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Measles is one of the deadliest and most contagious infectious diseases – and one of the most easily preventable

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Measles is one of the deadliest and most contagious infectious diseases – and one of the most easily preventable

Young children, pregnant people and the immunocompromised are among the most vulnerable to measles.
CHBD/E+ via Getty Images

David Higgins, University of Colorado Anschutz Medical Campus

“You don't count your children until the measles has passed.” Dr. Samuel Katz, one of the pioneers of the first measles vaccine in the late 1950s to early 1960s, regularly heard this tragic statement from in countries where the measles vaccine was not yet available, because they were so accustomed to losing their children to measles.

I am a pediatrician and preventive medicine physician, and I have anxiously watched measles cases rise worldwide while vaccination rates have dropped since the early days of the pandemic due to disruptions in vaccine access and the spread of vaccine misinformation.

In 2022 alone, there were over 9 million measles cases and 136,000 deaths worldwide, an 18% and 43% increase from the year before, respectively. The World Organization warned that over half the world's countries are at high risk of measles outbreaks this year.

The U.S. is no exception. The country is on track to have one of the worst measles years since 2019, when Americans experienced the largest measles outbreak in 30 years. As of mid-February 2024, at least 15 states have reported measles cases and multiple ongoing, uncontained outbreaks.

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Measles is on the rise across the U.S. once again, despite being eliminated in 2000.

While this measles crisis unfolds, U.S. measles vaccination rates are at the lowest levels in 10 years. Prominent figures like the Florida surgeon general are responding to local outbreaks in ways that run counter to science and public health recommendations. The spread of misinformation and disinformation from anti-vaccine activists online further promotes misguided ideas that measles is not a serious health threat and measles vaccination is not essential.

However, the evidence is clear: Measles is extremely dangerous for everyone, and especially for young children, pregnant people and people with compromised immune . But simple and effective tools are available to prevent it.

Measles is a serious illness

Measles is one of the most deadly infectious diseases in human history. Before a vaccine became available in 1963, around 30 million people were infected with measles and 2.6 million people died from the disease every year worldwide. In the U.S., measles was responsible for an estimated 3 million to 4 million infections. Among reported cases, there were 48,000 hospitalizations, 1,000 cases of encephalitis, or brain swelling, and 500 deaths every year.

Measles is also one of the most contagious infectious diseases. According to the Centers for Disease Control and Prevention, up to 9 out of 10 people exposed to an infected person will become infected if they don't have protection from vaccines. The measles virus can stay in the and infect others for up to two hours after a contagious person has left the room. Measles can also hide in an unknowing victim for one to two weeks and sometimes up to 21 days before symptoms begin. Infected people can spread measles for up to four days before they develop its characteristic rash, and up to four days after.

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Close-up of abdomen with red measles rash
One characteristic measles symptom is a rash that spreads from the face to the rest of the body.
CDC/Heinz F. Eichenwald, MD

The initial symptoms of measles are similar to those of many other common viral illnesses in the U.S.: fever, cough, runny nose and red eyes. Several days after symptoms begin, characteristic tiny white spots develop inside the mouth, and a facial rash spreads to the rest of the body.

While most people's symptoms improve, 1 in 5 unvaccinated children will be hospitalized, 1 out of every 1,000 will develop brain swelling that can to brain damage, and up to 3 of every 1,000 will die. For unvaccinated people who are pregnant, measles infection can lead to miscarriage, stillbirth, premature birth and low birth weight.

The risk of severe complications from measles persists even after a person appears to be fully recovered. In rare cases, people can experience a brain disease called subacute sclerosing panencephalitis that develops seven to 10 years after infection and to memory loss, involuntary movements, seizures, blindness and eventually .

Beyond these individual health effects, the financial cost to society for containing measles outbreaks is significant. For example, a 2019 measles outbreak in Washington state is estimated to have cost US$3.4 million. Necessary efforts to control measles outbreaks pull millions of dollars' worth of critical resources away from other essential public health functions such as ensuring food safety, preventing injuries and chronic diseases, and responding to disasters.

Vaccines protect against measles

Why put communities at risk and allow these societal costs from measles when effective and safe tools are available to protect everyone?

