willis said. \"We are taking appropriate measures to protect the community against further spread,\" he said.\u003c/p>\u003c/blockquote>\n\u003cp>Carl Krawitt, the Marin father of a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">child who cannot be vaccinated\u003c/a> because he is recovering from cancer treatment, said he is \"sorry for children who are sick and hope they heal fast.\" Krawitt has been advocating for changes in policy that would require schools to bar unvaccinated children from school, until they are immunized.\u003c/p>\n\u003cp>Marin is the 10th California county to see measles cases in the outbreak that started \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">in connection to Disneyland\u003c/a> in December. The new cases bring the statewide total in the current outbreak to 81.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>New Law to be Introduced\u003c/strong>\u003c/p>\n\u003cp>The new cases come against a backdrop of a \u003ca title=\"http://www.latimes.com/opinion/editorials/la-ed-exemption-20150128-story.html\" href=\"http://www.latimes.com/opinion/editorials/la-ed-exemption-20150128-story.html\" target=\"_blank\">growing debat\u003c/a>e about California's use of the \"personal belief exemption\" which allows parents to opt-out of vaccines on behalf of their children. The statewide PBE rate is 2.5 percent, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" target=\"_blank\">but in many areas \u003c/a>the rates are significantly higher. Marin county's PBE rate is 6.45 percent; some \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/2014-15%20CA%20Kindergarten%20Immunization%20Assessment.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/2014-15%20CA%20Kindergarten%20Immunization%20Assessment.pdf\" target=\"_blank\">rural Northern California counties \u003c/a>are higher still. Nevada County's PBE rate is 21.55 percent.\u003c/p>\n\u003cp>Sen. Richard Pan (D-Sacramento) says he will \u003ca title=\"http://sd06.senate.ca.gov/news/2015-01-27-dr-richard-pan’s-2013-legislation-leads-more-vaccinated-children-schools-announces\" href=\"http://sd06.senate.ca.gov/news/2015-01-27-dr-richard-pan%E2%80%99s-2013-legislation-leads-more-vaccinated-children-schools-announces\" target=\"_blank\">introduce a bill \u003c/a>Friday that would require schools to notify parents of its immunization rates. They would also need to include a \"reference rate,\" he said, that would tell parents what public health officials say the rate of vaccination should be to protect people who cannot be vaccinated for medical reasons.\u003c/p>\n\u003cp>\"It's important to keep families informed of things their child may be at risk of at their school,\" Pan, who is also a pediatrician, said.\u003c/p>\n\u003cp>In addition, Pan said he wants to look at tightening the personal belief exemption. Only \u003ca title=\"http://www.vaccinesafety.edu/cc-exem.htm\" href=\"http://www.vaccinesafety.edu/cc-exem.htm\" target=\"_blank\">a minority of states\u003c/a> allow a personal belief exemption. \"Many other states have much stricter rules,\" Pan told me. \"There are \u003ca title=\"http://www.vaccinesafety.edu/cc-exem.htm\" href=\"http://www.vaccinesafety.edu/cc-exem.htm\" target=\"_blank\">many states \u003c/a>where you can only get exempted if you have a medical reason, or you can demonstrate a strong religious reason.\"\u003c/p>\n\u003cp>New York is one such state, and Pan said he plans to see if that approach might be a \"more appropriate model\" for California.\u003c/p>\n\u003cp>\"We need to look at what we need to do here in California,\" he said. \"We certainly understand people have different beliefs, but we also need children to be safe in their schools.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Krawitt, who has worried about the PBE rate in Marin and more broadly, was enthusiastic to hear of Pan's ideas. He said he and his wife would like to see a bill, but \"we would likely endorse it.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Considers Raising Smoking Age to 21",
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"content": "\u003cfigure id=\"attachment_5650\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/NoSmokingSign_DaveWhelan_Flickr_05072012.jpg\">\u003cimg class=\"wp-image-5650\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/NoSmokingSign_DaveWhelan_Flickr_05072012-620x443.jpg\" alt=\"Ninety percent of current smokers tried their first cigarette before turning 18. (Dave Whelan/Flickr)\" width=\"640\" height=\"458\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Ninety percent of current smokers tried their first cigarette before turning 18. (Dave Whelan/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>State lawmakers want to raise the legal smoking age in California from 18 to 21, arguing the change would reduce smoking rates overall and lower health care costs associated with tobacco use.\u003c/p>\n\u003cp>State Sen. Ed Hernandez (D-West Covina) introduced Senate Bill 151 on Thursday, saying the new legislation would increase protection for kids under 18 as well.\u003c/p>\n\u003cp>“It is much easier for someone who is 17 to get cigarettes from a friend who is 18,” he said. “Someone who is 21 is more likely to be in the workforce or in college, and unlikely to have a younger set of friends.”\u003c/p>\n\u003cp>Studies show that 90 percent of current smokers tried their first cigarette before turning 18. About 95 percent tried smoking before age 21.\u003c!--more-->\u003c/p>\n\u003cp>“The ages between 18 to 21 are such a critical period because that’s when a lot of smokers move from that experimental smoking period to being regular, daily smokers,” said Lindsey Freitas, senior director at the American Lung Association in California.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If passed, California would be the first state in the country to raise the minimum smoking age to 21. New York City and Healdsburg (Sonoma County) have done so on the municipal level.\u003c/p>\n\u003cp>Several states rejected similar proposals last year, including Utah, Maryland and Colorado.\u003c/p>\n\u003cp>Rep. Daniel Kagan opposed a bill in Colorado, saying 18-year-olds are adults who should be persuaded not to smoke, not banned from smoking.\u003c/p>\n\u003cp>“Do we tell them, you may not do this, we’re going to stop them? Or do we urge them to take responsibility for their actions and treat them like adults?” the Democrat said at the time. \"I come down on the side of treating 18-to-20-year-olds like adults.”\u003c/p>\n\u003cp>Altria Group Inc, an umbrella company that includes tobacco brands like Philip Morris, Marlboro, Parliament and Virginia Slims, did not respond to a request for comment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The company has opposed past state efforts to raise the minimum smoking age beyond 18, and urged waiting until the results become available from a study by the Food and Drug Administration on the public health implications of raising the smoking age. The findings are due to Congress this year.\u003c/p>\n\n",
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"excerpt": "Passage of bill would make state first in the country to adopt this kind of approach. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_5650\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/NoSmokingSign_DaveWhelan_Flickr_05072012.jpg\">\u003cimg class=\"wp-image-5650\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/05/NoSmokingSign_DaveWhelan_Flickr_05072012-620x443.jpg\" alt=\"Ninety percent of current smokers tried their first cigarette before turning 18. (Dave Whelan/Flickr)\" width=\"640\" height=\"458\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Ninety percent of current smokers tried their first cigarette before turning 18. (Dave Whelan/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>State lawmakers want to raise the legal smoking age in California from 18 to 21, arguing the change would reduce smoking rates overall and lower health care costs associated with tobacco use.\u003c/p>\n\u003cp>State Sen. Ed Hernandez (D-West Covina) introduced Senate Bill 151 on Thursday, saying the new legislation would increase protection for kids under 18 as well.\u003c/p>\n\u003cp>“It is much easier for someone who is 17 to get cigarettes from a friend who is 18,” he said. “Someone who is 21 is more likely to be in the workforce or in college, and unlikely to have a younger set of friends.”\u003c/p>\n\u003cp>Studies show that 90 percent of current smokers tried their first cigarette before turning 18. About 95 percent tried smoking before age 21.\u003c!--more-->\u003c/p>\n\u003cp>“The ages between 18 to 21 are such a critical period because that’s when a lot of smokers move from that experimental smoking period to being regular, daily smokers,” said Lindsey Freitas, senior director at the American Lung Association in California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If passed, California would be the first state in the country to raise the minimum smoking age to 21. New York City and Healdsburg (Sonoma County) have done so on the municipal level.\u003c/p>\n\u003cp>Several states rejected similar proposals last year, including Utah, Maryland and Colorado.\u003c/p>\n\u003cp>Rep. Daniel Kagan opposed a bill in Colorado, saying 18-year-olds are adults who should be persuaded not to smoke, not banned from smoking.\u003c/p>\n\u003cp>“Do we tell them, you may not do this, we’re going to stop them? Or do we urge them to take responsibility for their actions and treat them like adults?” the Democrat said at the time. \"I come down on the side of treating 18-to-20-year-olds like adults.”\u003c/p>\n\u003cp>Altria Group Inc, an umbrella company that includes tobacco brands like Philip Morris, Marlboro, Parliament and Virginia Slims, did not respond to a request for comment.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The company has opposed past state efforts to raise the minimum smoking age beyond 18, and urged waiting until the results become available from a study by the Food and Drug Administration on the public health implications of raising the smoking age. The findings are due to Congress this year.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Call the Midwife: A Home Birth Story",
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"content": "\u003cfigure id=\"attachment_23671\" class=\"wp-caption aligncenter\" style=\"max-width: 632px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png\">\u003cimg class=\"size-full wp-image-23671\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png\" alt=\"The author's wife, Pippa, and their daughter, Caitlin, who was born at home, in 1982. (Courtesy: Nick Allen)\" width=\"632\" height=\"568\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png 632w, https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM-400x359.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM-320x288.png 320w\" sizes=\"(max-width: 632px) 100vw, 632px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The author's wife, Pippa, and their daughter, Caitlin, who was born at home, in 1982. (Courtesy: Nick Allen)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Stephen Talbot\u003c/strong>\u003c/p>\n\u003cp>My wife, Pippa, gave birth like a giraffe, standing up.\u003c/p>\n\u003cp>I was astonished. This wasn’t quite the nativity scene I’d imagined. Then again, I should not have been too shocked. Pippa grew up in South Africa, she’s very keen on giraffes, and she likes doing things unconventionally.\u003c/p>\n\u003cp>I should also mention that this was happening at home, in our bedroom, in the middle of the night, and that no one else was around. Except for our two-year-old son asleep in another room.\u003c/p>\n\u003cp>Not to worry. Women have been giving birth in their homes, in their own fashion, for centuries, right? Well, actually, not so much these days, at least not in this country. A mere \u003ca title=\"http://www.cdc.gov/nchs/data/databriefs/db144.htm\" href=\"http://www.cdc.gov/nchs/data/databriefs/db144.htm\" target=\"_blank\">1.36 percent of births in the United States\u003c/a> in 2012 took place outside a hospital.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But this was 1982; we lived in a more freewheeling San Francisco, and home births with midwives were not so rare. In fact, our son Dashiell had been born in the very same bedroom, in then funky Bernal Heights, ushered into the world by his mother and a full cast of attendants. Led by a very experienced (if unlicensed) midwife, the birth team included her assistant, her back-up doctor complete with a traveling medical kit and oxygen tank, and three other doctors, all women, who happened to be relatives or close friends. I even had a bit role as a labor coach. There was little need for this full entourage, but it was reassuring.\u003c/p>\n\u003cp>Dash was three weeks past his due date — these days two weeks is the usual maximum before labor is induced. But Pippa had been intent on a home delivery and at the last possible moment, after a spicy dinner and some strong tea, she went into labor. With the midwife’s expert help, all went well. In just under three hours, from start to finish, our son slid into the world in that small room full of people.\u003c/p>\n\u003cp>This time, however, the room was empty, except for Pippa, me and our rapidly approaching second child. My only reassuring thought was that I’d been through this before, and I hadn’t passed out.\u003c/p>\n\u003cp>Frankly, I would have opted for a hospital delivery, but I wasn’t the one having the baby.\u003c/p>\n\u003cp>Pippa had been born at home in Johannesburg, and in those days, especially for a privileged family, the doctor came to you. Even though Pippa was a social worker in a San Francisco medical clinic, she still preferred to avoid hospitals unless absolutely necessary. For a pregnant American, this attitude was considered rebellious, even ill-advised. And the U.S. medical establishment still discourages home birth.\u003c/p>\n\u003cp>But the British national health service \u003ca title=\"http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html\" href=\"http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html\" target=\"_blank\">now agrees\u003c/a> with Pippa, declaring late last year that it’s safer in the UK for healthy women with uncomplicated pregnancies to give birth at home or in a birthing clinic than in a hospital. Naturally, “\u003ca title=\"http://www.kqed.org/tv/programs/archive/index.jsp?pgmid=20957\" href=\"http://www.kqed.org/tv/programs/archive/index.jsp?pgmid=20957\" target=\"_blank\">Call the Midwife\u003c/a>” on KQED is one of Pippa’s favorite British import shows.\u003c/p>\n\u003cp>For this second pregnancy, Pippa had chosen a team of licensed midwives affiliated with a local San Francisco hospital.\u003c/p>\n\u003cp>When her first labor cramps woke her around midnight, she promptly called the midwife on duty. They timed the contractions over the phone. The midwife advised her to take a warm bath to slow down the labor and give her a call later.\u003c/p>\n\u003cp>Pippa drew the bath and I started vacuuming. It’s a habit I picked up from my mother. She vacuumed with great vigor before any major event at home. It’s the one household chore I’ve never minded. It's something about operating machinery and making myself useful. Very appealing.\u003c/p>\n\u003cp>But before I could finish the carpeting in our living room, Pippa emerged — starkers — from the bath, saying, “Bloody hell, this baby won’t wait.” Wrapping herself in a robe, grabbing the phone, she notified the midwife, “This is it, ready or not.”