Health Matters by Dr.Paul: Measles Making an Unwelcome Comeback
For years measles has been rare in developed countries like the USA, Canada and the UK thanks to the availability of a very effective vaccine. Alarmingly however, we are seeing an increasing number of measles cases and outbreaks in these countries. Experts feel that this unwelcome comeback is due to the seemingly growing number of people who choose not to vaccinate themselves or their children. To demonstrate the seriousness of the situation, on January 18, 2019, the state of Washington declared a state of emergency due to an ongoing measles outbreak. At the international level, the World Health Organization (WHO) has listed vaccine refusal/hesitancy as one of the top ten health threats in 2019.
The measles(rubeola) virus is the most contagious virus known today. In fact, one person with measles can spread it to up to 18 people. For comparison, a person with the flu can spread it to up to 2 others. The virus is spread by direct or indirect contact with droplets from the nose, mouth and throat of an infected person. Serious measles complications include severe lung or brain infections and the death rate is between 1 and 3 per 1000 persons infected. Sadly, in developing countries, where authorities struggle with vaccine availability, measles is among the most common causes of death in children less than 5 years of age.
Measles vaccine protects individuals and the community
During the last half century, the measles vaccine, now provided as the MMR vaccine that also protects against mumps and rubella, has proven to be quite safe and effective. Aside from individual protection, the other benefit is "Herd Immunity". This means that an entire community is protected against a certain infection, even though not every single person has been vaccinated. This indirectly protects individuals who cannot be vaccinated and young children too young to be vaccinated. The more people vaccinated, the higher the rate of herd or community-wide protection. For measles, we can protect virtually everyone by achieving a vaccination rate of more that 95%. In some areas where measles is making a comeback, less than that are vaccinated, due solely to vaccine hesitancy.
As a pediatrician and public health leader, I am a quite concerned about the return of measles that is due mainly to “man-made” reasons; more specifically, vaccine refusal or hesitancy. It is very frustrating because measles is truly a vaccine-preventable disease. The good news is that there is a simple solution: vaccinate as many people as possible. Otherwise the unwanted return of measles will continue to grow and spread, and this would be a real, yet preventable shame.
On a personal final note, when it comes to measles and other potentially dangerous infections that vaccines can prevent, I would rather get the shot rather than the germ.