Tag: measles encephalitis

Why Have We Forgotten About the Importance of Vaccination Against Measles?

While most of us know that measles is a serious, life-threatening disease, there are still some folks that want you to think that it is nothing to worry about.

It’s just a rash and fever, right?

The Importance of Vaccination Against Measles

Actually, while most people did recover after having a high fever, irritability, and other symptoms for a week or more, some didn’t. That’s why doctors at the time called it a harmless killer.

In the pre-vaccine era, hospitalizations, tracheotomies, encephalitis, sepsis, death from measles were not rare.
In the pre-vaccine era, hospitalizations, tracheotomies, encephalitis, sepsis, death from measles were not rare.

And why many were looking forward to a vaccine to get measles under control, as measles was a leading killer at the time.

Seymour Musiker calls on pediatricians to take action to get more kids vaccinated against measles.
A call for pediatricians to take action to get kids vaccinated against measles.

While measles vaccination was getting off to a slow start at the time, it should be obvious that there was a big need for these vaccines.

“Thus it is up to each one of us to convince our own segment of the population since this seems to be the only way to do it. And it is up to each one of us to remind our fellow physicians to cover his segment of the population.”

Norman Lewak, MD

Fortunately, everyone did finally take action and while it was a little later than originally planned, we got measles under control.

“Vigorous endorsement and execution of this aim by physicians and responsible health authorities should eliminate measles by 1970, and a suitable motto for the five-year period might well be “Mortus a morbilli.”

Lewis L. Coriell, MD

And the endemic spread of measles was eliminated in the United States in 2000.

Of course, that doesn’t mean that we eliminated or eradicated measles. It simply means that all cases and outbreaks are linked to someone from outside the United States.

Now, as too many people are either scared or have forgotten about the importance of vaccination against measles, cases are rising, continuing to reach new record levels.

So what’s next?

“All we need is one concerted campaign to get every susceptible vaccinated. One death, one brain-damaged child, or even one child who needs hospitalization is one too many.”

Norman Lewak, MD

Let’s get everyone vaccinated and protected.

Vaccines are safe, with few risks, and they are obviously necessary.

Measles is not a mild disease. And it never was.

More on the Importance of Vaccination Against Measles

More About Measles Deaths in the United States

Anti-vaccine folks like to talk about death and measles, as long as they can talk about vaccine deaths, something they seem to think happens commonly.

“Over the past ten years in the U.S., there has been one reported death from the measles, and it is unclear based on the medical history of the patient whether and how measles played a role in their death. During the same time period (based on Vaccine Adverse Event Reporting System (VAERS) reports), there have been 105 reported deaths associated with the MMR or MMRV vaccinations.”

Measles Madness: Dr. Brian Hooker’s Statement to WA Legislators

There are two big problems with this statement, that is so often repeated that it is clearly a PRATT – a point refuted a thousand times.

The reports in VAERS about deaths after MMR are not proof of a cause-and-effect relationship.

“Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.”

Guide to Interpreting VAERS Data

In fact, studies have shown that most of the reports of deaths submitted to VAERS are coincidental and not causally associated with a vaccine.

But what about deaths following a natural measles infection?

There are plenty of those that anti-vaccine folks love to ignore.

Wide-ranging Online Data for Epidemiologic Research = WONDER
Wide-ranging Online Data for Epidemiologic Research = WONDER

Where are they?

There were actually 5 SSPE deaths and 2 measles deaths in 1999, but I started the list from 2000, as that was when the endemic spread of measles was eliminated in the United States.
There were actually 5 SSPE deaths and 2 measles deaths in 1999, but I started the list from 2000, as that was when the endemic spread of measles was eliminated in the United States.

These deaths are all in the CDC Wonder database.

Before the death of the woman in Washington in 2015, the CDC caused a lot of confusion by stating that “the last verifiable death in the United States from acute measles infection occurred in 2003 when there were 2 reported deaths.”

Does that mean that the measles deaths in 2005, 2009, 2010, and 2012 didn’t happen?

Of course not!

The information in the CDC Wonder database comes from death certificates that are sent in from all over the United States to the National Vital Statistics System. The system isn’t like VAERS though, where just anyone can send in a report. Still, they are unverified, which is why the CDC doesn’t mention them all.

Still, if anti-vaccine folks are going to push VAERS reports that we know are likely coincidental, then they shouldn’t ignore these measles deaths.

More About Measles Deaths in the United States

What Are the Signs and Symptoms of Measles?

The first measles vaccine was developed in 1963 and its use led to a quick drop in measles cases in the United States.

In fact, as most people know, the endemic spread of measles was declared eliminated in the United States in 2000.

What does that mean?

A typical case of measles, as described in 1920, doesn't sound very mild or marvelous as some folks claim it to be.
A typical case of measles, as described in 1920, doesn’t sound very mild or marvelous as some folks claim it to be.

For one thing, it means that many people in the United States have never actually seen anyone with measles.

What Are the Signs and Symptoms of Measles?

