In the fall of 1990, the city of Philadelphia started seeing cases of measles. It eventually became an epicenter for a major measles outbreak that went well into 1991. It caused over 1,400 cases, with a majority of the cases in unvaccinated children, and led to 9 kids dying.1 Paul Offit, MD, director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia (CHOP), treated several children involved in that outbreak.
“Both children’s hospitals [in Philadelphia] were utterly overwhelmed with that virus. You had to make decisions about who would or wouldn’t come into the hospital,” Offit said.
Within that outbreak, 486 cases and 6 measles-associated deaths were reported to the Philadelphia Health Department from members of 2 fundamentalist church communities. The 2 communities promoted, “a reliance on prayer, not medical care, to cure disease.”1
Flash forward to today, and Texas is in the midst of a measles outbreak largely amongst the Mennonite community.2 Yesterday, the Texas Department of State Health Services updated the public and said there is now 124 cases that have been identified since late January. Eighteen of the patients have been hospitalized. Five of the cases are vaccinated. The rest are unvaccinated, or their vaccination status is unknown.3 The Associated Press is reporting 1 person has died.2Additionally, there are 9 cases in New Mexico.2
“I do expect to see greater amounts of measles outbreaks in the coming year for this reason: the CDC recently reported that more parents are choosing nonmedical vaccine exemptions for their children than ever before. There are a number of jurisdictions where the number of children who are now at risk for measles has become so great that we have lost herd immunity. So, I think what you’re seeing in West Texas right now that has spilled over into New Mexico, is probably a sign of more to come.”
Offit points out that for the younger generation of clinicians, who have little to no experience in seeing and treating measles, there are some clinical care nuances and considerations when dealing with measles.
“Young doctors really haven’t seen measles, and so they may not be so quick to diagnose it. The other thing that I worry about is that they may be quick to bring children into the hospital who don’t necessarily need to be hospitalized because you don’t want the measles virus in your hospital,” Offit said. “It’s very hard to contain measles. It has a contagious index, meaning how many people you infect during a typical day that is five times greater than COVID…When you bring measles into the hospital, there are a lot of children who are immune compromised, and therefore may be at greater risk of measles.”
Offit does understand parents’ concerns around the number of childhood vaccines, but cautions families about not getting these vital immunizations. “We ask a lot of parents in this country; we ask them to get vaccines against 14 different diseases in the first few years of life, which can mean as many as 25 shots during that time. It can mean as many as 5 shots at 1 time to prevent diseases that most people don’t see, using biological fluids most people don’t understand. So, I think pushback on vaccines is understandable, but know this, the canary in the coal mine—whenever you start to see vaccine rates erode—is measles. It’s always the first one to come back, because it’s not only the most contagious vaccine preventable disease, it is the most contagious infectious disease.”
He stresses measles can make children very sick including patients having a high fever, be photophobic, and dehydrated, and it can lead to more serious health issues including pneumonia, and a rare chronic measles disorder, subacute sclerosing panencephalitis (SSPE), a neurological disease that can be fatal.
“This is not a disease you want to get. Every year, before there was a vaccine, about 50,000 children would be hospitalized and 500 would die.”
