Measles Anywhere is a Result of Measles Everywhere
Apr 03, 2017

Will we ever stop seeing cases of measles?

Last week, officials confirmed the first case of measles in Michigan this year. That may not sound significant.  It’s only one case in one state, but it’s actually one of 21 cases of measles reported across 7 different states so far this year.

17757243_10210140079997364_6840572758006483074_n-1Last week we also heard the World Health Organization warn of measles outbreaks across Europe.  This image, published in an article from The Sun in the UK, illustrates how widespread the outbreaks have been.  There are currently 14 countries seeing endemic transmission of measles, to include such countries as France, Germany, Italy, Poland, Romania, Switzerland and the Ukraine.  Maybe not the countries you were expecting.  And maybe some countries you plan to visit.

Although measles was declared eliminated in the U.S. in 2000, and even eliminated from all of the Americas in 2016, measles still kills an estimated 115,000 children per year all across the globe – that’s 314 measles related child deaths each day.  Clearly, measles remains a signifiant global health concern.

And it’s not just measles deaths we worry about.  Measles can be a serious illness requiring hospitalization. As many as 1 out of every 20 children with measles gets pneumonia, and about 1 child in every 1,000 who get measles will develop encephalitis – a swelling of the brain that can lead to convulsions, and can leave the child deaf or intellectually disabled.  For every 1,000 children who get measles, one or two will die from it.

When we consider the impact of measles worldwide, we begin to understand why every case is relevant and in someway related, and here’s why:Screen Shot 2017-04-02 at 6.56.10 PM

Measles is a highly contagious airborne disease.  

When one person has measles, 90 percent of the people they come into close contact with will become infected, if they are not already immune. The virus can linger in the air for up to two hours after an infected  person has coughed or sneezed.  If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected.  This means you don’t even have to have contact with the contagious person to become infected. That is why one a case of measles can easily be spread to others.

Disease elimination is not the same as disease eradication. 

Measles elimination is defined as the absence of continuous disease transmission for 12 months or more in a specific geographic area.  Measles is no longer endemic in the United States, but that doesn’t mean we don’t still see measles cases.  The cases we see here begin with transmission elsewhere.  Sometimes cases originate with  U.S. citizens who unknowingly contract measles while traveling abroad and then became sick and spread the virus upon returning home.  Other times, travelers from other countries arrive in the U.S. while contagious.  In both instances, these individuals can spread measles to anyone they come in contact with who isn’t already immune.  In recent years, this has caused several widespread outbreaks of measles in the U.S.

There are still many people in this world who are not vaccinated against measles.

It’s estimated that in 2010 about 85% of the global population has received at least one dose of measles vaccine.  While that may sound good, it’s still not good enough to stop the spread of measles.  Because measles is extremely contagious, the immunity threshold – which is the percentage of individuals who need immunity in order to prevent a disease from spreading – is as high as 95%.  Sadly, as of 2014, only about 63% of countries have an immunization rate that is above 90% and even 90% isn’t good enough.  

In the U.S., we are fortunate that there is a high percentage of people who have received their vaccines and have immunity to measles.  And yet, even in this highly vaccinated population, there are a still a few groups that remain at risk and quite a few cases each year.   SOTI-MeaslesCasesIG

  • The un-vaccinated; this includes anyone who is not yet old enough to be vaccinated or who willingly refuses to be vaccinated.  
  • The under-vaccinated; defined as those who’ve only had one of the two recommended doses of measles vaccine.
  • Those who were vaccinated but didn’t confer immunity. 

If you’ve had a measles vaccine, the chances that you will get measles is extremely low.  But there are no guarantees.  Between 2% and 5% of people do not develop immunity after the first dose of measles vaccine. Such vaccine failure can occur for a variety of reasons and is why a second dose of vaccine is suggested.  This second dose allows people who didn’t respond properly to the first dose to possibly respond to the second dose, and after both doses are administered, it’s believed that vaccine efficacy is as high 98-99 percent.  While measles vaccine remains one of our most effective vaccines, it’s still not perfect and therefore a very small chance of infection remains.

Additionally, it is not uncommon for people to be unknowingly under-vaccinated.  They may have received an MMR vaccine before two doses were recommended or they just never got around to getting that second dose.  For anyone who is uncertain whether they had two doses, they should consult their healthcare provider, especially if they live in an area that is experiencing a measles outbreak, or are planning to travel to a country where measles is endemic.

Most people who are exposed to measles here in the U.S. will probably never realize it because their vaccine induced immunity will keep them from getting sick.  However, the disease remains a significant risk to those who willingly refuse the measles vaccine, or who are too young to have received it.

The CDC recommends that the first ose of MMR vaccine – which is the vaccine that protects against measles, mumps and rubella – be administered to children between the ages of 12-15 months.
The reason we usually don’t Measles112315administer the vaccine until babies are more than 12 months old is because there is evidence that the baby still has some passive immunity from the mom which can actually prevent the baby from mounting a robust immune response to the vaccine. Once the baby is 6 months old that immune response begins to wane, and by 12 months it is believed that children will receive optimal immunity from the vaccine.  However, if a child lives or is traveling to an area that has a known measles outbreak, it is advisable for that child to get an MMR vaccine prior to 12 month of age.  Since they still may not confer the most immunity at a younger age, those babies will then need to get another MMR vaccine when we can be more certain that the passive immunity from the mother is gone after 12 months of age.

