Measles Outbreak Update from CMO Gregg DeNicola MD
By now, I am sure you’re aware that we are suffering through a nationwide measles epidemic with Washington state being hit particularly hard. On Monday, the first confirmed case was identified in Orange County with three cases in Los Angeles County announced just prior to this. In the US, before the vaccine was introduced in 1963, there were 4 million measles cases a year with 48,000 hospitalizations and 500 deaths every year. Once the vaccines were available, those numbers dropped dramatically. In fact, in 2000, the CDC announced the measles was eradicated.
For the vaccine to work, it requires what is known as “herd” immunity. This means a certain percentage of people needs to be immunized to keep it from spreading through the population. Because measles spreads so easily , the percentage needed for herd immunity is really high at over 95%. When states began relaxing the laws regarding mandatory vaccinations, the percentage fell below 95%. This made the current outbreak inevitable and predictable.
In short, everybody in the community who can get the vaccine should to stop the virus respect spreading.
Prior to 1957, they were two nationwide epidemics that infected nearly 99% of the population. Therefore, for patients born before 1957, it is generally assumed you are immune. This would be a lifetime immunity and no shots or boosters are needed.
For patients that had the vaccine between 1963 -1967, it is felt that those vaccinations no longer give immunity. In simple language, those shots “didn’t count“.
All children and adults over the age of 12 months should have two measles vaccines. For most Americans, this would mean receiving a second shot in adulthood. If your first shot was between 1963 and 1967, you would need two more shots on top of that one.
As Chief Medical Officer of Caduceus, I call for all of our patients to come in to receive their update on the measles vaccination. We will be happy to work with you to catch you up so that you will not become infected or spread the infection.
If there is any doubt, it is safer to take the vaccine than guess, even if you do not actually need it. Additionally, we can check your blood to see if you are immune.
Although all health plans cover childhood vaccines, many do not cover adult vaccines. In the event your vaccine is not covered, our cash price is $120.
Please feel free to share this information with friends and family. It is essential to stop the infection now so there are no measles associated deaths in Orange County this year.
Gregg Denicola MD Chief Medical Officer
FDA proposes rule to notify women with dense breasts about increased cancer risk and imprecise mammograms
The FDA is proposing a rule for breast cancer screenings that would require doctors to give women more information about the risks associated with dense breasts. Read the full article here.
Caduceus Chief Medical Officer, Gregg DeNicola MD, shares his take for our patients.
“Informing women that their amount of breast density may affect results of the mammogram and their risks be outlined just makes common sense; it’s hard to imagine any body opposing this recommendation. Yes; it is more time necessary to advise patients as the physician, but it is essential women are educated on the details of their mammogram. In California, such a requirement already exists and is enforced so it will have little impact for our patients, but to set this as a national standard is just smart medicine.”
Hormone replacement therapy for women- Is it right for you?
There have been many recent articles and online buzz about hormone replacement therapy for women and our Chief Medical Officer and Caduceus physician Gregg DeNicola MD wanted to weigh in on the discussion.
To provide some perspective, in 2002, an extensive study of over 16,000 women supported by the National Institutes of Health, was halted after discovering that the drugs, a combination of estrogen and progestin, caused small increases in breast cancer, heart attacks, strokes and blood clots. Those risks outweighed the drugs’ benefits -a small decrease in hip fractures and a decrease in colorectal cancer. A year later a comparable study was also stopped in the UK after comparable findings.
Chief Medical Officer Dr. DeNicola agrees, “The fact is a large, prospective study has never been executed proving hormone replacement therapy is indeed safe. This is an emotional issue and the data is definitely conflicting. Both sides have ample data to support their position. At Caduceus, we do not routinely recommend or dissuade the use of HRT. The decision is individualized after discussion between the patient and provider. Until the evidence is more definitive, it is the most prudent policy for our patients.”
More questions? Schedule an in-office or virtual video chat with your Caduceus provider.
Millions of Americans incorrectly think they have food allergies, study finds
You may have read the story recently that new research suggests Americans may be over-diagnosing themselves with food allergies. A study published in the medical journal JAMA Network Open estimates that nearly 19 percent of adults think they have food allergies, but less than 11 percent actually do.
Caduceus Chief Medical Officer Gregg Denicola MD adds, “I have felt this way for a long time and agree less than 10 percent of Americans have documented food allergies. Most allergies are to fish and nuts. (more…)
New Peanut Allergy Drug Shows ‘Lifesaving’ Potential
Results from a new study may lead to approval of what could be the first drug that ameliorates potentially deadly reactions in children with severe peanut allergies. Caduceus physician and Chief Medical Officer Gregg DeNicola MD weighs in, “I agree with the spirit of the article; a breakthrough and very promising, but not necessarily a cure. Peanut allergy sufferers will need to abstain until further evidence can support the findings.”
Colorectal cancer screening? To screen or not to screen before 50?
As CMO for Caduceus Medical Group, Gregg Denicola MD agrees that colon cancer is striking at a younger age than previous years. Especially in high-risk populations, earlier screening may be beneficial.
He shares that the data that the American Cancer Society is using appears to be somewhat mixed and does not definitively show a benefit for screening prior to age 50. Also he notes, there would be increased costs in earlier screening recommendations and whether finding a cancer a few years earlier would decrease mortality has not been proven effective. (more…)