The first recognized infections — in two Canadians and a visiting American — occurred around the Olympic closing ceremonies. "Downtown Vancouver was shoulder-to-shoulder on many days of that period," notes Dr. Monika Naus of the British Columbia Centre for Disease Control.
So far, measles has spread to 16 people in Vancouver, Naus says. Half of them are in one large unvaccinated household. The parents reject vaccination.
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In the end, the San Diego outbreak was confined to a dozen children. No big deal, you might think — except that it upended a lot of lives, and the county spent $10,000 for each of those cases in order to keep the virus from spreading more widely. That, and the fact that more than 95 percent of the general population was immune, kept the outbreak far more limited than the previous San Diego measles outbreak in 1991, when there were 1,000 cases and three deaths.
Afterward, Waters and her colleagues looked into who the vaccine refusers were and what their attitudes toward vaccination were.
They're college educated, higher-income and believers in the power of a "natural" lifestyle — things like organic food and prolonged breast-feeding — to keep their children's immunity strong enough to ward off vaccine-preventable diseases.
And they just don't believe it when government officials like Karen Waters say vaccines don't cause autism.
"It is wrapped up in their attitudes about government," Waters says. "I don't think they think I'm the enemy. I think they think I'm well-intended but misinformed."
Many communities have pockets of vaccine refusers. So the United States and other countries with growing numbers of "intentionally unvaccinated" people are likely to see more outbreaks.