A key feature of great civilizations is that they strive to prevent outbreaks of deadly contagious diseases. So it’s more than worrisome that measles is making what the World Health Organization calls a “dramatic resurgence” in Europe.
Measles, an entirely preventable disease, has in a single year doubled the number of its cases in four European nations, including Great Britain, in the first half of 2019: 90,000 cases versus 44,000 in 2018. Measles has come back with such force that the countries no longer may be considered as having eliminated the infection.
This is a continental meance, too, as the New York Times reported:
Albania, Britain, the Czech Republic and Greece, which had declared measles eliminated, joined 12 other nations — including France, Germany, Poland, Romania and Russia — where the disease is endemic, the WHO said.
The United States is on the brink not only of entering a similar dubious “nonelimination” status with measles, the Trump Administration is flailing with harsh, anti-immigration policies that are promoting the rise of other significant infections of influenza and mumps.
Let’s be clear right here and bust any xenophobic or racist beliefs that immigrants inherently carry and spread diseases and pose an unacceptable health risk. Many of those on the move and heading to the U.S. southern border are poor. They are fleeing dangerous and repressive conditions in their homelands. They are traveling great distances in dire conditions to seek better lives here. They arrive at the nation’s borders, exhausted, weak, and desperate. And current federal policies have called for rounding up too many of them, and incarcerating men, women, and especially children in abject and unacceptable situations. Trump officials have terminated a legal exception that allowed immigrants to avoid deportation while receiving medical care for serious conditions.
The administration also is declining recommendations by public health experts to inoculate the detained for preventable illnesses, including the flu and mumps. And poor conditions have led to outbreaks in various facilities, many of which have been kept with tight control over who may visit or check on conditions, including members of Congress.
U.S. officials’ failure to deal with detained people’s spreading infections also may be sending an unhelpful message about the proven, powerful protection that vaccinations provide.
Common childhood infections like measles and mumps may not seem serious to healthy people in western industrialized nations. But they can create significant health risks. For starters, even “routine” infections in families with two or three kids can cause domestic strain, requiring care giving from a parent with homebound youngsters who may be ill and contagious for weeks.
The diseases also may become more serious, carrying known complications: Measles can come with dehydrating diarrhea (an issue that can get out of hand fast in the young), ear infections that lead to hearing loss, as well as pneumonia and brain swelling (encephalitis), the federal Centers for Disease Control and Prevention says. The agency notes that 1 to 3 of every 1,000 children who become infected with measles will die from respiratory and neurologic complications.
With the mumps, various parts of the body can become inflamed, including the brain, spinal cord, and pancreas, the CDC says. The disease also can attack male and female reproductive organs, and it can cause deafness.
The flu, of course, persists as a major, lethal scourge. Influenza killed about 80,000 people in the 2017-2018 season, the CDC says. The previous high for a regular flu season, based on analyses dating back more than three decades, was 56,000 deaths.
It is painful that the toll of many communicable diseases could be slashed — if humans around the globe got their shots.
As with all medical interventions, vaccines carry risks. These are far outweighed by their benefits. Big, rigorous studies of vaccines, their side-effects, harms, and benefits should be slam-dunk convincing. They can protect us from a history of suffering and deaths from measles, rubella (so-called 3-day or German measles), chicken pox, diphtheria, mumps, tetanus, whooping cough, polio, meningitis, human papilloma virus, hepatitis (A&B), shingles, pneumococcus (pneumonia), and the flu.
But, as WHO has warned, reticence, skepticism, or outright denial about the evidence and effectiveness of vaccines is a burgeoning and significant problem.
The New Yorker magazine delves into the difficulties in defeating the anti-vaccination fallacies, focusing on public health officials’ efforts to deal with the spread of measles in Orthodox Jewish communities in Brooklyn. The piece is long but contains thought-provoking discussions on the challenges of coping with wild, conspiratorial, and anti-science thinking. One way involves a different approach, focused less on health care providers arguing facts and busting myths:
It’s called the “motivational-interview technique, a less combative and less condescending way of fielding patients’ concerns and presenting the justifications for vaccines,” the New Yorker reported. “Don’t overwhelm them with data. Address their stated concerns, one at a time. ‘I strongly recommend’ rather than ‘You’d be stupid not to.’ Have the recommendation gently reiterated by everyone along the way: receptionists, nurses, pharmacists, home-care workers. ‘Drop the pamphlets,’ [advised Rabbi Yitzchok] Sternberg … Common sense helps. When a mother protests that her child has a cold and that the vaccine shot might just make things worse, Sternberg says, ‘The baby’s cranky anyway, so you might as well get it over with.’”
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the value in their staying healthy and out of health care settings rife with medical errors. Inoculations work. Please get them. It soon will be time to get the annual flu shot. It’s worth doing, as with all vaccinations — it’s not just for yourself but also for the “herd immunity” you help to build and that protects your friends, loved ones, and colleagues.
History shows that civilizations can rise and fall fast, with diseases playing key roles in their decline. We’ve got a lot of collective good that we can, if we can figure how to rebuild our trust in facts, evidence, science, and public health.