Measles outbreak hits all time high in 2011: How come now?

Seventeen outbreaks and two hundred eleven cases may not seem like much, but when it comes to “Measles” the numbers tell a different story.  The Center for Disease Control reported the highest number of outbreaks and cases since Measles since reported as “eliminated” in the year 2000.  The best question we can ask is, “How did we go from “eliminated” to “outbreak” in one decade for an illness that was seemingly inoculated decades ago?”  What exactly is an outbreak and why does what would seem like a controllable number cause such startling reactions? 

An outbreak reflects “three or more cases linked by time and location”.  The cases reported linked to travel abroad, involving an average age individual of 14 years old, with 70 patients hospitalized, however, no reported deaths.  MMR (measles, mumps and rubella) vaccine helped to eliminate the problem over in the past, but with the increase in travel and exposure that risk may or may not be avoidable.

"Last year many U.S. travelers brought back more than they bargained for," said Dr. Ann Schuchat, director, CDC's Office of Infectious Diseases, National Center for Immunization and Respiratory Disease. "This is the most reported number of cases of the measles in 15 years."

While many parents opt out of the MMR vaccine for various reasons, the CDC believes the recent outbreak is just another good reason to receive the vaccine:

"It's really important for families to know that measles are still a threat," Schuchat said. "In some places it's easy to exempt from a vaccine. We believe that for many parents a reason to decline a vaccine is they don't think the disease exists, they believe it's gone ... No one wants their child to die from measles in 2012."

History of MMR vaccination

Known for being as common as death and taxes, measles affected hundreds of thousands during the pre-1960’s era.  The demand for a vaccine was so high that Maurice Hilleman, who worked for Merck & Co., one of the largest pharmaceutical companies in America who developed the MMR vaccine in 1960, which was later licensed in 1971 in the United States.  Starting in 1963, MMR vaccines began as an initial vaccination for children to receive at 12 months, directly giving them the measles.  By 1989, the second MMR vaccine was produced and required to be given to children at 15 months, as a follow up should their bodies build immunity (usually only affecting around 2-4% of children) after the initial dosage.  Once the initial vaccine was introduced in the U.S.A. its victims dropped by a staggering 90%, from hundreds of thousands to tens of thousands.  Increased uptake of the vaccine into the 1970’s reduced the number infected down to the thousands, followed by a renewed push for the vaccine to be required in the 1990’s. 

Anyone born after 1957 is a candidate for the vaccine, while those born before 1957 weren’t required to have the vaccine because they were likely exposed to measles or possibly had it.  Even, though cases are rare in the U.S., the disease affects over 20 million people around the world killing 200,000+ of its victims annually.  The real danger to Americans is exposure to the illness without having the immunization, especially when traveling abroad.  While most children receive the vaccine, parents are able to “opt-out” from their children receiving the vaccine, for religious and/or personal reasons. 

Measles symptoms include:

*High fever above 101

*Body rash lasting for 3 or more days

*Runny nose and cough

Measles is considered a high infectious disease, killing 1-2 children out of every 1000 diagnosed.  In comparison to many other infectious diseases that might not sound too serious but the likelihood is that number will continue to grow with exposure. 

Autism and the MMR vaccine

The controversy over the connection between the MMR vaccine and Autism still rages on today.  As recent as 2011, a study Prof. Bruce Tonge & Dr. Avril Brereton, of ACT Now (Autism Consultation and Training) believed that the controversy over the relationship between the two was based on faulty research (http://www.med.monash.edu.au/spppm/research/devpsych/actnow/download/factsheet16.pdf).  A study by Dr. Andrew Wakefield, of Free Royal Hospital, first raised the concern as a result of a study performed on twelve children who quickly developed Autism symptoms shortly after receiving the initial MMR vaccine in 1998.  However, he concluded, “We did not prove a link between measles, mumps and rubella vaccine and the syndrome described (autistic endrocolitis).  Virological studies are underway that help resolve this issue.” 

According to the Centers for Disease Control (CDC), there isn’t enough direct evidence linking the two. 

“Because signs of autism may appear around the same time children receive the MMR vaccine, some parents may worry that the vaccine causes autism. Vaccine safety experts, including experts at CDC and the American Academy of Pediatrics (AAP), agree that MMR vaccine is not responsible for recent increases in the number of children with autism. In 2004, a report by the Institute of Medicine (IOM) concluded that there is no link between autism and MMR vaccine, and that there is no link between autism and vaccines that contain thimerosal as a preservative.” http://www.cdc.gov/vaccinesafety/Vaccines/MMR/MMR.html

Quick Tips for Wellness:  The MMR Vaccine provides needed protection against a highly infectious disease.

Resources:  http://en.wikipedia.org/wiki/MMR_vaccine, http://www.cdc.gov/vaccinesafety/Vaccines/MMR/MMR.html, http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0003140

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