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Measles vaccines have been so effective, providing lifelong protection to over 97% of people who receive two vaccine doses, that they are victims of their own . Initial widespread measles vaccination had reduced measles cases by 99% compared to before the vaccine was available, and consequently, most people in the U.S. are unaware of the seriousness of this disease.

Person looking at Florida Health measles and MMR shot information sheet
Measles is a highly preventable disease.
Paul Hennessy/NurPhoto via Getty Images

Despite the success of highly effective vaccination programs in the U.S., anyone can still come into contact with measles in their community. Measles is most often brought into the U.S. by unvaccinated American travelers returning home and sometimes from foreign visitors. For people traveling out of the country, the threat of measles exposure is even greater, with widespread outbreaks occurring in many travel destinations.

Public health leaders who embrace and promote vaccination and follow simple, proven infectious disease containment measures can prevent measles disease spread. Every single preventable illness, complication, hospitalization or death from measles is one too many.The Conversation

David Higgins, Research Fellow and Instructor in Pediatrics, University of Colorado Anschutz Medical Campus

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Brain study identifies a cost of caregiving for new fathers

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theconversation.com – Darby Saxbe, Professor of Psychology, USC Dornsife College of Letters, Arts and Sciences – 2024-05-09 07:33:13

Dads have stepped up to do more hands-on parenting over the past few decades.

Abraham Gonzalez Fernandez/Moment via Getty Images

Darby Saxbe, USC Dornsife College of Letters, Arts and Sciences

Parenting makes the heart grow fonder, and the brain grow … smaller? Several studies have revealed that the brain loses volume across the transition to parenthood. But researchers like me are still figuring out what these changes mean for parents.

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In a new study that looked at brain change in first-time fathers, my colleagues and I found that brain volume loss was linked with more engagement in parenting but also more sleep problems and mental symptoms. These results might point to a cost of caregiving, traditionally shouldered by women but increasingly borne by also.

Brain changes for mom come with new baby

Caring for an infant demands new motivations and skills, so it is no surprise that it might also sculpt the brain. Research in rodents first identified remodeling of both the structure and function of the brain during pregnancy and parenthood. A new body of research is unearthing similar effects in human parents, too.

In a pair of studies, researchers recruited first-time mothers for a brain scan that occurred before they became pregnant and then scanned them again a few months after birth. Gray matter – the layer of brain tissue that contains neuronal cell bodies – shrank in the mothers but not in a comparison group of women who did not become mothers.

Although a shrinking brain sounds bad, researchers theorized that this more streamlined brain could be adaptive, helping social information more efficiently and therefore facilitating sensitive caregiving. In keeping with this hypothesis, studies have linked maternal brain changes with women's degree of attachment to infants and with their responses to images of their infants. Women who lost more gray matter volume also appeared more bonded with their babies.

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New dads' brains change, too

Most studies of the parental brain have focused on women, but emerging evidence suggests that similar brain changes might occur in new fathers, too. My collaborators and I had previously identified brain volume loss in men transitioning to fatherhood, in similar parts of the brain that changed in mothers.

Before you picture the shrunken-head guy from the “Beetlejuice,” keep in mind that these changes were subtle. Fathers showed smaller, less statistically significant brain changes than mothers.

Dads vary in how invested they are in caring for the baby, so as a next step, we wanted to know how men's brain changes across the transition to fatherhood map onto their experiences of new parenthood.

To test this question, we looked more closely at 38 men we scanned in California before and after their baby's birth. During pregnancy and again at three, six and 12 months postpartum, we asked the fathers how they were feeling about their infants and how well they were sleeping. We also asked about their symptoms of depression, anxiety or other mental health problems.

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As before, we saw significant prenatal-to-postpartum brain differences across the entire cortex, the outermost layer of the brain that carries out many higher-order functions, such as language, memory, problem-solving and -making. On average, men in our sample lost about 1% of their gray matter volume across the transition to parenthood.

Consistent with the research on mothers, men's brain volume reductions did indeed seem to track with their parenting. If men told us during pregnancy that they wanted to take more time off from work after the birth, and felt more bonded to their unborn child, they subsequently lost more gray matter volume, especially in the frontal and parietal lobes – parts of the brain involved in executive functioning and sensorimotor processing, respectively.

