By Denise Grady (New York Times)
Dr. RESHEF’s Comments:
One of the most painful phenomena in medicine is a medical intervention that is time-proven and saves lives taking a back seat to myth and untruth. Childhood vaccination has a long and storied record for saving lives and preventing morbidity. A campaign of fear, based on a now-debunked theory connecting vaccination to autism, combined with religious misconceptions, has not only compromised the unvaccinated. These persons threaten the health of others. Justifiably, many physicians, especially pediatricians, refuse to see unvaccinated patients.
Measles has been spreading in the United States at a rate that worries health officials, with 102 cases so far this year in at least 14 states.
Most infections are linked to an outbreak that began in Disneyland in December, almost certainly started by someone who brought the disease in from another country. A “smattering” of other imported cases have also occurred, according to Dr. Anne Schuchat, the director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention.
Measles was eliminated from the United States in 2000, meaning that the infection no longer originates here. But worldwide, there are still about 20 million cases a year; in 2013, about 145,700 people died of measles. Travelers can bring the virus into the United States and transmit it to people who have not been vaccinated.
Measles spreads through the air and is among the most contagious of all viruses; in past epidemics, it was not uncommon for one patient to infect 20 others. Some 90 percent of people exposed will get sick (unless they are immune because they have had measles already or have been vaccinated). The virus can hang suspended in the air for several hours, so it is possible to catch measles just by walking into a room where an infected person has recently spent time. Inhaling a tiny amount of viral particles is enough to cause illness.
The disease is cause for particular concern because it can have severe complications, including pneumonia and encephalitis, which can be fatal. Those who survive encephalitis can wind up with brain damage. Measles can also cause deafness. And even without complications, the virus makes children very sick, with high fevers, a rash and sore eyes. Painful ear infections are also common.
Here are some commonly asked questions about measles and the vaccine that prevents it.
Q. Has the United States been particularly hard-hit?
A. Many relatively wealthy countries are having worse outbreaks. Virtually all of continental Europe has been undergoing a large outbreak since 2008, with more than 30,000 cases in several years.
France, which gets more tourists than any other country, had 15,000 measles cases in 2013, with at least six deaths. About 95 percent of the cases were in people who had never been vaccinated or had not had both recommended doses.
In the United States, vulnerable communities have had outbreaks in the last few years, including Orthodox Jews in Brooklyn and the Amish in Ohio. But vaccination rates are also relatively low in some wealthy, liberal neighborhoods. The Seattle suburb of Vashon Island is believed to have the lowest vaccination rates of any health district in the country.
Who is most at risk of becoming seriously ill from measles?
Babies and young children who have not been vaccinated are most vulnerable, and most at risk for dangerous complications.
“Even in developed countries like the U.S., for every thousand children who get measles, one to three of them die despite the best treatment,” Dr. Schuchat said during a news teleconference last week. In the United States from 2001 to 2013, 28 percent of young children with measles needed to be treated in the hospital.
In pregnant women who have never been immunized or never had measles, the disease increases the chance of premature labor, miscarriage and having a baby with a low birthweight. People with leukemia and other diseases that weaken the immune system are also at risk of severe illness from measles.
The best protection for high-risk people, Dr. Schuchat said, is a high rate of vaccination in everyone else, so the disease cannot gain a foothold and start spreading.
Is the measles vaccine safe?
There is no evidence that the vaccine causes harm. Research in 1998 linking it to autism was proved fraudulent and was retracted. Children may briefly run a low fever — an increase of about 1 degree Fahrenheit — after the shot and may develop a mild rash.
When should children get the measles vaccine?
They need two shots, one when they are 12 to 15 months old, and another when they are 4 to 6 years old, according to the C.D.C. The injections contain a mix of vaccines to prevent measles, mumps and rubella.