Measles: a dangerous illness

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(Dahl dedicated this book to his daughter Olivia)

In 1988, author Roald Dahl wrote a heart wrenching, personal and telling essay,  “MEASLES: A dangerous illness,”  in response to the growing anti-vaccine trend at that time in the UK.  His words ring as true today as they did then.

Olivia, my eldest daughter, caught measles when she was seven years old.  As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it.  Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her hot to fashion little animals out of colored pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything.

‘Are you feeling all right?’ I asked her.

‘I feel all sleepy,’ she said.

In an hour she was unconscious.  In twelve hours she was dead.

The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her….that was in 1962, but even now, if a child with measles happens to develop the same deadly reaction from measles as Olivia did, there would still be nothing the doctors could do to help her.

On the other hand, there is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. They can insist that their child is immunized against measles.

Fast forward to February, 2015, some 15 years after measles was ‘eliminated’ in the United States due to vaccination, and we are facing a measles outbreak that has health officials extremely concerned.

(Credit:  Centers for Disease Control and Prevention)

(Credit: Centers for Disease Control and Prevention)

The Centers for Disease Control and Prevention reports “from January 1 to January 30, 2015, 102 people from 14 states were reported to have measles. Most of these cases are part of a large, ongoing multi-state outbreak linked to an amusement park in California.” Colorado has one confirmed case.

(Credit: CNN)

(Credit: CNN)

This current outbreak, which started with 59 people at Disneyland in Anaheim, California in December, primarily sickened infants, children and adults who had not been vaccinated.  Those people then went back to their communities and the spread continued.

Dr. Sean O’Leary, Pediatric Infectious Diseases Specialist at Children’s Hospital Colorado and Assistant Professor of Pediatrics at the University of Colorado, says “this is not a big surprise.  Because of a widely discredited study in 1998, linking measles vaccinations and autism, many parents bought into the idea that they should not immunize their children.  In England first, immunization rates dropped with large measles outbreaks and deaths.  Then it hit France and Switzerland.”

In 2010, 12 years after that study was released and caused such an uproar, the British medical journal, Lancet, “decided to issue a complete retraction after an independent regulator for doctors in the U.K. concluded…that the study was flawed.”

“Vaccines are a victim their own success,” explains Dr. Rachel Herlihy, Deputy Director of Disease Control for the Colorado Department of Public Health and Environment tells me. “Both physicians and parents today don’t have first hand experience with these diseases.”

Young boy with measles rash. (Credit: Centers for Disease Control)

Young boy with measles rash. (Credit: Centers for Disease Control)

Dr. Herlihy understands that people have different concerns about vaccines, and divides them into two camps, “those who are vaccine hesitant, with many questions, and those who believe children shouldn’t be vaccinated at all.  I’m a doctor and a scientist and I firmly believe the benefits far outweigh the risks.”

“For Colorado,” adds Dr. O’Leary, “I believe we’ve dodged some bullets.  We haven’t had a large outbreak.  But I believe it’s not a matter of ‘if,’ but ‘when.’ There are enough pockets of people who don’t immunize their children that measles could spread quickly if it winds up in those communities.”

Measles is extremely contagious.  “If someone with measles walks into a basketball gym,” says Dr. O’Leary, “a person on the other side of the gym who hasn’t been vaccinated can get it.” That includes infants, since a child’s first MMR (measles, mumps and rubella) vaccine is given around 12-15 months of age.

According to the CDC,

measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected. Infected people can spread measles to others from four days before to four days after the rash appears.

(Credit: National Institue of Allergy and Infectious Diseases)

(Credit: National Institue of Allergy and Infectious Diseases)

With all the discussion to immunize or not flooding your social media outlets and the media, you’re probably hearing a lot about ‘the herd immunity.’ Marcel Salathe,  Assistant Professor of Biology and Adjunct Faculty of Computer Science and Engineering at Pennsylvania State University, defines it well in an article posted in The Conversation.

The basic idea is that a group (the “herd”) can avoid exposure to a disease by ensuring that enough people are immune so that no sustained chains of transmission can be established. This protects an entire population, especially those who are too young or too sick to be vaccinated.

Dr. Salathe advocates that everyone be immunized.

There is an ethical argument to be made for the goal of 100% vaccination coverage. It sends the right message. Everyone who can get vaccinated, should get vaccinated – not only to protect themselves, but to protect those who can’t, through herd immunity

“The good news is that more than 90% of parents in the United States are making sure their children are immunized,” says Dr. O’Leary, “and if your child is not vaccinated, get your child immunized ASAP. If you are concerned, talk to your pediatrician. If your child is protected, with an MMR at 12-15 months and a second MMR before kindergarten, they are okay, even with this outbreak.”

In addition to children, Dr. Herlihy says there are two groups of people who need to make sure their records up to date and are immunized:  “international travelers and health care workers. And if you’re an adult born after 1957 and don’t know about your vaccine and can’t check your records, there’s no harm in getting a measles vaccine.”

Both Drs. O’Leary and Herlihy feel “this is a wake up call for us.” And many in the scientific community say when we are all aware of what the measles virus does, then more will vaccinate.

Roald Dahl is among those who didn’t have the choice to vaccinate:

I was unable to do that for Olivia in 1962 because in those days a reliable measles vaccine had not been discovered. Today a good and safe vaccine is available to every family and all you have to do is to ask your doctor to administer it.

If you’d like more information to address your concerns, here are three websites:

http://www.childrensimmunization.org/

http://www.immunize.org/

http://www.aap.org/en-us/Pages/Default.aspx

lois.melkonian@kdvr.com                                                                           http://www.twitter.com/LoisMelkonian
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Lois’ Living Through It blogs are posted on Mondays and Thursdays. Join her Monday mornings around 8:45am on Good Day Colorado.

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