3D rendering illustration of brain inside transparent head

Engaged fathers lost more brain volume in the frontal lobe, colored blue, and parietal lobe, colored yellow.

libre de droit/iStock via Getty Images Plus

Greater volume loss also emerged among fathers who told us that they spent more time with their infants at three months postpartum, took more pleasure in interacting with their infants and experienced less parenting stress. Taken together, our results dovetailed with the prior studies of mothers and suggested that more motivated, hands-on fathers lost more gray matter volume across their transition to parenthood.

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The plot thickened when we looked at mental health and sleep quality. Men who lost more brain volume also reported greater depression, anxiety, general psychological distress and worse sleep at both six and 12 months after birth. These results held up when we controlled for the same measures during pregnancy.

This finding provides a clue to a possible direction of causality: Rather than prenatal sleep problems or psychological distress predicting greater brain change, we found instead that fathers' gray matter volume loss preceded their postpartum sleep problems and mental health, above the effect of their well-being before birth.

Parenting comes with highs and lows

Importantly, this research is preliminary: We had a small sample of fathers who were willing to participate in our intensive research study. These results need to be replicated in larger and more representative groups of fathers.

Still, as one of the first longitudinal studies of male brain changes across the transition to first-time parenthood, our findings illustrate that perinatal brain changes may reflect both adaptation and vulnerability. The very same changes linked with fathers' greater investment in caregiving also seemed to heighten their risk of sleep trouble and mental health problems.

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man seated on floor with his hand to his head, supporting a crying baby

with a baby can be tough.

Prostock-Studio/iStock via Getty Images Plus

As any new parent will tell you, caring for an infant is a . Becoming a parent forces a realignment of life priorities and can bring magic and meaning to everyday life. But parenting can also be dull, repetitive, lonely and draining.

Perhaps our findings in fathers point to a cost of caregiving, a burden that has long been familiar to mothers but may be increasingly shared by men as fathers step up their participation in hands-on parenting.

The take-home message here is not that men should stop caring for children. A slew of research suggests that children with involved fathers do better across the board: academically, economically and emotionally. And fathers themselves that parenthood makes their lives richer and more meaningful.

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Instead, results like these public health priorities that invest in fathers – and parents in general – through policies that reduce stress for new parents in the first months after birth, such as paid leave and workplace efforts to normalize -taking among men.The Conversation

Darby Saxbe, Professor of Psychology, USC Dornsife College of Letters, Arts and Sciences

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Section 702 foreign surveillance law lives on, but privacy fight continues

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theconversation.com – Peter Swire, Professor of and Ethics, Georgia Institute of Technology – 2024-05-09 07:32:58

The E. Barrett Prettyman Federal Courthouse in Washington, D.C., houses the U.S. Foreign Intelligence Surveillance Court.

AP Photo/ Evan Vucci

Peter Swire, Georgia Institute of Technology

What would you do if you had to vote in Congress on a crucial national security program, when you also knew that the FBI had systematically ignored privacy safeguards in the program for years? That was the choice that Congress in April, when it ultimately decided to reauthorize Section 702 of the Foreign Intelligence Surveillance Act, known as FISA.

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Section 702 originally became law in 2008, when a great deal of previously “foreign” surveillance had shifted to the United States. In the old days, the National Security Agency carried out its communications surveillance overseas, such as keeping an eye on China or the Soviet Union. By 2008, however, the most important national security surveillance was often obtained within the U.S., such as when emails came through the United States as part of internet traffic.

Section 702 addressed this mix of foreign and domestic data gathering. Under court-approved procedures, it allows the to gather communications, but only where the target of the surveillance is a foreign person who is outside of the U.S. Although no court approval is needed when the NSA intercepts communications overseas, Section 702 requires court-approved safeguards when the information gathering occurs in the U.S.

This lecture explains the origins and purpose of Section 702.

Privacy violations

NSA surveillance triggered headlines in 2013 when the revelations by former agency contractor Edward Snowden showed that the amount and type of government surveillance had grown far beyond what even experts realized after the terrorist attacks of Sept. 11, 2001. I was honored to be named by President Barack Obama to a special Group on Intelligence and Communications Technologies in 2013 to propose surveillance reforms. Our report was one of the sources for the USA Freedom Act of 2015, the biggest set of privacy reforms for surveillance since FISA was created in 1978.

