In 2014, in the midst of a highly-publicized and often acrimonious “debate” about the relative benefits and harms of child vaccinations, the United States saw a 21st century record 644 cases of measles in 27 states after virtually eliminating the disease just a few years earlier, says the Centers for Disease Control – and 2015 isn’t starting out any better. The potentially deadly disease seems to be making a comeback and it may even be zeroing in on Florida.
This January alone, more than100 people from 15 different states have already contracted the disease. Most of those cases have been linked to an outbreak that started at Disneyland in Anaheim, CA.
In the first week of February, National Public Radio reported another, smaller outbreak some 1,900 miles further east in Ohio. Whether or not Florida’s Disney operations along with the similar theme parks, beaches and other attractions in the state will be affected is unknown but with “spring break” rapidly approaching, local and state officials are concerned the annual influx of visitors and partiers could bring the disease into the Sunshine State suddenly and with alarming results. Visit Florida says a record 26.3 million people visited the state last January, February and March of and it expects similar numbers this year.
Dr. Patricia Lewis, medical director, and Rose Parker, RN, director of nursing at the Florida Department of Health for Indian River County, warn there is only one way to avoid the measles and that, they say in unison, is to “get vaccinated.”
Both Parker and Lewis are keenly aware of just how fast measles can spread. They echo the statement by the CDC that, “Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It can spread to others through coughing and sneezing and can live for up to two hours on a surface or in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface and then touch their eyes, noses, or mouths, they can become infected. Measles is so contagious that if one person has it, 90 percent of the people close to that person (who have not been immunized) will also become infected.”
Dr. Dennis King, a primary care physician at Indian River Medical Center shares Parker and Lewis’ point of view. According to King, “Vaccination is the best way to prevent measles and I recommend that all children be vaccinated.”
The overwhelming majority of doctors nationwide concur but a sizable contingent of citizens motivated by religious belief, political persuasion or alternative theories of health care adamantly opposes vaccination.
One hundred years ago infectious diseases such as measles were much, much more deadly. In 1912, millions of Americans of every age group were infected with the measles virus annually, leading to an average of 6,000 measles-related deaths each and every year from 1912 to 1922. 60,000 lives were lost in one decade. Most were children.
Fast-forward to the 1950s and those 20th century numbers were a bit better. While an estimated three to four million Americans were still infected by the disease each year, the number of deaths was down to 400 or 500 annually.
The first effective measles vaccine didn’t show up until 1963 and when it did infection rates plummeted from millions to thousands a year. In 1971 vaccinations for measles, mumps and rubella (German measles) were combined into the MMR vaccine which, as Parker explains, “is usually given to children between 12 and 15 months of age and again at between four and six years of age.”
Subsequent to the near universal use of the MMR vaccine, measles infection and death rates fell even further and by 2004, only 37 cases of measles were reported in the entire country. The bulk of those 37 cases were attributed to unvaccinated people traveling to foreign countries where measles vaccines were not in common use and bringing the disease back home with them.
Then something odd happened: The internet.
Anonymous posts started to crop up with a variety of conspiracy theories about childhood immunizations. They were (and still are) posts with few if any scientific credentials but they’re still being read.
“It’s not everybody,” says Lewis, “but some people come across those stories and believe them.”
In Forbes Magazine, Steven Salzberg, author of “Fighting Pseudoscience,” writes, “What’s sad about this – tragic, really – is that we eliminated measles from the U.S. thanks to the measles vaccine. But we had 644 cases in 27 states in 2014, the most in 20 years. And 2015 is already on track to be worse. Measles may become endemic in the U.S, circulating continually, thanks to the increasing numbers of unvaccinated people. The anti-vaccine movement has turned this public health victory into defeat. Anti-vaxxers have been relentless in the efforts to spread misinformation. Despite overwhelming scientific evidence that vaccines are beneficial, they endlessly repeat a variety false claims including the premises that . . . the preservative thimerosal in vaccines causes autism and natural immunity is all you need.”
The claims, says Salzberg, are dead wrong.
USA Today seems to agree with Parker, Lewis, King and Salzberg. In the first week of February it reported that “nearly one in seven public and private schools have measles vaccination rates below 90 percent: A rate considered inadequate to provide immunity.”
In fact, in the paper’s analysis of the immunization data for 13 states, including Florida, shows that, “hundreds of thousands of students attend schools ranging from small, private academies in New York City to large public elementary schools outside Boston to Native American reservation schools in Idaho, where vaccination rates have dropped precipitously low, sometimes under 50 percent.”
As Florida braces for yet another influx of spring break visitors from all 50 states hot on the heels of outbreaks in California and the mid-west, state healthcare workers are keeping a sharp eye out for measles. Those most at risk are the unvaccinated, pregnant women, infants under 6 months old and those with weakened immune systems.
Under the circumstances, the advice from Parker, Lewis and King to “get vaccinated” appears to make even more sense than ever. No one should be willing to return to the days of 6,000 measles deaths a year.