\u003c/p>\n\u003cp>I was not feeling quite so ready myself. The midwife was now on her way, but she lived in Marin County, north of the Golden Gate Bridge. She wouldn't be here anytime soon. I encouraged Pippa to relax. But as the contractions came stronger and faster, relaxation was not much of an option. With mounting anxiety, I called the nearest doctor I could think of, our friend Kathy, who lived in our neighborhood. She’s a gerontologist, but at that moment I was not particularly picky.\u003c/p>\n\u003cp>Pippa began pacing, insisting that our child’s arrival was imminent. I implored her to hold back. She informed me this was no longer possible. A brief “I Love Lucy” scene ensued in which I kept yelling, “Not yet!” and Pippa kept moaning, “Yes, now.” Then she pressed her hands against the wall and pushed and I saw the undeniable validity of her argument. Our child’s head was emerging.\u003c/p>\n\u003cp>In a flash, she was born. I had just enough sense to reach over and let her slide out into my hands. It was a basket catch, Willie Mays-style. She was slippery, and she was blue. Wrong color, I thought. I stuck my finger in her little mouth, she gagged, coughed, and instantly turned a proper pink. I was euphoric with relief.\u003c/p>\n\u003cp>The doorbell rang. I handed our gurgling baby to her joyous, exhausted mother, and raced downstairs to admit a breathless Kathy. Upstairs, she quickly ascertained that everyone was alive and breathing and apparently healthy. She started to ask how this happened, but I interrupted to ask, “Aren’t we supposed to cut the umbilical cord?”\u003c/p>\n\u003cp>Scissors were promptly sterilized in boiling water; the deed was done.\u003c/p>\n\u003cp>The next hour or so passed in a daze, but we were all smiling now, temporarily delirious, as this newborn child, Caitlin, began to nurse. By dawn the house was full of relatives and friends, including the midwife who, apologizing for her late arrival, made certain all was well. It had been chaotic, but successful. A delivery in less than an hour. Mother and daughter doing fine.\u003c/p>\n\u003cp>When he awoke, our son Dash walked out of his room, saw all the people, yawned, and wondered aloud, “What’s happening?”\u003c/p>\n\u003cp>“You have a baby sister,” I said, “born right here at home.” And he wandered into our bedroom to see for himself.\u003c/p>\n\u003cp>Caitlin was not the only baby born at home in San Francisco that year. But over time, Pippa and I noticed that home births were going out of fashion. Our own son and his wife chose to have their first baby last year in a hospital in Santa Monica, where they were very happy with the way things went. Deliveries at home or in birthing clinics aren’t for everyone.\u003c/p>\n\u003cp>But now, 30 years after the home birth of my daughter, and after much debate over the soaring frequency of hospital C-sections, I wonder if this \u003ca title=\"http://www.nice.org.uk/guidance/CG190\" href=\"http://www.nice.org.uk/guidance/CG190\" target=\"_blank\">new endorsement by British medical authorities\u003c/a> of non-hospital births will lead to a resurgence in midwifery, even in the U.S.\u003c/p>\n\u003cp>My advice to prospective parents? Hospital or not, just in case, be prepared to handle that delivery yourselves.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Stephen Talbot was a staff reporter and producer at KQED from 1980-89. He has written and produced over 40 documentaries for public television, including the PBS series FRONTLINE and his music show, SOUND TRACKS. He’s a proud new grandfather.\u003c/em>\u003c/p>\n\n",
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"excerpt": "My wife, Pippa, gave birth like a giraffe, standing up. I should also mention that this was happening at home.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23671\" class=\"wp-caption aligncenter\" style=\"max-width: 632px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png\">\u003cimg class=\"size-full wp-image-23671\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png\" alt=\"The author's wife, Pippa, and their daughter, Caitlin, who was born at home, in 1982. (Courtesy: Nick Allen)\" width=\"632\" height=\"568\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM.png 632w, https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM-400x359.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/01/Screen-Shot-2015-01-27-at-5.09.55-PM-320x288.png 320w\" sizes=\"(max-width: 632px) 100vw, 632px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The author's wife, Pippa, and their daughter, Caitlin, who was born at home, in 1982. (Courtesy: Nick Allen)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Stephen Talbot\u003c/strong>\u003c/p>\n\u003cp>My wife, Pippa, gave birth like a giraffe, standing up.\u003c/p>\n\u003cp>I was astonished. This wasn’t quite the nativity scene I’d imagined. Then again, I should not have been too shocked. Pippa grew up in South Africa, she’s very keen on giraffes, and she likes doing things unconventionally.\u003c/p>\n\u003cp>I should also mention that this was happening at home, in our bedroom, in the middle of the night, and that no one else was around. Except for our two-year-old son asleep in another room.\u003c/p>\n\u003cp>Not to worry. Women have been giving birth in their homes, in their own fashion, for centuries, right? Well, actually, not so much these days, at least not in this country. A mere \u003ca title=\"http://www.cdc.gov/nchs/data/databriefs/db144.htm\" href=\"http://www.cdc.gov/nchs/data/databriefs/db144.htm\" target=\"_blank\">1.36 percent of births in the United States\u003c/a> in 2012 took place outside a hospital.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But this was 1982; we lived in a more freewheeling San Francisco, and home births with midwives were not so rare. In fact, our son Dashiell had been born in the very same bedroom, in then funky Bernal Heights, ushered into the world by his mother and a full cast of attendants. Led by a very experienced (if unlicensed) midwife, the birth team included her assistant, her back-up doctor complete with a traveling medical kit and oxygen tank, and three other doctors, all women, who happened to be relatives or close friends. I even had a bit role as a labor coach. There was little need for this full entourage, but it was reassuring.\u003c/p>\n\u003cp>Dash was three weeks past his due date — these days two weeks is the usual maximum before labor is induced. But Pippa had been intent on a home delivery and at the last possible moment, after a spicy dinner and some strong tea, she went into labor. With the midwife’s expert help, all went well. In just under three hours, from start to finish, our son slid into the world in that small room full of people.\u003c/p>\n\u003cp>This time, however, the room was empty, except for Pippa, me and our rapidly approaching second child. My only reassuring thought was that I’d been through this before, and I hadn’t passed out.\u003c/p>\n\u003cp>Frankly, I would have opted for a hospital delivery, but I wasn’t the one having the baby.\u003c/p>\n\u003cp>Pippa had been born at home in Johannesburg, and in those days, especially for a privileged family, the doctor came to you. Even though Pippa was a social worker in a San Francisco medical clinic, she still preferred to avoid hospitals unless absolutely necessary. For a pregnant American, this attitude was considered rebellious, even ill-advised. And the U.S. medical establishment still discourages home birth.\u003c/p>\n\u003cp>But the British national health service \u003ca title=\"http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html\" href=\"http://www.nytimes.com/2014/12/04/world/british-regulator-urges-home-births-over-hospitals-for-uncomplicated-pregnancies.html\" target=\"_blank\">now agrees\u003c/a> with Pippa, declaring late last year that it’s safer in the UK for healthy women with uncomplicated pregnancies to give birth at home or in a birthing clinic than in a hospital. Naturally, “\u003ca title=\"http://www.kqed.org/tv/programs/archive/index.jsp?pgmid=20957\" href=\"http://www.kqed.org/tv/programs/archive/index.jsp?pgmid=20957\" target=\"_blank\">Call the Midwife\u003c/a>” on KQED is one of Pippa’s favorite British import shows.\u003c/p>\n\u003cp>For this second pregnancy, Pippa had chosen a team of licensed midwives affiliated with a local San Francisco hospital.\u003c/p>\n\u003cp>When her first labor cramps woke her around midnight, she promptly called the midwife on duty. They timed the contractions over the phone. The midwife advised her to take a warm bath to slow down the labor and give her a call later.\u003c/p>\n\u003cp>Pippa drew the bath and I started vacuuming. It’s a habit I picked up from my mother. She vacuumed with great vigor before any major event at home. It’s the one household chore I’ve never minded. It's something about operating machinery and making myself useful. Very appealing.\u003c/p>\n\u003cp>But before I could finish the carpeting in our living room, Pippa emerged — starkers — from the bath, saying, “Bloody hell, this baby won’t wait.” Wrapping herself in a robe, grabbing the phone, she notified the midwife, “This is it, ready or not.”\u003c/p>\n\u003cp>I was not feeling quite so ready myself. The midwife was now on her way, but she lived in Marin County, north of the Golden Gate Bridge. She wouldn't be here anytime soon. I encouraged Pippa to relax. But as the contractions came stronger and faster, relaxation was not much of an option. With mounting anxiety, I called the nearest doctor I could think of, our friend Kathy, who lived in our neighborhood. She’s a gerontologist, but at that moment I was not particularly picky.\u003c/p>\n\u003cp>Pippa began pacing, insisting that our child’s arrival was imminent. I implored her to hold back. She informed me this was no longer possible. A brief “I Love Lucy” scene ensued in which I kept yelling, “Not yet!” and Pippa kept moaning, “Yes, now.” Then she pressed her hands against the wall and pushed and I saw the undeniable validity of her argument. Our child’s head was emerging.\u003c/p>\n\u003cp>In a flash, she was born. I had just enough sense to reach over and let her slide out into my hands. It was a basket catch, Willie Mays-style. She was slippery, and she was blue. Wrong color, I thought. I stuck my finger in her little mouth, she gagged, coughed, and instantly turned a proper pink. I was euphoric with relief.\u003c/p>\n\u003cp>The doorbell rang. I handed our gurgling baby to her joyous, exhausted mother, and raced downstairs to admit a breathless Kathy. Upstairs, she quickly ascertained that everyone was alive and breathing and apparently healthy. She started to ask how this happened, but I interrupted to ask, “Aren’t we supposed to cut the umbilical cord?”\u003c/p>\n\u003cp>Scissors were promptly sterilized in boiling water; the deed was done.\u003c/p>\n\u003cp>The next hour or so passed in a daze, but we were all smiling now, temporarily delirious, as this newborn child, Caitlin, began to nurse. By dawn the house was full of relatives and friends, including the midwife who, apologizing for her late arrival, made certain all was well. It had been chaotic, but successful. A delivery in less than an hour. Mother and daughter doing fine.\u003c/p>\n\u003cp>When he awoke, our son Dash walked out of his room, saw all the people, yawned, and wondered aloud, “What’s happening?”\u003c/p>\n\u003cp>“You have a baby sister,” I said, “born right here at home.” And he wandered into our bedroom to see for himself.\u003c/p>\n\u003cp>Caitlin was not the only baby born at home in San Francisco that year. But over time, Pippa and I noticed that home births were going out of fashion. Our own son and his wife chose to have their first baby last year in a hospital in Santa Monica, where they were very happy with the way things went. Deliveries at home or in birthing clinics aren’t for everyone.\u003c/p>\n\u003cp>But now, 30 years after the home birth of my daughter, and after much debate over the soaring frequency of hospital C-sections, I wonder if this \u003ca title=\"http://www.nice.org.uk/guidance/CG190\" href=\"http://www.nice.org.uk/guidance/CG190\" target=\"_blank\">new endorsement by British medical authorities\u003c/a> of non-hospital births will lead to a resurgence in midwifery, even in the U.S.\u003c/p>\n\u003cp>My advice to prospective parents? Hospital or not, just in case, be prepared to handle that delivery yourselves.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Not Vaccinated? 'Stay Home from School,' Says Marin Dad of Leukemia Patient",
"title": "Not Vaccinated? 'Stay Home from School,' Says Marin Dad of Leukemia Patient",
"headTitle": "Vital Signs | State of Health | KQED News",
"content": "\u003cp>Carl Krawitt has watched his son, Rhett, now 6, fight leukemia for the last 4½ years. For more than three of those years, Rhett has undergone round after round of chemotherapy. Last year, he finished chemotherapy, and doctors say he is in remission.\u003c/p>\n\u003caside class=\"pullquote alignright\">Do you want to help the family of a child with cancer? Make sure your own children are vaccinated, doctor says.\u003c/aside>\n\u003cp>Now, there's a new threat: measles. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">An outbreak tied to Disneyland has grown from 9\u003c/a> to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/21/state-measles-cases-now-at-59-expect-more-2/\" target=\"_blank\">73 cases \u003c/a>in just two and a half weeks. Public health officials fear it will spread further.\u003c/p>\n\u003cp>Rhett cannot be vaccinated, because his immune system is still rebuilding. It may be months more before his body is healthy enough to get all his immunizations. Until then, he depends on everyone around him for protection -- or what's known as \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>.\u003c/p>\n\u003cp>But Rhett lives in Marin, a county with the \u003ca title=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">dubious honor of having the highest rate of \"personal belief exemptions\"\u003c/a> (PBE) in the Bay Area and among the highest in the state. This school year, 6.45 percent of Marin's kindergarteners have a PBE, which allows parents to lawfully send their children to school unvaccinated against communicable diseases like measles, polio, whooping cough and more. The statewide average is 2.50 percent.\u003c!--more-->\u003c/p>\n\u003cp>Carl Krawitt has just about had enough. \"It's very emotional for me,\" he said. \"If you choose not to immunize your own child and your own child dies because they get measles, OK, that's your responsibility, that's your choice. But if your child gets sick and gets my child sick and my child dies, then … your action has harmed my child.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Krawitt is taking action of his own. His son attends Reed Elementary in Tiburon, a school with a 7 percent PBE rate, nearly triple the statewide average. Krawitt had previously worked with the school nurse to make sure that all the children in his son's class were fully vaccinated. He said the school was very helpful and accommodating.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\">\u003cimg class=\"alignright size-full wp-image-23583\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/lookup.jpg\" alt=\"lookup\" width=\"300\" height=\"151\">\u003c/a>Now Krawitt and his wife, Jodi, have emailed the district's superintendent, requesting that the district \"require immunization as a condition of attendance, with the only exception being those who cannot medically be vaccinated.\"\u003c/p>\n\u003cp>Carl Krawitt provided me with Superintendent Steven Herzog's response. Herzog didn't directly address their query, instead saying: \"\u003cspan class=\"Apple-style-span\">We are monitoring the situation closely and will take whatever actions necessary to ensure the safety of our students.