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MEASLES
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I’m fully vaccinated against measles. What should I know?
Can I transmit the virus? Does vaccine protection wane? Does my child get antibodies?
(Reprinted with permission) |
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Measles continues to pepper the news:
- A new outbreak in Georgia
- Report last week of a 45-fold rise in measles in Europe
- CDC released a national alert for physicians to keep an eye out for cases
I am getting a lot of questions! Here’s what you need to know if you’re fully vaccinated.
Can I get measles if I’m fully vaccinated?
The MMR vaccine works incredibly well—you’re 35 times less likely to get measles than someone with no immunity.
But nothing is perfect. A breakthrough case is rare but possible (3 out of 100 fully vaccinated people will get infected). The disease does tend to be milder.
We don’t know why there are breakthrough cases, but there are two possibilities:
- Waning immunity (see more below); or
- Vaccine didn’t work in the first place for whatever reason. 5% of people do not get protection after the first dose, but 95% of those will be fully protected after a second dose.
If I am exposed, can I transmit measles?
Transmission after vaccination, especially if you’re asymptomatic, is rare:
- We see this in the lab data. A small study found no viral shedding among asymptomatic or mildly ill patients. But this is a very old study, and we need to replicate findings with more sensitive lab equipment.
- We see this in the epidemiological data. While there are several studies showing spread among vaccinated people, especially after intense or prolonged exposure, the epidemiological implications don’t seem to be dramatic. In other words, cases don’t transmit enough to sustain outbreaks.
In 2011, there was a well-documented outbreak in New York. This was the first documented measles outbreak where the index case had two doses of MMR. Out of 88 close contacts, 4 got infected and had symptoms. Those who got infected had more than 200 contacts, and none got measles. (Note: We would expect ~90% to get infected if this population didn’t have immunity.)
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Figure by YLE
Why does the measles vaccine work better than the Covid-19 vaccine?
These are very different viruses:
- Mutates differently. Measles is much more restricted in how it mutates compared to Covid-19. For example, new versions of measles don’t come out every few months to escape our immunity. The 1960 measles virus is largely the same today. (See this previous YLE post for more).
- Infects differently. Measles is a lot slower at infection. It requires going deep into the body to start replicating. Because of this, the measles vaccine is much better at stopping transmission, as our body has much more time to control measles infection. This is different from Covid-19, which replicates on the surface of the nasal cavity very quickly. It’s hard for our cells to reach it in time to prevent replication.
If we are protected from measles for life, why are there booster rumors?
I think this happening for a few reasons:
- MMR combines protection for three diseases into one shot: Measles, mumps, and rubella. Each of these wanes at different rates, which is confusing:
- Measles. Measles antibodies are incredibly durable (the most durable of the three) but wane over time. This isn’t too concerning because we have T cell protection, too. Studies that followed people for 17 years showed the vast majority (~91%) remained above the threshold needed for protection. What happens if they continue to wane? We are at the mercy of time, but currently, outbreaks continue to occur among unvaccinated people.
- Mumps antibodies are also durable but wane faster than measles. Approximately 25% lose protection within 8 years and 50% within 19 years of vaccination. This is why some consider a third dose of MMR before kids go to college.
- Rubella wanes, too, but you’re generally considered fully protected for life. Recent studies showed that the younger a person is, the quicker it wanes. This raises the question of whether women, especially those who get pregnant at an older age, need another booster.
- Other countries are discussing the possibility of a measles booster, for example for health care workers in Korea. Studies show a booster provides benefits, but they are short-lived.
- The guidance says if you were born before 1957, it is assumed you had measles and you’re fully protected. This group can probably skip getting MMR for measles protection unless other factors are at play (e.g., chemotherapy).
As vaccines have started eliminating diseases, people’s exposure to those diseases in the community has declined. This is good news, but it also means our immune systems have had less opportunity for boosting by asymptomatic infections (i.e., hybrid immunity). We don’t know the implications of this, but we are keeping a close eye on the data.
I hear measles infection-induced immunity is more durable than vaccine-induced immunity?
