THE DOCTOR IS IN
OP / ED BY DR. ADIL MANZOOR
As of late March, 17 states have recorded measles cases. This will surprise many because for so long, measles was a condition Americans did not need to worry about. In fact, people born after the turn of the century can be forgiven for not knowing about the condition at all, as the disease was declared eliminated in the US in 2000. So, why then is the condition resurfacing after being kept quiet for so long? Should we be worried? Well, let’s find out.
For starters, measles (or rubeola) is a viral disease, characterized by high fever, cough, runny nose, and a red, blotchy rash that spreads all over the body. It typically takes between 8 and 12 days for symptoms to start developing, typically starting with a fever, fatigue, respiratory issues, and watery eyes. About two to four days after these first set of symptoms, the rash usually develops, starting at the face before migrating downwards to the rest of the body.
The rash itself lasts between seven to ten days, possibly accompanied by other symptoms like white spots inside the mouth and sore throat. Measles itself is not a very serious condition, as far as full recovery goes, with most people feeling completely better after two weeks.
However, about a third of reported measles cases have a health complication, which may be any of diarrhea, ear infections, pneumonia, brain infections, and seizures. In rare cases, these complications may lead to death.
Perhaps the most formidable feature of measles, however, is how contagious is it. And boy, is it contagious. Picture this: if ten unvaccinated people were in a room and someone with measles walked into that room, nine of the ten people would get measles. The condition can be transmitted by contact with the infected individual or even by breathing the same air as them because the measles virus can remain in the air and on surfaces for up to two hours.
Although many people attribute the start of the disease to the appearance of the rash, the infected individual is actually infectious four days before and after the rash. This basically means you can get measles from someone you didn’t even think had measles and then you start transmitting before you get the rash, and the cycle continues.
Fortunately, the measles disease is very sensitive to vaccination. If you get a dose of the measles vaccine, you have a 93% chance of never having the disease; with a second dose of the vaccine, the likelihood jumps to 97%. Those are very generous odds. What’s more, if you have had the condition before, you are immune for the rest of your life. So, for most vaccinated people, there is nothing to worry about, which also explains why the US could confidently declare the disease eliminated in 2000 after their extensive vaccination program. This then leads to a critical question: why then is the recent outbreak occurring? Take a guess.
If your guess is related to vaccination, then you would be spot on. Really, it’s the only reason an outbreak of measles can occur. Of course, the trigger for the outbreak itself can be linked to travelers from regions with less serious measles vaccination policies and programs, but it doesn’t change the fact that the outbreak only grew because there are unvaccinated people. The next logical question is: why now? And I’m sure you know the answer.
After the introduction of the COVID vaccine, we saw some of the most polarizing and utterly surprising views about one of the single biggest medical inventions ever – vaccines. Taking the COVID vaccine became political, along with some of the other strategies proposed to reduce the spread of the coronavirus. It was insane. And, as you would imagine, many people started to allow their views on the COVID vaccine to influence their views of vaccines generally.
The result then was people refusing to vaccinate their kids for measles and other diseases that childhood vaccination can effectively eradicate. So, of course, an outbreak of measles started, because why not?
Well, the saving grace for us is that measles is not a condition with high mortality because otherwise, we all would have been screwed. Very screwed. With good management of the condition and increased vaccination, the outbreak should not be anything out of the ordinary.
Nonetheless, one can only wonder the next condition that will take advantage of people’s irrational aversion to vaccines. And that’s definitely something to be concerned about. We have come too far to have to deal with all of these.
This article was written by Dr. Adil Manzoor, DO, a Board-Certified Internist; Board certified Pediatrician who works as a Hospitalist and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice, Mobile Medicine NJ; House Call Doctors. He is also currently pursuing an Executive MBA and a Master’s of Science in Healthcare Leadership at Samuel Curtis Johnson Graduate School of Management and the Weill Cornell Graduate School of Medical Sciences.
References
- https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-measles-vaccination?topicsurvey=ht7j2q)&gad_source=1&gclid=Cj0KCQjw2a6wBhCVARIsABPeH1uwMbMLwDEarRxNPJOw8-IGO-gty4GY-C1MjkiOkzuOAvtfdlzSlrcaAiksEALw_wcB
- https://nyc.gov/assets/doh/downloads/pdf/imm/faq-measles.pdf
- https://newsnetwork.mayoclinic.org/discussion/understanding-measles-and-the-current-outbreak/
- https://healthmatters.nyp.org/measles-outbreak-everything-you-need-to-know/
