The Re-emergence of Measles

By Alesia Khomchyk | Biology Major

Measles is one of the most serious infectious diseases in the world because it spreads like wildfire. While the most common way that measles spreads is through air droplets, it can be spread virtually in every way possible. If an individual breathes in this toxin, it can potentially be fatal if the person has not taken the necessary precautions in order to prevent from getting ill (Abad 2). There aren’t any drugs or specific remedies that cure measles. The only way to genuinely combat the virus is through preventing it from happening altogether. Luckily, there is a vaccine that is 97–99% effective in doing such a job (DiPaola 50); however, not everyone agrees with such straightforward methods. Nonetheless, there is a strong correlation between the lack of vaccination against measles and its re-emergence; more individuals refuse to get vaccinated because of the increased number of myths and lack of information given about the vaccine.

The measles virus was first discovered in the Middle East in the 11th-12th centuries. It initially spread from cattle living in such close proximity to the human population (Moss & Griffin 153). Measles typically spreads in the late winter, early spring time. An individual can contract the virus in practically any way, from touching a doorknob, bodily fluids, or air droplets. The disease can be transmitted through an unbroken chain of acute infections; its mutation rate is very high (Moss & Griffin 153). When the virus enters the host via air droplets, it progresses into the host’s respiratory tract (Moss 2492). From there, it infects everything else gradually in the following order: local lymph nodes, blood, spleen, lymphatic tissue, lungs, thymus, liver, and skin (Moss & Griffin 156). While the infection is spreading, it takes anywhere from 10 to 14 days to have visible symptoms that one has contracted the disease (Moss 2496, McFee 240). The symptoms that appear alongside the infection are koplik’s spots (white lesions), rash, fever, cough, and conjunctivitis (eye irritation, pink eye, inflammation) (Moss & Griffin 153). Measles is an extremely virulent infection and if an individual comes out alive after contracting it, they are highly likely to have defective cell immunity because of the damage that the disease inflicts on the immune system (Moss 2496, Nii-Trebi 1). Post-measles encephalitis occurs in one out of one thousand patients within the first two weeks of being measles-free (Moss 2496). Post-measles encephalitis symptoms include fever, seizures, and neurological abnormalities. If this happens, it is usually fatal (Moss 2496).

Before the vaccine was introduced, 2.6 million people died globally each year (Moss & Griffin 154–155), because once an individual gets infected there is not much any doctor can do (Helmecke 5137).

Though it is common to say that the disease itself takes lives, it is actually pneumonia that accounts for most of measles deaths. In fact, it is one of the leading causes of death in children (Moss & Griffin 153). The virus had been virtually unstoppable until the 1960’s, when John Enders, a biomedical scientist, discovered a vaccine that could help prevent the virus from taking over the human population (Moss & Griffin 153). The vaccine reduces mortality and interrupts transmission of the virus. Before the vaccine was introduced, 2.6 million people died globally each year (Moss & Griffin 154–155), because once an individual gets infected there is not much any doctor can do (Helmecke 5137). Some remedies to help relieve the symptoms include taking a lot of vitamin A, anti-virulent drugs, and antibiotics (Moss 2490); however, the virus takes a huge toll on bodily cells and systems, so the development of a vaccination was a fantastic breakthrough. Vaccination can help prevent all of the symptoms, aftershocks, and fatalities that come along with measles. The vaccine tends to be more effective when two doses of vaccine are administered at separate times (Abad 1, Roose 290, Urbano 535). There is a 90% reduction in deaths from the years when the vaccine did not exist. A decade ago, there were 164,000 deaths from measles globally (Moss & Griffin 153). More recently, in 2016, there were 89,780 deaths globally, and most of those were people who refused to get vaccinated (Moss & Griffin 154–155). It is 97%-99% effective in preventing disease contraction (DiPaola 50). Thus, sizable evidence suggests the vaccines effectiveness; however, there are still people that believe that vaccination is harmful, while others reject it because of their culture or religion.

In the early 2000’s, the disease was thought to have been eradicated completely, but then the rise in the amount of people refusing to get their vaccination rose dramatically (Horne 10321). The refusal to vaccinate has been ascending at an alarming rate. There are hundreds of reasons why an individual would refuse to participate in the vaccination process of a particular disease. Certain people choose not to vaccinate because of health issues such as allergies. Personal biases toward vaccination also have an effect, as well as cultural or religious beliefs. In addition, there are countless myths surrounding the vaccination process. The majority of these rumors are false and need to be addressed in order to eradicate the disease completely.