This is true. Infection-induced antibodies wane less quickly among adults and fetuses compared to vaccine-induced immunity.
The problem is that an infection comes with many more risks than a vaccine. If I were to bet on it, I would rather have the odds on the right than left.
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Are babies protected if their mom was fully vaccinated?
Anyone trying to conceive should have MMR titers checked, and if levels are low, MMR should be administered 28 or more days before conception.
The vast majority of moms transfer antibodies of all three—measles, mumps, and rubella—to fetuses. Once born, antibodies wane really quickly and are almost all gone at 6-12 months of age.
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So why do we wait until 12 months to get children vaccinated?
We try to get to the sweet spot by balancing a few factors: maternal antibodies waning, maturity of the immune system, and the most common age of infection. For example, maternal antibodies can greatly reduce the infants response to the MMR vaccine. So we want to be sure these wane before getting a child vaccinated.
That said, if there is a measles outbreak, protection is needed ASAP for young children. Early vaccination is one provisional measure we can take.
Bottom line
If you’re fully vaccinated, you can be confident in your protection. We continue to follow the data, but failure to vaccinate still plays the biggest role in measles in the United States compared to vaccine failures.
Love, YLE
FORMER LAW PARTNER SENTENCED TO 10 YEARS IN PRISON FOR LAUNDERING $400 MILLION OF ONECOIN FRAUD PROCEEDS
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Former Law Firm Partner Sentenced To 10 Years In Prison For Laundering $400 Million Of OneCoin Fraud Proceeds
WPCNR FBI WIRE From U.S. Attorney’s Office, Southern District of New York
Damian Williams, the United States Attorney for the Southern District of New York, announced today that MARK SCOTT was sentenced to 10 years in prison by U.S. District Judge Edgardo Ramos for laundering approximately $400 million of proceeds from the massive international fraud scheme known as “OneCoin.” Today’s sentencing followed SCOTT’s conviction on all counts at trial on November 21, 2019.
U.S. Attorney Damian Williams said: “Mark Scott, previously convicted at trial of laundering over $400 million of OneCoin proceeds for ‘Crypto Queen,’ Ruja Ignatova, used his law license as a means to participate in a massive money laundering scheme for a cryptocurrency that had no value since its inception. Scott, an equity partner at a prominent international law firm, had boasted of earning ‘50 by 50.’ Indeed, Scott accomplished his goal, but by fraud and deception, and will now spend a decade in prison and has been ordered to forfeit all of his illegal proceeds.”
According to the Indictment, documents filed in the case, and evidence introduced at trial:
OneCoin, which began operations in 2014 and was based in Sofia, Bulgaria, marketed and sold a fraudulent cryptocurrency by the same name through a global multi-level-marketing (“MLM”) network. OneCoin began operating in the U.S. in or around 2015. The OneCoin scheme was one of the largest fraud schemes ever perpetrated. Between the fourth quarter of 2014 and the fourth quarter of 2016 alone, the scheme took in more than $4 billion from at least 3.5 million victims.
OneCoin marketed its fake cryptocurrency through a global MLM network of OneCoin members. Unlike legitimate cryptocurrencies, OneCoin had no actual value and was conceived of as a fraud from day one. The misrepresentations made to OneCoin investors were legion, and the cryptocurrency was worthless. Among other things, OneCoin lied to its members about how its cryptocurrency was valued, claiming that the price of OneCoin was based on market supply and demand, when in fact OneCoin itself arbitrarily set the value of the coin without regard to market forces. The purported value of a OneCoin grew steadily from €0.50 to approximately €29.95 per coin, as of in or about January 2019. The purported price of OneCoins never decreased in value.