As long as measles remains endemic in so many parts of the world, it can spread to any country, including those that have eliminated the disease. And as long as the disease continues to spread, then there continues to be work to do to protect people  from this dangerous, yet preventable disease.  

This Getting Measles Cases to Zero video from Matt Ferrari helps to define the challenges that lie ahead in the efforts to eradicate measles.  

There is much to be done before we can expect to achieve success, but everyone can do their part by being vaccines.  Be a part of the solution by ensuring that everyone in your family is up-to-date on their measles vaccine, especially before you travel. 

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35 responses to “Measles Anywhere is a Result of Measles Everywhere”

  1. Michelle says:

    21 cases so far this year?!! Sound the alarms and hit the panic button.
    Here’s what it was like before fearmongering https://www.youtube.com/watch?v=mDb0ZS3vB9g

  2. Lawrence says:

    @michelle – given how infectious and dangerous measles is, one case is one too many…

  3. Lawrence says:

    Sorry, but using cartoons as evidence?

    Seriously?

  4. Lawrence says:

    If you believe that a TV Sitcom would show the real side of measles, you are sadly mistaken.

    Somehow I don’t see Marsha dying of SSPE to be very “funny” or deliver the ratings…..

  5. Peter says:

    Lawrence, you really do drink the Kool Aid don’t you.

  6. Lawrence says:

    You are aware what VAERS is, don’t you?

  7. Peter says:

    Chris, more than 11 cases in 4 years? But you have no concern over the many more injuries actually caused by the vaccine itself? Unbelievable.

  8. Peter says:

    I am aware Lawrence, it’s a reporting system. You know, so people can report things.

  9. Peter says:

    It’s a little game you all play, it’s a reporting system so they can say they are tracking problems with vaccines but on the other hand, they can say it isn’t legitimate information. How convenient is that?

  10. Lawrence says:

    Perhaps you should read the reports….because they really don’t say that the vaccine was responsible.

  11. Lawrence says:

    And all serious VAERS reports are actually followed up upon by the CDC – in fact, it was VAERS that showed the first indications that there was an issue with the original Rotavirus vaccine.

    There is also the Vaccine Safety Datalink, which is an active reporting system – there are multiple layers of vaccine safety, conveniently ignored by anti-vaxers.

  12. Peter says:

    And the 416 deaths and over 8000 injuries from the vaccine since 1990? Those are to be ignored?

  13. Lawrence says:

    “They” say nothing of the sort….VAERS is exactly what you stated – a reporting system. Reports are followed up on & the data is analyzed in an attempt to find trends.

    It’s actually a very handy system – in my Rotavirus example, the system was able to detect a single additional serious adverse reaction, per 100,000 doses – which was enough to have the vaccine pulled from the market.

  14. Lawrence says:

    “Reported.” Not confirmed – those are simply reports.

    As I stated, and as the VAERS database states in its disclaimer, follow-ups to the reports are not included.

  15. Lawrence says:

    https://thepoxesblog.wordpress.com/2015/02/08/vaccine-injuries-from-the-mmr-a-review-of-vaers/

    Here is a very good explanation of the fallacy of the anti-vax “review” of VAERS….done by an actual epidemiologist.

  16. Peter says:

    Lawrence, some of those kids died the day they received the vaccine and most all others within a few days of receiving the vaccine. Many kids had health issues before receiving the vaccination, so they can claim whatever they want, but it is obvious the vaccine was the final straw that killed them.

  17. Lawrence says:

    “Obvious?” Really?

    And by what actual evidence do you make that blanket assertion?

  18. Lawrence says:

    See, this is an example of anti-vaxers “knowing” something, without actually providing any evidence to support their beliefs.

    They “know” vaccines are bad, thus they can ignore any and all evidence to the contrary.

    Someone like me, on the other hand, will examine all of the available evidence – both domestic and international. I also understand the basic sciences – including biology, virology, epidemiology, and chemistry (and statistics as well)

    So, when presented with the evidence, I am prepared to evaluate it according to the science involved – not making emotional statements and blanket assertions.

  19. Peter says:

    Logic

    A child perfectly healthy with no issues eats nuts, swells up, can’t breathe….everyone says the child must have had a reaction to the nuts. Testing shows they have a nut allergy.
    Everyone agrees its the nuts and to not give the child any more nuts.

    A perfectly healthy child with no issues uses a new cream, skin breaks out, its red and hurts….everyone says the child must be allergic to the cream.
    Parents decide to not use that cream again.

    A perfectly healthy child with no issues drinks milk and develops hives and start vomiting …..everyone says it must be the milk. Testing shows the child is allergic to dairy.
    Everyone agrees the child cannot tolerate milk and for the child’s sake, will avoid dairy in their diet.

