In the past year, there have been outbreaks of measles nationwide – a worrying trend for an entirely preventable disease that was once thought to have been virtually wiped out in North America.
Back in the 1960s, it seemed as though we had eliminated the disease, at least in the developed world, thanks to a fabulous vaccine, which is usually paired with mumps and rubella vaccines, called MMR. We vaccinated our children and we rarely, if ever, saw a case. This was a huge success, given that the disease can be deadly.
However, measles has come back – with a vengeance. There are two main reasons for this. First, although measles was rarely seen in North America, it was still prevalent in other countries. When a susceptible person visits one of those countries, or if unvaccinated people from abroad visit us, it is easy to bring the virus here. And measles is a very contagious virus.
Second, a significant number of people chose not to be vaccinated, or are hesitant about receiving the vaccine. This has resulted in communities with high levels of unvaccinated people throughout the country. Now, public health officials are dealing with a growing number of cases, which presents increased risks for the entire population.
According to the U.S. Centers for Disease Control and Prevention, everyone should understand four things about measles:
1. It’s a potentially life-threatening and life-altering disease. Yes, it is a rash, it’s itchy and uncomfortable and causes fever in children. But about 25 per cent of people with measles end up in hospital. In one out of every 1,000 cases, it will cause brain swelling, which can lead to brain damage. And it kills one or two out of every 1,000 people who contract it, even in countries with advanced health-care systems, like ours.
2. It is a very contagious virus. It spreads in the air from coughing or sneezing. And it spreads early in the disease’s progression, before symptoms develop. The virus can linger in the air in a room for two hours after someone with the disease has left, and about 90 per cent of those who are not immune will become ill from breathing that air. It’s therefore easy to understand how even one case of measles can infect large numbers of people.
3. Even if there are few cases of measles in a community, every unprotected person is at risk, due to the frequency of international travel.
4. The best protection from this disease is vaccination. Those born before 1957 are very likely to have had the disease and are immune for life. Those born after 1957 have generally been offered immunization. However, we now know that we need two shots of MMR (or MMRV) to properly protect against the disease. Lots of people only received a single dose of MMR, and while a single dose does provide protection (it’s about 93 per cent effective), two doses increase that protection to over 97 per cent and is considered the requirement for children today.
Health-care workers, people serving in the military, as well as those who travel to at-risk areas should definitely get both shots. For others, many guidelines suggest that one is often enough. However, given the amount of international travel that takes place on a daily basis, the cosmopolitan nature of our communities, the lessons of how quickly viruses can spread, as we saw with SARS, and the death rate from this preventable disease, it would be wise to play it safe and get both doses.
I am immune, as I had the disease as a child. My children and grandchildren have been immunized, as I would never gamble on their health. But unfortunately, far too many people these days are willing to take that gamble – and are paying the price.