SCOTT, who was employed between June 2015 and September 2016 as an equity partner at Locke Lord LLP, a prominent international law firm, was first introduced to OneCoin’s co-founder, RUJA IGNATOVA, in September 2015. Beginning in early 2016, SCOTT formed a series of fake private equity investment funds in the British Virgin Islands known as the “Fenero Funds.” SCOTT then disguised incoming transfers of approximately $400 million into the Fenero Funds as investments from “wealthy European families,” when in fact the money represented proceeds of the OneCoin fraud scheme. SCOTT layered the money through various Fenero Fund bank accounts in the Cayman Islands and the Republic of Ireland. SCOTT subsequently transferred the funds back to IGNATOVA and other OneCoin associated entities, this time disguising the transfers as outbound investments from the Fenero Funds. As part of the scheme, SCOTT and his co-conspirators lied to banks and other financial institutions all over the world, including to banks in the U.S., to cause those institutions to make transfers of OneCoin proceeds and evade anti-money laundering procedures.
SCOTT, who boasted about earning “50 by 50,” was paid more than $50 million for his money laundering services. He used that money to purchase, among other things, a collection of luxury watches worth hundreds of thousands of dollars, a Ferrari and several Porsches, a 57-foot Sunseeker yacht, and three multimillion-dollar seaside homes in Cape Cod, Massachusetts.
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In addition to the prison term, SCOTT, 55, of Coral Gables, Florida, was sentenced to three years of supervised release. SCOTT was also ordered to forfeit a money judgment in the amount of $392,940,000, several bank accounts, a yacht, two Porsche automobiles, and four real-estate properties.
Mr. Williams praised the outstanding work of the Federal Bureau of Investigation and the Internal Revenue Service – Criminal Investigation.
The case is being prosecuted by the Office’s Complex Frauds and Cybercrime Unit. Assistant U.S. Attorneys Nicholas Folly, Juliana Murray, and Kevin Mead are in charge of the prosecution.
Contact
FBI FLASH! NEW YORK PRESBYTERIAN HOSPITAL PAYS OVER $801,000 TO SETTLE CLAIMS THAT PHYSICIAN PRACTICES IMPROPERLY BILLED GOVERNMENT HEALTH CARE PROGRAMS
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New York Presbyterian Hospital Pays Over $800,000 to Settle Claims that Physician Practices in Brooklyn Improperly Billed Government Health Care Programs
Government Alleged that Radiation Oncology Practices Failed to Properly Review Images Taken for Guided Radiation Therapy
Breon Peace, United States Attorney for the Eastern District of New York, announced today that New York Presbyterian Hospital (NYPH) has agreed to pay $801,000 to resolve claims that two radiology practices improperly billed Medicare, Medicaid and TRICARE for images used in image guided radiation therapy treatments (IGRT) provided to cancer patients.
The settlement agreement, which resolved claims under the Federal False Claims Act, was approved on January 19, 2024 by United States District Judge William F. Kuntz, II.
“The defendants provided substandard care to cancer patients by not properly or timely reviewing medical imaging and then billed taxpayer funded healthcare programs for these shoddy services,” stated United States Attorney Breon Peace. “My Office is committed to holding healthcare providers accountable for such conduct.”
Mr. Peace thanked the U.S. Department of Health and Human Services, Office of Inspector General, Federal Bureau of Investigation, Office of Personnel Management, Defense Healthcare Agency, and the New York State Office of Attorney General’s Medicaid Fraud Control Unit for their work on this case.
Radiation Therapist Associates, P.C. (RTA) and Leading Edge Radiation Oncology Services, PLLC (LEROS), which are no longer operating, provided outpatient radiation oncology services to several Brooklyn communities. RTA was a physician practice located within Methodist Hospital and operated under a contract with a predecessor of NYPH. LEROS was operated by an overlapping group of physicians and was a joint venture between NYPH’s predecessor and LEROS.
IGRT is a type of cancer treatment that uses imaging technologies such as PET, MRI, and CT to deliver radiation more accurately and safely to cancer cells. It uses periodically taken images to guide the precise delivery of radiation.
The United States claimed that between 2012 and 2018, RTA and LEROS billed for images utilized in IGRT when such images were either not reviewed, or were not timely reviewed, and therefore were not reasonable and necessary. Further, the investigation found that initial consultation sessions at RTA were in some instances billed at a higher coding level than appropriate.