    A perfectly healthy child with no issues receives their vaccines and runs a high fever, seizes and subsequently loses eye contact, language, no longer wants to be touched, their stools are liquid and burn the skin …..everyone says it can’t possibly be the vaccines.
    Testing shows the child is heavy metal toxic, has severe gut dysfunction and is subsequently diagnosed with autism.
    Everyone still says it’s not the vaccines.
    Parent is expected to continue vaccinating.

    Welcome to today’s logic.

  20. Lawrence says:

    @Peter – tell us, what “heavy metals” are contained in the MMR vaccine?

  21. Lawrence says:

    Here’s some logic for you – Downs Syndrome, a genetic condition, has many co-morbidities, including other birth defects like heart valve problems (very common).

    Is it quite likely that a genetic condition like autism will have physical co-morbitities as well.

  22. Lawrence says:

    You also seem to be making additional assertions, again, without providing any evidence to back it up.

  23. Peter says:

    It amazes me that you play dumb, and for what? I don’t think you get paid to act this way.
    You seem to think that high fevers, seizures, loss of eye contact, loss of language, IBS, and loss of fine motor skills are just a normal day at the office when it comes to vaccines. Really sad that you can’t stand up and protect those that need you to.

  24. Lawrence says:

    None of that has anything to do with vaccines.

  25. Joel A. Harrison, PhD, MPH says:

    @ Peter:

    As an analogy, VAERS is like someone brought in by police as a person of interest in a crime or, even, just a material witness. Police often look at several, sometimes many, people before focusing on one. However, since I was quite young, pre-teen, I’ve been interested in how many innocent people have been convicted. In almost every case, the police focused immediately on one person, totally blinded to other possibilities. People like you who assume that the first suspect, that is, VAERS report blaming a vaccine, is correct fit the same mold. It is currently estimated that approximately 20,000 innocent people are in American prisons.

    As an example, there are several genetic conditions that don’t activate until after a certain age, that is, the child appears to develop normally and suddenly regresses. Two are Rett’s syndrome and Dravet’s syndrome. As for high fevers and seizures, many children experience at least one febrile seizure. There is a logical fallacy called “post hoc ergo prompter hoc,” basically after something thus the something caused it.” However, many things occur, some we don’t notice. A kid gets a shot; but eats something that has some microbe on it or inhales something or . . . In 1976, a man in Pittsburg got the flu shot at his doctor’s office and died from a massive heart attack. It was all over the newspapers. Turns out he had had several heart attacks and was in terrible shape. What would they have said if he had the heart attack just before the needle penetrated his skin?

    Studies of kids on the autism spectrum where videos were available prior to receiving MMR vaccine found signs of ASD early on. However, there are critical stages in development when differences become markedly noticeable. A child crawling and making sounds, even if a bit different, aren’t noticeable; but when they reach age where they should be talking and walking, then noticeable.

    Some studies have found that many who post on VAERS are lawyers representing clients. However, parents who post often focus on what they think may have caused a problem, ignore other factors, and often the time interval. For instance, if a child gets a shot and an hour later goes into anaphylactic shock, impossible it was caused by the shot. Anaphylactic shock is an immediate immune system reaction. Something else intervened; but the parent, already primed by misleading news stories and antivaccinationist websites will immediately blame the vaccine.

    And it isn’t just the Vaccine Safety Network that gives almost real time data (large HMOs give data on shots given, kids demographics, and any adverse reactions, so the timing, diagnoses, etc. immediately available); but several additional programs that look into VAERS reports. In fact, the post-marketing surveillance of vaccines and the regulation that gives the CDC and FDA immediate authority to halt the use of a vaccine, as Lawrence mentioned regarding the rotavirus vaccine, is far better than any protections we have for other pharmaceuticals or even food.

    I suggest you start with CDC webpage on vaccine safety at:

    https://www.cdc.gov/vaccinesafety/ensuringsafety/index.html

    It discusses, among other things, Variance Safety Monitoring. And on the left, Research and Vaccine Safety Partners.

    I also suggest you go to your local library and check out some books on history of infectious diseases.

    As for Michelle’s YouTube of sitcom portrayal of measles, I suggest you read my article where an episode from the Brady Bunch was used, just how absurd I point out in depth:

    Don’t Sacrifice The Good For The Perfect: A Review of Cathy Jameson’s “A Strong Message About Vaccines.” at:

    http://www.ecbt.org/images/articles/Don’t_Sacrifice_The_Good_For_The_Perfect.pdf

  26. Milwauken says:

    Thank you, Joel. Unfortunately Peter doesn’t care about facts that challenge his beliefs. But your comment is still valuable to more educable folks.

  27. Lawrence says:

    Not the real Ken Reibel…just FYI.

  28. Lawrence says:

    And quoting from a self-published book by a notorious anti-vaxers isn’t a very good argument to make.

  29. Jessie says:

    Measles is a bummer to get.

  30. […] Measles Anywhere is a Result of Measles Everywhere […]

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