measles

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--Akrasia25 (talk) 12:31, 7 March 2019 (UTC)

In article: "In 1980, 2.6 million people died of it,[6]"

In source: "Before the introduction of measles vaccine in 1963 and widespread vaccination, major epidemics occurred approximately every 2–3 years and measles caused an estimated 2.6 million deaths each year." 1980 does not appear anywhere in the source. Please edit. — Preceding unsigned comment added by 184.74.151.135 (talk) 15:13, 5 April 2019 (UTC)

You are correct. thank you for catching that error. MartinezMD (talk) 19:25, 5 April 2019 (UTC)
User:MartinezMD ref states 1980 here https://web.archive.org/web/20150203144905/http://www.who.int/mediacentre/factsheets/fs286/en/
Doc James (talk · contribs · email) 19:49, 5 April 2019 (UTC)
User:Doc James thank you. The IP editor was correct however that it wasn't in the tagged source. Would you be kind enough to add this or substitute it? MartinezMD (talk) 19:56, 5 April 2019 (UTC)

This edit request has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.

Regarding the last confirmed measles death in the US, the source that is cited to claim that the 29 year old woman that died was vaccinated actually does not support that claim.

"First Measles Death in US Since 2003 Highlights the Unknown Vulnerables – Phenomena: Germination". 2015-07-02. Archived from the original on 2015-07-03. Retrieved 2015-07-03."

All that it says is that "According to investigative work by the state department, the woman had been vaccinated, though spokesperson Donn Moyer told me her mother was not able to locate a vaccination record. " But the referenced article it self does not point to a source with the "investigative work by the state department". I recommend either supporting the claim with an actually reference to the investigative work, or simply write that "it is unclear if she was vaccinated or not". The following article seems to have a more factual assessment of her status. I recommend citing this one instead.

https://www.seattletimes.com/seattle-news/health/fatal-measles-case-linked-to-exposure-at-tribal-clinic-records-show/

Furthermore, the link to the reference provided in the current wiki page is actually not working, only an archived version of it exists. The link I provide above, does work. — Preceding unsigned comment added by 73.61.19.49 (talk) 15:19, 17 April 2019 (UTC)

Read the archived source more carefully. It says "Update: According to further state info, the woman learned she might have been exposed to measles; had her degree of immune protection checked, and discovered she would have had enough immunity to protect against measles if she had not been taking the immune-suppressing drugs." MartinezMD (talk) 16:26, 17 April 2019 (UTC)

My point is exactly that. It says " According to further state info" without citing any sources. Anyone can write an article that says "according to state info, XYZ is true". Unless someone can provide with a source for the said state info, this should be removed and not trusted. Facts, not fiction. — Preceding unsigned comment added by 193.137.158.241 (talk) 14:14, 22 April 2019 (UTC)

The news reports are summaries, not primary sources. From the article you cite - "That’s according to emails and documents from Washington State Department of Health (DOH) officials released in response to a Seattle Times Public Records Act request." So they don't publish the verbatim report. Since we consider reliable sources accurate, that's what we use. We also can't help when websites trim their pages; the archived copy is considered valid. Also, you don't have to change the "question answered" parameter to "no". You're getting a reply and there is a conversation thread now. MartinezMD (talk) 14:29, 22 April 2019 (UTC)

The Reliable source page that you sent me says, regarding news stories sources, that "Whether a specific news story is reliable for a fact or statement should be examined on a case-by-case basis", which implies that Wiki should be open to verifying the validity of a statement, and not just accept it at face value. Several news agencies seem to agree on the fact that the woman died, that she was taking suppressive drugs, what her age was, and that her mother did not know her vaccination status. It is indeed a bit hard to find the original WA state DOH report. So I think it is honest to go with the consensus. Furthermore, after some investigation, I found some interview that relates to an interview with a spokesman from the DOH that seems to give some detail about the vaccination status issue (https://www.npr.org/2015/07/06/420594973/first-measles-death-in-12-years-renews-vaccination-concerns). It seems like the vaccination status is indeed unknown, but that, they did some blood tests, and they found that she had antibodies of a kind that could have fought measles. Now, this does not necessarily imply that she had been vaccinated. She could have had those antibodies naturally, or via some other (but not measles) vaccine. So, I suggest that we replace the current source with the one I provided, and that we write that, "it is unclear if the woman had been vaccinated against measles, and her official vaccination status is "unknown", although, according the WA DOH department, blood tests reveled that she had antibodies that, if not under suppressive drugs, would have been able to fight of the disease". Not sure I agree with you regarding the yes/no status. If there are unanswered issues, the status should be "no", even though I really appreciate you having answered some of my posts. Cheers ! — Preceding unsigned comment added by 193.137.158.164 (talk) 17:06, 23 April 2019 (UTC)