There are a lot of myths that have come about in relation to vaccines. One being that vaccination is related to children developing autism (Horne 10321). This lie came about from news sources without credibility or evidence; nonetheless, word spread and people believed it to be the truth because the way it was presented was very convincing.

Some individuals believe that vaccination is harmful because the inoculation gives people the dead or weak version of pathogens. They claim that those pathogens are harmful to the body because even though they may be dead or weakened, they are still a form of a deadly disease. For example, fear is high surrounding vaccinating children based on the idea that the virus will be inside their body and therefore infect it. Some parents would rather take the chance of getting the disease from the environment than to put it in their child’s system (Yermakovich). What these fears miss, however is that if the pathogen is dead, there is no way that it can suddenly infect the body (Greenwood 2531). This is also true about vaccines having side effects. Though certain vaccines may present mild symptoms once injected, there is little to no chance the individual will get seriously ill (Greenwood 2531). The pathogen is weakened or dead so it will not present any severe symptoms (Greenwood 2532). The Center for Disease Control (CDC) has made efforts multiple times to reassure parents that vaccination is perfectly safe, but have only made it worse.

Groups of individuals assume that the CDC and healthcare providers are only pushing the vaccine to earn money (Horne 10321). However, the evidence speaks for itself; it is not some kind of conspiracy theory. It is much more beneficial to vaccinate than to take the risk of getting sick with measles.

Other individuals believe that since other people are getting the vaccination, they are safe from infections (Liashko). This is a partially true statement, but only when vaccination rates are at a certain percentage. When a certain percentage of people are vaccinated and are immune from a virus, they have what is called “herd immunity” (Berezin 234, DiPaola 51). Herd immunity lowers rates of outbreaks occurring because the number of vaccinated people far outnumbers the amount of people that are not. This is calculated to be a percentage. Anything below the percentage required for the immunity to take action will result in huge outbreaks of the disease (Nii-Trebi 2). For measles, this percentage comes to be about 90–95% of people need to be vaccinated in order to obtain herd immunity (Salathé). Although herd immunity is something that can be considered positive for the people who reject vaccination or those unable to be vaccinated, it doesn’t provide 100% immunity. It is still more beneficial to eradicate the disease completely via vaccination, so that nobody has to worry about any outbreaks. To look at it another way, one would always have to be aware of the current percentage of vaccinations, which is a hassle. It is more likely than not that as a population, there will always be certain people who do not want to vaccinate, so it is better to be one of the people who are immune from the virus altogether (Nii-Trebi 1–2).

All of these myths come from the lack of education about vaccination and the diseases themselves. Sometimes viruses may not seem as serious when they are not happening near certain people, so they refuse to get vaccinated for such reasons; it does not feel like a possibility that they will get sick, or if they do, the disease will not be as serious. People are more likely to think positively about themselves and their livelihood. This phenomenon is known as the “optimism bias” (Sharot).

Not only do people refuse to get vaccinated for their personal biases against vaccines, but also because of the culture and religion they grew up around. When considering religious views, people refuse to get vaccinated for two main reasons. The first is believing that the human body is a sacred place, and the second is that vaccines contain human tissue. Since the first reason is that the body is sacred, that means that it should not be injected with any chemicals or foreign matter including vaccines (“Cultural Perspectives on Vaccination”). Vaccines challenge the beliefs about the value of human life. These views come from a broad spectrum of religions and cultures, with the main one being Muslim. Furthermore, certain denominations of Christianity, or other cultures that are parallel to these religions may also have these beliefs. Though changing a religious stance on anti-vaccination is unlikely, it is very possible to transform an attitude that has a negative bias towards vaccination. To do so, the public needs to be informed about the facts and myths surrounding measles, and its vaccination purpose as well as progress.

Informing the public may seem like a daunting task because people are not very likely to change their minds if they have a strong opinion about a subject (“Cultural Perspectives on Vaccination”). Refusal to vaccinate can potentially bring more harm to an individual rather than good (Horne 10321). The benefits outweigh the risks far more when it comes to fighting against the measles virus by vaccination (Horne 10321), thus education is essential. One way to reach out to people is to tell the stories of people who did not get their child or themselves vaccinated and regretted it. People tend to listen more when there is a testimony in play (Horne 10322). The public needs to understand the extent of this epidemic. It is not just some propaganda to drain public money (Horne 10322). It is something that can be very dangerous if not prevented or taken care of properly. The key lies within the public education about this epidemic. It is a real possibility to eradicate this terrible disease forever.

There is definitely a strong correlation between the re-emergence of measles and its refusal of vaccination rates.