As we are seeing more and more measles cases each year, it makes it important for everyone to learn how to recognize what measles looks like. Measles is so contagious, that missing just one case can lead to a lot of other people getting exposed unnecessarily and can keep an outbreak going.

So what does measles look like?

Call before you go to the ER or to see your doctor if you think your child has measles so that you don't put others at risk.
Call before you go to the ER or to see your doctor if you think your child has measles so that you don’t put others at risk.

After being exposed, kids with measles will develop:

  • a high fever
  • cough and/or runny nose
  • red, watery eyes with photophobia (dislike of bright light)
  • sore throat
  • irritability
  • decreased appetite

That sounds like many other viral infections that kids get though, which is why measles is so hard to diagnose, at least at the beginning stages of the illness, when kids only have the first signs of measles – the fever, cough, runny nose, and conjunctivitis.

Koplik spots, small gray-white spots in your mouth, are another clue that a child might have measles. They can develop on the second or third day of fever.

Next, after having the high fever for 3 to 5 days, kids develop a worsening fever and the classic measles rash. It is important to note that you are contagious well before you get the rash though, up to about four days before the rash develops, providing plenty of chances to expose others before you ever know you have measles.

“It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body.”

Measles Signs and Symptoms

While many diseases have a fever with or followed by a rash, it is very characteristic of measles that the fever continues for a few more days as the child develops the rash.

“You’ll usually feel most ill on the first or second day after the rash develops.”

Measles Symptoms

This is when most kids get diagnosed, typically with laboratory confirmation.

Unfortunately, because of the high fever and irritability, they may have sought medical attention a few times and could have exposed a lot of people already, especially as you continue to be contagious until you have had the rash for at least four days.

“After a few days, the fever subsides and the rash fades.”

Measles Signs and Symptoms

All together, these classic measles symptoms typically last about a week. As the rash fades, parents might notice staining and then a fine desquamation (skin peeling).

Of course, if any complications develop, the symptoms can last much longer.

What complications? Remember, measles was once called a harmless killer

Complications of measles can include:

  • ear infections
  • diarrhea
  • croup
  • pneumonia
  • seizures
  • encephalitis
  • myocarditis

And tragically, some kids don’t survive having measles.

“Furthermore, the risk of contracting other infections or dying remains high for several months after recovery from acute measles infection.”

Treating Measles in Children

And although most do survive the acute infection, we know that these kids are still at risk for getting other infections in the next few months and are at a later risk for SSPE.

Get vaccinated. Stop the outbreaks. There is no good reason that our kids should have to get measles today.

More on the Signs and Symptoms of Measles

How Many People Get Measles Each Year?

It used to be that measles was very common and almost everyone got measles.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.

While it was a so-called rite of passage and a part of growing up, it wasn’t something you looked forward to, as some kids didn’t survive having measles.

How Many People Get Measles Each Year?

Fortunately, measles case counts have dropped in the post-vaccine era.

How much did they drop?

Let’s see..

Year Cases
1920 469,924
1941 894,134
over 400 measles deaths each year
1962 503,282
1969 25,826
1970 47,351
1978 26,871
1979 13,597
1983 1,497
1986 6,282
1989 18,193
1990 27,786
1991 9,643
1992 2,200
1993 312
last record high number of measles cases
1994 963
1995 281
1996 508
1997 138
1998 100
1999 100
2000 86
2001 116
2002 44
2003 55
record low number of measles cases
2004 37
2005 66
2006 55
2007 43
2008 140
2009 71
2010 61
2011 220
2012 55
2013 187
worst year for measles since 1994, with the largest single outbreak (377 cases in Ohio) since the endemic spread of measles was eliminated
2014 667
2015 188
2016 86
2017 120
2018 372
2019 1,234+

Can you guess when the first measles vaccines were introduced?

Can you guess when we started to give kids a second dose of the MMR vaccine?

Can you guess when Wakefield became popular and Dr. Bob’s vaccine book was released?

Do you know how much it costs to contain these outbreaks?

Do you understand the consequences of a natural measles infection?

Can you explain why we will almost certainly have the second highest number of measles cases in one year since 1994, even though we see the devastation that high rates of measles is causing in Europe and other parts of the world?

How many people will get measles in the United States this year?

A lot has changed since we got reassurance from the CDC that we were seeing an expected range of measles cases, although there were plenty of warning signs then that this was going to be one for the record books.
A lot has changed since we got reassurance from the CDC that we were seeing an expected range of measles cases, although there were plenty of warning signs then that this was going to be one for the record books.

Although no one is reporting on this, with several large ongoing outbreaks still not under control – it will be another record year for measles in the United States.

The Rockland County measles outbreak already exceeds the total yearly case count for 11 of the past 19 years!
The Rockland County measles outbreak exceeded the total yearly case count for 11 of the past 19 years – in January!

And with several large outbreaks continuing overseas, next year doesn’t look like it will be much better, especially with reports of a measles resurgence in many regions of the world.

More on Measles and Measles Cases