I honestly don't understand your issue. You've now found yet another reliable source, NPR,(which I'm now adding to the article) that reports the mother's statement she was vaccinated, and also the statement that she had antibodies. If you tried finding my vaccine record you wouldn't find it either as it was 50 years ago. How would that invalidate the fact that I was vaccinated for example? Also, no, you don't get antibodies without the vaccine or having the illness previously. Antibody formation requires a specific exposure. I disagree with your proposal for these reasons, and unless editors have another opinion, the question is answered.MartinezMD (talk) 17:26, 23 April 2019 (UTC)
Agree with User:MartinezMD. Here is the full quote,

MCEVERS: And had she been vaccinated for measles? ALECCIA: You know, her vaccination status is uncertain. Her mother tells health officials that she was vaccinated as a child, but they don't have any of the documentation that proves it. And so she's technically classified as kind of an unknown vaccination status. But just after she was exposed, the young woman was tested, and she was found to have antibodies against measles, enough that would've protected a healthy person. But she also had multiple underlying health conditions. And so her immune system was suppressed, and she was vulnerable to the infection anyway.

There is two full sentences explaining the situation for a single death. My opinion is that is sufficient. Ian Furst (talk) 00:37, 24 April 2019 (UTC)
Hello, I disagree that there is proof that she was vaccinated. If there was proof, her status would not be "uncertain". I cannot force the edit, but clearly the current article inaccurately gives a certainty where there is none. Furthermore, if having antibodies was irrefutable proof of vaccination, her record would be "vaccinated". The fact that the doctors left her status as "uncertain" means that she might have gotten the antibodies from something other than the vaccine. For example, babies get antibodies from the mother when breastfeeding (I am not saying this is the case here, what I am saying is that biology is complicated and uncertain. There are many mechanisms by which something can come about). I think it would be fair to change "she had been vaccinated" to "her official vaccination status is uncertain, although she was found to have antibodies against measles". — Preceding unsigned comment added by 194.210.209.83 (talk) 17:14, 26 April 2019 (UTC)
You can disagree. You're welcome to do that, but you've received an answer. Please stop changing the question being answered to No if you don't like the answer you get. Secondly, an adult does not have maternal IgA antibodies. Antibodies to the measles (adult IgG - which are the levels that are measured) are either vaccine or viral induced. So either she previously had the disease or previously was vaccinated.MartinezMD (talk) 17:45, 26 April 2019 (UTC)
I disagree, and I believe that I am correct in saying that it is fair, for truth sake, for the official government status to be reported in the wiki page. I do not understand why the wiki should state something that *might* not be true, and if it is irrefutable proof, why the government won't change the status? Furthermore, I believe that we all agree on the facts. (1) She has the antibodies, (2) she might have been vaccinated, but it is (3) not 100% certain she has been vaccinated against measles specifically, (4) the official status is uncertain. I do not understand why you do not want to report the truth in the wiki. Sorry, this issue has not been addressed. — Preceding unsigned comment added by 136.167.207.15 (talk) 17:25, 14 May 2019 (UTC)
  Not done: please establish a consensus for this alteration before using the {{edit semi-protected}} template. There is clearly no consensus right now. MrClog (talk) 17:56, 5 June 2019 (UTC)

The second last sentence in the 2nd para says this: Most people do not get the disease more than once.[6] However, the WHO fact sheet cited in [6] above doesn't say anything about this: [1]

Changed the reference to the CDC Pink book Ch 13, p. 212. They discuss that the IgG response is similar to either vaccine or wild-type virus, and that it persists for years. Ian Furst (talk) 20:41, 20 April 2019 (UTC)
You don't even need a biological explanation, just epidemiology. We typically do not see repeat cases of measles, regardless of the reason. MartinezMD (talk) 17:48, 26 April 2019 (UTC)
This isn't really the place, because this isn't about the article, but you should not assume you are immune if you have had it before. Last month, a man who thought he was immune because he had it as a child infected 38 people.[2] I'm not saying you wouldn't be, but it isn't safe to assume that. Natureium (talk) 17:50, 26 April 2019 (UTC)
That's why I said typically ;) In cases like the one you cite, it's possible he had measles before. It's also possible he was misdiagnosed and had another illness as a child. MartinezMD (talk) 21:04, 26 April 2019 (UTC)

This is a viewpoint not a review aricle:

Sundaram, ME; Guterman, LB; Omer, SB (March 2019). "The True Cost of Measles Outbreaks During the Postelimination Era". JAMA. doi:10.1001/jama.2019.1506. PMID 30844023.

