A Past Preview of the Future?

The Texas measles outbreak is a warning shot for us locally

Allentown Morning Call, April 9, 1934, p.3

There's a lot of news to follow these days. So we might be forgiven for not knowing about the events unfolding in Texas right now of particular concern to anyone with children or grandchildren: A measles outbreak that has quickly sickened nearly 150 people, most of them children. One school-aged child has died and twenty have been hospitalized.

Measles is one of the most contagious diseases in the world. The way one doctor explained it to me, if one person with measles is in a room with a hundred unprotected people, more than ninety of those people will catch measles. Infection disease doctors measure the contagiousness of things like measles with a number called "R naught" (or R0). The R0 value of a disease tells us how many unprotected people in the community will be infected, on average, by every person who has the disease. The R0 for measles is somewhere between 12 and 18. As a point of contrast, the R0 for the flu is typically between 1 and 2.

Measles is a very serious and dangerous disease, particularly to young children. In the years after WWI, it killed approximately 6,000 Americans annually-- most of them children. The danger is evident by the kind of coverage it received in every local community around the country during this period. The picture at the top is taken from an Allentown Morning Call article on April 9, 1934 which goes on to describe public health workers hired by the borough tasked with making sure quarantined measles cases stayed in their homes, including hanging special quarantine tags on their front doors. By the late 1950s, improvements in the country's medical care reduced that number of annual deaths from measles to 400-500, with another 48,000 being hospitalized. Measles can have substantial impacts on those who don't die, including compromised immune systems, blindness, and encephalitis (swelling of the brain) leading to intellectual disabilities.

Photo by CDC/NIP/Barbara Rice - http://phil.cdc.gov/phil/ (ID#: 132)

Most of us don't know these facts, nor are we accustomed to seeing children suffering from measles like the child in the picture above. That's because scientists developed a safe and effective vaccine against measles that has been given to American children since 1968, which-- by 2000-- virtually eliminated the disease and it's threat to children's lives.

Tragically, though, measles is back and much of the blame falls on our broken politics of misinformation and partisan polarization. The politicization of the covid pandemic response left large numbers of Americans skeptical of public health information and the enormous benefits vaccines provide to society. The result has been an alarming rise in the number of parents who prevent their children from receiving vaccines for a wide variety of preventable diseases, including measles.

Lack of vaccination is the primary cause of the current measles outbreak in Texas, including the death of one child. Of the 146 cases thus far, 79 of the victims have been unvaccinated and the vaccination status of another 62 is unknown. But the real problem is that when it comes to infectious diseases, it isn't just the children of parents who choose to leave their kids unvaccinated that are risk. These infected kids also threaten the health of young babies in the community, because the vaccine is typically not given until a baby is a year old. And they make it possible for even those who are vaccinated to come into contact and contract the disease, because no vaccine is 100% effective. Decisions about vaccination thus impact not only those making such decisions; they impact everyone in a community whether they like it or not.

Yes, anyone with kids or grandkids should be worried about the news from Texas. Because measles is so contagious, 95% or more of the people in a community need to be vaccinated against it to stop it's spread-- this is what public health officials call 'herd immunity.' Alas, the overall measles vaccination rate in the U.S. is now below that number, at 93%. And in some places and schools, the number is much lower. The vaccination rate in the Texas county where the measles outbreak started is just 82%. Thankfully, the latest data shows that the measles vaccination rate in Lehigh County is still enough to keep kids safe in East Penn-- at 96%. But there are worrying signs; this number has declined in just the last few years, from the 98% of older kids in Lehigh County who are vaccinated.

So talk to family members, neighbors, and friends about this issue. Let them know that none of us should let partisan ideology get in the way of the health and safety of the kids in our community. And as the nation's capacity to identify, contain, and prevent outbreaks like the one in Texas are currently being dismantled (the current administration has cut 10% of the workforce at the Centers for Disease Control and the National Institutes of Health, and prohibited the publication of research findings without prior political review), it is more important than ever that we work as a local community to protect our kids from potential harm.