Saturday, February 21, 2015

In the midst of the current resurgence of measlesacross the United States, many people may still believe it's a harmless, transient disease.

In the midst of the current resurgence of measlesacross the United States, many people may still believe it's a harmless, transient disease.
31. Say (O Muhammad  to mankind): "If you (really) love Allah then follow me (i.e. accept Islamic Monotheism, follow the Qur'an and the Sunnah), Allah will love you and forgive you of your sins. And Allah is Oft-Forgiving, Most Merciful."
32. Say (O Muhammad ): "Obey Allah and the Messenger (Muhammad )." But if they turn away, then Allah does not like the disbelievers.
33. Allah chose Adam, Nuh (Noah), the family of Ibrahim (Abraham) and the family of 'Imran above the 'Alamin(mankind and jinns) (of their times).
34. Offspring, one of the other, and Allah is the All-Hearer, All-Knower.
35. (Remember) when the wife of 'Imran said: "O my Lord! I have vowed to You what (the child that) is in my womb to be dedicated for Your services (free from all worldly work; to serve Your Place of worship), so accept this, from me. Verily, You are the All-Hearer, the All-Knowing."
36. Then when she delivered her [child Maryam (Mary)], she said: "O my Lord! I have delivered a female child," - and Allah knew better what she delivered, - "And the male is not like the female, and I have named her Maryam (Mary), and I seek refuge with You (Allah) for her and for her offspring from Shaitan (Satan), the outcast."
37. So her Lord (Allah) accepted her with goodly acceptance. He made her grow in a good manner and put her under the care of Zakariya (Zachariya). Every time he entered Al-Mihrab to (visit) her , he found her supplied with sustenance. He said: "O Maryam (Mary)! From where have you got this?" She said, "This is from Allah." Verily, Allah provides sustenance to whom He wills, without limit."
38. At that time Zakariya (Zachariya) invoked his Lord, saying: "O my Lord! Grant me from You, a good offspring. You are indeed the All-Hearer of invocation."
39. Then the angels called him, while he was standing in prayer in Al-Mihrab (a praying place or a private room), (saying): "Allah gives you glad tidings of Yahya (John), confirming (believing in) the Word from Allah [i.e. the creation of 'Iesa (Jesus), the Word from Allah ("Be!" - and he was!)], noble, keeping away from sexual relations with women, a Prophet, from among the righteous."
40. He said: "O my Lord! How can I have a son when I am very old, and my wife is barren?" Allah said: "Thus Allah does what He wills."
41. He said: "O my Lord! Make a sign for me." Allah said: "Your sign is that you shall not speak to mankind for three days except with signals. And remember your Lord much (by praising Him again and again), and glorify (Him) in the afternoon and in the morning."3. Aal-'Imran

But experts warn that even before the telltale skin rash appears, the infection typically shows up in the eyes. In rare cases, measles can trigger long-term vision problems and evenblindness.
Also, one or two of every 1,000 children who get measles will die from it, according to the U.S. Centers for Disease Control and Prevention.
"It's not as simple as you get the measles and that's it," said Dr. Jonathan Song, an associate professor of ophthalmology at the Keck School of Medicine at the University of Southern California, in Los Angeles.
Severe complications from measles can include brain swelling that -- along with irritation or clouding of the eye's cornea -- can rob children of their sight.
"Almost all people who get measles will get the red eyes called conjunctivitis," Song said. "Once they get red eyes ... they can develop inflammation of the cornea, which can break down the cornea and lead to scarring and even blindness."
The CDC reported 141 people from 17 states and Washington, D.C., were known to have measles as of Feb. 13, and most of them had not been immunized. The vast majority of those recently infected are part of a large, ongoing multistate outbreak linked to Disneyland in California.
Measles causes up to 60,000 cases of blindness worldwide each year, according to a survey published by the U.S. National Library of Medicine. Most of those blinded by the infection are in developing nations and suffer from a vitamin A deficiency.
But regardless of nutritional status, children can develop measles-related vision complications either because their mothers contracted the virus during pregnancy, or by acquiring measles during childhood, eye experts said.
"The most common eye complications don't cause vision loss and are temporary," said Dr. Jane Edmond, a pediatric ophthalmologist at Texas Children's Hospital in Houston.
"But the rare encephalitis [brain swelling] that can occur with measles in a child can be devastating and of course, the eyes are hooked up to the brain, so another way to affect vision is through this brain-based injury," said Edmond, who is also a spokesperson for the American Academy of Ophthalmology.
The earlier a child is infected with measles, the more likely any resulting eye damage will be lifelong, Song said. In the cornea -- the clear tissue serving as the "window" into the eye -- the virus can progress from inflammation and redness to scarring that blocks the clarity of images reaching the brain.
"Total vision loss depends a lot on age," Song said. "In a normal child, the visual system develops within the first four months of life, when babies are forming connections from brain to eye. So if anything is blocking the front of the eye, that can be permanent."
Sometimes, measles infection damages or destroys cells in the retina, Song and Edmond said. The retina, which lines the back of the eye, senses light and sends signals to the brain. In rare cases, the virus even damages the optic nerve, causing potentially irreversible blindness, according to the academy of ophthalmology.
Both ophthalmologists and the academy recommend routine measles vaccinations as a way of preventing visual complications of the infection, among other serious outcomes.
About 90 to 95 percent of all vaccine-eligible people need to be immunized against measles to confer so-called "herd immunity" to others in society who cannot be immunized, public health experts say. People who should not be vaccinated include pregnant women and seriously ill children, the CDC says.
"What if you got the measles and it was no big deal, but you infected somebody for whom it was?" asked Edmond. "Yes, measles in our country doesn't have a lot of bad [outcomes], but you have to think about others."