Under the terms of the agreement with the United States and the State of New York, NYPH will pay a total of $801,000, with $694,999.71 going to the United States and $106,000.29 to the State of New York. These funds will go to the Medicare, Medicaid, and TRICARE programs.
The settlement includes the resolution of a civil action brought under the qui tam or whistleblower provisions of the False Claims Act. Under the qui tam provisions of the False Claims Act, a private party can file an action on behalf of the United States and receive a portion of the settlement if the government takes over the case and reaches a monetary agreement with the defendant. The claims resolved by the settlement are allegations only and there has been no admission of or determination of liability.
The case is being handled by Assistant U.S. Attorney Matthew Silverman of the Office’s Civil Division.
E.D.N.Y. Docket No. 17-CV-6356
United States ex rel. RAD Claim, LLC v. Radiation Therapist Associates, P.C. et al.,
COALITION FOR THE HOMELESS: MIGRANTS HOMELESS IN NYC — FREEZING, UNABLE TO WORK — NEW YORK FAILS THEM
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COMMON COUNCIL APPROVES SEIA NEW 2 YEAR CONTRACT. DELAYS LOWERING SPEED LIMIT IN CITY TO 25 UPON FURTHER REVIEW.
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WPCNR COMMON COUNCIL CHRONICLE-EXAMINER. by John F. Bailey January 30, 2024:
The January 25 Stipulation of Agreement settling a new contract with the Service Employees International Association and the City of White Plains was passed unanimously by the Common Council last night. The contract covers city fiscal years 2024-2025, beginning July 1, and 2025-26. Workers are granted 3% raises in each year and dental contribution goes up $25 each year.
The council approved various Department of Public Works projects, but declined to pass the ordinance lowering the citywide speed limit to 25MPH subject to more discussion.
Councilman John Martin objected to lower speed limits to 25 on the wide boulevards, Hamilton Avenue and Dr. Martin Luther King Boulevard, saying he felt it would be impossible to enforce and felt the council should discuss the whole city wide plan for lowering the speed limit.
Council President Victoria Presser commented there needed to be city outreach to educate citizens on the nuances of the new speed limit restrictions.
Deputy Commissioner of Parking and Traffic, Tom Soyk said it would take about 2 months for all signage to be changed. Mayor Tom Roach said the purpose of the lowering of the speed limit was to prevent deaths, by slowing the heavier, higher SUV vehicles that hit persons in the chest at higher speeds.
It was unclear when or how the matter would be taken up.
You can see the entire Special Meeting, including the comments on speed limits at ON COMMON COUNCIL TV at
http://whiteplainsny.new.swagit.com/views/701/common-council
The 52 North Broadway mixed use residential development that has been on hold for 2-1/2 years was displayed. William Null presented a slightly changed site plan, eliminating drive through traffic, (a request of surrounding neighborhoods), a previous objection, lowering some heights of buildings to preserve the street view, and adjusting roads to accommodate DPW access and egress. It is expected to submit a site plan for Common Council approval at the next Common Council meeting. William Null, the representing attorney said the developer was fully behind the project, but without approval of the site plan by the Common Council, they could not have applied for financing the last 2-1/2 years. After approval, they could entertain bids for construction and proceed with financial arrangements and construction plans.
COUNTY EXECUTIVE GEORGE LATIMER IN WEEKLY UPDATE HIGHLIGHTS HEART MONTH, SAYS COVID IS STILL SOMETHING TO BE WARY OF, CALLS FOR NEW RECRUITS TO COUNTY EMERGENCY SERVICE . MAYOR ROACH ADDRESSES ENVIRONMENT PROGRESS IN WP –COMPLETE COVERAGE OF TODAY’S BRIEFING
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https://www.youtube.com/watch?v=qkreDF9XzPo
SEE THE COMPLETE BRIEFING ON YOUTUBE AT THIS LINK ABOVE:
NEW SPEED LIMITS PROPOSED IN WHITE PLAINS LOWER MAXIMUM SPEED TO 25 WITH EXCEPTIONS ON KEY ROUTES
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WPCNR TRAFFIC TRIBUNE. From The City of White Plains. January 29, 2024:
Added to the agenda at the Special Meeting at City Hall tonight, is an ordinance lowering the speed limit in White Plains with exceptions for key access and egress routes TO 25 MPH
Street by Street exceptions to the 25 MPH limit, elsewhere, including most of the core downtown, the speed limit is 25 MPH. Practice!
