I almost never write about childrenâ€™s health. Iâ€™m not a pediatrician, and most of what I know about kidsâ€™ health I learned as a dad, not in training. This topic, however, is important enough to concern all of us.
Measles is a very contagious viral illness that causes high fever, a rash, cough and a runny nose. Complications can include pneumonia, brain inflammation and death. In 1958 there were 763,094 cases of measles reported in the US. The measles vaccine was introduced in 1963, and widespread vaccination has nearly eliminated measles in the US, with fewer than 150 cases annually since 1997. In 2000 endemic US transmission (contagion from patient to patient in epidemics) was declared eliminated.
This year 64 cases of measles have been reported in the US so far, making it the largest number of cases since 2001. Twelve cases were in California. No deaths have been reported.
All but one of the patients were unvaccinated or had unknown vaccination status. The one vaccinated patient with measles reminds us that the vaccine is very effective, but not perfect. Being vaccinated is not a guarantee of immunity, and part of the protection that each child has is the crowd of vaccinated children around her. Some of the 64 children with measles this year were too young to have been vaccinated, but 14 of them had claimed exemptions from the vaccination because of religious or personal beliefs.
On almost all issues of controversy I side with patient autonomy and individual liberty. I certainly would not advocate overriding the parentsâ€™ right to refuse vaccinations on behalf of their children. But I would assert that these parents are reckless, and I donâ€™t want their children in the same school cafeteria, playground, or pediatrician waiting room as my kids.
New York Times article: Measles in U.S. at Highest Level Since 2001
Centers for Disease Control and Prevention feature: Measles Update: Outbreaks Continue in US
Morbidity and Mortality Weekly Report early release: Measles â€“ United States, January 1 â€“ April 25, 2008