Who Dies with Measles?

Measles is another of those diseases that some claim used to be mild and a rite of passage for kids.

That’s why there was an episode of the Brady Bunch about it, right?

An episode in which all of the kids got sick and they had to call two pediatricians to do house calls…

Who Dies with Measles?

While measles was a rite of passage for kids, it wasn’t the kind you looked forward to, because measles is rarely mild.

“Before a vaccine became available in 1963, measles was a rite of passage among American children. A red rash would spread over their bodies. They would develop a high fever. Severe cases could cause blindness or brain damage, or even death.”

CDC says measles almost eliminated in U.S.

Instead, most people develop 10 days of measles symptoms, including a high fever, cough, runny nose, watery eyes, and a rash. Photophobia, irritability, sore throat, headache, and abdominal pain are other symptoms that children with measles might have.

Many require hospitalization and some die.

But isn’t it just older people or those with immune system problems that die with measles?

“From 1964 through 1971, 16.7% of the death certificates reviewed noted some underlying pathologic condition.”

Roger Barkin, MD on Measles mortality. Analysis of the primary cause of death.

Nope.

It is most often children, typically young children, without any medical problems who die.

In the post-vaccination era, no one would be expected to die with measles, but those with immune system problems sometimes do, as most others are vaccinated and protected. As vaccinated rates drop though, even otherwise healthy children and adults can once again die of measles.

Remember the measles outbreaks at the end of the 1980s?

“Complications were reported in 672 (9.8%) cases, including otitis media in 318 (4.6%) cases, pneumonia in 178 (2.6%), diarrhea in 171 (2.5%), and encephalitis in five (0.1%). Nine hundred thirteen patients (13.3%) were hospitalized, and 10 measles-associated fatalities were reported (case-fatality rate: 1.5 deaths per 1000 reported cases). Eight of the deaths were reported in children less than 5 years of age, all of whom were unvaccinated. None had a reported underlying illness or immunodeficiency. Most deaths have been attributed to pneumonia.”

Measles — United States, First 26 Weeks, 1989

Probably not, but from 1989 to 1991 there were at least 123 measles deaths across the United States, even after measles had been declining for years with the introduction of the measles vaccine in the 1960s. Most of the deaths were otherwise healthy, without underlying medical problems.

They were unvaccinated and unprotected.

Because we don’t typically hear any details about measles deaths, including the almost 90,000 measles deaths that continue to occur around the world each year, most people likely assume that measles only kills in third world countries, where kids are already sick or malnourished. Of course, that wouldn’t explain how over one hundred people died with measles in Europe over the past few years…

Still think that measles isn’t deadly?

Tragically, there are plenty of stories (although most are never reported in the news and we don’t hear about them) and case reports that will prove you wrong:

• Olivia Dahl died with measles when she was 7-years-old (1962)
• an unvaccinated 3-year-old died in Maricopa County (1970)
• a 13-year-old girl who had previously been vaccinated with one of the first inactivated measles vaccines which were found to be ineffective and were replaced with the newer live vaccines died in Michigan (1978)
• a 9-month-old died in Chicago (1990)
• an unvaccinated 13-year-old died in Kansas (1990)
• Tammy Bowman, an 11-year-old unvaccinated girl died in Michigan (1990)
• an unvaccinated 13-year-old became the first person in the UK to die with measles in 14 years (2006)
• a 14-year-old died of Subacute Sclerosing Panencephalitis (SSPE), a late complication of a natural measles infection (2015)
• an immunocompromised woman died after she was exposed in an outbreak in Clallam County, Washington (2015)
• a 6-year-old boy with leukemia died in Italy caught measles from his intentionally unvaccinated sibling (2017)
• an 11-month-old unvaccinated infant died in Greece (2017)
• an intentionally unvaccinated 9-year-old girl with chromosomopathy, which is not a contraindication to getting vaccinated, died in Italy (2017)
• a 10-month-old unvaccinated boy who likely caught measles when he had been hospitalized for an RSV infection, died in Italy (2018)
• a 16-year-old who had received a heart transplant when she was 2-years-old died in France (2018)
• an unvaccinated toddler in Jerusalem (2018)

Measles as a rite of passage?

“We baby boomers were apparently the last generation whose doctors, and therefore parents, accepted the measles as just one more annoying rite of passage of childhood that also happened to prime the immune system and provide lifelong immunity. Medical texts prior to the advent of the vaccine described measles as a benign, selflimiting (sic) childhood infectious disease that posed little risk to the average well-nourished child.”

Darrerl Crain, DC on The Great Measles Misunderstanding

While early pediatric textbooks did a great job describing the symptoms of measles, they also did a great job of documenting that measles was never a benign disease, something anti-vaccine folks still misunderstand because vaccines can do such a good job controlling the disease.

Do benign, self-limiting childhood infections diseases kill hundreds of children every year?

Measles as a rite of passage is something we don’t want to have to go back to. It was a rite of passage that was endured because there was no other choice.

We have a choice now.

Don’t be misled into making the wrong one.

Don’t help anti-vaccine folks bring back measles and other vaccine-preventable diseases.

Vaccines are safe, effective and necessary.

“Today, vaccination is a cornerstone of pediatric preventive health care and a rite of passage for nearly all of the approximately 11,000 infants born daily in the United States.”

Cohn et al on Immunizations in the United States: A Rite of Passage

Getting vaccinated and protected is a rite of passage that you can look forward to, thanks to the many benefits of vaccines, not one that you should dread or avoid.

More on Measles Deaths

• Immunizations in the United States: a rite of passage.
• Measles was no big deal — until my daughter caught it
• Minnesota officials remind parents that measles can cause seizures, comas, death
• The Clinical Significance of Measles: A Review
• CDC – Measles Signs and Symptoms
• CDC – Photos of Measles and People with Measles
• CDC – Measles It Isn’t Just a Little Rash
• MMWR – Epidemiologic Notes and Reports Update: Measles Outbreak — Chicago, 1989
• MMWR – Measles — United States, First 26 Weeks, 1989
• MMWR – Current Trends Measles — United States, 1989 and First 20 Weeks 1990
• MMWR – Current Trends Measles — United States, 1990
• MMWR – Measles Outbreak — New York City, 1990-1991
• MMWR – Notes from the Field: Subacute Sclerosing Panencephalitis Death — Oregon, 2015
• The measles vaccine protects against more than just the measles
• Measles vaccination has saved an estimated 17.1 million lives since 2000
• Comparing risks – Measles vs MMR
• Measles is more dangerous than we thought, and vaccines are as safe as we thought
• Late 19th-Century Maps Show Measles Mortality Before Vaccines
• Study – Measles mortality. Analysis of the primary cause of death.
• Study – Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality.
• Report – Measles epidemics of variable lethality in the early 20th century.
• Case Report – Fatal measles presenting as acute respiratory distress syndrome in an immunocompetent adult.
• Study – Measles mortality reduction contributes substantially to reduction of all cause mortality among children less than five years of age, 1990-2008.
• Schoolboy, 13, Dies as Measles Makes a Comeback
• CDC says measles almost eliminated in U.S. The Herald-Palladium. Saint Joseph, Michigan. Friday, September 3, 1999