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According to a new, uncommon study, Chicago, Los Angeles and Miami are the cities most likely to experience future measles outbreaks.
Researchers at the University of Texas at Austin and Johns Hopkins University have mapped the 25 counties most at risk for measles because of their vaccine and vaccine exemption rates. the proximity of airports.
A similar map published last year has been surprisingly accurate in the prediction of many cases this year. But the two groups of scientists failed to predict the outbreak of measles that began in Brooklyn, the largest in the country.
One expert noted that these forecasting models need to be refined and that disease control and prevention centers should make them a priority in the fight against measles cases.
The study, published this week in The Lancet Infectious Diseases, revealed that Cook County, which includes Chicago, was the most likely to experience a measles outbreak. The counties of Los Angeles and Miami-Dade came next, followed by Queens County in New York and counties including the cities of Seattle, Phoenix, Fort Lauderdale, Las Vegas, Houston and Honolulu.
To assess the risks, the researchers examined the number of children in The counties of the country enjoyed non-medical exemptions in immunization, including "religious", "philosophical" or "personal convictions" exemptions, according to state law.
The team then focused on countries with international airports, since every US outbreak since 2000 began with a case imported from overseas.
They have given greater weight to airports with many passengers from countries with thousands of measles cases, including India, China, Mexico, Japan, Ukraine, the Philippines and Thailand.
However, the two studies failed to predict what is currently the largest epidemic in the country – that which affects orthodox Jews in the Williamsburg district of New York – which is located in Brooklyn, not in Queens.
(The Lancet authors stated that their predictions were correct about two-thirds of the time, provided that counties "spatially adjacent" to those that they considered to be potential hot spots were included.)
"What we have not calculated at all is that it would come from Israel," said Sahotra Sarkar, professor of philosophy and integrative biology at the University of Texas at the University of Texas. Austin and co-author of the new study.
A similar study published last June in PLOS Medicine assessed the risk of measles outbreaks in 18 states benefiting from an exemption from philosophical or personal beliefs about immunization. The research was conclusive: nearly half of the meteorological hot spots reported by scientists – particularly Washington, Texas, and Michigan – had an epidemic this year.
"In the major leagues, it's a stellar batting average," said Dr. Peter J. Hotez, director of the Vaccines Development Center at Texas Children's Hospital and co-author of the "Children's Hospital". PLOS Medicine study.
Dr. Hotez and his colleagues have not examined the state of New York because it does not provide for "philosophical" exemptions to vaccination, although the state allows the religious authorities – a loophole that the legislator plans to remove.
"What I did not expect was an epidemic in Jewish communities," joked Dr. Hotez. "In my book, the Jews make vaccines. (Dr. Hotez, a Jewish researcher on tropical disease vaccines, cited pioneers such as Albert Sabin, Jonas Salk, Stanley Plotkin, and Rachel Schneerson.)
Drs Hotez and Sarkar said they would need to learn to better take into account the fact that immunization rates are not evenly distributed among the urban counties. low rates tend to cluster in smaller ethnic, religious or educational communities.
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According to the C.D.C., over the last five years, 75% of measles cases have occurred in very united communities, such as Somalis in Minneapolis, Amish in Ohio and Orthodox Jews in Brooklyn.
The measles outbreak this year in Clark County, near Portland, Washington, includes 72 cases related to Russian-speaking immigrants from the former Soviet Union, according to a Vox article quoting C.D.C. sources. Many immigrants were skeptical about the government's medical requirements, including vaccination.
According to Dr. Sarkar, near Austin, Texas, vaccination rates are the lowest among children attending Waldorf schools and some charter schools where families refuse vaccination.
Andrew Wakefield, the former British doctor who launched the misconception that measles vaccine is at the root of autism, has influenced many people, although this research was discredited long ago.
After losing his medical license, Mr. Wakefield moved to Austin, where he directed films condemning the vaccination.
"He has a very well-off clientele here," said Dr. Sarkar.
The Austin area is number 22 on its list of places most likely to experience a measles outbreak.
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