To sum it all up, there is definitely a strong correlation between the re-emergence of measles and its refusal of vaccination rates. This is alarming because there is no cure for the virus. The only way to make sure one does not contract it and die is through the preventative measure of being vaccinated.

The benefits of the vaccine far outweigh the risks, yet the number of people refusing to get vaccinated is rising, and it has a strong correlation to the unexpected rise in outbreaks of the disease (Horne 10321). Some of the reasons why people might not want to get vaccinated include the belief that the vaccine causes autism and other abnormalities in the body, individuals actually contracting the disease from the vaccination, and they are safe from the virus because other people vaccinate. Other people refuse to get the vaccine because they have certain religious or cultural views. Those views include not injecting any chemicals or foreign objects into the body, and because human tissues are used in the vaccine (“Cultural Perspectives on Vaccination”). These views can be combated by educating the public on what the measles virus does to an individual’s body upon infection. Education can come in the form of testimonies (Horne 10322). Testimonies seem to have a strong effect on people and their emotions. The CDC should be making plans to eradicate the virus again with such methods.

There is a real possibility that this disease can be eradicated from the face of the earth if the whole population got vaccinated. Individuals around the world need to get educated on the effects of measles, and the effects of not being vaccinated; that is when the vaccination refusal rate will go down significantly. Breaking all of the misconceptions that come along with the disease and the vaccination process should help significantly. That is how the re-emergence of measles must be fought off; the education of individuals plays a huge role in eradicating this horrifying virus completely.

References:

Abad, C. L., and N. Safdar. “The Reemergence of Measles.” Current Infectious Disease Reports, 7 Oct. 2015.

Berezin, Mabel, and Alicia Eads. “Risk Is for the Rich? Childhood Vaccination Resistance and a Culture of Health.” Social Science and Medicine, 20 July 2016.

“Cultural Perspectives on Vaccination.” History of Vaccines, College of Physicians of Philadelphia, 10 Jan. 2018.

DiPaola, Francesca, et al. “A Casualty of the Immunization Wars : The Reemergence of Measles.” JAAPA: Journal of the American Academy of Physician Assistants (Haymarket Media, Inc.), vol. 25, no. 6, June 2012.

Greenwood, Kathryn P., et al. “A Systematic Review of Human to Human Transmission of Measles Vaccine Virus.” Vaccine, 12 Apr. 2016.

Helmecke, Megan R., et al. “Challenges of Applying Measles Control Guidance.” American Journal of Infection Control, June 2013.

Horne, Zachary, et al. “Countering Antivaccination Attitudes.” Proceedings of the National Academy of Sciences of the United States of America, Aug. 2015.

Liashko, Anna. Personal Interview. 25 Mar. 2018.

McFee, Robin B. “Selected Epidemics and Emerging Pathogens.” Disease a Month, Sept. 2017.

Moss, William J. “Measles.” The Lancet, vol. 390, no. 10111, pp. 2490–2502. Dec 2017.

Moss, and Griffin. “Measles.” The Lancet, vol. 379, no. 9811, 2011, pp. 153–64.

Nii-Trebi, Nicholas Israel. “Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges.” BioMed Research International 2017 (2017): PMC. Web. 23 Feb. 2018.

Roose, Jozefien, et al. “Modified Measles: A Diagnostic Challenge.” Acta Dermato-Venereologica, vol. 98, no. 2, Feb. 2018.

Salathé, Marcel, and Computer Science and Engineering. “Herd Immunity and Measles: Why We Should Aim for 100% Vaccination Coverage.” The Conversation, The Conversation, 23 Mar. 2018.

Shakoor, Sadia et al. “Hospital Preparedness in Community Measles Outbreaks — challenges and Recommendations for Low-Resource Settings.” Emerging Health Threats Journal 8 (2015): PMC. Web. 23 Feb. 2018.

Sharot, Tali. The Optimism Bias. Films On Demand (TED Talk), 18 April. 2013, http://fod.infobase.com.ezproxy.bethel.edu/. Accessed 24 April. 2018.

Urbano, Paulo Roberto, et al. “Reemergence of Mumps in Sao Paulo, Brazil — the Urgent Need for a Booster Shot Campaign to Prevent a Serious Infectious Disease.” SciELO, 2017.

Yermakovich, Alina. Personal Interview. 25 Mar. 2018.

ABOUT THE AUTHOR:

Alesia Khomchyk is a freshman at Bethel University from Maple Grove, Minnesota. She is majoring in biology in hopes of one day becoming a cardiothoracic surgeon. Alesia likes studying anatomy and physiology, spending time with friends, and watching Grey’s Anatomy in her free time.