\"\u003c/span>\u003c/p>\n\u003cp>Typically, response to health emergencies rests with county health officers. During the current measles outbreak, we've already seen that unvaccinated students at Huntington Beach High School in Orange County \u003ca title=\"http://www.latimes.com/local/lanow/la-me-ln-students-exposed-to-measles-oc-20150120-story.html\" href=\"http://www.latimes.com/local/lanow/la-me-ln-students-exposed-to-measles-oc-20150120-story.html\" target=\"_blank\">were ordered to stay \u003c/a>out of school for three weeks after a student there contracted measles. It's a way to contain an outbreak.\u003c/p>\n\u003cp>But those steps were taken in the face a confirmed case at the school.\u003c/p>\n\u003cp>When I called Marin County health officer Matt Willis to see what he thought of keeping unvaccinated kids out of school even if there were no confirmed cases, he sounded intrigued. \"This is partly a legal question,\" he said.\u003c/p>\n\u003cp>But he was open to the idea and said he was going to check with the state to see what precedent there was to take such an action. Right now, there are no cases of measles anywhere in Marin and no suspected cases either. Still, \"if the outbreak progresses and we start seeing more and more cases,\" Willis said, \"then this is a step we might want to consider' -- requiring unvaccinated children to stay home, even without confirmed cases at a specific school.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/188229275\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Rhett has been treated at UCSF, and his oncologist there, Dr. Robert Goldsby, said that Rhett is likely at higher risk of complications if he were to get measles. \"When your immune system isn't working as well, it allows many different infections to be worse,\" he said. \"It's not just Rhett. There are hundreds of other kids in the Bay Area that are going through cancer therapy, and it's not fair to them. They can't get immunized, they have to rely on their friends and colleagues and community to help protect them.\"\u003c/p>\n\u003cfigure id=\"attachment_23648\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/pre-op-helping-doctors-12-6-10.jpg\">\u003cimg class=\"size-medium wp-image-23648\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/pre-op-helping-doctors-12-6-10-300x225.jpg\" alt=\"Rhett Krawitt, just weeks after starting chemotherapy, in 2010. (Courtesy: Carl Krawitt)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rhett Krawitt, just weeks after starting chemotherapy, in 2010. (Courtesy: Carl Krawitt)\u003c/figcaption>\u003c/figure>\n\u003cp>Goldsby pointed to the number of people who, when facing a friend or family member who receives a challenging diagnosis, will immediately ask how they can help. \"Many families will say, 'What can I do to help? What can I do to help?'\" he said, repeating it for emphasis. \"One of the main things they can do is make sure their [own] kids are vaccinated to protect others.\"\u003c/p>\n\u003cp>Krawitt has been speaking up about vaccination for a long time now. He told me about going to a parent meeting at his daughter's school just before the start of the school year, where a staff member reminded parents not to send peanut products to school, since a child or children had an allergy. \"It's really important your kids don't bring peanuts, because kids can die,\" Krawitt recalls the group being told.\u003c/p>\n\u003cp>The irony was not lost on him. He told me he immediately responded, \"In the interest of the health and safety of our children, can we have the assurance that all the kids at our school are immunized?\"\u003c/p>\n\u003cp>He found out later from a friend that other parents who were present were \"mad that you asked the question, because they don't immunize their kids.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>http://vimeo.com/118290318\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Carl Krawitt has watched his son, Rhett, now 6, fight leukemia for the last 4½ years. For more than three of those years, Rhett has undergone round after round of chemotherapy. Last year, he finished chemotherapy, and doctors say he is in remission.\u003c/p>\n\u003caside class=\"pullquote alignright\">Do you want to help the family of a child with cancer? Make sure your own children are vaccinated, doctor says.\u003c/aside>\n\u003cp>Now, there's a new threat: measles. \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">An outbreak tied to Disneyland has grown from 9\u003c/a> to \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/21/state-measles-cases-now-at-59-expect-more-2/\" target=\"_blank\">73 cases \u003c/a>in just two and a half weeks. Public health officials fear it will spread further.\u003c/p>\n\u003cp>Rhett cannot be vaccinated, because his immune system is still rebuilding. It may be months more before his body is healthy enough to get all his immunizations. Until then, he depends on everyone around him for protection -- or what's known as \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>.\u003c/p>\n\u003cp>But Rhett lives in Marin, a county with the \u003ca title=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" href=\"http://ww2.kqed.org/news/2013/08/21/marin-vaccinations/\" target=\"_blank\">dubious honor of having the highest rate of \"personal belief exemptions\"\u003c/a> (PBE) in the Bay Area and among the highest in the state. This school year, 6.45 percent of Marin's kindergarteners have a PBE, which allows parents to lawfully send their children to school unvaccinated against communicable diseases like measles, polio, whooping cough and more. The statewide average is 2.50 percent.\u003c!--more-->\u003c/p>\n\u003cp>Carl Krawitt has just about had enough. \"It's very emotional for me,\" he said. \"If you choose not to immunize your own child and your own child dies because they get measles, OK, that's your responsibility, that's your choice. But if your child gets sick and gets my child sick and my child dies, then … your action has harmed my child.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Krawitt is taking action of his own. His son attends Reed Elementary in Tiburon, a school with a 7 percent PBE rate, nearly triple the statewide average. Krawitt had previously worked with the school nurse to make sure that all the children in his son's class were fully vaccinated. He said the school was very helpful and accommodating.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\">\u003cimg class=\"alignright size-full wp-image-23583\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/lookup.jpg\" alt=\"lookup\" width=\"300\" height=\"151\">\u003c/a>Now Krawitt and his wife, Jodi, have emailed the district's superintendent, requesting that the district \"require immunization as a condition of attendance, with the only exception being those who cannot medically be vaccinated.\"\u003c/p>\n\u003cp>Carl Krawitt provided me with Superintendent Steven Herzog's response. Herzog didn't directly address their query, instead saying: \"\u003cspan class=\"Apple-style-span\">We are monitoring the situation closely and will take whatever actions necessary to ensure the safety of our students.\"\u003c/span>\u003c/p>\n\u003cp>Typically, response to health emergencies rests with county health officers. During the current measles outbreak, we've already seen that unvaccinated students at Huntington Beach High School in Orange County \u003ca title=\"http://www.latimes.com/local/lanow/la-me-ln-students-exposed-to-measles-oc-20150120-story.html\" href=\"http://www.latimes.com/local/lanow/la-me-ln-students-exposed-to-measles-oc-20150120-story.html\" target=\"_blank\">were ordered to stay \u003c/a>out of school for three weeks after a student there contracted measles. It's a way to contain an outbreak.\u003c/p>\n\u003cp>But those steps were taken in the face a confirmed case at the school.\u003c/p>\n\u003cp>When I called Marin County health officer Matt Willis to see what he thought of keeping unvaccinated kids out of school even if there were no confirmed cases, he sounded intrigued. \"This is partly a legal question,\" he said.\u003c/p>\n\u003cp>But he was open to the idea and said he was going to check with the state to see what precedent there was to take such an action. Right now, there are no cases of measles anywhere in Marin and no suspected cases either. Still, \"if the outbreak progresses and we start seeing more and more cases,\" Willis said, \"then this is a step we might want to consider' -- requiring unvaccinated children to stay home, even without confirmed cases at a specific school.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/188229275&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/188229275'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Rhett has been treated at UCSF, and his oncologist there, Dr. Robert Goldsby, said that Rhett is likely at higher risk of complications if he were to get measles. \"When your immune system isn't working as well, it allows many different infections to be worse,\" he said. \"It's not just Rhett. There are hundreds of other kids in the Bay Area that are going through cancer therapy, and it's not fair to them. They can't get immunized, they have to rely on their friends and colleagues and community to help protect them.\"\u003c/p>\n\u003cfigure id=\"attachment_23648\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/pre-op-helping-doctors-12-6-10.jpg\">\u003cimg class=\"size-medium wp-image-23648\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/pre-op-helping-doctors-12-6-10-300x225.jpg\" alt=\"Rhett Krawitt, just weeks after starting chemotherapy, in 2010. (Courtesy: Carl Krawitt)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rhett Krawitt, just weeks after starting chemotherapy, in 2010. (Courtesy: Carl Krawitt)\u003c/figcaption>\u003c/figure>\n\u003cp>Goldsby pointed to the number of people who, when facing a friend or family member who receives a challenging diagnosis, will immediately ask how they can help. \"Many families will say, 'What can I do to help? What can I do to help?'\" he said, repeating it for emphasis. \"One of the main things they can do is make sure their [own] kids are vaccinated to protect others.\"\u003c/p>\n\u003cp>Krawitt has been speaking up about vaccination for a long time now. He told me about going to a parent meeting at his daughter's school just before the start of the school year, where a staff member reminded parents not to send peanut products to school, since a child or children had an allergy. \"It's really important your kids don't bring peanuts, because kids can die,\" Krawitt recalls the group being told.\u003c/p>\n\u003cp>The irony was not lost on him. He told me he immediately responded, \"In the interest of the health and safety of our children, can we have the assurance that all the kids at our school are immunized?\"\u003c/p>\n\u003cp>He found out later from a friend that other parents who were present were \"mad that you asked the question, because they don't immunize their kids.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Amanda Stupi\u003c/strong>\u003c/p>\n\u003cp>An \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/21/state-measles-cases-now-at-59-expect-more-2/\" target=\"_blank\">outbreak of measles\u003c/a> and a \u003ca href=\"http://pediatrics.aappublications.org/gca?submit=Get+All+Checked+Abstracts&gca=pediatrics%3Bpeds.2014-2715v1\" target=\"_blank\">new report \u003c/a>that identified clusters of vaccine refusals in Northern California have become this week's hot topics. As such, KQED's daily talk show \u003ca href=\"http://www.kqed.org/a/forum/R201501230900\" target=\"_blank\">Forum\u003c/a> devoted an hour to the outbreak, and opened up the phones to listeners' questions. The result: the sharing of some very good information. Here are answers to five common questions:\u003c/p>\n\u003cp>\u003cstrong>1. Can people who have been vaccinated against the measles still get it? \u003c/strong>\u003c/p>\n\u003cp>Of the confirmed measles cases in California, at least five are people who were fully vaccinated. Experts aren't exactly sure why this is the case.\u003c/p>\n\u003cp>\"No vaccine is 100 percent effective,\" said Dr. Yvonne Maldonado, chief of the division of infectious diseases at Lucille Packard Children's Hospital. The measles vaccine comes close -- it protects 99 out of 100 people, but that's \"one percent of a lot of people,\" she said.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>2. What are the symptoms of measles?\u003c/strong>\u003c/p>\n\u003cp>Health care practitioners often refer to measles' symptoms as \"the three C's\": cough, coryza (runny nose) and conjunctivitis (red, watery eyes). High fever can also accompany these symptoms. After these symptoms are present, a rash appears on the face and spreads to the rest of the body.\u003c/p>\n\u003cp>Given how common coughs and runny noses are, measles can be tough to tell apart from other infections.\u003c/p>\n\u003cp>\"The child looks ill,\" said Maldonado. \"Some children can have these symptoms and not feel super sick, but these children are definitely not feeling well.\"\u003c/p>\n\u003cp>\u003cstrong>3. How is measles spread? \u003c/strong>\u003c/p>\n\u003cp>It is airborne in \"very, very small droplets,\" said Maldonado. How small? As small as 5 \u003ca href=\"http://www.ohiogt.com/pe/micron.html\" target=\"_blank\">microns\u003c/a>. These droplets can take as long as two hours to drop to the ground, meaning that a classroom or a doctor's exam room where an infected child visits can remain infectious for up to two hours after that child leaves the room.\u003c/p>\n\u003cp>People with measles are infectious starting four days before the rash starts -- during the time when they have cough and runny nose, similar to a cold -- and continuing for four days after it appears.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/187547647&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>4. Should I get a booster shot just to be safe?\u003c/strong>\u003c/p>\n\u003cp>If you are an adult and you know you did not have the second dose of the vaccine, Maldonado suggests getting a booster. If you are not sure about your vaccination history, your doctor can do a blood test to check your immunity levels. But what's easier is to go ahead and get the booster. Even if it turns out to be an extra shot, it won't hurt you.\u003c/p>\n\u003cp>Most people born before 1957 have probably had the disease and are immune to it.\u003c/p>\n\u003cp>Erica Pan, with the \u003ca href=\"http://www.acphd.org/\" target=\"_blank\">Alameda County of Public Health\u003c/a>, says that if you received your first vaccination shot between 1963 and 1967 you may want to talk to your doctor as there have been instances of \"breakthrough infections\" in adults who received their vaccines during that period.\u003c/p>\n\u003cp>\u003cstrong>5. The \u003ca href=\"http://www.cdc.gov/vaccines/vpd-vac/measles/faqs-dis-vac-risks.htm\" target=\"_blank\">CDC\u003c/a> recommends children get the first of two measles vaccines between 12-15 months of age. What if my child is less than a year old? Can we still vaccinate her?\u003c/strong>\u003c/p>\n\u003cp>In many countries with highter exposure rates children do get vaccinated as young as 3 to 6 months, but \"we know that the vaccine doesn't work that well at that age,\" Maldonaldo said. The optimal time for an immune response to the vaccine starts at 12 months of age.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The measles vaccine can be given to kids as young as six months if they will be travelling abroad or parents are concerned because of an outbreak. But because it is unclear how well the measles vaccine administered to young infants works over the long haul, Maldonado says that parents should follow up with the complete two dose vaccine after the child is 12 months old.