“Help me, Rhonda!” Not the song by the 1965 Beach Boys, but just my way of requesting help for something I do not understand, namely measles in the U.S. and why the significant increase in the number of cases this year.
The CDC is reporting 1044 cases of measles in the United States thus far in 2019. This is the greatest number of cases reported in the U.S. since 1994, when 963 cases were reported for the entire year. Why the recent increase in the number of cases? Some would try to blame that increase, especially in Brooklyn, on religious exemptions, but I have not seen any figures documenting that the number of religious exemptions has dramatically increased. Certainly some parents are fearful of potential side effects, and choose not to have their child vaccinated, but I am not aware of this number significantly increasing.
As most of us know, measles is basically a highly contagious childhood viral infection that has occasional severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). Children younger than 5 years of age and adults older than 20 years of age are more likely to suffer from complications, and about 1 in 5 unvaccinated people in the U.S. who get measles are hospitalized. The key word in this last statement is “unvaccinated.”
Once quite common, measles can now almost always be prevented with a vaccine. The measles vaccine has been in use for over 50 years. It is safe, effective and inexpensive. It costs approximately one US dollar to immunize a child against measles. Two doses of the vaccine are recommended to ensure immunity and prevent outbreaks, as about 15% of vaccinated children fail to develop immunity from the first dose. Most people born before 1957 have been exposed to measles and have immunity. Those born after 1957, but before 1964 may not have immunity as the vaccine came along in 1963, but in general those that are susceptible to measles are unvaccinated. Again, the key word is “unvaccinated.”
So let’s try to use some common sense here. The number of measles cases in the U.S. is up dramatically this year, and there have been outbreaks in 28 states. Some outbreaks, e.g. the one in Newark, have been due to unvaccinated travelers in airports, and in some, the index case was in someone who travelled from afar, as in Washington State where the initial case was in a child, almost surely unvaccinated, who had come from Ukraine. However, I have not seen any data suggesting that there are more travelers to the U.S. this year.
It seems to me that one key point has been missing, or perhaps purposely not reported in this outbreak story. One unvaccinated individual can get measles, but an outbreak only occurs when that initial individual passes the virus to other unvaccinated individuals. Is there a reason why there might be a significant increase in unvaccinated people in the U.S. compared to years past? There is, of course, an obvious answer to that question . . . an increase in the number of individuals, a lot of whom are most likely unvaccinated, coming in droves across our southern border. To put things in perspective, $800,000 was spent containing one potential outbreak in Clark County, Washington, and this was only one of the multiple outbreaks across 28 different states. Perhaps this money could have been better spent vaccinating 800,000 illegal immigrants.
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