An illness of the past makes a comeback.
The measles virus — formerly a hallmark of childhood — used to infect 3 to 4 million people in the United States each year. But after a vaccine was developed, the disease was nearly eliminated by the year 2000.
But now the disease has started to make a return in a population unfamiliar with the short- and long-term effects of a measles infection. While people may be familiar with the telltale rash and fever, many may not know that the disease can lead to long-term, or even lifelong, effects.
As more outbreaks of the disease have been reported in the United States, experts are concerned that complications from the disease could cause lasting problems for children.
In 2000, measles was declared eliminated from the United States.
However, in recent years, the Centers for Disease Control and Prevention (CDC) noted an uptick in measles cases.
In 2014, there were a reported 667 cases in 27 states.
Worldwide cases of the disease have spiked. Despite cost-effective vaccines being widely available, the World Health Organization (WHO) reported over 110,000 measles deaths globally in 2017, with the majority of the cases being children under 5.
From 2016 to 2017, the number of measles cases increased by 31 percent worldwide according to a CDC report.
In 2018, the New Jersey Department of Health has confirmed 18 cases from mid-October to late November. And as of December 5, the New York Department of Health and Mental Hygienehas confirmed 39 cases of measles in Brooklyn — particularly in Orthodox Jewish communities — since October.
The initial child who contracted the illness was unvaccinated and acquired measles on a trip to Israel, where there have been almost 900 confirmed cases.
Last year, a measles outbreak in Minnesota infected 65 people, nearly all toddlers, and left 20 of them hospitalized.
Measles is one of the most highly contagious viruses on the planet. It can spread to others simply by coughing and sneezing. Once in the air, it can infect those who come into contact with it for up to two hours.
The CDC reports that measles is so contagious that if one person has it, 90 percent of people close to that person who don’t have the immunization will become infected.
The return of measles has frustrated many medical experts, both because it spreads easily among people who aren’t vaccinated and because it can cause dangerous short- and long-term consequences for young people.
For those infected, the more serious complications of measles include:
- encephalitis, an infection that causes brain swelling
- extreme dehydration
- ear infections
This means there aren’t only dangerous short-term symptoms, but a potential for long-term permanent damage from the infection.
“Acute encephalitis, which often results in permanent brain damage, occurs in approximately 1 of every 1000 cases of measles. In the post-elimination era, death predominantly resulting from neurologic and respiratory complications has occurred in 1 to 3 of every 1000 cases reported in the United States,” said Dr. Claudette Poole, assistant professor in the University of Alabama at Birmingham Department of Pediatric Infectious Disease.
Measles also can put patients at risk for “immune amnesia,” or suppression for years after recovering from the original infection, according to a study published in Science.
“Immune suppression associated with acute measles infection has been long known, and children often succumbed to other infections following measles,” said Poole. The study found that the immune system could be impacted for two to three years after initial infection.
Poole pointed out that the measles virus impaired the “memory immunity,” which means the body was less able to fend off infections that it should have had antibodies for.
“Their study seems to suggest that the measles virus impairs memory immunity, which has a lasting effect on affected individuals. [They would] be at risk from infections for quite some time after the acute measles infection,” she said.
Measles, while once native to countries outside of the United States, is finding its way back in this increasingly global society. The United States isn’t isolated. With an increasing number of international flights, the opportunity to transmit harmful illnesses around the globe is within a day’s reach.
Additionally, pockets of unvaccinated people in this country make the spread of the disease more likely if it’s introduced.
In 2015, at Disneyland in Anaheim, California, a measles outbreak led to 26 infections that were found in four states. The outbreak supposedly began when a 20-year-old California woman visited the park and took several flights to visit family in Seattle.
Most of those individuals affected by the illness were unvaccinated.
Currently, there are no specific antiviral treatments to help treat measles once a person has contracted the virus, although vaccines have saved lives.
The WHO reports show that with the help of immunizations, over 21 million lives have been saved since the year 2000.
Remedies of vitamin A supplements can decrease the potential for long-term effects. However, there’s still substantial risk of complication from the illness.
“To prevent outbreaks of measles within a community, vaccination rate for the population needs to be above 95 percent. In other words, at least 95 percent of the population needs to be vaccinated against measles to prevent an outbreak,” said Poole.
Despite being declared eliminated in the United States in 2000, the measles virus has made a comeback. Many people don’t know the measles virus can lead to long-term health effects including brain damage, hearing loss, and immune suppression.
When the percentage of people vaccinated falls below 95 percent and a measles case is introduced to the population, a “measles outbreak will occur,” according to Poole.
“As measles outbreaks continue to occur across the world with increasing rates in the US and Europe, the risk of exposure is a reality for everyone,” said Poole.