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Amanda Stupi\u003c/strong>\u003c/p>\n\u003cp>An \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/21/state-measles-cases-now-at-59-expect-more-2/\" target=\"_blank\">outbreak of measles\u003c/a> and a \u003ca href=\"http://pediatrics.aappublications.org/gca?submit=Get+All+Checked+Abstracts&gca=pediatrics%3Bpeds.2014-2715v1\" target=\"_blank\">new report \u003c/a>that identified clusters of vaccine refusals in Northern California have become this week's hot topics. As such, KQED's daily talk show \u003ca href=\"http://www.kqed.org/a/forum/R201501230900\" target=\"_blank\">Forum\u003c/a> devoted an hour to the outbreak, and opened up the phones to listeners' questions. The result: the sharing of some very good information. Here are answers to five common questions:\u003c/p>\n\u003cp>\u003cstrong>1. Can people who have been vaccinated against the measles still get it? \u003c/strong>\u003c/p>\n\u003cp>Of the confirmed measles cases in California, at least five are people who were fully vaccinated. Experts aren't exactly sure why this is the case.\u003c/p>\n\u003cp>\"No vaccine is 100 percent effective,\" said Dr. Yvonne Maldonado, chief of the division of infectious diseases at Lucille Packard Children's Hospital. The measles vaccine comes close -- it protects 99 out of 100 people, but that's \"one percent of a lot of people,\" she said.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>2. What are the symptoms of measles?\u003c/strong>\u003c/p>\n\u003cp>Health care practitioners often refer to measles' symptoms as \"the three C's\": cough, coryza (runny nose) and conjunctivitis (red, watery eyes). High fever can also accompany these symptoms. After these symptoms are present, a rash appears on the face and spreads to the rest of the body.\u003c/p>\n\u003cp>Given how common coughs and runny noses are, measles can be tough to tell apart from other infections.\u003c/p>\n\u003cp>\"The child looks ill,\" said Maldonado. \"Some children can have these symptoms and not feel super sick, but these children are definitely not feeling well.\"\u003c/p>\n\u003cp>\u003cstrong>3. How is measles spread? \u003c/strong>\u003c/p>\n\u003cp>It is airborne in \"very, very small droplets,\" said Maldonado. How small? As small as 5 \u003ca href=\"http://www.ohiogt.com/pe/micron.html\" target=\"_blank\">microns\u003c/a>. These droplets can take as long as two hours to drop to the ground, meaning that a classroom or a doctor's exam room where an infected child visits can remain infectious for up to two hours after that child leaves the room.\u003c/p>\n\u003cp>People with measles are infectious starting four days before the rash starts -- during the time when they have cough and runny nose, similar to a cold -- and continuing for four days after it appears.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/187547647&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cstrong>4. Should I get a booster shot just to be safe?\u003c/strong>\u003c/p>\n\u003cp>If you are an adult and you know you did not have the second dose of the vaccine, Maldonado suggests getting a booster. If you are not sure about your vaccination history, your doctor can do a blood test to check your immunity levels. But what's easier is to go ahead and get the booster. Even if it turns out to be an extra shot, it won't hurt you.\u003c/p>\n\u003cp>Most people born before 1957 have probably had the disease and are immune to it.\u003c/p>\n\u003cp>Erica Pan, with the \u003ca href=\"http://www.acphd.org/\" target=\"_blank\">Alameda County of Public Health\u003c/a>, says that if you received your first vaccination shot between 1963 and 1967 you may want to talk to your doctor as there have been instances of \"breakthrough infections\" in adults who received their vaccines during that period.\u003c/p>\n\u003cp>\u003cstrong>5. The \u003ca href=\"http://www.cdc.gov/vaccines/vpd-vac/measles/faqs-dis-vac-risks.htm\" target=\"_blank\">CDC\u003c/a> recommends children get the first of two measles vaccines between 12-15 months of age. What if my child is less than a year old? Can we still vaccinate her?\u003c/strong>\u003c/p>\n\u003cp>In many countries with highter exposure rates children do get vaccinated as young as 3 to 6 months, but \"we know that the vaccine doesn't work that well at that age,\" Maldonaldo said. The optimal time for an immune response to the vaccine starts at 12 months of age.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The measles vaccine can be given to kids as young as six months if they will be travelling abroad or parents are concerned because of an outbreak. But because it is unclear how well the measles vaccine administered to young infants works over the long haul, Maldonado says that parents should follow up with the complete two dose vaccine after the child is 12 months old.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Judge Rules on Medi-Cal Backlog, Orders Timely Access to Benefits",
"title": "Judge Rules on Medi-Cal Backlog, Orders Timely Access to Benefits",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_2574\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-e1409248436930.jpg\">\u003cimg class=\"size-large wp-image-2574\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-620x411.jpg\" alt=\"(s_falkow: Flickr)\" width=\"620\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(s_falkow: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/1/judge-finally-rules-on-backlog-lawsuit-orders-state-to-adhere-to-45-day-deadline\" href=\"http://www.californiahealthline.org/capitol-desk/2015/1/judge-finally-rules-on-backlog-lawsuit-orders-state-to-adhere-to-45-day-deadline\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>On Thursday, an Alameda County Superior Court judge issued a \u003ca href=\"http://www.californiahealthline.org/~/media/Files/2015/PDFs/Jan%202015%20MediCal%20injunction.ashx\" target=\"_blank\">preliminary injunction\u003c/a> requiring the state to adhere to a 45-day limit for processing Medi-Cal applications.\u003c/p>\n\u003cp>The ruling by Judge Evelio Grillo was a victory for health care advocates in a lawsuit over the state's extensive backlog in processing Medi-Cal applications. The Medi-Cal expansion and the first open enrollment period for Covered California brought millions of applications to the door of the Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>Computer issues hampered the processing of many of those applications, and in March 2014 the backlog of unprocessed claims peaked at more than 900,000 applications. It took many months to clear the bulk of those applications. Some of them are still hanging fire almost a year later, said Jen Flory, senior attorney in the Sacramento office of the Western Center on Law and Poverty.\u003c!--more-->\u003c/p>\n\u003cp>\"They've been working on it, but it's not complete. There are large numbers of people they're still processing, and different counties are reporting different numbers,\" Flory said. \"From our perspective, anytime there's even one person where services are withheld, that's a problem. The number is down, but I would need to see the number zero.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>DHCS officials said the ruling simply reflects changes already made at the department, where recent applications have been processed within the 45-day limit.\u003c/p>\n\u003cp>\"That action, along with other extensive efforts undertaken throughout 2014, has virtually cleared the number of pending individuals, reducing it by more than 95 percent,\" department officials said in a written statement.\u003c/p>\n\u003cp>Doing the math from the peak of 900,000 unprocessed applications, that leaves roughly 45,000 applications still pending from 10 months ago.\u003c/p>\n\u003cp>That remaining backlog dismays Lucy Quacinella, founder of Multiforum Advocacy Solutions, a private legal firm in San Francisco. Quacinella was lead attorney in the lawsuit.\u003c/p>\n\u003cp>\"This ruling is very significant,\" Quacinella said. \"The state made some improvements that never would have happened without the lawsuit. We would absolutely be looking at a growing backlog right now.\"\u003c/p>\n\u003cp>Quacinella said the state now must clear those final pending applications.\u003c/p>\n\u003cp>\"The ruling requires the department to complete eligibility reviews and give a final decision,\" she said. \"And if the state is unable to do that, they have to grant preliminary eligibility to those who are likely eligible.\"\u003c/p>\n\u003cp>DHCS officials said that's happening right now.\u003c/p>\n\u003cp>\"DHCS is processing the remaining pending applicants this week,\" DHCS officials said in their written release, \"and once all needed verifications of information are complete, eligible individuals will be moved into coverage.\"\u003c/p>\n\u003cp>It has been a complicated and thorny problem, the statement said.\u003c/p>\n\u003cp>\"There are multiple factors affecting DHCS' ability to process individuals into coverage, including the need to receive documents from applicants to verify eligibility, as well as some technology issues,\" the statement said. \"Of the remaining pending applications, many are individuals who have not yet provided information needed to verify their eligibility, and many others are duplicate applications that will be removed from the system.\"\u003c/p>\n\u003cp>The second open enrollment period for Covered California started Nov. 15, 2014, and runs through Feb. 15. That effort impacts Medi-Cal, because many Covered California applicants, if they look like they might be eligible for Medi-Cal, are referred to DHCS. That big bump in Medi-Cal enrollment applications has gone smoothly this time around, DHCS officials said.\u003c/p>\n\u003cp>\"Importantly, improvements to our system have resulted in immediate enrollment for more than 80 percent \u003cspan>of new applicants found eligible for Medi-Cal,\" the DHCS statement said. \"We are committed to complying with any court orders and to further improving this process so that all individuals who qualify for coverage can be enrolled in Medi-Cal as quickly as possible.\"\u003c/span>\u003c/p>\n\u003cp>Advocates praised DHCS for that instant enrollment success.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Instant enrollment makes us all happy,\" Flory said. \"They have taken some steps to avoid the backlog, and that's something. They were voluntary steps. Now it's required.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_2574\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-e1409248436930.jpg\">\u003cimg class=\"size-large wp-image-2574\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/01/Gavel-20111114-620x411.jpg\" alt=\"(s_falkow: Flickr)\" width=\"620\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(s_falkow: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By David Gorn,\u003c/strong> \u003ca title=\"http://www.californiahealthline.org/capitol-desk/2015/1/judge-finally-rules-on-backlog-lawsuit-orders-state-to-adhere-to-45-day-deadline\" href=\"http://www.californiahealthline.org/capitol-desk/2015/1/judge-finally-rules-on-backlog-lawsuit-orders-state-to-adhere-to-45-day-deadline\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>On Thursday, an Alameda County Superior Court judge issued a \u003ca href=\"http://www.californiahealthline.org/~/media/Files/2015/PDFs/Jan%202015%20MediCal%20injunction.ashx\" target=\"_blank\">preliminary injunction\u003c/a> requiring the state to adhere to a 45-day limit for processing Medi-Cal applications.\u003c/p>\n\u003cp>The ruling by Judge Evelio Grillo was a victory for health care advocates in a lawsuit over the state's extensive backlog in processing Medi-Cal applications. The Medi-Cal expansion and the first open enrollment period for Covered California brought millions of applications to the door of the Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>Computer issues hampered the processing of many of those applications, and in March 2014 the backlog of unprocessed claims peaked at more than 900,000 applications. It took many months to clear the bulk of those applications. Some of them are still hanging fire almost a year later, said Jen Flory, senior attorney in the Sacramento office of the Western Center on Law and Poverty.\u003c!--more-->\u003c/p>\n\u003cp>\"They've been working on it, but it's not complete. There are large numbers of people they're still processing, and different counties are reporting different numbers,\" Flory said. \"From our perspective, anytime there's even one person where services are withheld, that's a problem. The number is down, but I would need to see the number zero.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>DHCS officials said the ruling simply reflects changes already made at the department, where recent applications have been processed within the 45-day limit.\u003c/p>\n\u003cp>\"That action, along with other extensive efforts undertaken throughout 2014, has virtually cleared the number of pending individuals, reducing it by more than 95 percent,\" department officials said in a written statement.\u003c/p>\n\u003cp>Doing the math from the peak of 900,000 unprocessed applications, that leaves roughly 45,000 applications still pending from 10 months ago.\u003c/p>\n\u003cp>That remaining backlog dismays Lucy Quacinella, founder of Multiforum Advocacy Solutions, a private legal firm in San Francisco. Quacinella was lead attorney in the lawsuit.\u003c/p>\n\u003cp>\"This ruling is very significant,\" Quacinella said. \"The state made some improvements that never would have happened without the lawsuit. We would absolutely be looking at a growing backlog right now.\"\u003c/p>\n\u003cp>Quacinella said the state now must clear those final pending applications.\u003c/p>\n\u003cp>\"The ruling requires the department to complete eligibility reviews and give a final decision,\" she said. \"And if the state is unable to do that, they have to grant preliminary eligibility to those who are likely eligible.\"\u003c/p>\n\u003cp>DHCS officials said that's happening right now.\u003c/p>\n\u003cp>\"DHCS is processing the remaining pending applicants this week,\" DHCS officials said in their written release, \"and once all needed verifications of information are complete, eligible individuals will be moved into coverage.\"\u003c/p>\n\u003cp>It has been a complicated and thorny problem, the statement said.\u003c/p>\n\u003cp>\"There are multiple factors affecting DHCS' ability to process individuals into coverage, including the need to receive documents from applicants to verify eligibility, as well as some technology issues,\" the statement said. \"Of the remaining pending applications, many are individuals who have not yet provided information needed to verify their eligibility, and many others are duplicate applications that will be removed from the system.\"\u003c/p>\n\u003cp>The second open enrollment period for Covered California started Nov. 15, 2014, and runs through Feb. 15. That effort impacts Medi-Cal, because many Covered California applicants, if they look like they might be eligible for Medi-Cal, are referred to DHCS. That big bump in Medi-Cal enrollment applications has gone smoothly this time around, DHCS officials said.\u003c/p>\n\u003cp>\"Importantly, improvements to our system have resulted in immediate enrollment for more than 80 percent \u003cspan>of new applicants found eligible for Medi-Cal,\" the DHCS statement said. \"We are committed to complying with any court orders and to further improving this process so that all individuals who qualify for coverage can be enrolled in Medi-Cal as quickly as possible.\"\u003c/span>\u003c/p>\n\u003cp>Advocates praised DHCS for that instant enrollment success.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Instant enrollment makes us all happy,\" Flory said. \"They have taken some steps to avoid the backlog, and that's something. They were voluntary steps. Now it's required.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "State Measles Cases Now at 73; Expect More",
