Michael Abrahams | The return of measles
Measles, unfortunately, is making a comeback. The only time most Jamaicans hear the word “measles” is in relation to vaccination. Most of us have never seen anyone afflicted with the viral illness, and the reason for this is that the disease has been superbly controlled by the process of vaccination.
Measles was identified by physicians before the eleventh century and may have originated in animals. It has been a scourge for centuries, afflicting millions of people, and has been blamed, in part, for decimating native populations of the Americas as Europeans explored the New World. For example, it is one of the many “gifts” that Christopher Columbus and other explorers brought to this side of the world in 1492, along with smallpox, whooping cough, chicken pox, bubonic plague, typhus and malaria. Indigenous people had no immunity to these infections, and it has been estimated that the Native American population fell precipitously, by as much as 95 per cent, over the next 150 years, due such diseases.
In the nineteenth century, as travelling and trading became more established, Pacific Islanders paid dearly. In 1848, a third of the native population of Hawaii was killed, and in 1875, the HMS Dido brought measles to Fiji, eliminating a third of their population, too.
In 1846, Danish physician Peter Ludwig Panum travelled to the Faroe Islands (between Iceland and Norway) to study a measles outbreak there and realized that none of the elderly residents who had been infected in an outbreak in 1781 were affected, and in doing so, discovered that infection confers survivors with immunity to the virus. But it was not until 1954, when Thomas C. Peebles isolated the virus in an infected 11-year-old boy, that work began on a vaccine, which was eventually licensed in the United States in 1963.
The evidence for the efficacy of the vaccine is powerful and unequivocal. Prior to 1963, when there was no measles vaccine, outbreaks occurred every few years, causing 2.6 million deaths annually. Today, five decades later, we have come close to eliminating it from the face of the planet. Since the turn of the century, the measles vaccine has saved over 21 million lives, decreasing the global death toll by 80 per cent in less than two decades.
So what went wrong? Why is this disease still rearing its ugly head and threatening to gain a foothold in so many areas?
Scientific research has shown that at least 95 per cent of a population must be vaccinated for herd immunity, the protection of the population from the relevant germ, to occur. Herd immunity is especially beneficial to persons who cannot be vaccinated, such as children under the age of 12 months, immunocompromised individuals, persons with severe allergic reactions to the vaccine and pregnant females. So not only do vaccines directly protect immunized individuals, they also indirectly protect others in the community. Not surprisingly, as the vaccination percentage drops, the risk of outbreak rises.
Unfortunately, vaccination rates have fallen in several countries and communities, and one of the main reasons is fear. In 1998, a report in the British medical journal ‘Lancet’ claimed a possible link between the measles vaccine and autism. The report was later debunked as fraudulent, and its author, Dr Andrew Wakefield, lost his medical license after an investigation found that he had manipulated his data and altered patients' medical histories to make his findings and conclusions more convincing.
Unfortunately, many are still afraid of vaccination, and a powerful and vocal “anti-vaxxer” movement has developed and grown, hindering vaccination efforts and placing the vulnerable at risk.
In addition to misinformation and fear-mongering by anti-vaxxers, complacency, misplaced priorities and inadequate funding have all contributed to the resurgence of this nuisance.
Vaccination is necessary to halt the spread of this highly contagious disease. It is recommended that children get two doses of the MMR (measles, mumps, rubella) vaccine. The first dose should be administered at 12 to 15 months and the second at four to six years. Adults without evidence of immunity from vaccine records or laboratory tests should also get vaccinated.
No vaccine is 100 per cent effective or devoid of possible side effects but, in the case of measles, the benefits of vaccination far outweigh the risks.
Children still die from measles, and this should never happen once a safe and cost-effective vaccine is available.