Could use a better ref Doc James (talk · contribs · email) 22:36, 2 May 2019 (UTC)

Replaced with a better ref Doc James (talk · contribs · email) 22:43, 2 May 2019 (UTC)
Doc, can you be clear about what was wrong with it? Yes, it's not technically classified as a review but functionally it acts as one. I don't see the issue. It's clearly a secondary source from JAMA reviewing the literature (albeit on a focused topic). It's not a systematic review by any means but it more than suffices for the claim that measles infection causes immunosuppression. I don't have an issue with the Nature Disease Primer review being used but I think it's important to clarify the issue at hand. TylerDurden8823 (talk) 02:58, 3 May 2019 (UTC)
It is labelled as a "viewpoint".
It is not clear what percentage of the complications are due to the immunosuppression. Many may occur for other reasons. Ie the measles infection itself with respect to viral pneumonia.
We state the number of deaths measles causes already and thus we do not need to list death a second time in the infobox.
This source lists the common complications.[3] Doc James (talk · contribs · email) 04:50, 3 May 2019 (UTC)
"It's labeled as a viewpoint." So? This doesn't elaborate on why this source would be problematic. The article is sourced stating that the immunosuppression is the reason for these secondary complications. Obviously, viral pneumonia is a direction manifestation but this isn't what's being referred to. The CDC link indeed lists those common complications but makes no mention whether immunosuppression from measles virus infection is linked to these complications. The other source clearly linked the two. Here are a few more sources that explicitly state the MV infection-related immunosuppression is responsible for these consequences (some may be exacerbated by malnutrition in the developing world as well (e.g., diarrhea): [4], [5] (per the abstract for this one, I don't have access to the full article), and [6]. TylerDurden8823 (talk) 07:35, 3 May 2019 (UTC)
Also, this is already in the text of the Measles article: "

"However, infection is also associated with several weeks of immune suppression with the consequence that the primary causes of measles deaths are secondary infections." TylerDurden8823 (talk) 07:41, 3 May 2019 (UTC)

Our article actually says "In addition, measles can suppress the immune system for weeks to months, and this can contribute to bacterial superinfections such as otitis media and bacterial pneumonia"
Yes the immunosupporession increases the risk of bacterial infection but I am not seeing the source claim that all the bacterial infections related to measles are due to immunosuppression and that there is no other mechanism. Doc James (talk · contribs · email) 22:36, 3 May 2019 (UTC)
We don't necessarily have to say all but these sources make it clear that the immunosuppression is, at the very least, largely responsible for the secondary infections that occur following the primary measles virus infection. I'm not saying it's the only mechanism, but that it is an established mechanism. As the article currently stands, it does not make that connection and it should. TylerDurden8823 (talk) 23:21, 3 May 2019 (UTC)

Does this not sum it up?:

• "Common complications include diarrhea (in 8% of cases), middle ear infection (7%), pneumonia (6%), and immunosuppression."

• We could also go with "Common complications include diarrhea (in 8% of cases), middle ear infection (7%), and pneumonia (6%). These occur in part due to measles induced immunosuppression."

Doc James (talk · contribs · email) 22:40, 3 May 2019 (UTC)

No, the first version you have there isn't sufficient. . It doesn't explain to the reader that some of those complications are due to the immunosuppression. That's an important concept. I think the second version would be fine. Also, I would still like to know what the specific objection(s) were to the JAMA Viewpoint article as I asked earlier. TylerDurden8823 (talk) 23:19, 3 May 2019 (UTC)
Have placed the refs by the text it supports.
Yah the viewpoint is published by JAMA. I would prefer a proper review article, which I added, but I guess we could also use the viewpoint. Doc James (talk · contribs · email) 02:12, 5 May 2019 (UTC)