"title": "State Measles Cases Now at 73; Expect More",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_23586\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/84933742-e1421892431232.jpg\">\u003cimg class=\"size-large wp-image-23586\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/84933742-640x426.jpg\" alt=\"Five Disney staff members are among California's cases. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Five Disneyland staff members are among California's cases. (David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update, Monday, 1/26:\u003c/strong> The California Department of Public Health (CDPH) \u003ca title=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" href=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" target=\"_blank\">said Monday that California now has 73\u003c/a> confirmed cases of measles.\u003c/p>\n\u003cp>\u003cstrong>Update, Friday, 1/23:\u003c/strong> The CDPH said Friday that 68 Californians have confirmed cases of measles.\u003c/p>\n\u003cp>\u003cstrong>Original post, Wed. 1/21:\u003c/strong>\u003c/p>\n\u003cp>State health officials report \u003ca title=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" href=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" target=\"_blank\">59 confirmed cases\u003c/a> of measles in nine counties. The patients range in age from 7 months to 70 years. The California Department of Public Health has linked 42 of these cases to people who visited Disneyland or Disney's California Adventure Park. Initially, cases were linked to people who visited the parks in mid-December, but there are more confirmed cases who visited the parks in January while infectious.\u003c/p>\n\u003cp>The outbreak has spread beyond California with seven cases in Utah, Washington, Colorado and Oregon. Mexico has also confirmed a case.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Vaccination status is known for 34 of the California patients. State officials say that 28 were not vaccinated at all, one was partially vaccinated and five were fully vaccinated. (Six of the unvaccinated were babies, too young to be vaccinated.)\u003c/p>\n\u003cp>\u003cstrong>\"Devastating Consequences\"\u003c/strong>\u003c/p>\n\u003cp>\"Measles is not a trivial illness,\" said state epidemiologist Dr. Gil Chavez. \"It can be very serious with devastating consequences.\" Those consequences include pneumonia, encephalitis, and even death. Before the measles vaccine was introduced in 1963, 500 people a year died of the disease nationwide. In the current outbreak, 25 percent of people with measles have been hospitalized.\u003c!--more-->\u003c/p>\n\u003cp>In 1989-1991, a measles epidemic swept California and other places around the U.S. There were 17,000 cases in California, and 70 people died. In Philadelphia, nine children died in just three months. \"The city was in a panic,\" Dr. Paul Offit of Children's Hospital of Philadelphia told me, \"I saw children die of measles dehydration … measles encephalitis, measles can kill you.\"\u003c/p>\n\u003cp>By county, the case numbers are as follows:\u003c/p>\n\u003cul>\n\u003cli>Alameda 5\u003c/li>\n\u003cli>L.A. County 12\u003c/li>\n\u003cli>Orange 20\u003c/li>\n\u003cli>Riverside 4\u003c/li>\n\u003cli>San Bernardino 3\u003c/li>\n\u003cli>San Diego 10\u003c/li>\n\u003cli>San Mateo 1\u003c/li>\n\u003cli>Santa Clara 1\u003c/li>\n\u003cli>Ventura 1\u003c/li>\n\u003c/ul>\n\u003cp>Chavez stressed that Disneyland was a safe place to go -- as long as you are vaccinated. \"If you are not vaccinated, stay away from Disneyland,\" he said. The problem is not with Disneyland itself, but any place where large numbers -- including people from foreign countries -- congregate. Chavez described Disneyland staff as being helpful and \"quite concerned\" about the outbreak. Five Disneyland staff members are among the 59 cases.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/187317626&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Measles was declared eliminated from the United States in 2000, but can still be reintroduced if someone from another country is infected and travels to the U.S. -- or an unvaccinated person in the U.S. travels abroad and brings the illness back.\u003c/p>\n\u003cp>Measles is a\u003ca title=\"http://www.cdc.gov/vaccines/vpd-vac/measles/faqs-dis-vac-risks.htm\" href=\"http://www.cdc.gov/vaccines/vpd-vac/measles/faqs-dis-vac-risks.htm\" target=\"_blank\"> highly infectious, airborne illness\u003c/a>. It starts off with fever as high as 105 degrees, followed by symptoms that resemble a cold -- a cough and runny nose. The hallmark of measles is a red rash that appears first on the face and upper neck, then spreads to the rest of the body. If someone with measles coughs or sneezes, droplets of virus can live on surfaces up to two hours.\u003c/p>\n\u003cp>On the press call with reporters Wednesday afternoon, Kathleen Harriman with the California Department of Public Health described published case reports of a person with measles at a basketball game -- and people across the court became infected, \"because the virus can float and hang out in the air for a long, long time,\" she said.\u003c/p>\n\u003cp>Dr. Chavez urged everyone who was not vaccinated to \u003ca title=\"http://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html\" href=\"http://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html\" target=\"_blank\">get immunized\u003c/a>. The first dose of vaccine, called MMR as it protects against measles, mumps and rubella, is given at 12-15 months of age. The second dose is given at age 4-6. Most people who get the vaccine do not experience side effects, but the \u003ca title=\"http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#mmr\" href=\"http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#mmr\" target=\"_blank\">most common ones \u003c/a>are fever and a mild rash.\u003c/p>\n\u003cp>If you were born before 1957, you are presumed to be immune to measles, because the disease was so widespread before the introduction of the vaccine. For years, only one dose was recommended, it protects 95 percent of people. The second dose was recommended starting in 1991. If you don't know your vaccine status, Harriman said you can safely get the MMR vaccine -- if it's an extra dose, it won't hurt you, she said.\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>Related:\u003c/strong> \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">Look Up Your School's Vaccine Opt-Out Rate Online\u003c/a>\u003c/p>\n\u003cp>Local health officers in counties affected are busy tracing those who infected patients have been in contact with. Dr. Erica Pan, deputy health officer of Alameda County, says the county has shifted resources from ebola preparedness to contact tracing for measles. Last year there were four cases of measles in Alameda County, she said, \"but we had 400 contacts to investigate.\"\u003c/p>\n\u003cp>The measles outbreak comes after years of increase of parents refusing vaccines for their children. From the 2007-2008 to 2013-2014 school years, the rate of kindergarten parents choosing the \"personal belief exemption\" to refuse vaccines doubled. While the statewide rate of personal belief exemptions reached 3.15 percent, geographic clusters had \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" target=\"_blank\">significantly higher opt-out rates\u003c/a>.\u003c/p>\n\u003cp>But that steady increase in vaccine refusals was halted with the current school year -- likely due to a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" target=\"_blank\">new state law\u003c/a>. This school year is the first when parents who chose to opt out needed to meet first with a health care provider to discuss vaccines and vaccine preventable illnesses. The goal is to dispel misinformation and fear of vaccines. The opt-out rate dropped from 3.15 to 2.54 percent, nearly a 20 percent decrease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That change in vaccine refusals may be too late for this outbreak, but state officials are nonetheless pleased. \"That may change the number of people opting not to vaccinate out of pure misinformation,\" Chavez said.\u003c/p>\n\n",
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"description": "Update, Monday, 1/26: The California Department of Public Health (CDPH) said Monday that California now has 73 confirmed cases of measles. Update, Friday, 1/23: The CDPH said Friday that 68 Californians have confirmed cases of measles. Original post, Wed. 1/21: State health officials report 59 confirmed cases of measles in nine counties. The patients range in age",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23586\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/84933742-e1421892431232.jpg\">\u003cimg class=\"size-large wp-image-23586\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/84933742-640x426.jpg\" alt=\"Five Disney staff members are among California's cases. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Five Disneyland staff members are among California's cases. (David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Update, Monday, 1/26:\u003c/strong> The California Department of Public Health (CDPH) \u003ca title=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" href=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" target=\"_blank\">said Monday that California now has 73\u003c/a> confirmed cases of measles.\u003c/p>\n\u003cp>\u003cstrong>Update, Friday, 1/23:\u003c/strong> The CDPH said Friday that 68 Californians have confirmed cases of measles.\u003c/p>\n\u003cp>\u003cstrong>Original post, Wed. 1/21:\u003c/strong>\u003c/p>\n\u003cp>State health officials report \u003ca title=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" href=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" target=\"_blank\">59 confirmed cases\u003c/a> of measles in nine counties. The patients range in age from 7 months to 70 years. The California Department of Public Health has linked 42 of these cases to people who visited Disneyland or Disney's California Adventure Park. Initially, cases were linked to people who visited the parks in mid-December, but there are more confirmed cases who visited the parks in January while infectious.\u003c/p>\n\u003cp>The outbreak has spread beyond California with seven cases in Utah, Washington, Colorado and Oregon. Mexico has also confirmed a case.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Vaccination status is known for 34 of the California patients. State officials say that 28 were not vaccinated at all, one was partially vaccinated and five were fully vaccinated. (Six of the unvaccinated were babies, too young to be vaccinated.)\u003c/p>\n\u003cp>\u003cstrong>\"Devastating Consequences\"\u003c/strong>\u003c/p>\n\u003cp>\"Measles is not a trivial illness,\" said state epidemiologist Dr. Gil Chavez. \"It can be very serious with devastating consequences.\" Those consequences include pneumonia, encephalitis, and even death. Before the measles vaccine was introduced in 1963, 500 people a year died of the disease nationwide. In the current outbreak, 25 percent of people with measles have been hospitalized.\u003c!--more-->\u003c/p>\n\u003cp>In 1989-1991, a measles epidemic swept California and other places around the U.S. There were 17,000 cases in California, and 70 people died. In Philadelphia, nine children died in just three months. \"The city was in a panic,\" Dr. Paul Offit of Children's Hospital of Philadelphia told me, \"I saw children die of measles dehydration … measles encephalitis, measles can kill you.\"\u003c/p>\n\u003cp>By county, the case numbers are as follows:\u003c/p>\n\u003cul>\n\u003cli>Alameda 5\u003c/li>\n\u003cli>L.A. County 12\u003c/li>\n\u003cli>Orange 20\u003c/li>\n\u003cli>Riverside 4\u003c/li>\n\u003cli>San Bernardino 3\u003c/li>\n\u003cli>San Diego 10\u003c/li>\n\u003cli>San Mateo 1\u003c/li>\n\u003cli>Santa Clara 1\u003c/li>\n\u003cli>Ventura 1\u003c/li>\n\u003c/ul>\n\u003cp>Chavez stressed that Disneyland was a safe place to go -- as long as you are vaccinated. \"If you are not vaccinated, stay away from Disneyland,\" he said. The problem is not with Disneyland itself, but any place where large numbers -- including people from foreign countries -- congregate. Chavez described Disneyland staff as being helpful and \"quite concerned\" about the outbreak. Five Disneyland staff members are among the 59 cases.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/187317626&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Measles was declared eliminated from the United States in 2000, but can still be reintroduced if someone from another country is infected and travels to the U.S. -- or an unvaccinated person in the U.S. travels abroad and brings the illness back.\u003c/p>\n\u003cp>Measles is a\u003ca title=\"http://www.cdc.gov/vaccines/vpd-vac/measles/faqs-dis-vac-risks.htm\" href=\"http://www.cdc.gov/vaccines/vpd-vac/measles/faqs-dis-vac-risks.htm\" target=\"_blank\"> highly infectious, airborne illness\u003c/a>. It starts off with fever as high as 105 degrees, followed by symptoms that resemble a cold -- a cough and runny nose. The hallmark of measles is a red rash that appears first on the face and upper neck, then spreads to the rest of the body. If someone with measles coughs or sneezes, droplets of virus can live on surfaces up to two hours.\u003c/p>\n\u003cp>On the press call with reporters Wednesday afternoon, Kathleen Harriman with the California Department of Public Health described published case reports of a person with measles at a basketball game -- and people across the court became infected, \"because the virus can float and hang out in the air for a long, long time,\" she said.\u003c/p>\n\u003cp>Dr. Chavez urged everyone who was not vaccinated to \u003ca title=\"http://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html\" href=\"http://www.cdc.gov/vaccines/hcp/vis/vis-statements/mmr.html\" target=\"_blank\">get immunized\u003c/a>. The first dose of vaccine, called MMR as it protects against measles, mumps and rubella, is given at 12-15 months of age. The second dose is given at age 4-6. Most people who get the vaccine do not experience side effects, but the \u003ca title=\"http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#mmr\" href=\"http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#mmr\" target=\"_blank\">most common ones \u003c/a>are fever and a mild rash.\u003c/p>\n\u003cp>If you were born before 1957, you are presumed to be immune to measles, because the disease was so widespread before the introduction of the vaccine. For years, only one dose was recommended, it protects 95 percent of people. The second dose was recommended starting in 1991. If you don't know your vaccine status, Harriman said you can safely get the MMR vaccine -- if it's an extra dose, it won't hurt you, she said.\u003c/p>\n\u003cp style=\"text-align: center\">\u003cstrong>Related:\u003c/strong> \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">Look Up Your School's Vaccine Opt-Out Rate Online\u003c/a>\u003c/p>\n\u003cp>Local health officers in counties affected are busy tracing those who infected patients have been in contact with. Dr. Erica Pan, deputy health officer of Alameda County, says the county has shifted resources from ebola preparedness to contact tracing for measles. Last year there were four cases of measles in Alameda County, she said, \"but we had 400 contacts to investigate.\"\u003c/p>\n\u003cp>The measles outbreak comes after years of increase of parents refusing vaccines for their children. From the 2007-2008 to 2013-2014 school years, the rate of kindergarten parents choosing the \"personal belief exemption\" to refuse vaccines doubled. While the statewide rate of personal belief exemptions reached 3.15 percent, geographic clusters had \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/18/bay-area-communities-are-home-to-clusters-of-people-refusing-vaccines/\" target=\"_blank\">significantly higher opt-out rates\u003c/a>.\u003c/p>\n\u003cp>But that steady increase in vaccine refusals was halted with the current school year -- likely due to a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/23/new-requirement-for-vaccine-exemption-passed-by-senate/\" target=\"_blank\">new state law\u003c/a>. This school year is the first when parents who chose to opt out needed to meet first with a health care provider to discuss vaccines and vaccine preventable illnesses. The goal is to dispel misinformation and fear of vaccines. The opt-out rate dropped from 3.15 to 2.54 percent, nearly a 20 percent decrease.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That change in vaccine refusals may be too late for this outbreak, but state officials are nonetheless pleased. \"That may change the number of people opting not to vaccinate out of pure misinformation,\" Chavez said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Bay Area Communities Are Home to Clusters of People Refusing Vaccines",
