Why Measles Continues to Plague Us

6 minute read

This post is in partnership with the History News Network, the website that puts the news into historical perspective. The article below was originally published at HNN.

Not so long ago (2011) the world was declared officially free of the cattle disease, rinderpest. As with the 1980 eradication of human smallpox, the basic weapon was vaccination. The rinderpest virus and measles virus are very similar, perhaps diverging from a common ancestor about 1,000 years back. We’ve had effective measles vaccines for around 50 years and the world could, and should, be rid of measles. But, apart from the problem of getting vaccine into war zones and other problems in very poor nations, we are nowhere near doing that. Why is that so?

The latest outbreak associated with visitors to Disneyland is just one of continuing, sporadic events all over the advanced world. Measles is very infectious. Classically, a young, unvaccinated person is taken on family vacation to a country where the virus is actively circulating, contracts the disease and brings it back to spread rapidly in (often) an “alternative” school where there are many other unprotected children. Such schools are often the choice for intelligent, well-educated parents.

What’s happening with measles is a good example of the maxim that: “partial knowledge is dangerous.” In the main, people have a very limited understanding of infectious diseases. Viruses grow in cells and kill them. One virus particle is enough to initiate a full cycle of replication in what becomes a “factory” producing millions of progeny that are, in turn, released to go on and infect other cells. With influenza, the disease that I study, the successive cycles of infection, cell loss and inflammation are limited to the respiratory tract. That kills if the lung damage is sufficiently severe. With measles, though, the virus travels the body and can end up in any tissue.

Most 1st world citizens and doctors who are under 60 have never seen a case of measles. Those who do know anything about this disease understand that the kids get prominent skin spots. Each one of those red “lesions” reflects a focus of virus growth. The measles virus invades via the oropharynx, multiplies there and is then disseminated via the blood. The effects in the skin are obvious, but we don’t see what’s happening in the lung, the brain, the middle ear and elsewhere. The measles sequelae can include long-term hearing problems, persistent lung damage and (fortunately rare) the terrible disease subacute sclerosing panencephalitis (SSPE). In SSPE, a defective measles virus “hides out” in the brain, then suddenly re-emerges in adolescence. A fit teenager can suddenly go into a coma and die. SSPE disappeared with the widespread use of the measles vaccine. Nobody wants to see it return.

The measles vaccine is an “attenuated” virus strain that undergoes limited replication, infects few cells and does not disseminate widely via the blood. Given that the recommended immunization schedule has been followed, it provides long-lasting immunity.

So why does this vaccine get such a bad rap with some parents? Apart from a tendency of “empowered” adults to disregard medical advice and say “I will decide what is given to my child,” there are claims that injecting the measles, mumps rubella (MMR vaccine) is associated with the development of autism. This appeared in a 1998 paper by Andrew Wakefield and 12 others published in the prestigious British journal, The Lancet. The data set was just 11 cases, and the correlation was with MMR, not with the measles vaccine as such. There has been no confirmation, despite massive, international efforts to replicate the Wakefield et al findings. Major issues have been identified with the original Lancet paper, which has been retracted by the authors, excepting Dr. Wakefield. Apart from the tragedy that children are now needlessly contracting measles, the claim distracted those who are seeking a cause for autism, particularly some in the patient advocacy groups.

