Measles outbreaks increase, with cases hitting highest level since 2000

lameasles-300x225Almost two decades after public health officials declared them eradicated from this nation’s children, measles infections have returned with a vengeance to the United States, rising to the highest level in almost two decades, with hundreds of cases in almost two dozen states, and the incidences climbing still.

The outbreaks have been concentrated in New York, in Brooklyn in a religious community, and in Washington state. But authorities have taken aggressive steps, including quarantine orders for hundreds of students and staff on two big college campuses across town from each other (UCLA and Cal State, LA), to ensure that the disease is contained and does not spread in Los Angeles.

Alex Azar, who heads the federal Health and Human Services Department, said in a statement about the familiar infection: “Measles is not a harmless childhood illness, but a highly contagious, potentially life-threatening disease. We have the ability to safely protect our children and our communities. Vaccines are a safe, highly effective public health solution that can prevent this disease. The measles vaccines are among the most extensively studied medical products we have, and their safety has been firmly established over many years in some of the largest vaccine studies ever undertaken.”

Azar and other public health officials have expressed worry that, as the federal Centers for Disease Control and Prevention has described it, “The outbreaks in New York City and New York State are among the largest and longest lasting since measles elimination in 2000. The longer these outbreaks continue, the greater the chance measles will again get a sustained foothold in the United States.”

As they battle measles’ spread now, authorities also are confronting another powerful challenge, too: medical misinformation and its viral dissemination via social media. Individuals and communities, with hesitancy if not outright rejection of more than a century of experience and countless rigorous research studies, share and spread counter-factual notions about vaccines and their risks.

Like all medical treatments, vaccines carry risks. But they are far outweighed by their proven success in saving tens of millions of lives and of preventing youngsters, in particular, from the ravages of a range of infections. As the CDC reminds about measles:

Measles is a serious respiratory disease (in the lungs and breathing tubes) that causes a rash and fever. It is very contagious … Measles can be dangerous, especially for babies and young children. From 2001-2013, 28% of children younger than 5 years old who had measles had to be treated in the hospital. For some children, measles can lead to: pneumonia (a serious lung infection); lifelong brain damage; deafness; [and] death

The New York Times reported that members of religious communities have expressed concerns about vaccines, notably due to the materials that go into them, whether chemical or derived from living tissues. Still, the newspaper said, “vaccination is endorsed by top Jewish and Islamic scholars, and by the Vatican. Religious authorities have meticulously studied how vaccines are made and what is in them, and still have ruled that they do not violate Jewish, Islamic or Catholic law.”

In California, anxious and angry parents thronged hearings in the state capital on proposed revisions to toughen the state’s already stringent law requiring vaccinations for youngsters. The parents’ arguments were rooted in emotion and fear, not necessarily in facts, say, about vaccinations’ potential harms. Legislators were unconvinced and have moved forward with plans to curtail individual doctors’ capacity to exempt kids from vaccination with little explanation.

California officials have said the state’s vaccination laws have helped prevent even more infections in the current measles outbreak. It is concerning, though, because experts say many college-age young people grew up in a time of vaccination laxity, and when the current anti-vaccination trend was taking root, so they may not have the needed immunity from the disease.

Public health officials have taken some heat for their decisions to impose quarantines and fines for their violation and for failure by parents to immunized youngsters and to allow them to be in public places. Though skeptics question their resort to traditional and perhaps draconian measures, experts outside of LA, for example, have praised the fast, decisive action.

Current measles outbreaks have been traced to international sources — visitors and travelers from the rest of the world where infections rage. The World Health Organization, for example, has reported that more than 20 million youngsters globally miss out each year in receiving a key first dose of measles vaccination.

With economic globalization and the planet shrunken by advances in technology and transportation, diseases can hopscotch the planet and spread in a flash. In cosmopolitan metropolises like LA, New York, and Washington, D.C., where populations churn and mingle furiously, rapid transmission of contagions could create public health nightmares. This is not just the stuff for novelists like the late Michael Crichton but the worry of elite strategists about U.S. national security. And, indeed, a component of the vaccine disinformation has been traced to international (Russian) efforts to sow domestic discord and worse in Europe and the United States. President Trump, the record should show, has been largely unhelpful both in supporting global and domestic public health efforts to deal with diseases and in encouraging vaccinations.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the injuries that can be inflicted on babies and children, especially while they are in medical care. Experience shows that there’s a great way to avoid all too common medical errors and mistreatment — stay healthy and out of the hands of doctors and hospitals. Hand-wringing parents should know that vaccinations not only can keep their kids from unhappy, even dreadful and sometimes fatal illness, it can keep families out of what can be costly, prolonged periods of dealing with sick kids. With so many parents working night and day already to make ends meet, moms and dads should have nightmares even thinking about needing to stay home for a couple of weeks at a time to tend to one or several of their kids with an infectious disease.

Please talk  with your pediatrician or trusted primary care physician if you have doubts about vaccines. We all need to get them, to maintain them if booster shots are called for, and to safeguard not only ourselves and our loved ones via “herd immunity,” the shared protections that communities enjoy when high percentages of their members are vaccinated. Do take the time to double-check that your own shots are up to date and in order, and that older sons and daughters have immunizations that will protect them in the close confines of college and university.

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