Michael Rosenthal
(5/2019)
Every day in the newspapers we read about the resurgence
of measles, a highly contagious infectious disease caused
by a virus. Symptoms of measles generally appear 10-12
days after exposure to the virus, and last 7-10 days.
Symptoms typically include high fever, cough, runny nose,
and inflamed eyes. Small white spots inside the mouth may
form, and a flat red rash starts on the face and spreads
over the body. One can be lucky with measles and not have
further complications. I had measles in grade school in
the 1940s, and recovered without any problems.
In my childhood a quarantine
period was initiated in which you were required to stay in
your house, and they placed a red sign next to your house
door warning people that a measles case was within. I was
fortunate. I recovered from the affliction with no lasting
effects, and I went back to school and moved on with my
childhood. Some folks were not so lucky. Complications
included diarrhea, a middle ear infection, and pneumonia,
and in rare cases, seizures, blindness, and brain
inflammation have been known to occur.
Measles is an endemic disease,
meaning that it can be continually present in a community,
and fortunate people develop resistance. Its impact on
underdeveloped communities can be illustrated by horrific
historical statistics. Between 1855 and 2005 measles is
estimated to have killed some 200 million persons
worldwide. As an example, measles killed 20 percent of
Hawaii’s population in the 1850s. Seven to eight million
children are thought to have died annually from measles
before the vaccine was introduced.
So how do you get measles? Measles
is an airborne disease which spreads through the coughing
and sneezing of infected people. If you are unvaccinated,
you can easily become infected by passing through a group
of people who are infected with the virus.
Ninety percent of those persons
who have not acquired immunity and share living space with
an affected person can be expected to acquire the disease.
In the United States in the 1960s before a vaccine was
developed about 3,000 persons per million acquired the
disease. The development of the measles vaccine, applied
in childhood, led to the fall of measles to one case per
million persons by the year 2000.
The vaccine was developed by
Maurice Hilleman at Merck labs, where he eventually rose
to be senior vice president. He then directed the Merck
Institute for Vaccinology for the next twenty years, and
he was an Adjunct Professor of Pediatrics at The
University of Pennsylvania in Philadelphia until his death
in 1985. A vaccine was licensed to prevent the disease in
1963, and an improved vaccine was introduced in 1968.
Hilleman was an American microbiologist who specialized in
vaccinology, and developed over 40 vaccines. He was the
developer of vaccines for measles, mumps, hepatitis A,
hepatitis B, chickenpox, meningitis, pneumonia and for
several other viruses.
Measles currently affects some 20
million people worldwide annually, primarily in Africa and
Asia. Global vaccination initiatives have greatly reduced
the incidence of measles, but it is still a serious health
hazard. Vaccination has had a major impact on prevention
of the disease. In 1980, 2.6 million people worldwide died
from measles. In 2014 the number of deaths globally fell
to 73,000. Most deaths are children less than five years
old.
So, we have a highly infectious
disease which has potential for death, easily spreads, but
has a vaccine available that protects one from the disease
100%. Why is there a problem?
As you see if you read newspapers
or watch news on TV, U.S. Measles cases have risen to the
second highest level in nearly 20 years, more in the first
three months of 2019 than in all of 2018. As of early
April, 387 cases of measles had been reported in 15
states, including New York, California, Texas, Michigan,
and Washington State, and a handful of cases in Maryland.
What has caused this dramatic increase in a preventable
disease?
Across the United States and
around the world, anti-vaccine activists have spread
misinformation about vaccines, lowering child immunization
rates. There are those who believe immunization causes
autism. This is absolutely not true! The anti-vaccine
movement is found in some religious and ethnic
communities, as well as in some political groups.
In Africa measles cases are up
700% so far this year, compared to 2018. In Madagascar
tens of thousands of people have been sickened and 800
people have died of measles since September. In poor
countries around the world, the vaccine availability is a
major factor in the increase. Worldwide, the World Health
Organization reported 112,163 cases of measles in the
first three months of 2019, compared with 28,124 cases for
the same period in 2018. They also point out that the
actual number of cases is even larger, since only 1 in 10
cases is reported.
In the United States this
situation has led to a secondary battle as to whether
vaccination should be required by law and whether legal
bans from public places should on placed on unvaccinated
children.
My scientific analysis of the
situation is that there is absolutely no threat from
measles vaccines administered by medical personnel. Be
sure you and yours are adequately vaccinated! If you have
not had measles and are unsure whether you have had an
up-to-date vaccine, consult your physician.
We recently received a pamphlet
from the Town of Emmitsburg entitled, Emmitsburg Cigarette
Litter Prevention. Any of us who walks along the sidewalk
becomes aware of all the discarded cigarette butts on and
near the sidewalk. Cigarette butts are more than just
irritating eyesores. They are carried in storm water
runoff to local streams, rivers, and waterways. Cigarette
filters contain cellulose acetate, a plastic that is not
biodegradable, and thus accumulates in the environment.
Tobacco litter represents 34% of all litter in outdoor
recreation areas. The brochure makes the following
recommendations: Carry a portable or pocket ashtray; the
Emmitsburg Town Office will be handing out free ashtrays
for a while. Use receptacles when they are available to
dispose of cigarette butts. Do not throw cigarette butts
out of car windows! According to the Emmitsburg Town Code,
cigarette butts are considered litter, and accumulations
are a municipal infraction and subject to a fine of $75
per day. The Town of Emmitsburg is trying to help solve
this problem. A $2500 grant from the Keep America
Beautiful fund is being used to purchase four receptacles
along Main Street and one receptacle at the Community
Pool. For more information on this topic, the brochure
recommends the website: www.PreventCigaretteLitter.org
Read other articles by Michael Rosenthal