The Measles Epidemic of 2014-2015- UPDATE

The Measles Epidemic of 2014-2015- UPDATE

January 29, 2015

The United States is right now experiencing an epidemic of measles, a threat to children not seen in the US commonly since the 1950's.

The Current Epidemic

It appears all the current cases of measles erupted from one source, a child with measles in the Disneyland in California.   To date there are 70 people who have the disease measles from that one source, but many thousands exposed.

What is Measles?

Many think of measles as yet another pesky but harmless, colorful, childhood illness, like chickenpox.  And there are some similarities- both cause fever, and a very distinctive rash, highly contagious, and once occurred in most all children.

But the difference is that measles can cause a permanent and quite severe impairment of the brain, leaving the affected person forever disabled.   

Across the world, measles is blamed for about 5% of all childhood deaths.  

So, it is not a harmless childhood infection, despite the fact that most children who get it recover well.

The key symptom of measles is a unique rash- large red dots- and also usually causes a very intense pink eye, cough, runny nose, and high fever.   But you have to have the measles rash to be diagnosed with it.

The Broader Context 

This is not the first outbreak of measles in the United States since we came close to eradicating it in the 1960's.    But the difference this time is our reaction to the news that otherwise healthy children are now in harms way.

There is only one reason that countries experience measles epidemics:  if enough children are not immunized to allow the virus to spread.   One a population reaches a certain percentage of being immunized against measles, the disease disappears.  This fact has been demonstrated time and again.

In recent measles epidemics, there has been not so much concern, because the nation has been in the grip of a passionate worry that the measles immunization causes autism.  And so, for many years, when the word measles was raised, the word autism came to mind, and the fear of the disease paled in comparison to the threat of autism.

Now, however, the fact that the measles immunization has nothing to do with autism has actually taken hold across the nation.  Today, parents of young children are less and less concerned about the idea the measles immunization can cause harm, and so the very real threat to their child that measles poses is rising up, and rapidly.

This explains why this Disneyland outbreak has captured the headlines like no other in many years.  The image of children being put at risk of serious neurologic hazard from a visit to Disneyland has struck fear and concern across the US.

BOTTOM LINE

The measles outbreak from Disneyland is not very large, but is happening.  Time will tell if it grows or dissipates.  But the real lesson of this outbreak is that the era of worry about the measles immunization is drawing to a close, and families across the country are once more becoming united in having their children not risk the tragedies that a measles infection can cause.

A special note:  We can give the MMR to even young infants who are exposed.  Normally we wait to one year of age, because prior to that time mother's antibodies will clear the vaccine.  But if an exposure occurs, MMR can be given during infancy, it just won't count as a long-term MMR in the series.

To your health,
Dr. Arthur Lavin

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