Measles

It would be difficult not to notice the many reports of measles occurring in the United States this year. Between January 1 and May 20, 2011, the Centers for Disease Control and Prevention received reports of 118 cases of measles. Most of the cases (89%) were associated with importation of the infection from outside the United States.

We have to look back to 1996, before the elimination of measles in the United States, to find more measles cases in the same number of weeks. That year, the CDC recorded a total of 508 cases. The median number of U.S. measles cases in each of the past 10 years has been 56, so this year’s figures are already markedly higher.

The measles virus is extremely contagious: on average, 90% of those exposed to someone with the measles will get the disease themselves unless they’ve been vaccinated, or have had measles before. Combine that with international travel at unprecedented levels, measles outbreaks occurring all over the world, and pockets of unvaccinated individuals in the United States, and it’s not surprising that we’ve seen so many U.S. cases this year. More

National Infant Immunization Week is April 23-30 this year. This week, the History of Vaccines blog features posts about several diseases that can be prevented by vaccination of infants.

Rubeola, or measles (as it's more commonly known) is an extremely contagious viral disease. It causes a distinctive rash, fever that can reach 104°F or higher, runny nose, and cough, and has many potential complications including ear infection (in about 10% of cases) and pneumonia (about 5% of cases). In about one in a thousand cases, the patient develops encephalitis, a swelling of the brain. About one out of every thousand patients will die.

The rubeola virus spreads easily and rapidly via coughs and sneezes, and remains active and infectious in the air for up to two hours. As a result, a person can become infected just by breathing the air in a room that was occupied by a measles patient as much as two hours earlier. There is no treatment for the disease, although supportive care may be provided, and efforts may be made to lower the patient's fever. More

A January 5, 2011 report in the British Medical Journal investigates the 1998 paper that first alleged a link between the MMR vaccine and autism. The author, Brian Deer, presents evidence that the paper resulted from research fraud. The History of Vaccines blog looks at the history of the paper and how it has profoundly affected research, public health, and the public perception of vaccines over the last 12 years.

In the wake of a paper published in the Lancet in 1998, vaccination rates in Britain plummeted. The lead author of the paper, Andrew Wakefield, rose to infamy as a result of his claims that the combination measles, mumps and rubella (MMR) vaccine had caused autism in the 12 children in the study, and frightened parents began to delay or completely refuse vaccination for their children, both in Britain and the United States. Since then, outbreaks of previously eliminated diseases have sickened and killed children in both countries. More

The New York Times on October 5 ran a short piece on first mentions of measles and measles preventives on its pages. The item focuses on John Enders’s early measles vaccine, tested in 1960 at the Willowbrook State School in New York and in Nigeria.

Read on for History of Vaccines videos on early measles vaccines. More

This week we’ve heard about two far-flung imported measles cases. One is in our backyard: a 47-year-old Pennsylvania woman traveled to Malawi, which has been experiencing a measles outbreak, and brought a case home with her. Another brings back memories of the 2008 San Diego measles outbreak: an unvaccinated child traveled to Europe and returned with the illness.

In the San Diego case, authorities have identified five locations where people may have been exposed to the virus. The story is here.

The Pennsylvania case was described in a notice from a county health department, listing seven locations where the traveler may have exposed others between July 27-August 3, including the Philadelphia International Airport and a suburban Philadelphia Whole Foods grocery store. An email sent out by a local politician claimed that the Whole Foods had agreed to post a sign notifying customers of the possible exposure. On a quick visit to the store, however, I failed to find the sign, and the staff I talked to there didn’t know about the incident. More