Talk:Measles/Archive 2

Infectivity period

Can we discuss please the infectivity period? The article says:

"and infectivity lasts from two to four days prior, until two to five days following the onset of the rash (i.e. four to nine days infectivity in total) [2]"

while the source that was cited says:

"The infection has an average incubation period of 10-12 days (range 7-18 days) and infectivity lasts from 4 days before the rash of measles appears until 4 days after it disappears.[3]"

which I think is quite different to what the article days. The source "[3]" adds nothing new to this in my view.

I find all kinds of differing answers on this in the net and I think it would be great to get a definitive answer.

As I am not knowledgeable in this area myself, it would be great if experts could have a look.

Thanks!

Jaeljojo (talk) 13:03, 19 January 2013 (UTC)

with no one having answered I took the liberty to include both beliefs in the article. Happy to discuss Jaeljojo (talk) 19:22, 22 January 2013 (UTC)

I'm not an expert on this, but if you have lingering questions, please as people at WT:MED to comment. Thanks! Biosthmors (talk) 19:34, 22 January 2013 (UTC)

thanks, will do Jaeljojo (talk) 19:42, 24 January 2013 (UTC)

Recent Outbreaks

Is Sydney the capital of Australia? "In November 2011, an outbreak was reported in Sydney, the capital city of Australia with at least 12 reported cases.[76]"? I'm pretty sure it's Canberra 82.44.75.170 (talk) 21:32, 16 April 2013 (UTC)

Correct. Capital of NSW, or major city. Nice place. Midgley (talk) 00:07, 20 April 2013 (UTC)

According to the New Zealand herald, online Sunday 21 April 2013, "Suspected measles death in UK sparks wave of vaccinations". More at: http://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=10878815 Kdarwish1 (talk) 05:40, 21 April 2013 (UTC)

I know this section is already flagged for clean-up, but I wanted to point out that the following statement is false/misleading: "Vaccination is not mandatory in Europe, in contrast to the United States and many Latin American countries, where children must be vaccinated before they enter school" (end of paragraph 9). Although most parents in the U.S. do immunize their children, it is not actually a law. K.Grey (talk) 17:21, 12 June 2013 (UTC)

The 'Recent Outbreaks' section suffers from major WP:RECENTism. The disease plagued humanity for at least thousands of years, but the largest part of the article is about minor outbreaks after the period where it was any threat at at. This section is basically a trivia section, and I suspect only really exists at its size because this information is easily accessible on the internet without any real work. The sections on its history and how it came to be virtually eradicated needs to be greatly expandsed. 212.67.168.234 (talk) 08:05, 5 May 2014 (UTC)

References

Should we add the outbreak in Venezuela? 1613 cases between January and July 2018 according to the Pan American Health Organization, WHO in the Americas. Imiro (talk) 18:17, 1 August 2018 (UTC)

"There are suggestions below for improving the article to meet the good article criteria."

Actually, there are not. Midgley (talk) 00:15, 20 April 2013 (UTC)

I've provided a couple of examples for potential improvement in new sections on this talk page. Additionally, a lot of the recent outbreaks listed have not had followups that discuss the outbreaks as if they have already passed.

In August 2011, an outbreak in New Zealand has seen 94 confirmed cases in Auckland alone. - This right here is an example of what I am talking about. "Has seen" implies the outbreak as still currently occurring, and the article sourced comes from the time period of the outbreak, so more recent sources are needed for some of these.

It also might not be needed (or notable) to include smaller outbreaks of <50 or <100 people as these small outbreaks occur in even the most developed countries every now and then. Or at least these smaller outbreaks should be merged into paragraphs. ComfyKem (talk) 21:00, 29 April 2013 (UTC)

Outdated graphs

There are four epidemiological graphs on the Measles page: two showing measles incidence before and after vaccine introduction, one showing vaccine uptake in every country and another showing the disability-adjusted life year (DALY) for every country. All of these seem to be outdated by a few years, but the two that necessitate newer statistics are the vaccine uptake graph and the disability-adjusted life year graph. The DALY graph is showing 2002 stats and the vac rate graph is showing 2007 stats, yet the year we are in appears to be 2013(and the Measles Initiative has done a lot of work in recent years), and as such, more up-to-date graphs are needed. I believe the WHO provides these stats, so could someone update them or explain how to? ComfyKem (talk) 20:35, 29 April 2013 (UTC)

Merging sections

Should the evolution and genotype sections be merged into the cause section as subsections? Cause is discussing the virus, yet the article as a whole is centered around the disease. Diseases don't evolve or have genotypes, but viruses do. ComfyKem (talk) 20:39, 29 April 2013 (UTC)

