It's crazy the difference a decade can make. In the early 2000s, it was thought that measles had been eradicated from the United States -- after all, the vaccination was widespread, and standard preventative care given to children nationwide. The few cases of measles left were isolated incidences: small groups of infection spread from international travelers with the disease.
But on Thursday, the U.S. Centers for Disease Control and Prevention released new data showing that 2013 is likely to be the worst year for measles since 1996. Through Aug. 24, there have been 159 cases of measles in the country; in 1996 there were about 500 reported cases.
Both these numbers pale in comparison to what it was like before the vaccine became standard care; according to the CDC, in the 1950s, there were hundreds of thousands -- in some years closing in on a million -- cases annually. Nevertheless, the rising rate of measles is certainly alarming.
Why Have the Measles Returned?
"This is very bad. This is horrible," said Dr. Buddy Creech, a pediatric infectious disease expert, in a telephone briefing with the CDC. "The complications of measles are not to be toyed with, and they're not altogether rare."
Measles cause ear infections in 10 percent of the children infected by the disease, and about 5 percent get pneumonia. Even scarier is the fact that one or two in every 1,000 infected by the disease die, according to the CDC. With numbers as low as they are right now, this isn't yet cause for concern -- but if we return to rates closer to those of the 1950s, it could become a major epidemic. Consider that the disease still kills about 164,000 people globally every year (more than half of these deaths occur in India).
In 2001, the CDC teamed up partners across the globe, including the World Health Organization, to form the Measles & Rubella Initiative, one of the most ambitious projects ever, with the stated goal of reducing measles-related deaths by 15 percent from 2000 numbers by the year 2015. The results have been pretty stunning: They claim that from 2000 to 2011, global measles deaths were reduced from 548,000 to 158,000, with particular success in Sub-Saharan Africa.
The work of the Initiative (and all of our public health officials of the last 50 years) has, however, has stalled in recent years, and the group fears it may not reach its goals. The shift in trends over the last few years may, some believe, be due a small group of parents who have chosen not to vaccinate their children.
Consider this: According to the CDC, 92 percent of measles cases in 2013 were in unvaccinated people. The largest outbreak in 2013, for example, was in a community of Haredi Ultra-Orthodox Jews in Brooklyn, whose religious beliefs disallow vaccination. Another major outbreak in Texas occurred among members of the Eagle Mountain International Church, where pastor Terri Pearsons preached her belief that the MMR (mumps, measles, and rubella) vaccine can cause autism.
MMR Vaccine and Autism
Back in 1998, the Lancet published a study connecting the MMR vaccine to the development of autism spectrum disorder. But by 2004, the journal had retracted the paper and soon after, the author of the study, Andrew Wakefield, was stripped of his medical license for falsifying data. In the years since, dozens of studies and reports have found no link between MMR vaccine and autism.
Yet despite the preponderance of data to the contrary, Pearsons' belief is, these days, shared among a growing number of concerned (and particularly outspoken) parents -- most famously, former Playboy model and current co-host of "The View," Jenny McCarthy.
Approximately one-third of parents surveyed by Institute of Medicine (IoM) in 2003, for example, expressed concerns about the safety of childhood vaccines including the MMR regimen; a recently published 2012 of survey of vaccination coverage reports that about 10 percent of parents refused or delayed required immunizations for their children. Rates of vaccination range across the country; pockets of resistance exist in areas like certain counties in California and the Pacific Northwest.
The question of the MMR vaccine remains one of the most controversial subjects in health and medical science.
The Cost of Avoiding the MMR Vaccination
Not vaccinating your children has real costs. From a purely economic perspective, there is a pretty solid incentive for making vaccination a worldwide requirement. In a 2011 article for Wired, Maryn McKenna found that to treat a single 14-person outbreak, two Arizona hospitals had to spend $799,136 to contain the disease -- a cost that doesn't include the man hours spent by the state's department of health.
And this was simply handling the measles itself; if a child were to be stricken with any of the potential complications of the disease, they could end up in the hospital facing life-threatening acute conditions -- which is well beyond a sticker price.
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