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Measles Outbreak

A measles outbreak in the United States in the 21st century? If someone had told me this would or even could happen I would have laughed because dreaded childhood disease had already been fought and conquered.

A 1954 medical article described measles as “inevitable as death and taxes.” The first measles vaccine was developed in the United States and made available in 1963, thankfully just in time for my own children to be immunized. After the vaccine was introduced reported numbers of cases fell dramatically and after improvement to the vaccine and the recommendation to add a second dose to the immunization regimen, measles was eliminated from the US in 2000. It’s baaack.

I trained and worked as a pediatrician before the development of the measles vaccine so I saw many miserable kids with measles. Pediatricians then prided themselves in recognizing early cases so the child could be isolated before exposing more children. Complications of measles were feared by parents and doctors alike. Pneumonia and encephalitis could be fatal or lead to permanent brain damage.

Touring East Africa in 1970 I visited Nairobi Children’s Hospital with an international group of pediatricians. We saw several shrouded small bodies being carried away and postulated the deaths resulted from an exotic tropical disease. We were wrong. A measles epidemic with a high fatality rate was raging. The World Health Organization and UNICEF immunization initiative has decreased the mortality rate overseas but as recently as 2013 there were 145, 700 measles-related deaths worldwide.

In the US there were 648 confirmed cases of measles in 2014 and 176 so far in 2015 (February). So many children and adults getting sick from a PREVENTABLE disease!The biggest outbreak started at Disneyland, a venue always filled with children. Although the index case has not been identified it is likely that this was an unvaccinated person who came from a country where measles is endemic or was infected by an unvaccinated person who was exposed to such a traveler

So how can this happen in the very country that created the vaccine estimated to have averted millions of measles deaths worldwide?

  1. The virus still exists in many parts of the world, a person can criss-cross the planet by air in hours, the incubation period can be as long as 14 days.
  2. The virus is very contagious, one sneeze can spread it, and 90% of unvaccinated exposed people will develop measles.
  3. Doctors here may not have seen measles. The early symptoms look like a respiratory infection so measles may not be recognized before a child has infected many others.
  4. The antivaccination movement means there are unvaccinated children in our midst who go to our schools, playgrounds, and theme parks. A single unvaccinated child who comes in contact with a person incubating the measles virus can start an outbreak. In addition this movement has weakened our “herd immunity.” When all or almost all people are immunized this will prevent an outbreak and protect those not old enough to get a measles shot and those whose immune systems are compromised by illness so they lack protective antibodies.

I will pull no punches. I am appalled that parents risk their children’s lives, as well as the lives of other children, because they hold an irrational, unproven belief. I find many examples of what I call “internet irrationality” today. Web surfing can uncover something to enforce any belief. We can retrieve whatever we believe and think, I read it, therefore it must be correct. However there is a “vaccine” for irrational beliefs: science that provides reproducible data.

My advice for the parent who understands the dangers of infectious diseases and immunizes their children? Be sure all immunizations are up to date. If your child has not been fully immunized against measles get to a doctor fast when there is any fever or respiratory symptom. Be aware of any outbreaks in the US and check with your child’s doctor before any family foreign travel.

My advice for the antivaccination parents? Please don’t take your children to places like Disneyland. Although you don’t seem to care about other children I do care about all children and I don’t want yours to get measles.

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