These sections IMHO should be moved to a new article on the Measles virus rather than being included in this article. The split between the virology of a disease and the clinical features of a disease is fairly standard on WP at this point. This arrangement is a lot easier to work with.DrMicro (talk) 08:15, 3 May 2013 (UTC)

Mortality

It says, under "Epidemiology", that "In sub-Saharan Africa, mortality is 10%." This is far excessive. Since there are 3-2 × 107 cases worldwide per year, and only 139,000 are fatal, and a very large portion (perhaps 40%) in sub-Saharan Africa, there is no way mortality can be anywhere near 10%. The reports I've read of outbreaks in sub-Saharan Africa suggest a mortality of more like 1%, sometimes less.--Solomonfromfinland (talk) 10:06, 5 May 2013 (UTC)

Thank you for pointing this out. I've reworded it to what the source actually states. ComfyKem (talk) 13:47, 5 May 2013 (UTC)

Fatality rate of (otherwise) healthy individuals in first world countries is not given as a separate category. It lists infection rates in USA and then lists global fatality rate - giving the impression that this rate applies to the USA. This would appear to be deliberately misleading. Whatdoctor — Preceding undated comment added 05:48, 12 July 2015 (UTC)

Hello! This is great article but it seems to me that there are discrepancies in the mortality's numbers: for instance one time it says 630000 deaths worldwide in 1990 in the epidemiology section and another time in the introduction it says 545000 in 1990 as well. This could be an argument for anti-vaccines lunatics to criticize such article. Can someone fix this and review the numbers? Thanks a lot. Fandediou78 (talk) 10:23, 11 September 2018 (UTC)

Citations

I recently saw two sections where it said, "This section does not cite any references or sources." However, I no longer see this, or any other notice indicating lack of proper citations. Did these sections get removed, or were citations added?--Solomonfromfinland (talk) 10:12, 5 May 2013 (UTC)

Hello. The two sections in question that had no references were titled Diagnosis and Genotypes. I have since provided sources for the diagnosis section, and the genotype section has been moved to the article Measles virus. ComfyKem (talk) 12:15, 5 May 2013 (UTC)

Hello. I see instances where no citations are offered but should be however because the page is protected, I can't edit it to suggest a citation. Measles.

barkway ([[User talk:barkway|talk]]) 11:45, 25 May 2015 (UTC)

@Barkway: Where do citations need to be added? I can add them. Tornado chaser (talk) 05:18, 26 June 2017 (UTC)

Anywhere a statement of fact, or a statement of statistics was used. The first and more obvious I saw was in the 2nd paragraph, after both the 1st and 2nd sentences. Paraphrasing here rather than copying lots of text: statement that vaccine is effective, and then the statistic about 75%...between 2011 and 2013.... Barkway (talk) 11:37, 26 June 2017 (UTC)

My mistake-Correction - In 2nd paragraph after the image of the child with the rash. Barkway (talk) 11:42, 26 June 2017 (UTC)barkway Barkway (talk) 11:42, 26 June 2017 (UTC)

I will go through and add citations where they appear neccacary. Tornado chaser (talk) 15:18, 26 June 2017 (UTC)

Fatality rate confused with Mortality rate

It states the fatality rate as x in 1000, this is the mortality rate. Because the article confuses these two types of rates the figures given need reviewing. — Preceding unsigned comment added by 86.152.113.198 (talk) 14:34, 12 May 2013 (UTC)

What's the difference (and please give a reference)? - Embram (talk) 20:00, 7 February 2015 (UTC)

See Case_fatality_rate and Mortality_rate. In short, fatality rate is the percentage of people who get sick that die and mortality rate is the percentage of people in a population that get sick and die. Rabies has a fatality rate of almost 100% but the mortality rate in the US would be less than 1 in 1,000,000. CurlyMoeLarry (talk) 20:22, 2 December 2018 (UTC)

Move complications

The subsection “Complications” should probably be moved from “Signs and symptoms” to “Prognosis”. Do you agree?--Solomonfromfinland (talk) 07:30, 15 May 2013 (UTC)

I do agree, but the current parts of Prognosis would have to be rewritten so as not to provide repetitive information. The "risk factors for complications" in the Cause section may need to be moved as well. ComfyKem (talk) 08:58, 16 May 2013 (UTC)

