The recent outbreak of measles at Disneyland is a reminder of how infections that once were eradicated can re-emerge in the 21st century. The California Public Health Department had 59 confirmed cases since the outbreak started in December. Several more cases were confirmed in states outside of California, like Mexico, Oregon, Washington State, Colorado, and Utah. There are reports that the outbreak may have started at the Anaheim park between December 15th and 20th.
Since these confirmed cases, there has been a push for unvaccinated individuals to stay away from the theme parks or get vaccinated. Children younger than 12 months should not be taken to these parks or infected areas, as they are unable to get the vaccine and thus are susceptible to the infection. It is important to remember that this infection has moved away from the parks and into schools and other communities.
This recent attack begs the general public to re-visit the age old anti-vaccination discussions since the 1800s. In fact, there was the Vaccination Act of 1853 that ordered mandatory vaccination for infants up to 3 months old. This Act extended the age to 14 years in 1867. Of course, these age thresholds have changed. The World Health Organization (WHO) recommends the first dose of vaccine to be given at age 9 months in high risk areas, and 12 months in low prevalence areas.
Fear of the measles vaccine causing autism is based on no actual evidence. Here is some evidence to back this statement:
Stratton K, Gable A, Shetty P, McCormick M. Immunization safety review: Measles-mumps-rubella vaccine and autism. Washington, DC: Institute of Medicine, National Academies Press; 2001.
What the heck is measles?
Measles is an infection that is a viral infection that causes a rash, fever, and a cough. The virus can be spread from person to person.
There is a vaccine that can prevent measles. It is called the MMR vaccine. This vaccine is unique in that it protects against, measles, mumps, and rubella. People need 2 doses of this vaccine to protect against measles. So who is at risk?
What are the symptoms?
The initial symptoms may include the following:
1. Fever as high as 104 F
2. Feeling sick, as if you have the flu
3. Loss of appetite
4. Spots in the mouth that look like grains of salt
After the initial symptoms people start feeling better after 2 days after the rash starts. By day 3 and 4 the rash turns brown and goes away.
The skin might peel or flake off.
Other symptoms include cough, shortness of breath, chest pain, or headache.
How can you make a diagnosis of measles?
The clinical history is most important as is the physical exam.
Anti-measles IgM and IgG is generally detectable in 3 days after the appearance of the rash. It may be negative on the day of the rash and as well as 30 days after the rash appears. So getting to your doctor as quickly as possible is important. However, please notify your doctor that you are coming as measles is infectious and the people in the clinic might be susceptible to the infection upon your arrival.
Is there a treatment for measles?
Not particularly. The treatment for measles is supportive. There is some role for vitamin A in certain settings. Intravenous fluids and treatment for any super imposed infections is critical. This means that there might be pneumonia or ear infection on top of the acute measles infection,
Has the recent outbreak affected your perspective on vaccinations?
Primary care has lost its appeal over the last few years. If you look at healthcare delivery from a distance, you will notice that there is this unnecessary rise in specialty care. Almost every organ is specialized! I am all for it, but boy does it get confusing as there are so many people who get involved in one's care. In the meantime, the average primary care visit has reduced to just about 7 minutes. So, how can a primary care physician go through each concern in an efficient manner? The current situation is leading to a tremendous about of physician burn out.
According to helpguide.com the following are signs that are concerning for burnout:
Not sure about you, but as a physician, I can say almost every physician I know meets this criteria. The last bullet point definitely touches on the control insurance companies have on the care we provide. Healthcare is the only business in the world where a third party decides what the customer will get and for what price, regardless of what the physician advises. This leads to tremendous frustration for the patient and their physician. The average wait time to see your primary care physician is 2-3 weeks nationally. Moreover, the cost of medications and hospitalizations continue to rise.
Finally, think about this: Do you understand everything that your insurance policy covers or not covers?
We pay such high premiums for a product that we barely understand. Why do we allow this to happen? When we go out to eat, buy merchandise, or purchase any other service we focus on the details and know exactly what we are getting in return. Now that we are required to have health insurance by Federal law, we are mandated to go to the marketplace to purchase these confusing products. It is only after an illness, major surgery, or hospitalization that we realize what kind of a coverage or lack of coverage we actually have.
Is it me or is this just crazy?!
Primary care does not need to be expensive and for that matter, health care in general should not be so expensive. Furthermore, in my journey in building a practice to help my clients the most, I have partnered with some incredible companies. I have learned that medications, laboratory, and pathology do not have to cost so much! So, why the high premiums?
Our vision at LiveActive Primary Care is for our clients to be worry free when they join. Every little service does not cost extra. We want your primary concern when you walk through our doors is, "I joined. Now let's take care of me." That attitude excites us! We will align resources with community partners at discounted rates to improve your quality of life.
Direct primary care decreases our panel of patients to less 1,000 patients! Compare that to the average 2,500 to 5,000 patients in a traditional practice! This means more time for you!
Benefits of direct primary care include:
My partner in our Health Suite 110 is an outstanding physician and a board certified Family Medicine physician. The two of us make a great team to provide you excellent care! Give us a try and we will be honored to be your personal physician for years to come!
We hope to grow the Health Suite 110 with more physicians. We would love to have a "Med/Peds" physician - this is someone who is trained in Internal Medicine and Pediatrics. We are also interested in Family Medicine or Pediatric Medicine physicians. If you or know someone that is interested, please give us a call!
We are so close to purchasing our space and next step is the complete build!! Contractors and our architect have put together some designs and we are moving forward with our vision to provide the best and comprehensive care possible.
In the meantime, please do not hesitate to give us a call as we can make house visits until our clinic is built. We are also available to provide care at retirement homes, assisted living, and any independent living arrangement. So get started today and we will waive the home visit fee until our clinic is built!
Call (913) 667-0787 or email us at info@LiveActivePC.com.
"He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all."