- Central Westchester Parkway: from Grant Avenue to the City Line, 45 MPH
- Mamaroneck Avenue from Bryant Avenue to the City Line, 40 MPH EXCEPT SCHOOL DAYS, when it is reduced to 25 MPH in school zones marked by flashing lights and 25 MPH flasing signs.
- Mamaroneck Avenue From Bryant Avenue both North and South Bound to BLOMINGDALE RD, 30MPH
- North Street, both North and Southbound between Ridgeway and White Plains Avenue, 40MPH, except school days when limit is 25 MPH marked by flashing lights and signs reading 25MPH.
- North Street, both North and Southbound between Ridgeway to and the City line, 40MPH
- Westchester Avenue (eastbound) between White Plains Avenue and the City line, 40 MPH
- Westchester Avenue (eastbound) between Paulding Street and the Bloomingdale Road ramp, 30MPH
- Bryant Avenue, between North Street and Westchester Avenue both eastbound and westbound, 35MPH. From North Street to Mamaroneck Avenue, 30MPH
- Westchester Avenue Frontage Road eastbound from Bloomingdale Road ramp to I-287 eastbound junction, 40MPH
- Bloomingdale Road, 30MPH
- Central Avenue, 30 MPH
- North Broadway, northbound and southbound between Barker Avenue and the Cityline, 30MPH.
- Old Mamaroneck Road , northbound and southbound, between Bryant Avenue and the City line. 30MPH
- Tarrytown Road. 30MPH
- White Plains Avenue
A letter included in the “backup material” the speed limit is being lowered under the new New York State Legislation (A.1007, A/S.2021-A) which now allows cities to reduce city wide limits to 25 miles per hour in the amended Section 1643 of the Vehicle and Traffic Law. The former traffic the default maximum speed through a city, town, or village was 30 MPH.
By giving municipalities local control to reduce speed limits, this legislation will improve public safety and prevent pedestrian fatalities.
The amendment to the city Traffic Ordinance is in accordance with recommendations of the Transportation Commission, Department of Parking/Traffic Division and is to become effective upon adoption by the Common Council.
JAN. 29: COVID, FLU, RSV INFECTIONS DECLINE IN NORTH EAST. “WAVE” IN DECLINE: DR. CAITLIN RIVERS
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Welcome to the Northeast edition of Outbreak Outlook! It is only available to paid subscribers. If you wish to become a paid subscriber and access region-specific information, please click the Subscribe Now button below. Thanks for reading! -Caitlin
Respiratory Diseases
ILI
The Northeast continues facing moderately elevated flu activity in outpatient settings, though the situation is improving rapidly.
Northeast Region: ILI Activity
Percent of doctors visits for ILI symptoms
In Maine, influenza-like illness (ILI) has persisted, with a slight increase of 0.3%. Rhode Island and New Hampshire have experienced relatively stable ILI levels over the past week.
On the other hand, several states have seen significant declines in ILI. For instance, Pennsylvania had a decrease of 0.5%, Massachusetts saw a drop of 0.7%, New Jersey experienced a reduction of 0.9%, and Vermont had a decline of 0.3%. These numbers suggest that ILI has peaked in these areas.
Northeast Region: Change in ILI Activity
Percent of doctors visits for ILI symptoms
Influenza hospitalization rates also retreated across the board last week, with the steepest decreases seen in New Jersey, Massachusetts, and New Hampshire. More moderate yet meaningful drops happened in New York, Connecticut, Pennsylvania, and Maine as well.
