Measles has returned to haunt the United States of America

Officials have declared a public health emergency in the United States due to a measles outbreak in Washington. The rising number of cases in the state has been linked to travellers returning from Israel and Ukraine where the disease is relatively common. So far there have been 51 confirmed cases within Washington but no fatalities.

For those who don’t know, measles is a highly infectious virus of the respiratory system. The most prominent symptoms are high fever and conjunctivitis (red eyes), leading up to the appearance of a typical skin rash that usually covers the entire body. In 2000 the World Health Organisation stated that measles had been eliminated in the United States. However, 2018 saw the second highest number of cases reported, 372 from 17 separate outbreaks, since the disease was “eliminated.” The primary reason for this is a decline in vaccination levels within the country.

Clark County, Washington, currently has 50 confirmed cases with a further four suspected. The county, somewhat unsurprisingly, also has one of the worst vaccination rates in the state. Over 22 per cent of public school students are not up to date with the vaccines they need.

According to the CDC, 90 per cent of unvaccinated people who come into contact with someone carrying the measles virus will contract it too. The virus can linger in the air up to two hours after an infected person coughs or sneezes and so it is incredibly difficult to prevent spread between unvaccinated individuals. Measles is an incredibly dangerous disease with some infected people suffering from pneumonia and encephalitis (swelling of the brain). Of those infected, two in every 1000 children will die.

It’s not just in the United States where this is a problem. Within just the past week outbreaks have been declared in the Philippines and Madagascar, and last year Europe saw the highest number of measles cases in over a decade. Earlier this year the World Health Organisation reported that people choosing not to vaccinate has become a global health problem.

Vaccines work by preparing the body to fight a disease without causing any of the dangerous symptoms of that disease. If a pathogen enters the body, your immune system will respond by producing antibodies specific to that microorganism. Every disease requires a different antibody and so it can take a few days after infection for your immune response to be working at full capacity. This is fine for a disease like the common cold where you experience mild discomfort such as a sore throat or blocked nose, but when you are infected by measles this delay is too long and severe side effects of the disease will already have occurred.

With the measles vaccine, the body has already had to fight a mild strain of the disease and so has already produced the necessary antibodies. Your immune system contains memory cells due to this first infection, allowing you to identify pathogens much earlier on and so destroy the threat before you become sick. There is very strong evidence to show the useful role that vaccines have played in improving global health care and yet there are still many who do not trust them. There are some small side effects and risks to vaccines, however the measles two-dose vaccine is 97 per cent effective against the virus and so these small risks are hugely outweighed by the benefits. Demand for the measles vaccine has increased 500% in Clark County compared to this time last year. People are rushing to get up to date with their, and their children’s, boosters in order to stay healthy. Healthcare officials in the United States and around the world are hopeful that the recent outbreaks will help increase vaccination rates across the country and allow measles to be eradicated there once more.

 

Image: Johnny Silvercloud via Flickr

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