See 40 Stunning Images Captured Through A Microscope

Jumping spider eyes at 20x magnification.Noah Fram-Schwartz
A bed bug at 50x magnification.Stefano Barone
A mite in a forest at 10x magnification.José R. Almodóvar
Cultured embryonic chicken dorsal root ganglia neuron explant at 60x magnification.Dr. Michael John Bridge
A crawling bone cancer cell
A crawling bone cancer cell at 8000x magnification.Dr. Dylan T. Burnette
Active fluid flow around P. damicornis
Active fluid flow around P. damicornis at 4x magnificationDr. Douglas Brumley
Chrysochroa buqueti (jewel beetle) carapace, near eye
A Chrysochroa buqueti (jewel beetle) at 45x magnification. Charles Krebs
Focal conic-like domain with varying degrees of modulation and checkerboard patterns
Focal conic-like domain with varying degrees of modulation and checkerboard patterns at 40x magnification.Dr. Rajdeep Deb
Leptothorax acervorum (ant) carrying its larva
ALeptothorax acervorum (ant) carrying its larva at 5x magnification.Geir Drange
Sagittal brain slice showing cell nuclei (cyan) and Purkinije cells (red) expressing EGFP
A sagittal brain slice showing cell nuclei at 40x magnification.Dr. Marco Dal Maschio
Mouse brain vasculature
A mouse brain vasculature at 2x magnification.Dr. Ali Erturk
Tradescantia zebrina (wandering jew) leaf stomata
A Tradescantia zebrina (wandering jew) leaf stomata at 40x magnification.Dr. Jerzy Gubernator
Tigriopus californicus (copepod), couple, lateral view
A Tigriopus californicus (copepod) at 10x magnification.Dr. Terue Kihara
Chrysochroa buqueti (jewel beetle) carapace, near eye
A Chrysochroa buqueti (jewel beetle) carapace, near eye at 450x magnification.Charles Krebs
Live zebrafish embryo at 22 hours post-fertilization
Live zebrafish embryo at 22 hours post-fertilization.Dr. Philipp Keller
Casuarina equisetifolia (beach oak) twigs with scale leaves, transverse section
A Casuarina equisetifolia (beach oak) twigs at 125x magnification.Anatoly Mikhaltsov
Bovine pulmonary artery endothelial cells stained for actin (pink), mitochondria (green) and DNA (yellow
Bovine pulmonary artery endothelial cells.Dr. Muthugapatti K. Kandasamy
A Vespula vulgaris (common wasp) stinger at 5x magnification.Geir Drange
Ant Eye
An ant eye at 20x magnification.Noah Fram-Schwartz
Conichalcite pseudomorph after azurite
Conichalcite pseudomorph after azurite at 6x magnification.Honorio Cócera-La Parra
Pleurosigma angulatum (diatoms
Pleurosigma angulatum (diatoms) at 100x magnification.Christian Gautier
Lilium anther, second division tetrads
Lilium anther, second division tetrads at 500x magnification.Raymond Sloss
Montana Dryhead agate, unpolished
Montana Dryhead agate at 50x magnification.Douglas L. Moore
Tripolycyanamide crystal
Tripolycyanamide crystal at 100x magnification.Yanping Wang
Young Starfish
A young starfish at 5x magnification.Steven Wilbert
A Solea sp. (fish) at 25x magnification.David Linstead
Pleurotaenium ovatum
Pleurotaenium ovatum (micro algae) at 40x magnification.Rogelio Moreno Gill
A Magnesium chloride and potassium alum mixture at 25x magnification.Chao Zhang
A rhombohedral cleavage in calcite crystal at 10x magnification.Alessandro Da Mommio
Autofluorescence in marine algae
Marine algae at 40x magnification. Waldo Nell
A Ceriodaphnia sp. (water flea) at 20x magnification.Rogelio Moreno Gill
A snowflake at 8x magnification.Michael Peres
Shipworm Lyrodus pedicellatus, a wood-boring mussel
A Shipworm Lyrodus pedicellatus and a wood-boring mussel at 20x magnification.Andrea Wurzinger-Mayer
Anagallis arvensis (scarlet pimpernel)
Anagallis arvensis (scarlet pimpernel) at 80x magnification. Jens H. Petersen
Flower embryo
A flower embryo at 40x magnification.Samuel Silberman
Underside of the Brown dog tick and Lonestar tick mouthparts
The underside of a Brown dog tick and Lonestar tick at 100x magnification.Dr. Igor Robert Siwanowicz
Living Micrasterias in contrast Interphako at 100 magnification.Frank Fox
Recrystallized bismuth iodide under crossed polars
Recrystallized bismuth iodide at 100x magnification.Sebastian Blaise Sparenga
Hydra and Volvox
A Hydra and Volvox at 10x magnification.Steven Wilbert
Appendages of a common brine shrimp
Appendages of a common brine shrimp at 100x magnification.Dr. Igor Robert Siwanowicz

Why was this underpowered Lancet study so readily accepted? The thought that you might cause your child to develop autism is obviously horrific, and the problem with autism is that it often emerges around the age that children are receiving the standard vaccines. Listening to people arguing this case, it’s obvious that people will connect anything bad that happens to their kids back to vaccines given weeks, or even months previously. And the fact of the matter is that vaccination, like any medical procedure, has to be looked at through the lens of relative risk. There was a recent situation in Australia where an influenza vaccine was too “reactogenic,” causing fever and convulsions in a few very young children. The vaccine was quickly withdrawn and replaced by a safer product, with the event being thoroughly investigated by the US FDA and by the relevant Australian authorities. There were similar issues way back with whooping cough vaccines, which have been replaced by much “cleaner” products, though they are less effective in the immunity sense.

If, in reading this, you want to find out more, go online and watch the excellent NOVA documentary: Vaccines: Calling the Shots. Made by the Australian film-maker Sonya Pemberton, it first aired “down under” as Jabbed and was modified for a US audience. Then, I did my utmost to write an easily understood chapter on infection and immunity and how vaccines work in my recent (2013) Q&A book, Pandemics: What Everyone Needs to Know.

We all realize that parents want to do their best by their kids. That involves, though, not believing what some dubious and ignorant “celebrity” says on TV, but doing your utmost to understand the evidence and find out what is real. There is no virtue in ignorance, especially in deliberate ignorance that can compromise the wellbeing of children. Measles is highly infectious, and vaccination is a collective responsibility. According to the World Health Organization, some 145,700 children died of measles in 2013, with most fatal cases being in babies who are too young to be vaccinated and/or those with poor nutritional status. Who would want to be responsible for killing a vulnerable child?

Peter Doherty shared the 1996 Nobel Prize for Physiology or Medicine for illuminating the nature of the cellular immunse defense. He is a member of the Department of Microbiology and Immunology, University of Melbourne, Australia. You can find him on Twitter @ProfPCDoherty

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