"title": "Bay Area Communities Are Home to Clusters of People Refusing Vaccines",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_23542\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/RS1529_76489007-lpr1-e1421641630337.jpg\">\u003cimg class=\"size-large wp-image-23542\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/RS1529_76489007-lpr1-640x411.jpg\" alt=\"(Jeff J. Mitchell/Getty Images)\" width=\"640\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jeff J. Mitchell/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Although vaccines are among the safest, most effective ways to protect children from major communicable diseases, many parents, for reasons that range from \u003ca href=\"http://www.sciencebasedmedicine.org/cashing-in-on-fear-the-danger-of-dr-sears/\" target=\"_blank\">ill-informed\u003c/a> to \u003ca href=\"http://www.nclnet.org/survey_one_third_of_american_parents_mistakenly_link_vaccines_to_autism\" target=\"_blank\">infuriating\u003c/a>, still doubt this. As a result, many choose immunization schedules that defy science or refuse to vaccinate altogether.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“These kinds of clusters can be associated with later epidemics.\"\u003c/aside>\n\u003cp>If these parents were distributed randomly, their decisions would be less likely to harm others, especially babies too young for vaccination. But as previous studies have shown, parents who use “\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22698009\" target=\"_blank\">personal belief exemptions\u003c/a>” to avoid school vaccination requirements often live in the same communities.\u003c/p>\n\u003cp>Now,\u003ca title=\"http://pediatrics.aappublications.org/gca?submit=Get+All+Checked+Abstracts&gca=pediatrics%3Bpeds.2014-2715v1\" href=\"http://pediatrics.aappublications.org/gca?submit=Get+All+Checked+Abstracts&gca=pediatrics%3Bpeds.2014-2715v1\" target=\"_blank\"> in a study \u003c/a>published Monday in the journal \u003cem>Pediatrics\u003c/em>, researchers have (perhaps not surprisingly) found the same phenomenon among parents of infants and toddlers. These younger children face the highest risk of dying from whooping cough and other vaccine-preventable diseases.\u003c/p>\n\u003cp>The study has come out as the state is grappling with a measles outbreak\u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/13/disneyland-measles-cases-now-at-26/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/13/disneyland-measles-cases-now-at-26/\" target=\"_blank\"> linked to people who visited Disneyland \u003c/a>in mid-December.\u003c!--more-->\u003c/p>\n\u003cp>Dr. Tracy Lieu, director of Kaiser's Division of Research, led the research team. They knew that places like Marin and Sonoma counties had higher rates of personal belief exemptions, she says. But those parents probably refused those vaccines some years ago, Lieu says. Her team hoped to spot clusters of refusal earlier, when recommended vaccines are due, so they could take steps to ward off outbreaks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Early warning signs\u003c/strong>\u003c/p>\n\u003cp>To look for at-risk communities, Lieu and her colleagues analyzed the medical records of 155,000 children in Kaiser's system who lived in 13 Northern California counties and were born between 2000 and 2011. They were looking both for children who had received no vaccines and for children who had been \"under-immunized,\" meaning they had missed one or more shots by age three.\u003c/p>\n\u003cp>Researchers then matched these children's vaccination records to their addresses, to see if these children were clustered geographically.\u003c/p>\n\u003cp>Across the 13 counties analyzed, the proportion of children who’d missed one or more shots increased from an average of 8 percent at the beginning of the study period to 12.4 percent at the end.\u003c/p>\n\u003cp>But that's a broad geographic range. When the researchers drilled down to the county level, they found pockets of even higher rates of under-immunization ranging from 9.2 percent in Santa Clara County to 17.9 percent in Marin County between 2010 and 2012.\u003c/p>\n\u003cp>Five hot spots stood out between 2010 and 2012, including a 1.8-mile area in Vallejo, where 22.7 percent of kids were under-vaccinated. More than 10,000 toddlers lived within these five clusters.\u003c/p>\n\u003cp>The team also identified five clusters where all vaccines were refused for the babies and toddlers in the study:\u003c/p>\n\u003cul>\n\u003cli>10.2 percent of kids in an area from El Cerrito to Alameda\u003c/li>\n\u003cli>7.4 percent in northeastern San Francisco\u003c/li>\n\u003cli>6.6 percent in Marin and southwest Sonoma counties\u003c/li>\n\u003cli>5.5 percent Northeastern Sacramento County and Roseville\u003c/li>\n\u003cli>13.5 percent of kids in a small area south of Sacramento\u003c/li>\n\u003c/ul>\n\u003cp>Altogether, nearly 9,000 young children lived in these clusters.\u003c/p>\n\u003cp>In nearly every case, vaccine-refusal clusters overlapped with large areas of under-immunization.\u003c/p>\n\u003cp>When Lieu’s group analyzed vaccination against specific diseases, they found that under-vaccination rates for the MMR vaccine – which protects against measles, mumps and rubella – were 1.69 times higher for children living in Marin and Sonoma counties compared with other areas.\u003c/p>\n\u003cp>“These are early signals,” says Lieu. “These kinds of clusters can be associated with later epidemics.”\u003c/p>\n\u003cp>\u003cstrong>Vaccination Refusal Helps Disease Spread\u003c/strong>\u003c/p>\n\u003cp>The Disneyland measles outbreak is a stark reminder that pathogens can gain a foothold where vulnerable people congregate. That’s why states require children to be fully vaccinated before entering kindergarten. The easier it is to opt out of these mandates, the \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=203593\" target=\"_blank\">more likely disease will follow\u003c/a>.\u003c/p>\n\u003cp>“Not surprisingly, areas that are under-immunized directly correlate with those areas at greatest risk of infections when they occur,” says Dr. Paul Offit, who directs the Vaccine Education Center at Children’s Hospital of Philadelphia and was not associated with the study. When enough people stop vaccinating, he says, measles and whooping cough, among the most contagious diseases, rapidly exploit holes in \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">community, or herd, immunity\u003c/a>.\u003c/p>\n\u003cp>Last year, when a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">record number of California parents\u003c/a> claimed personal belief exemptions, health officials reported the \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a6.htm?s_cid=mm6316a6_e\" target=\"_blank\">most measles cases\u003c/a> seen here since 1995 and the most \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis_Report_1-7-2015.pdf\" target=\"_blank\">whooping cough cases\u003c/a> since 1947.\u003c/p>\n\u003cp>Marin, Napa and Sonoma counties -- where Lieu and her team found under-immunization clusters ranging from 17.5 to 18.1 percent between 2010 and 2012 -- had the highest rates of whooping cough in the state in 2014. During the same time, a review of state immunization records shows, vaccination rates for whooping cough at nearly two-thirds of Marin schools, a third of Napa schools and 37 percent of Sonoma schools fell below targets to halt disease spread.\u003c/p>\n\u003cp>Prof. Saad Omer at Emory University earlier found that clusters of personal belief exemptions contributed to the 2010 California whooping cough epidemic that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">killed 10 babies.\u003c/a> Omer says that by using electronic medical records, Lieu and her team have developed a tool that can estimate risk earlier, without having to wait until children enter school.\u003c/p>\n\u003cp>The main problem with this clustering behavior, says Omer, is that every child’s risk for disease depends on what others do. That's because no vaccine is 100 percent effective, so even a vaccinated child could get sick if exposed. (In the Disneyland measles outbreak, at least four of the cases had been vaccinated.)\u003c/p>\n\u003cp>Children on chemo or who have other genuine medical reasons for exemption are particularly vulnerable when they interact with unvaccinated people, whether at school or places like Disneyland.\u003c/p>\n\u003cp>“I don’t know how many Make-a-Wish Foundation kids were (at Disneyland),\" Omer said in reference to the foundation that grants wishes to children with life-threatening illnesses. \"But parents of kids with all sorts of illnesses like to give them an opportunity to have fun like other kids. ... And they depend on \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>.”\u003c/p>\n\u003cp>\u003cstrong>Bad Decisions\u003c/strong>\u003c/p>\n\u003cp>Some parents think measles isn’t such a big risk, Offit says. And compared to the pre-vaccine days, he says, when every year millions of children got sick, 48,000 were hospitalized and 500 died, that’s true. But as a veteran of the \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/8483622\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/8483622\" target=\"_blank\">1991 Philadelphia measles\u003c/a> epidemic that infected 1,400 and killed nine children who weren’t immunized, Offit cautions that playing the odds is a dangerous game.\u003c/p>\n\u003cp>But creating rules that make that game safer is challenging in a society that cherishes individual rights. “We’re open-minded in the U.S.,” Offit says, “even to the point where we let parents hurt their children.”\u003c/p>\n\u003cp>But increasingly, pediatricians, including Offit’s wife, Bonnie, refuse to help parents do that.\u003c/p>\n\u003cp>The alternative is to sit back and let parents make bad decisions.\u003c/p>\n\u003cp>Not long ago, a one-and-a-half-year-old boy was admitted to Offit’s hospital. He’d been seen at the hospital’s outpatient clinic at two, four, six and 12 months -- all the times when kids get the pneumococcal vaccine. But his parents chose not to vaccinate and the staff didn’t push it, Offit says. “He came in with pneumococcal meningitis,\" and then suffered a devastating \u003ca title=\"http://www.nlm.nih.gov/medlineplus/ency/article/001421.htm\" href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001421.htm\" target=\"_blank\">brain herniation\u003c/a>, Offit said. \"He will never see, walk or speak again and probably won’t live past five. It’s not OK.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.lizagross.com/\">Liza Gross\u003c/a> is an independent science journalist based in the San Francisco Bay area who writes frequently about science and society.\u003c/em>\u003c/p>\n\n",
"disqusIdentifier": "23535 http://blogs.kqed.org/stateofhealth/?p=23535",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23542\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/RS1529_76489007-lpr1-e1421641630337.jpg\">\u003cimg class=\"size-large wp-image-23542\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/RS1529_76489007-lpr1-640x411.jpg\" alt=\"(Jeff J. Mitchell/Getty Images)\" width=\"640\" height=\"411\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Jeff J. Mitchell/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Although vaccines are among the safest, most effective ways to protect children from major communicable diseases, many parents, for reasons that range from \u003ca href=\"http://www.sciencebasedmedicine.org/cashing-in-on-fear-the-danger-of-dr-sears/\" target=\"_blank\">ill-informed\u003c/a> to \u003ca href=\"http://www.nclnet.org/survey_one_third_of_american_parents_mistakenly_link_vaccines_to_autism\" target=\"_blank\">infuriating\u003c/a>, still doubt this. As a result, many choose immunization schedules that defy science or refuse to vaccinate altogether.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“These kinds of clusters can be associated with later epidemics.\"\u003c/aside>\n\u003cp>If these parents were distributed randomly, their decisions would be less likely to harm others, especially babies too young for vaccination. But as previous studies have shown, parents who use “\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22698009\" target=\"_blank\">personal belief exemptions\u003c/a>” to avoid school vaccination requirements often live in the same communities.\u003c/p>\n\u003cp>Now,\u003ca title=\"http://pediatrics.aappublications.org/gca?submit=Get+All+Checked+Abstracts&gca=pediatrics%3Bpeds.2014-2715v1\" href=\"http://pediatrics.aappublications.org/gca?submit=Get+All+Checked+Abstracts&gca=pediatrics%3Bpeds.2014-2715v1\" target=\"_blank\"> in a study \u003c/a>published Monday in the journal \u003cem>Pediatrics\u003c/em>, researchers have (perhaps not surprisingly) found the same phenomenon among parents of infants and toddlers. These younger children face the highest risk of dying from whooping cough and other vaccine-preventable diseases.\u003c/p>\n\u003cp>The study has come out as the state is grappling with a measles outbreak\u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/13/disneyland-measles-cases-now-at-26/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/13/disneyland-measles-cases-now-at-26/\" target=\"_blank\"> linked to people who visited Disneyland \u003c/a>in mid-December.\u003c!--more-->\u003c/p>\n\u003cp>Dr. Tracy Lieu, director of Kaiser's Division of Research, led the research team. They knew that places like Marin and Sonoma counties had higher rates of personal belief exemptions, she says. But those parents probably refused those vaccines some years ago, Lieu says. Her team hoped to spot clusters of refusal earlier, when recommended vaccines are due, so they could take steps to ward off outbreaks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Early warning signs\u003c/strong>\u003c/p>\n\u003cp>To look for at-risk communities, Lieu and her colleagues analyzed the medical records of 155,000 children in Kaiser's system who lived in 13 Northern California counties and were born between 2000 and 2011. They were looking both for children who had received no vaccines and for children who had been \"under-immunized,\" meaning they had missed one or more shots by age three.\u003c/p>\n\u003cp>Researchers then matched these children's vaccination records to their addresses, to see if these children were clustered geographically.\u003c/p>\n\u003cp>Across the 13 counties analyzed, the proportion of children who’d missed one or more shots increased from an average of 8 percent at the beginning of the study period to 12.4 percent at the end.