Even after these reforms, however, two types of problems cast doubt on how the FBI in particular was using its FISA authorities. First, the FBI was not the procedures required by the courts for accessing information about Americans in the Section 702 databases. As a result, the FBI conducted over 3 million searches of Americans' email and other records in 2021. After a public furor and changed policies, that number dropped to 119,383 in 2022.

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Second, during the 2016 campaign, the FBI began an investigation into whether people associated with the Trump campaign were coordinating activities with the government of Russia, as part of what became known as the Crossfire Hurricane investigation. Although the Department of Justice Inspector General Michael Horowitz found “no evidence that the FBI consulted” with any political in opening its investigation, he found significant violations in FISA applications. These included submitting legal documents to judges with allegations that the FBI knew were incorrect. Horowitz also found that the incident highlighted the weakness of existing rules against a politically motivated investigation.

Renewal debate

The FISA 702 authority was set to expire at the end of 2023, but Congress extended the authority until April 19, 2024. Perhaps the biggest controversy was whether access to Americans' data in the 702 databases should be available only with a warrant issued by a judge, upon showing probable cause. Privacy advocates argued that such a warrant requirement would protect Americans' constitutional rights, while the government said the requirement would be unworkable in practice.

Assistant Matthew G. Olsen explains the Justice Department's position on renewing Section 702, its opposition to a requirement for warrants to query the surveillance data about Americans' information.

The Privacy and Civil Liberties Oversight Board, an independent executive branch agency that makes nonbinding recommendations about privacy and civil liberties aspects of national security, split 3-2 in favor of requiring such a warrant.

In the House of Representatives, the motion to require a warrant resulted in a tie vote, falling short of the simple majority it needed to pass. The House eventually did reauthorize the FISA 702 program, by a vote of 273-14, but only for two years rather than the longer period sought by the administration. Soon after, as the deadline approached, the Senate approved the same law, 60-34.

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Although the warrant requirement did not pass, the law included reforms that supporters said would address the flaws in the FBI's previous actions. House Speaker Mike Johnson published a list of 56 key reforms to make FISA more protective of privacy. Some of the reforms created new safeguards to limit the FBI's ability to query the 702 databases about Americans. Others created new rules to trigger congressional and senior administration scrutiny for sensitive investigations such as those affecting political officials.

Renewal fight, Round 2

Privacy advocates, however, have been far from satisfied with the new amendments to FISA. For instance, the Electronic Privacy Information Center, the Brennan Center for Justice and FreedomWorks issued a paper stating: “Making 56 ineffective tweaks to a fundamentally broken law is not reforming it.”

These sharply conflicting viewpoints put members of Congress into a difficult spot. Many felt that the FBI deserved stricter measures to hold it accountable for its serious legal violations. I share that concern. On the other hand, I have had the during the presidential review group process to learn how Section 702 is used to protect the national security of our country. In a statistic I find credible, 60% of the president's daily intelligence briefings in 2023 contained Section 702 information reported by the NSA.

The result, for now, is that Section 702 is due to expire in April 2026. Congress will once again confront a genuinely difficult : how to protect U.S. national security while also upholding Americans' privacy and the rule of law.The Conversation

Peter Swire, Professor of Law and Ethics, Georgia Institute of Technology

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This article is republished from The Conversation under a Creative Commons license. Read the original article.

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watch out for foxtail seed pods that can harm your dog or cat this summer

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theconversation.com – Erik Olstad, Health Sciences Assistant Professor of Clinical Veterinary Medicine, of California, Davis – 2024-05-09 07:32:46

A foxtail seed pod.

Dario Argenti/Moment via Getty Images

Erik Olstad, University of California, Davis

Across much of the United States, spring is in full force. With warmer weather, people are taking their furry members out on longer walks and spending more time outside. Alongside blooming flowers and trees, your pet might into a small, unassuming grass seed pod known as a foxtail. Despite the cute name, foxtails can pose a major threat to your pet's health.

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I am a veterinarian in California's Central Valley, and foxtails are a issue where I work, especially during the spring and summer months.

What exactly are foxtails?

A seed pod that has lots of long seeds with sticky tendrils coming off each one.

Hordeum murinum, or wall barley, is a common source of foxtails.