Overall the data indicates peak flu activity likely occurred for most Northeastern states based on region-wide declines in hospitalizations. However pockets of stubborn ILI persist, keeping outpatient severity levels still moderately elevated.
COVID-19
The Northeast region experienced a drop in Covid-19 hospitalization rates over the past week, with weekly admissions falling 0.8 per 100,000 population. The decline, from a peak of 13 to 9 per 100k, suggests hospital burdens have started easing across Northeastern states after this season’s wave.
Northeast Region: New COVID-19 Hospitalizations
Average rate per 100,000 population
At the state level, decreases were observed in every state over the past week. The most significant declines were in Maine, Rhode Island, and New Hampshire. Additional substantial drops were seen in Vermont, New Jersey, and Massachusetts.
Smaller reductions were reported by Pennsylvania, New York, and Connecticut. With all 9 Northeastern states showing falling hospitalization levels, the region appears to be moving past its peak.
Northeast Region: Change in New COVID-19 Hospitalizations
Weekly new hospitalizations per 100,000
RSV
The Northeast mostly saw decreases in RSV PCR test positivity rates over the past week. Maine saw the most substantial drop at -2.9 percentage points. Other meaningful declines occurred in New Hampshire (-1.0 point), Massachusetts (-1.0 point), and New York (-0.8 points). Smaller decreases happened in Vermont, Connecticut, New Jersey, and Pennsylvania. Rhode Island did not report RSV data.
Northeast Region: RSV Activity
Test Positivity, Percentage
Stomach Bug
Norovirus activity in the Northeast is remaining steady, with test positivity around 11%. This first quarter of the year tends to be when norovirus circulates widely, so be cautious over the next few months. Remember that hand sanitizer is not particularly effective at preventing norovirus; soap and water is best.
Northeast Region: Norovirus Activity
Test Positivity, Percentage
Food recalls
The following foods are being recalled because they are contaminated. Please check your cupboards and throw out any of these items:
New
- Robitussin Honey CF Max cough syrup products (more info)
Previously reported:
- Brightfarm Spinach and Salad Kits (more info)
- Charcuterie meats sold by Fratelli Beretta and, newly, Busseto (more info)
- Tons of different granola and oatmeal products from Quaker (more info).
- If you have food allergies, you may wish to review these FDA safety alerts and USDA alerts for foods with undeclared allergens.
In other news
- Blastomycocis, a fungal infection mostly commonly associated with the northern Midwest and parts of the Southeast, is now being found more commonly in other regions, including Vermont. Blastomycosis is caused by a fungus that is found in wet soil and decaying organic matter. The illness is challenging to diagnose because its symptoms resemble other respiratory infections, including fever, and body aches. If untreated, can lead to serious illness or death. New research indicates a higher prevalence than previously known. A study examining health insurance claims in Vermont between 2011 and 2020 identified 114 cases, with 30% requiring hospitalization.
COMMON COUNCIL SPECIAL MEETING TAKES UP NEW CIVIL SERVICE WORKERS CONTRACT. TWO YEAR CONTRACT 3% EACH YEAR. REVISED PROPOSAL FOR FORMER GOOD COUNSEL PROPERTY
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WPCNR COMMON COUNCIL CHRONICLE-EXAMINER. From the City of White Plains. January 29, 2024:
A Special Meeting of the Common Council tonight is scheduled to vote on a new contract with Civil Service Employees Association. The meeting was announced by the City Friday. D
The new contract runs for two years and provides raises of 3% in the first year and 3% in the second year. The position of Legislative Aid will be established. The dental contribution will be increased $25 in each year.
The Common Council will also be presented with a newly revised proposal for the former Good Counsel property, at 52 North Broasway that has not been taken up since 2020. The former plan is pictured below.
Former plan for the 52 North Broadway property, formerly owned by the Sisters of the Good Counsel, that has not been considered since November 2020 when the covid epidemic was sweeping the city.A revision to it will be presented this evening.
The Special Meeting begins at 6:30 P.M. EST at City Hall, 255 Main Street,