Fifteen years after measles was declared eliminated in the United States, the recent outbreak traced to two Disney parks in California illustrates how quickly a resurgence can occur.
As of Wednesday afternoon, 59 cases had been reported in California residents since the outbreak began in the third week of December. Eight others in four U.S. states and Mexico have also been diagnosed with measles after visiting Disney parks, California health officials said.
Measles symptoms can occur up to three weeks after initial exposure, so the period for new infections directly linked to the original outbreak at the Disney parks has passed. However, secondary cases continue to be reported in those who caught the disease from people infected during visits to the parks. Disney officials also confirmed on Wednesday that five park employees who play costumed characters in the parks have been infected, the Associated Press reported.
And roughly two dozen unvaccinated students in Orange County have been ordered to stay home to try and contain the spread of measles.
Experts explain the California outbreak simply.
"This outbreak is occurring because a critical number of people are choosing not to vaccinate their children," said Dr. Paul Offit, director of the Vaccine Education Center and an attending physician at The Children's Hospital of Philadelphia's Division of Infectious Diseases.
"Parents are not scared of the disease" because they've never seen it, Offit said. "And, to a lesser extent, they have these unfounded concerns about vaccines. But the big reason is they don't fear the disease."
The United States declared measles eliminated from the country in 2000. This meant the disease was no longer native to the United States. The country was able to eliminate measles because of effective vaccination programs and a strong public health system for detecting and responding to measles cases and outbreaks, according to the U.S. Centers for Disease Control and Prevention.
But in the intervening years, a small but growing number of parents have chosen not to have their children vaccinated, due largely to what infectious-disease experts call mistaken fears about childhood vaccines.
Researchers have found that past outbreaks of vaccine-preventable diseases are more likely in places where there are clusters of parents who refuse to have their children vaccinated, said Saad Omer, an associate professor of global health, epidemiology and pediatrics at Emory University School of Public Health and Emory Vaccine Center, in Atlanta.
These so-called "vaccine refusals" refer to exemptions to school immunization requirements that parents can obtain on the basis of their personal or religious beliefs.
"California is one of the states with some of the highest rates in the country in terms of exemptions, and also there's a substantial clustering of refusals there," Omer said. "Perceptions regarding vaccine safety have a slightly higher contribution to vaccine refusal, but they are not the only reason parents don't vaccinate."
Other reasons include the belief that their children will not catch the disease, the disease is not very severe and the vaccine is not effective, Omer noted.
In California, vaccine exemptions have increased from 1.5 percent in 2007 to 3.1 percent in 2013, according to an analysis by the Los Angeles Times.
Recent legislation tightened the rules for personal belief exemptions by requiring parents to have doctors sign the exemption forms. But Omer said it is too soon to know the effects of the new law.
A big contributing factor to the parents' continuing concerns about vaccine safety was a 1998 fraudulent paper published and later retracted in the medical journal The Lancet. The study falsely suggested a link between the measles-mumps-rubella (MMR) vaccine and autism. The lead author of that paper, Andrew Wakefield, has since lost his medical license for having falsified his data.
Several dozen studies and a report from the Institute of Medicine have since found no link between autism and any vaccines, including the MMR vaccine.
Researchers have found that those who refuse vaccines tend to share similarities.
"In general, they're upper-middle to upper class, well-educated -- often graduate school-educated -- and in jobs in which they exercise some level of control," Offit said. "They believe that they can google the word vaccine and know as much, if not more, as anyone who's giving them advice."
Omer added that recent data has shown that measles cases tend to disproportionately involve people who are not vaccinated. "The higher the vaccination rates, the lower the frequency and size of outbreaks," he noted.
The most common side effects of the MMR vaccine are a fever and occasionally a mild rash. Some children may experience seizures from the fever, but experts say these seizures have no long-term negative effects.
The majority of recent outbreaks have been traced back to unvaccinated U.S. residents. Last year, 644 measles cases were reported to the CDC, the highest number of cases recorded since the disease was declared eliminated.
Almost half of those cases occurred in Ohio after unvaccinated U.S. residents traveled to the Philippines and returned ill. Similarly, more than half the outbreaks in the first half of 2013 originated with U.S. residents who traveled overseas and came back with measles.
Measles is one of the most contagious of human diseases. The airborne virus can linger in an area up to two hours after an infected person leaves, and approximately 90 percent of people without immunity will become sick if exposed to the virus.
Serious complications from measles can include pneumonia and encephalitis, which can lead to long-term deafness or brain damage. An estimated one in 5,000 cases will result in death, according to Offit.
"If a child died of measles in southern California, I think people would start vaccinating," Offit said. "I think it will take more suffering and more hospitalizations and more deaths to not see these outbreaks. We're compelled by fear, and we don't fear this disease enough.

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