\u003c/p>\n\u003cp>But that's a broad geographic range. When the researchers drilled down to the county level, they found pockets of even higher rates of under-immunization ranging from 9.2 percent in Santa Clara County to 17.9 percent in Marin County between 2010 and 2012.\u003c/p>\n\u003cp>Five hot spots stood out between 2010 and 2012, including a 1.8-mile area in Vallejo, where 22.7 percent of kids were under-vaccinated. More than 10,000 toddlers lived within these five clusters.\u003c/p>\n\u003cp>The team also identified five clusters where all vaccines were refused for the babies and toddlers in the study:\u003c/p>\n\u003cul>\n\u003cli>10.2 percent of kids in an area from El Cerrito to Alameda\u003c/li>\n\u003cli>7.4 percent in northeastern San Francisco\u003c/li>\n\u003cli>6.6 percent in Marin and southwest Sonoma counties\u003c/li>\n\u003cli>5.5 percent Northeastern Sacramento County and Roseville\u003c/li>\n\u003cli>13.5 percent of kids in a small area south of Sacramento\u003c/li>\n\u003c/ul>\n\u003cp>Altogether, nearly 9,000 young children lived in these clusters.\u003c/p>\n\u003cp>In nearly every case, vaccine-refusal clusters overlapped with large areas of under-immunization.\u003c/p>\n\u003cp>When Lieu’s group analyzed vaccination against specific diseases, they found that under-vaccination rates for the MMR vaccine – which protects against measles, mumps and rubella – were 1.69 times higher for children living in Marin and Sonoma counties compared with other areas.\u003c/p>\n\u003cp>“These are early signals,” says Lieu. “These kinds of clusters can be associated with later epidemics.”\u003c/p>\n\u003cp>\u003cstrong>Vaccination Refusal Helps Disease Spread\u003c/strong>\u003c/p>\n\u003cp>The Disneyland measles outbreak is a stark reminder that pathogens can gain a foothold where vulnerable people congregate. That’s why states require children to be fully vaccinated before entering kindergarten. The easier it is to opt out of these mandates, the \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=203593\" target=\"_blank\">more likely disease will follow\u003c/a>.\u003c/p>\n\u003cp>“Not surprisingly, areas that are under-immunized directly correlate with those areas at greatest risk of infections when they occur,” says Dr. Paul Offit, who directs the Vaccine Education Center at Children’s Hospital of Philadelphia and was not associated with the study. When enough people stop vaccinating, he says, measles and whooping cough, among the most contagious diseases, rapidly exploit holes in \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">community, or herd, immunity\u003c/a>.\u003c/p>\n\u003cp>Last year, when a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/09/11/vaccine-opt-out-rate-doubled-in-7-years-look-up-your-school-online/\" target=\"_blank\">record number of California parents\u003c/a> claimed personal belief exemptions, health officials reported the \u003ca href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a6.htm?s_cid=mm6316a6_e\" target=\"_blank\">most measles cases\u003c/a> seen here since 1995 and the most \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis_Report_1-7-2015.pdf\" target=\"_blank\">whooping cough cases\u003c/a> since 1947.\u003c/p>\n\u003cp>Marin, Napa and Sonoma counties -- where Lieu and her team found under-immunization clusters ranging from 17.5 to 18.1 percent between 2010 and 2012 -- had the highest rates of whooping cough in the state in 2014. During the same time, a review of state immunization records shows, vaccination rates for whooping cough at nearly two-thirds of Marin schools, a third of Napa schools and 37 percent of Sonoma schools fell below targets to halt disease spread.\u003c/p>\n\u003cp>Prof. Saad Omer at Emory University earlier found that clusters of personal belief exemptions contributed to the 2010 California whooping cough epidemic that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">killed 10 babies.\u003c/a> Omer says that by using electronic medical records, Lieu and her team have developed a tool that can estimate risk earlier, without having to wait until children enter school.\u003c/p>\n\u003cp>The main problem with this clustering behavior, says Omer, is that every child’s risk for disease depends on what others do. That's because no vaccine is 100 percent effective, so even a vaccinated child could get sick if exposed. (In the Disneyland measles outbreak, at least four of the cases had been vaccinated.)\u003c/p>\n\u003cp>Children on chemo or who have other genuine medical reasons for exemption are particularly vulnerable when they interact with unvaccinated people, whether at school or places like Disneyland.\u003c/p>\n\u003cp>“I don’t know how many Make-a-Wish Foundation kids were (at Disneyland),\" Omer said in reference to the foundation that grants wishes to children with life-threatening illnesses. \"But parents of kids with all sorts of illnesses like to give them an opportunity to have fun like other kids. ... And they depend on \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>.”\u003c/p>\n\u003cp>\u003cstrong>Bad Decisions\u003c/strong>\u003c/p>\n\u003cp>Some parents think measles isn’t such a big risk, Offit says. And compared to the pre-vaccine days, he says, when every year millions of children got sick, 48,000 were hospitalized and 500 died, that’s true. But as a veteran of the \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/8483622\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/8483622\" target=\"_blank\">1991 Philadelphia measles\u003c/a> epidemic that infected 1,400 and killed nine children who weren’t immunized, Offit cautions that playing the odds is a dangerous game.\u003c/p>\n\u003cp>But creating rules that make that game safer is challenging in a society that cherishes individual rights. “We’re open-minded in the U.S.,” Offit says, “even to the point where we let parents hurt their children.”\u003c/p>\n\u003cp>But increasingly, pediatricians, including Offit’s wife, Bonnie, refuse to help parents do that.\u003c/p>\n\u003cp>The alternative is to sit back and let parents make bad decisions.\u003c/p>\n\u003cp>Not long ago, a one-and-a-half-year-old boy was admitted to Offit’s hospital. He’d been seen at the hospital’s outpatient clinic at two, four, six and 12 months -- all the times when kids get the pneumococcal vaccine. But his parents chose not to vaccinate and the staff didn’t push it, Offit says. “He came in with pneumococcal meningitis,\" and then suffered a devastating \u003ca title=\"http://www.nlm.nih.gov/medlineplus/ency/article/001421.htm\" href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001421.htm\" target=\"_blank\">brain herniation\u003c/a>, Offit said. \"He will never see, walk or speak again and probably won’t live past five. It’s not OK.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.lizagross.com/\">Liza Gross\u003c/a> is an independent science journalist based in the San Francisco Bay area who writes frequently about science and society.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Disneyland Measles Cases Now at 26",
"title": "Disneyland Measles Cases Now at 26",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_23448\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/53249939-2-e1421198243700.jpg\">\u003cimg class=\"size-large wp-image-23448\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/53249939-2-640x426.jpg\" alt=\"(Marsaili McGrath/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The number of measles cases linked to having \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">visited Disneyland parks\u003c/a> in mid-December has climbed to 22 in California, according \u003ca title=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" href=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" target=\"_blank\">to state data\u003c/a>. There are four more cases in other states -- two in Utah and one each in Colorado and Washington.\u003c/p>\n\u003cp>While the incubation period for people who visited the parks between Dec. 17-20 ended on Jan. 10 -- meaning that anyone who was at Disneyland in that time frame would have gotten sick by now -- the \u003ca title=\"http://www.latimes.com/local/lanow/la-me-ln-disneyland-measles-20150113-story.html\" href=\"http://www.latimes.com/local/lanow/la-me-ln-disneyland-measles-20150113-story.html\" target=\"_blank\">Los Angeles Times is reporting\u003c/a> that an unvaccinated, infected woman took two flights after she became ill.\u003c/p>\n\u003cp>The woman was in her 20s, the TImes reported, had visited Disneyland in December and became ill on Dec. 28. \u003c!--more-->\u003c/p>\n\u003cp>Here's more from the \u003ca title=\"http://www.latimes.com/local/lanow/la-me-ln-disneyland-measles-20150113-story.html\" href=\"http://www.latimes.com/local/lanow/la-me-ln-disneyland-measles-20150113-story.html\" target=\"_blank\">Times:\u003c/a>\u003c/p>\n\u003cblockquote>\u003cp>She flew from Orange County to Seattle on Dec. 29, stayed with family in Washington's Snohomish County and returned to Orange County on Jan. 3. She wasn't diagnosed until Jan. 8 in California, health officials in Washington state said.\u003c/p>\n\u003cp>The passenger flew to Seattle on Alaska Airlines Flight 505 on Dec. 29, a Washington health official said. She returned to Orange County on Jan. 3 on Virgin America Flight 1780.\u003c/p>\u003c/blockquote>\n\u003cp>Measles is highly contagious, and the \u003ca title=\"http://www.cdc.gov/measles/about/transmission.html\" href=\"http://www.cdc.gov/measles/about/transmission.html\" target=\"_blank\">virus can live up to two hours \u003c/a>on a surface or in the airspace where the infected person coughed or sneezed, according to the Centers for Disease Control and Prevention. Initial measles symptoms include fever, cough, running nose and red eyes. After a few days, a red rash appears on the face and then spreads downward to the rest of the body.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nine suspected measles cases are under investigation. Four of them are related to Disneyland; five have \"no known links\" to Disney parks,\u003c/p>\n\u003cp>Here's the breakdown by county of the 22 confirmed cases in California:\u003c/p>\n\u003cul>\n\u003cli>Alameda 3\u003c/li>\n\u003cli>L.A. County 3\u003c/li>\n\u003cli>Orange 9\u003c/li>\n\u003cli>Riverside 2\u003c/li>\n\u003cli>San Bernardino 2\u003c/li>\n\u003cli>San Diego 2\u003c/li>\n\u003cli>Ventura 1\u003c/li>\n\u003c/ul>\n\u003cp>Carlos Villatoro, a spokesman for the California Department of Public Health (CDPH), said in an email that 21 of the state's cases \"had direct links to Disney parks,\" and one was a \"secondary case,\" meaning the patient had direct contact with a \"Disney-linked case.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Vaccination status of the California cases is as follows:\u003c/p>\n\u003cul>\n\u003cli>12 cases were not vaccinated (although previous reports indicated \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">two were too young to be vaccinated\u003c/a>)\u003c/li>\n\u003cli>4 were vaccinated\u003c/li>\n\u003cli>6 had unknown vaccination status or no vaccination documentation at this time.\u003c/li>\n\u003c/ul>\n\n",
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"excerpt": "The outbreak is traced to people who visited Disneyland parks Dec. 17-20.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23448\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/53249939-2-e1421198243700.jpg\">\u003cimg class=\"size-large wp-image-23448\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/53249939-2-640x426.jpg\" alt=\"(Marsaili McGrath/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The number of measles cases linked to having \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">visited Disneyland parks\u003c/a> in mid-December has climbed to 22 in California, according \u003ca title=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" href=\"http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx\" target=\"_blank\">to state data\u003c/a>. There are four more cases in other states -- two in Utah and one each in Colorado and Washington.\u003c/p>\n\u003cp>While the incubation period for people who visited the parks between Dec. 17-20 ended on Jan. 10 -- meaning that anyone who was at Disneyland in that time frame would have gotten sick by now -- the \u003ca title=\"http://www.latimes.com/local/lanow/la-me-ln-disneyland-measles-20150113-story.html\" href=\"http://www.latimes.com/local/lanow/la-me-ln-disneyland-measles-20150113-story.html\" target=\"_blank\">Los Angeles Times is reporting\u003c/a> that an unvaccinated, infected woman took two flights after she became ill.\u003c/p>\n\u003cp>The woman was in her 20s, the TImes reported, had visited Disneyland in December and became ill on Dec. 28. \u003c!--more-->\u003c/p>\n\u003cp>Here's more from the \u003ca title=\"http://www.latimes.com/local/lanow/la-me-ln-disneyland-measles-20150113-story.html\" href=\"http://www.latimes.com/local/lanow/la-me-ln-disneyland-measles-20150113-story.html\" target=\"_blank\">Times:\u003c/a>\u003c/p>\n\u003cblockquote>\u003cp>She flew from Orange County to Seattle on Dec. 29, stayed with family in Washington's Snohomish County and returned to Orange County on Jan. 3. She wasn't diagnosed until Jan. 8 in California, health officials in Washington state said.\u003c/p>\n\u003cp>The passenger flew to Seattle on Alaska Airlines Flight 505 on Dec. 29, a Washington health official said. She returned to Orange County on Jan. 3 on Virgin America Flight 1780.\u003c/p>\u003c/blockquote>\n\u003cp>Measles is highly contagious, and the \u003ca title=\"http://www.cdc.gov/measles/about/transmission.html\" href=\"http://www.cdc.gov/measles/about/transmission.html\" target=\"_blank\">virus can live up to two hours \u003c/a>on a surface or in the airspace where the infected person coughed or sneezed, according to the Centers for Disease Control and Prevention. Initial measles symptoms include fever, cough, running nose and red eyes. After a few days, a red rash appears on the face and then spreads downward to the rest of the body.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nine suspected measles cases are under investigation. Four of them are related to Disneyland; five have \"no known links\" to Disney parks,\u003c/p>\n\u003cp>Here's the breakdown by county of the 22 confirmed cases in California:\u003c/p>\n\u003cul>\n\u003cli>Alameda 3\u003c/li>\n\u003cli>L.A. County 3\u003c/li>\n\u003cli>Orange 9\u003c/li>\n\u003cli>Riverside 2\u003c/li>\n\u003cli>San Bernardino 2\u003c/li>\n\u003cli>San Diego 2\u003c/li>\n\u003cli>Ventura 1\u003c/li>\n\u003c/ul>\n\u003cp>Carlos Villatoro, a spokesman for the California Department of Public Health (CDPH), said in an email that 21 of the state's cases \"had direct links to Disney parks,\" and one was a \"secondary case,\" meaning the patient had direct contact with a \"Disney-linked case.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Vaccination status of the California cases is as follows:\u003c/p>\n\u003cul>\n\u003cli>12 cases were not vaccinated (although previous reports indicated \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">two were too young to be vaccinated\u003c/a>)\u003c/li>\n\u003cli>4 were vaccinated\u003c/li>\n\u003cli>6 had unknown vaccination status or no vaccination documentation at this time.\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_20284\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/jpg-e1420908404158.jpg\">\u003cimg class=\"size-large wp-image-20284\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Kaiser-jpg-640x480.jpg\" alt=\"Kaiser Permanente’s medical center in Oakland. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente’s medical center in Oakland. (Lisa Aliferis/KQED) \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By April Dembosky\u003c/strong>\u003c/p>\n\u003cp>Mental health clinicians at Kaiser are walking off the job Monday, commencing a week-long, statewide strike. Their main complaint: Kaiser isn't hiring enough therapists and psychologists to see patients in a timely manner.\u003c/p>\n\u003cp>But the strike also comes after four years of contract negotiations between Kaiser and the National Union of Healthcare Workers have yielded few agreements.\u003c/p>\n\u003cp>\"We’ve tried one and two day actions in the past. Kaiser is not paying attention to that,\" says Clement Papazian, a social worker at Kaiser and a local union representative. \"We feel like it’s the appropriate time to escalate these actions.\"\u003c/p>\n\u003cp>Kaiser called the strike \"unnecessary and counterproductive.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>John Nelson, Kaiser's vice president of government relations, says the the hospital system is meeting its patients' mental health needs, even after Kaiser has taken on thousands of new patients under the Affordable Care Act.\u003c/p>\n\u003cp>\"Since 2011, we’ve grown membership by eight percent in California. We’ve increased the number of therapists in California who work at Kaiser Permanente by 25 percent,\" Nelson said. \"That's quite an accomplishment.\"\u003c!--more-->\u003c/p>\n\u003cp>Nelson said that health care systems across the country have been having difficulty hiring enough therapists and psychologists, because of a shortage of professionals. He said there isn't enough incentive to get people to enter the field.\u003c/p>\n\u003cp>\"There are challenges in encouraging folks to pursue that training and to go to school and complete the long licensing process,\" he said.\u003c/p>\n\u003cp>Kaiser has faced the ire of state regulators \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" target=\"_blank\">over wait times \u003c/a>for mental health care. In 2013, the Department of Managed Health Care fined Kaiser $4 million over long wait times for mental health care. Kaiser initially contested the fine, but agreed to pay it last September -- while still \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/09/kaiser-agrees-to-pay-4-million-fine-over-mental-health-care-drops-lawsuit/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/09/kaiser-agrees-to-pay-4-million-fine-over-mental-health-care-drops-lawsuit/\" target=\"_blank\">insisting it had not violated regulations\u003c/a>.\u003c/p>\n\u003cp>Nelson insisted the strike was really a bargaining strategy by the union. The latest issue to be debated in contract negotiations is retiree health benefits.\u003c/p>\n\u003cp>\"They want to carve out retiree health care,\" said Clement Papazian. He says Kaiser's latest proposal is to put current employees, once they retire, on a \"substandard\" Medicare plan. \"It’s a much less desirable health care benefit, and it's a bitter pill for those of us who work in health care and expend a career providing these services.\"\u003c/p>\n\u003cp>The union plans to hold rallies outside Kaiser facilities in Northern and Southern California throughout the week.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Nelson says Kaiser has enough non-union staff to handle any urgent psychiatric needs during the strike, but some routine therapy appointments will be canceled.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20284\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/jpg-e1420908404158.jpg\">\u003cimg class=\"size-large wp-image-20284\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/Kaiser-jpg-640x480.jpg\" alt=\"Kaiser Permanente’s medical center in Oakland. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaiser Permanente’s medical center in Oakland. (Lisa Aliferis/KQED) \u003ccite>(Lisa Aliferis/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By April Dembosky\u003c/strong>\u003c/p>\n\u003cp>Mental health clinicians at Kaiser are walking off the job Monday, commencing a week-long, statewide strike. Their main complaint: Kaiser isn't hiring enough therapists and psychologists to see patients in a timely manner.\u003c/p>\n\u003cp>But the strike also comes after four years of contract negotiations between Kaiser and the National Union of Healthcare Workers have yielded few agreements.\u003c/p>\n\u003cp>\"We’ve tried one and two day actions in the past. Kaiser is not paying attention to that,\" says Clement Papazian, a social worker at Kaiser and a local union representative. \"We feel like it’s the appropriate time to escalate these actions.\"\u003c/p>\n\u003cp>Kaiser called the strike \"unnecessary and counterproductive.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>John Nelson, Kaiser's vice president of government relations, says the the hospital system is meeting its patients' mental health needs, even after Kaiser has taken on thousands of new patients under the Affordable Care Act.\u003c/p>\n\u003cp>\"Since 2011, we’ve grown membership by eight percent in California. We’ve increased the number of therapists in California who work at Kaiser Permanente by 25 percent,\" Nelson said. \"That's quite an accomplishment.\"\u003c!--more-->\u003c/p>\n\u003cp>Nelson said that health care systems across the country have been having difficulty hiring enough therapists and psychologists, because of a shortage of professionals. He said there isn't enough incentive to get people to enter the field.\u003c/p>\n\u003cp>\"There are challenges in encouraging folks to pursue that training and to go to school and complete the long licensing process,\" he said.\u003c/p>\n\u003cp>Kaiser has faced the ire of state regulators \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" href=\"http://ww2.kqed.org/stateofhealth/2014/07/17/therapists-patients-criticize-kaiser-over-long-delays-for-therapy/\" target=\"_blank\">over wait times \u003c/a>for mental health care. In 2013, the Department of Managed Health Care fined Kaiser $4 million over long wait times for mental health care. Kaiser initially contested the fine, but agreed to pay it last September -- while still \u003ca title=\"http://ww2.kqed.org/stateofhealth/2014/09/09/kaiser-agrees-to-pay-4-million-fine-over-mental-health-care-drops-lawsuit/\" href=\"http://ww2.kqed.org/stateofhealth/2014/09/09/kaiser-agrees-to-pay-4-million-fine-over-mental-health-care-drops-lawsuit/\" target=\"_blank\">insisting it had not violated regulations\u003c/a>.\u003c/p>\n\u003cp>Nelson insisted the strike was really a bargaining strategy by the union. The latest issue to be debated in contract negotiations is retiree health benefits.\u003c/p>\n\u003cp>\"They want to carve out retiree health care,\" said Clement Papazian. He says Kaiser's latest proposal is to put current employees, once they retire, on a \"substandard\" Medicare plan. \"It’s a much less desirable health care benefit, and it's a bitter pill for those of us who work in health care and expend a career providing these services.\"\u003c/p>\n\u003cp>The union plans to hold rallies outside Kaiser facilities in Northern and Southern California throughout the week.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Nelson says Kaiser has enough non-union staff to handle any urgent psychiatric needs during the strike, but some routine therapy appointments will be canceled.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Nine Measles Cases Tied to Disneyland Parks",
"title": "Nine Measles Cases Tied to Disneyland Parks",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_23378\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/53249939-e1420672369712.jpg\">\u003cimg class=\"size-large wp-image-23378\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/53249939-640x426.jpg\" alt=\"(Marsaili McGrath/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Nine people who visited Disneyland or Disneyland California Adventure Park during December have confirmed measles cases, state health officials said Wednesday. Seven of the patients live in California and two live in Utah.\u003c/p>\n\u003cp>State and county health officers are investigating an additional four suspected cases, two in Utah and two in California. All the patients visited the parks in Orange County between Dec.15-20, California Department of Public Health officials said.\u003c/p>\n\u003cp>“If you have symptoms, and believe you may have been exposed, please contact your health care provider,” Dr. Ron Chapman, CDPH director and state health officer,\u003ca title=\"http://www.cdph.ca.gov/Pages/NR15-002.aspx\" href=\"http://www.cdph.ca.gov/Pages/NR15-002.aspx\" target=\"_blank\"> said in a statement\u003c/a>. “The best way to prevent measles and its spread is to get vaccinated.”\u003c!--more-->\u003c/p>\n\u003cp>Kathleen Harriman, chief of vaccine preventable diseases with the department, said that \"it's our speculation that there was an (infected) international visitor at one of the parks, and that person or persons was able to infect a lot of people.\"\u003c/p>\n\u003cp>Measles is \"a very infectious disease,\" she added, and was eliminated from the United States in 2000. \"So all the cases of measles in the United States originate with an imported case, even though there can be transmission once one of those cases gets here.\" Measles is airborne and highly contagious. \u003ca title=\"http://www.cdc.gov/measles/about/transmission.html\" href=\"http://www.cdc.gov/measles/about/transmission.html\" target=\"_blank\">It can live on a surface \u003c/a>where an infected person coughed or sneezed up to two hours and possibly infect others.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The California cases are in Alameda, Orange, Pasadena, Riverside and San Diego. The patients range in age from 8 months to 21 years. Of the seven California cases, six were not vaccinated, although two were too young to be vaccinated. The first of two recommended measles vaccine doses is typically given at 1 year of age.\u003c/p>\n\u003cp>Just one of the cases was fully vaccinated. Harriman said that while the measles vaccine is highly effective, \"it confers lifelong immunity in 99 percent of people who receive two doses,\" and there will always be a small number of people who can be infected despite vaccination.\u003c/p>\n\u003cp>One of the cases is in Alameda County. Deputy Chief Health Officer Dr. Erica Pan said officials are \"working with the health facility where the patient was seen\" to identify other patients and health care workers who may have been exposed.\u003c/p>\n\u003cp>Pan said health officers will quarantine susceptible contacts, especially those at high risk of developing disease, \"to make sure that contact stays home and away from other people to make sure that person does not infect others.\"\u003c/p>\n\u003cp>Initial measles symptoms include fever, cough, running nose and red eyes. After a few days, a red rash appears on the face and then spreads downward to the rest of the body.\u003c/p>\n\u003cp>Pan said if people are concerned they \"should check on their immunization status and get vaccinated\" if needed.\u003c/p>\n\u003cp>Disney officials told the Associated Press that they had not received any reports of staff contracting measles. Park officials are working with the health department to provide any necessary information, said Dr. Pamela Hymel, chief medical officer for Walt Disney Parks and Resorts.\u003c/p>\n\u003cp>The California Department of Public Health has notified the Centers for Disease Control of the cases.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>This post has been updated with a response from Disney.\u003c/em>\u003c/strong>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23378\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/53249939-e1420672369712.jpg\">\u003cimg class=\"size-large wp-image-23378\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/53249939-640x426.jpg\" alt=\"(Marsaili McGrath/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Nine people who visited Disneyland or Disneyland California Adventure Park during December have confirmed measles cases, state health officials said Wednesday. Seven of the patients live in California and two live in Utah.\u003c/p>\n\u003cp>State and county health officers are investigating an additional four suspected cases, two in Utah and two in California. All the patients visited the parks in Orange County between Dec.15-20, California Department of Public Health officials said.\u003c/p>\n\u003cp>“If you have symptoms, and believe you may have been exposed, please contact your health care provider,” Dr. Ron Chapman, CDPH director and state health officer,\u003ca title=\"http://www.cdph.ca.gov/Pages/NR15-002.aspx\" href=\"http://www.cdph.ca.gov/Pages/NR15-002.aspx\" target=\"_blank\"> said in a statement\u003c/a>. “The best way to prevent measles and its spread is to get vaccinated.”\u003c!--more-->\u003c/p>\n\u003cp>Kathleen Harriman, chief of vaccine preventable diseases with the department, said that \"it's our speculation that there was an (infected) international visitor at one of the parks, and that person or persons was able to infect a lot of people.\"\u003c/p>\n\u003cp>Measles is \"a very infectious disease,\" she added, and was eliminated from the United States in 2000. \"So all the cases of measles in the United States originate with an imported case, even though there can be transmission once one of those cases gets here.\" Measles is airborne and highly contagious. \u003ca title=\"http://www.cdc.gov/measles/about/transmission.html\" href=\"http://www.cdc.gov/measles/about/transmission.html\" target=\"_blank\">It can live on a surface \u003c/a>where an infected person coughed or sneezed up to two hours and possibly infect others.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The California cases are in Alameda, Orange, Pasadena, Riverside and San Diego. The patients range in age from 8 months to 21 years. Of the seven California cases, six were not vaccinated, although two were too young to be vaccinated. The first of two recommended measles vaccine doses is typically given at 1 year of age.\u003c/p>\n\u003cp>Just one of the cases was fully vaccinated. Harriman said that while the measles vaccine is highly effective, \"it confers lifelong immunity in 99 percent of people who receive two doses,\" and there will always be a small number of people who can be infected despite vaccination.\u003c/p>\n\u003cp>One of the cases is in Alameda County. Deputy Chief Health Officer Dr. Erica Pan said officials are \"working with the health facility where the patient was seen\" to identify other patients and health care workers who may have been exposed.\u003c/p>\n\u003cp>Pan said health officers will quarantine susceptible contacts, especially those at high risk of developing disease, \"to make sure that contact stays home and away from other people to make sure that person does not infect others.\"\u003c/p>\n\u003cp>Initial measles symptoms include fever, cough, running nose and red eyes. After a few days, a red rash appears on the face and then spreads downward to the rest of the body.\u003c/p>\n\u003cp>Pan said if people are concerned they \"should check on their immunization status and get vaccinated\" if needed.\u003c/p>\n\u003cp>Disney officials told the Associated Press that they had not received any reports of staff contracting measles. Park officials are working with the health department to provide any necessary information, said Dr. Pamela Hymel, chief medical officer for Walt Disney Parks and Resorts.\u003c/p>\n\u003cp>The California Department of Public Health has notified the Centers for Disease Control of the cases.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003cem>This post has been updated with a response from Disney.\u003c/em>\u003c/strong>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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