105

Under “Prognosis”, it says, “The vast majority of patients survive measles, though in some cases complications may occur, which may include bronchitis, and – in about 1 in 100,000 cases – panencephalitis, which is usually fatal.” (Citation deleted.) I wrote the 100,000 as 10⁵, but it was reverted. Do you think the 10⁵ form should be restored? I prefer 10⁵ because it is more concise; I don't believe in using 6 or 7 characters to write what can be written in 3.--Solomonfromfinland (talk) 05:22, 22 November 2013 (UTC)

In a non technical page like this the exponential notation is not productive. Many people are not comfortable with the notation and it may even be mistaken for a reference if it is in-line resulting in a person reading it as 10 instead of 100000 Using thousands commas is also not ideal because there is no way to determine except from context if they are an indication of 0.001 accuracy assumption instead of hinting at 100'000. I would suggest using 100000 as this is what it is and is universally understood by a reader from any country or educational background. Use in a formula or table in an engineering or scientific page would make sense.

Idyllic press (talk) 15:02, 18 September 2014 (UTC)

Medical science? Besides, counting zeros is very imprecise (compare 100000 to 1000000). 180.200.140.188 (talk) 10:12, 2 May 2015 (UTC)

The comma is very helpful and with it there is not an issue. Doc James (talk · contribs · email) 14:03, 2 May 2015 (UTC)

Disease that can be eliminated

Measles is a disease that can be eliminated and even eradicated. There are a few criteria that it fulfils to be entitled for elimination. It does not have any reservoir. There are a few other reasons. I think the list needs to be incorporated into this article. Diptanshu^Talk 08:04, 21 January 2014 (UTC)

Infection cases

There are a couple more years of US infection rates out from the CDC, but they are not terribly interesting (140, 71, 63, 220, 55, 187 for 2008-2013, respectively; this is roughly in line with the late nineties / early noughties). The current year has over 400 so far, though. I am thinking to wait until the 2014 rates are official before updating the relevant image, but I could do a provisional chart if people are interested. Relatedly, I am planning to do a version without text to facilitate use on other projects. Is there anything else people would like to see in this image? - 2/0 (cont.) 18:44, 29 June 2014 (UTC)

Copyright problem removed

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Disneyland

It would be nice to see statistics on the new outbreak going on that apparently started in Disneyland, especially the rate of infection among the vaccinated and un-vaccinated. — Preceding unsigned comment added by 184.99.114.73 (talk) 17:26, 25 January 2015 (UTC)

That's not really relevant to the article. & the entire recent outbreaks section reads like a newspaper, so it has to be rewritten. ComfyKem (talk) 20:16, 25 January 2015 (UTC)

Not exactly sure how a renewed epidemic possibly caused by reduced MMR use would not be relevant to the article. --71.55.212.99 (talk) 06:48, 31 January 2015 (UTC)

There are better ways to write about that other than creating a newspaper format in the recent outbreaks section. As stated before, that section needs to be rewritten. ComfyKem (talk) 09:51, 31 January 2015 (UTC)

"Ultra-Orthodox"

In the paragraph titled "Recent outbreaks", it begins by identifying a sect of Judaism as "Ultra-Orthodox" I am not Jewish myself, but "Ultra" seems like an offensive prefix to call any religious group. The proper name for this group is Haredi Judaism Intentionally offensive prefixes do not belong on Wikipedia per WP:GFFENSE 132.3.25.78 (talk) 20:57, 3 February 2015 (UTC)

The word "ultra-orthodox" is used in reliable sources including scientific publications. I doubt that it is offensive. Ruslik_Zero 20:07, 4 February 2015 (UTC)

Refering to the Haredi Judaism article: "However the term "ultra-Orthodox" is considered a derogatory slur by the community." Either that sentence has to go, or the usage of "ultra-Orthodox" should be exchanged for a more encyclopedic one.Jcmcc450 (talk) 17:47, 6 February 2015 (UTC)

Old graph showing Measles cases 1944-2007 better than none?

The Measles vaccine article has a graph (worth 1000 words) showing the effect of vaccines. Here's direct link at commons. Raquel Baranow (talk) 04:42, 9 February 2015 (UTC)

It is just for the USA. Have added to the subpage Epidemiology_of_measles#Outbreaks Doc James (talk · contribs · email) 11:44, 9 February 2015 (UTC)

Legal action on measles virus denial.

