Measles is now uncommon in the US, thanks to vaccination. Last year there were only 66 cases. But half of them came from a single, unvaccinated 17 year old who traveled to Romania on a church mission that visited an orphanage. The next day she returned to the US and attended a gathering of other church members, 33 from Indiana and one from Illinois. Three wound up in the hospital.
Measles vaccination is not 100% effective but it is estimated to be over 90% in pre-school and school aged children. In this instance, 32 of the 34 cases were unvaccinated:
“The outbreak occurred because measles was imported into a population of children whose parents had chosen not to vaccinate their children because of safety concerns, despite evidence that measles-containing vaccine is safe and effective,” the CDC said.
Nearly all of the 32 other U.S. cases in 2005 originated abroad, including 16 involving U.S. residents infected while traveling overseas and seven involving foreigners who were infected before visiting the United States. (AP)
The obvious lesson here is that measles vaccination is extremely important. Children should be vaccinated at 12 – 15 months and again prior to entering school. Measles infections during pregnancy can result in spontaneous abortion, premature labor and low birth weight. While most people are not affected fatally, in my youth, before the vaccine, there were an average of 400,000 clinical cases a year and undoubtedly many more, perhaps ten times as much, unrecognized or subclinical cases. There were on average over 120 deaths, triple the number of total cases we see now in the post vaccine era. The economic costs of those 400,000 cases was also substantial, not only in the costs of medical care and hospitalizations, but in lost work and school time for caregivers and the children themselves.
But there is another lesson, the one about international travel and the spread of infectious diseases from a Romanian orphanage to the heartland of America in just one day and via one person. It didn’t result in a huge measles outbreak because most Americans have been vaccinated (our vaccination rate is over 90%). That’s the product of a public health system. When we cut public health we also cut into programs like immunization and prenatal programs.
I think you know where I’m going on this.