You know those people who say measles is just a harmless little childhood disease? Epidemiologist Tara Smith has a few things to tell them.
Last year was the worst year for measles in two decades. While we’ve seen fewer than 100 cases of measles in most years since the turn of the century, that number spiked to 644 cases in 2014, from 23 separate outbreaks in 27 states.
Before the vaccine, the United States saw approximately 4 million cases of measles each year and 400 to 500 deaths. These are the stats that vaccine-deniers tend to emphasize—a relatively low number of deaths compared with the number of infections. However, those statistics alone leave out a big part of measles infections. Prevaccine, almost 48,000 people were also hospitalized each year because of measles and measles complications. One in 20 of those infected developed pneumonia. More rarely but more seriously, each year 1,000 became chronically disabled due to measles encephalitis.
Measles is not a benign disease.
Also, there’s the whole problem of antibiotic resistance now. What if that pneumonia turns out to be untreatable?
What many forget is that we had a massive outbreak of measles in the United States from 1989–1991. While our 644 cases in 2014 seems high compared with recent years, 25 years ago measles incidence spiked to 18,000 cases per year, with a total of more than 55,000 infections before the outbreak began to dwindle. It was the largest measles outbreak in this country since the 1970s.
It’s hard to argue that in 1989 we had problems with modern sanitation. Arguably, we were healthier 25 years ago than we are now, if one uses the U.S. obesity rates as one marker of health and good nutrition. We had antibiotics for secondary infections, such as pneumonia, that settle in to measles-infected lungs—and fewer antibiotic-resistant bacterial pathogens than we do in 2015. Measles-associated pneumonia isn’t easy to treat if it’s caused by a “superbug,” and we’ve not had to deal with a huge measles outbreak in the age of methicillin-resistant Staphylococcus aureus, or MRSA, and other drug-resistant bacteria.
Let’s not try that experiment, shall we?
Despite our advances and our modernity and our status as a developed country, we still saw 123 measles deaths during this epidemic—here, in the United States, where we get plenty of Vitamin A. There were also 11,000 hospitalizations—fully one-fifth of people infected with measles became sick enough to be hospitalized.
In modern-day America.
Bart Barrett, a physician who saw patients at the height of the epidemic, recalls one of those 123 deaths: a 1-year-old who developed complications. The family called paramedics, but by the time they arrived, it was too late. He was unvaccinated, which was common among young children during the 1989–91 outbreak.
And it’s common in some places now too. Bad move.
Nutrition and sanitation are no panacea for measles and no substitute for measles vaccination. Living in the United States does not magically protect you from dying from measles or other infectious diseases. Being generally healthy alone is not a guarantee that you won’t end up hospitalized from a measles infection. Your best defense against measles is an up-to-date MMR vaccine for yourself and your family, checking to see that you live in a neighborhood and school system where others are likewise vaccinated, and spreading the word that vaccines are safe and life-saving. The best way to respect measles is to acknowledge its potential to cause serious illness.
Lady Mary Wortley Montagu, thou shouldst be living at this hour.