BBC reports: German court orders measles sceptic biologist to pay 100,000 euros on a 2011 bet on proving that ilness is caused by a virus, not a "psychosomatic" condition:

http://www.bbc.com/news/world-europe-31864218

Maybe this news piece could be worked into the "measles" article? The quite large amount of court-imposed fine suggests to merit attention even outside Germany and Europe. 2A01:368:E013:2F:49C:126D:CA13:5B7F (talk) 10:00, 13 March 2015 (UTC)

Just a note, it's not a fine. Lanka offered 100,000 euros to anyone submitting proof that measles is caused by a virus. Someone submitted proof, and when Lanka refused to pay, took him to court. The court simply ruled that the proof met Lanka's conditions and he did indeed owe 100K euros.

173.46.233.182 (talk) 22:43, 17 September 2015 (UTC)

Um, there are reports in the Alt press that this fine was overturned. Example:

I'm not qualified to pass an opinion here. — Preceding unsigned comment added by 169.0.73.99 (talk) 10:07, 13 February 2017 (UTC)

Stefan Lanka won the case by the way. Bardens could not actually demonstrate a pure isolate of the so-called measles virus. — Preceding unsigned comment added by 74.12.52.39 (talk) 17:09, 29 March 2017 (UTC)

References

Lanka has not won, because there was no proof but because german law allows a person, who sets a price upon something to set the rules, under which the price is due. That is: while the proof was perfectly correct by science standards, Lanka could still not be forced to accept science standards, he is allowed to set his own standards. He did so, like creeps of his kind use to do always.Zettberlin (talk) 21:10, 5 March 2019 (UTC)

Why is there nothing about anti-vaxxers?

Why is there no mention of anti-vaccine advocates, the cretinous subhumans who are murdering our kids with their anti-vaccine crap? DudeWithAFeud (talk) 04:38, 12 September 2015 (UTC)

probably on Vaccine controversies juanTamad (talk) 08:34, 13 September 2015 (UTC)

LOL 81.152.178.219 (talk) —Preceding undated comment added 12:09, 5 April 2019 (UTC)

Merge Stimson line

This page should link to that one but I do not see a reason to merge. Doc James (talk · contribs · email) 05:46, 13 September 2015 (UTC)

merge it into measles, maybe, eliminate Stimson line?. juanTamad (talk) 08:36, 13 September 2015 (UTC)

Semi-protected edit request on 19 April 2017

Michaelpaulstevens (talk) 15:44, 19 April 2017 (UTC)

The "Society and culture" section refers to the Stefan Lanka court case. It fails to mention Lanka's successful appeal:

I suggest the following edit, to come after the last sentence in this section:

"In February 2016 Stefan Lanka successfully appealed against the ruling. The court's decision was based on Mr Lanka requesting a single piece of work proving, scientifically, that measles is caused by a virus and the diameters of the virus. The applicant (David Barden) had, on the other hand, supplied a number of publications which can only provide proof in their totality. Therefore, the appeal was granted."

Source: Michaelpaulstevens (talk) 15:44, 19 April 2017 (UTC)

Sure added a sentence. Doc James (talk · contribs · email) 22:35, 19 April 2017 (UTC)

References

Vaccine Shedding & Risk

I saw no mention of post-vaccine risk of exposure to others from vaccine shedding and/or cases of MMR-related disease post-vaccination when there are links to medical discussions of such incidents. Example - http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20649 Barkway (talk) 11:39, 26 June 2017 (UTC)barkway Barkway (talk) 11:39, 26 June 2017 (UTC)

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Virus shedding

@Barkway: I'm not sure if this should go here, MMR vaccine might be the place for this. As far as links go, this [1] is a legit scientific publication, but I want to find a source that directly adresses virus shedding, rather that mentioning it tangentially in a case study, as for vaccine associated illness 1 case study alone probably should not be used to source any medical fact, I will look for a better source for this. This source [2] does not meet WP:MEDRS and doesn't talk about virus shedding as it claims the virus doesn't exist. This source [3] also does not say anything about virus shedding or adverse effects of the vaccine, and wikipedia cannot be used as a reference in wikipedia. This [4] is a news article about a lawsuit over whether measles virus exists, so I'm not sure what it has to do with virus shedding? I will look for better sources and try to add mention of virus shedding to either this article or MMR vaccine and like I said, the first source was legit but we need more that a case study. Tornado chaser (talk) 13:19, 27 July 2017 (UTC)

Lancet seminar

doi:10.1016/S0140-6736(17)31463-0 JFW | T@lk 19:40, 2 December 2017 (UTC)

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Semi-protected edit request on 1 February 2018

Please add the three paragraphs below after this paragraph/line: "As noted above, the ACIP has long recommended that all adult international travelers who do not have positive evidence of previous measles immunity receive two doses of MMR vaccine before traveling,[44] but it has been reported that only 47% of eligible travelers underwent vaccination during pre-travel medical consultations." in the United States section of the Epidemiology section."