Curtis Clark/Wikimedia Commons, CC BY-SA

A foxtail isn't a specific plant. It is a type of grass seed pod that resembles a fox's tail. Multiple species of grass can create this type of seed pod, and foxtails are found across much of the United States. Regions of the western U.S., especially California, have the most foxtails.

The outside of the foxtail is covered in small sticky hairs designed to stick to things. You can feel them yourself if you pull a foxtail off a plant. Rub your fingers against the seed one way, and then the other, and you'll feel that one direction is smooth and the other direction is sticky.

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Foxtails aren't a big deal for people, as we don't have a lot of hair and tend to things that are itchy or painful, but it's a different story for pets.

A segment of the foxtail pod sticks to an animal's fur, where it's carried around until it eventually drops off and grows into grass. This sticky feature is great for the grass, as it helps spread the seeds around, but it also results in foxtail segments getting stuck to pets.

Once on the cat or dog, a segment of a foxtail can burrow into the skin, get stuck in the eyes, creep into ears, be inhaled into the nose, or even make its way into the lungs.

The health dangers of foxtails

The most common place where foxtails will burrow into a pet is the skin, especially in between dogs' toes. A foxtail embedded into the skin can cause irritation, redness, pain and infection. As the foxtail gets deeper into the skin, it brings harmful bacteria with it and creates a path of infection known as a draining tract.

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If a foxtail makes it into a dog's or a cat's ear, the pet will likely start shaking its head back and forth – it might look like it has an ear infection. The embedded foxtail can cause discomfort and sometimes infection.

A foxtail can stick to a pet's eye tissues, especially in cats, and migrate around the outer portions of the eye or behind the third eyelid, which is the protective tissue near the inner corner of their eye. This will cause discharge from the eye and discomfort and may scratch the eye's surface.

One of the most serious locations for a foxtail is in the lungs. Dogs may inhale foxtails while running through fields and breathing hard. The foxtail can sometimes get stuck in the nose, which will cause the pet to sneeze and look uncomfortable. Occasionally, a piece of a foxtail makes its way into the lungs, which can result in severe infection, trauma and even death. Surgery and hospitalization are almost always required in these cases.

Foxtail symptoms

Pet owners can learn what symptoms to look out for in order to make sure their pet gets prompt care if they end up with a foxtail embedded somewhere.

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If you see your dog or cat chewing on their paws, this might indicate that a foxtail has ended up in between the toes. Their paws may swell or grow red. If you see even a small pimplelike swelling in between your pet's toes, they may have a foxtail stuck in their paw.

Foxtails can get into a pet's nose, ears, eyes, lungs and more.

If your pet is frequently shaking its head, this can indicate that a foxtail made its way into the ear canal. Drainage or discharge from the eye can indicate that foxtail may have made its way around the eye. Sneezing or pawing at the nose can mean the foxtail may have made its way into the nose. Foxtails in the ear canal, eyes or nose will need to be by a veterinarian.

Coughing or hacking might mean a foxtail has made it to the tissues around the throat or the tonsils, or even deeper into the lungs. Each one of these symptoms requires care from a veterinarian, as they can grow serious if left untreated.

Preventing foxtail risks

Foxtails are everywhere in the , but there are some preventive steps pet owners can take to minimize the risks to their pets.

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If you have foxtails in your yard, you can remove them. Sometimes you can get rid of foxtails permanently, but this isn't always easy, as grasses are particularly good at reproducing and growing quickly.

Some locations have very few foxtails, while others have lots. Bring your pet to with fewer foxtails, if possible.

Some companies make mesh nets that can a dog's head to prevent exposure to the ears, nose, eyes and mouth. Pet boots can prevent foxtails from getting stuck in their paws.

A dog wearing shoes.

Dog booties can keep your pet's feet safe when you're in a foxtail-dense area.

AP Photo/Rodrigo Abd

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Grooming your pet regularly may help catch foxtails before they burrow into the skin. Removing mats and unkempt fur can also reduce the risk. If you get your pet examined at the vet at least once a year, the veterinarian may be able to find foxtails during these checkups before they escalate into a larger problem.

Foxtails are part of living in the United States. But a few simple steps can help keep pets safe while they enjoy the outdoors.The Conversation

Erik Olstad, Health Sciences Assistant Professor of Clinical Veterinary Medicine, University of California, Davis

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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