McHenry County pediatricians watching measles outbreak with concern

McHenry County pediatrician Dr. Laura Buthod has never seen a case of measles in her more than 20 years of practice.

Neither have Dr. Celina Miller nor Dr. Michael Fell, local pediatricians who have practiced almost as long.

Just 15 years ago, the Centers for Disease Control and Prevention declared the dangerous disease eliminated in the U.S. meaning it was no longer considered a consistent threat. In 2004, only 37 cases were diagnosed nationwide.

But that number has been surging upward in recent years, blamed in significant part on people who choose not to vaccinate their children. Thirty-four measles outbreaks were reported in the prior two years alone, totaling about 200 in 2013 and a preliminary 644 in 2014. The U.S. is now gripped by a significant multi-state measles outbreak, with at least 120 cases in 17 states as of last week, when the CDC last updated its data.

With a cluster of 10 cases confirmed in the Chicago area, nine of them tied to a KinderCare Learning Center in Palatine, local pediatricians are hoping that they don't see any cases themselves, and are urging parents who have chosen not to vaccinate their children to change their minds and not rely on inaccurate data linking vaccines to autism and other disorders.

“Now it’s a public health concern, because you’re putting other people’s lives at risk,” Miller said.

Illinois allows residents to opt their children out of the measles, mumps and rubella, or MMR, vaccine for either medical or religious reasons. While the percentage of vaccinated students in McHenry County schools stands at about 95 percent, the number of students citing religious exemptions is rising and stood at 548 last year, according to the McHenry County Department of Health.

Exemptions, as well as the strictness of the rules by which to acquire them, vary by state. Some states also allow exemptions for philosophical reasons – Illinois does not – while others allow no exceptions, except for a very significant medical reason, such as having a compromised immune system.

Children at highest risk are the immuno-compromised and children younger than 5 years old, especially infants who cannot get the MMR vaccine until they are at least a year old. It’s for this reason that a growing number of pediatricians have made the decision to not take non-vaccinated children as clients.

Fell, an Advocate Health Care physician, said his firm's clinics, including Children and Teens Medical Center in Lake in the Hills, have a simple rule that can be found on their website – if you choose not to vaccinate your children, even after the doctor has tried to convince you with sound science to do so, you have to find another pediatrician. While the main reason for the rule is the safety of other patients in the office, Fell said opposition to vaccination "strikes at the core" of the trust between patient and doctor.

“It creates a divide in the patient-physician relationship. If you feel that strongly about vaccination, how do we know you won’t feel strongly about any other [treatment] we believe in?” Fell said.

But Buthod and Miller, whose Crystal Lake and McHenry offices are part of Centegra Health System, do not have such a restriction. Buthod's office used to, but reversed course several years ago after the American Academy of Pediatrics recommended that pediatricians work with parents and try to convince them to change their minds.

Clients who refuse to vaccinate who see pediatricians in Buthod’s office are required to fill out a refusal form, and are bluntly told that vaccines are safe and defend against diseases that kill. And not a visit goes by without that information being pounded home, Buthod said.

The main culprit according to the doctors is a discredited 1998 study, published in the United Kingdom medical journal The Lancet, that linked the MMR vaccine to autism. It was discovered that the medical records on which the study had been based had all been manipulated, and that the paper’s lead author, who has since been stripped of his credentials to practice medicine, stood to gain financially because he applied for a patent for an “alternate” measles preventative agent just months before the study was published.

It was not until 12 years later, in 2010, that The Lancet retracted the article in its entirety.

“That’s what really started people second-guessing the safety of vaccination and particularly MMR. It’s taken some time for us to get the confidence of our parents back, that no, this does not cause autism – vaccines do not cause autism,” Buthod said. “You can’t go to your TV set or the Internet and say you’ve gotten all sides of the issue and all the facts.”

Also, vaccinations have been a victim of their own success in the fight against communicable disease, Buthod said. Parents today who oppose vaccination based on faulty science might be fooled into being more comfortable with their decision because they – unlike previous generations of parents who lived in fear of tetanus, polio, diphtheria, early-childhood meningitis and other deadly diseases – haven’t had to deal with epidemics.

While Miller has never seen a case of measles as a doctor, she saw it all the time growing up in the Philippines. Particularly bad cases can result in pneumonia, permanent hearing loss, brain damage if encephalitis sets in, and in some cases, death.

“It was one of those, ‘Oh my gosh’ diseases – you didn’t want anyone to get that,” Miller said.

Both Buthod and Miller said they have changed the minds of several of their handfuls of parents who opposed vaccination. But Fell said, despite the American Academy of Pediatrics recommendation, changing his group’s philosophy would not be fair to parents who do vaccinate, and would amount to tacit approval of the practice.

“I think we listen to what [opponents] have to say, but there’s only so many times you can beat your head against the wall,” Fell said.

Fell said he hears from a number of parents who are angry and upset about those who don’t vaccinate. An observation he sometimes hears from them is that they cannot send their children to school with peanut-butter sandwiches because a student may get an allergic reaction, but they can get an exemption to send their kids to school un-immunized against contagious disease.

All three pediatricians said they hope that the ongoing outbreak convinces parents who have not yet done so to have their children immunized.

“Every time you say no to a vaccination, you are putting that child at risk of death,” Miller said.