ADD: Despite the elimination of measles from the United States, there is still cause for concern that cases may come from other countries and infect the population. The following event of 2007 is further evidence that the United States should consider when encouraging measles vaccination throughout the population in order to prevent outbreaks like these.

In August of 2007, an International Sporting Event in Pennsylvania brought boys aged 10-13 together from all over the world. One of these boys (Case 1) brought measles and subsequently infected six other people. Before travelling, Case 1 exhibited a sore throat and malaise. Just four days later, while in Pennsylvania, he exhibited a measles compatible rash, cough, Koplik’s spots, and a fever. Because measles is infectious from anywhere from five days before to four days after the beginning of the rash, there is a long time period through which Case 1 may have infected other people. Case 2 reports having direct contact with Case 1 while in Japan. He exhibited symptoms a few days later and was quarantined.

Measles doesn’t only infect children and also can infect adults. Case 3 was a 54 year old woman who was on the same flight as Case 1. Similarly, Case 4 was a 25 year old man who interacted with Case 1 in the customs area in Detroit. Neither patient had any documentation of receiving a measles vaccine and this is further evidence of its highly contagious nature. The fifth patient was a 40 year old sales rep who had direct contact with Case 1. This man then returned to his hometown of Houston and, on a sales visit, infected two college-age roommates. None of the cases died or showed any signs of lasting impact from measles in this outbreak. However, this is a great example of the highly contagious nature of measles and its ability to spread all over the country very rapidly. Indeed, these six cases were all infected within 10 days of each other. Ulmera2 (talk) 05:13, 1 February 2018 (UTC)

Have shortened. I am not sure all these details are needed. Doc James (talk · contribs · email) 01:06, 2 February 2018 (UTC)

References

Semi-protected edit request on 20 March 2018

Request to add nuance to the statement saying that Measles was eradicated in the Americas to reflect the recent outbreak. Below is the link to the Panamerican Health Organization monthly bulletin stating over 900 cases in Venezuela in 2017. While the region is still considered to be measles free, conveying a change in trend may be useful for the reader. Thank you.

http://www.paho.org/hq/index.php?option=com_content&view=article&id=14087%3A6-february-2018-measles-epidemiological-update&catid=2103%3Arecent-epidemiological-alerts-updates&Itemid=42346&lang=fr Imiro (talk) 23:51, 20 March 2018 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. The article does not say that measles has been eradicated so there's nothing to add nuance to. Please specify what existing text you feel needs correction. Eggishorn (talk) (contrib) 17:37, 21 March 2018 (UTC)

Discussion of a video summary that may be used on this article

• Wikipedia_talk:WikiProject_Medicine#Video_reboot

Doc James (talk · contribs · email) 13:49, 8 May 2018 (UTC)

"Humans are the only natural hosts of the virus, and no other animal reservoirs are known to exist" is a completely false statement.

"Humans are the only natural hosts of the virus, and no other animal reservoirs are known to exist" is a completely false statement.

Non human primates are carry the virus. Here are a couple sources, but it does not take a lot of work to prove this point.

Lowenstine L.J. (1993) Measles Virus Infection, Nonhuman Primates. In: Jones T.C., Mohr U., Hunt R.D. (eds) Nonhuman Primates I. Monographs on Pathology of Laboratory Animals. Springer, Berlin, Heidelberg

Willy ME, Woodward RA, Thornton VB, Wolff AV, Flynn BM, Heath JL, Villamarzo YS, Smith S, Bellini WJ, Rota PA.Management of a measles outbreak among Old World nonhuman primates

MacArthur, J. A. et al. “Measles in Monkeys: An Epidemiological Study.” The Journal of Hygiene 83.2 (1979): 207–212. Print.

None of these publications claim that nonhuman primates are natural hosts of the measles virus. Unless there's some study I'm not aware of, the only nonhuman primates that become infected are those that are raised in captivity, where they are exposed to infected humans. CatPath (talk) 19:15, 9 May 2018 (UTC)

Stefan Lanka

Correction urgently needed - he wasn't forced to pay. Decision reversed on appeal. http://www.pepijnvanerp.nl/2017/01/disappointing-outcome-of-bardens-vs-lanka-measles-proven-to-exist-but-anti-vaxxer-lanka-keeps-his-money/GreatDebt (talk) 02:43, 24 January 2019 (UTC)