Despite the claims of the anti-vaccine religion about the risks, serious measles complications should an important consideration for any parent on the fence about giving their child the MMR vaccine. This isn’t some exaggeration to compel people to get vaccines – it’s a demonstrable fact.
Unless you’ve completely ignored the news, you can’t help reading about large measles outbreaks across the world – Europe, Oregon, many areas of the USA, and elsewhere. Though the outbreaks aren’t large, thanks to a high vaccination rate in the USA against the measles by responsible and informed parents, there are a number of cities and counties in the country that have vaccination uptake that is too low for the herd effect.
Despite the anti-vaccine tropes and lies about measles complications, it’s actually a serious disease with serious deleterious effects. It shouldn’t be dismissed with a wave of the hand.
All about measles complications
Measles (also called rubeola, not to be confused with rubella, or German measles) is a respiratory disease caused by the measles virus. Measles virus normally grows in the cells that line the back of the throat and lungs. The virus is spread through respiration (contact with fluids from an infected person’s nose and mouth, either directly or through aerosol transmission), and is highly contagious (see Note 1) — 90% of people without immunity sharing living space with an infected person will catch it.
There are no specific treatments for the disease. There are no miracle preventions.
The oft-repeated, and highly inaccurate, claim that vitamin A supplements can cure or prevent measles completely misses the mark. It’s important to supplement with vitamin A to prevent blindness as a result of measles, but it doesn’t reduce mortality or prevent some neurological issues. Moreover, it is most useful in children with vitamin A deficiency, not exactly a major issue in well-fed children in developed countries.
Even though vaccine deniers will claim that measles is not a serious health concern, which is not supported by real evidence, it is actually a fairly dangerous disease. According to the CDC, some of the many measles complications are:
- About 30% of measles cases develop one or more complications.
- Pneumonia, which is the complication that is most often the cause of death in young children.
- Ear infections occur in about 1 in 10 measles cases and permanent loss of hearing can result.
- Diarrhea is reported in about 8% of cases.
These measles complications are more common among children under 5 years of age and adults over 20 years old (usually those with lapsed immunity).
Even in previously healthy children, measles can be a serious illness requiring hospitalization. As many as 1 out of every 20 children with measles gets pneumonia, and about 1 child in every 1,000 who get measles will develop encephalitis, an inflammation of the brain that can lead to convulsions, deafness, and other long-term neurological deficits. For every 1,000 children who get measles, 1 or 2 will die from it. Measles also can make a pregnant woman have a miscarriage, give birth prematurely, or have a low-birth-weight baby.
There is only one good way to prevent measles unless you want your child to live in a hermetically-sealed bubble forever – get the MMR vaccine. Serious complications to measles can be as high as 3 out of every 10 children who get the disease. Serious complications from the MMR vaccine may be as low as 1 out of every 1 million children. And some of those complications may be higher, like 1 out of 40,000, but many of those complications of the vaccine are more likely from measles itself.
And, of course, let me repeat this for the thousandth time (probably more) – the MMR vaccine is not linked to autism.
A happy child who should never have to experience measles complications. Credit: Michael Mims @michaelrmims at Unsplash
SSPE – one of the worst measles complications
Subacute sclerosing panencephalitis (SSPE), a rare chronic, progressive encephalitis that affects primarily children and young adults, caused by a persistent infection of the measles virus. The disease starts with a measles infection, usually before the age of 2 years, followed by approximately 6-15 asymptomatic years. Some researchers think the asymptomatic period is around 5-8 years after the initial disease. Gradually, the disease progresses with psychological and neurological deterioration, which can include personality changes, seizures, and coma.
It is fatal. It is incurable. And it only happens as a result of measles.
Moreover, a recent study has established that SSPE may be a more frequent measles complication than previously thought. The researchers examined the California Department of Public Health records for reported measles cases during 1988-1991 and found that the incidence of SSPE was 1:1367 for children <5 years, and 1:609 for children <12 months at the time of the measles infection.
That is extraordinarily high risk for a fatal complication of measles. I do not understand why any parent would but put their child in harm’s way.
SSPE isn’t some academic, statistical threat – it is an existential threat to measles victims, where the parents won’t know that their child has been harmed until years later.
Which leads to a story about Angelina, a typical 6-year-old girl growing up in a small town in Bavaria, Germany. Angelina had measles at around seven months old but recovered quickly as many children do, and no one thought much of it.
Her mother said:
The diagnosis of SSPE was a shock to us. Within 8 weeks of our child entering the hospital, she could not walk or talk and has to be artificially fed. Actually, she was supposed to start school this year. This has been very difficult for us all.
According to one of the German physicians familiar with the case:
The course of this disease is not predictable. Between the first measles infection and the onset of SSPE may take many years; however, we know of cases where the disease became symptomatic many years earlier. The measles virus settles in affected patients during the initial infection where it proliferates undetected in the brain. Years later it destroys the brains cells. The disease often progresses in fits and leads to actual holes in the brain. Unfortunately, you cannot stop this progression of the measles virus. From what we know, SSPE is always fatal.
If that doesn’t scare you, I don’t know what to say. SSPE is probably one of the most dangerous measles complications.
But Angelina isn’t the only story about measles complications. We have the story about the five-year-old Italian girl, Clara, who died from SSPE after contracting measles. If only she had been vaccinated.
Now you may be asking why these children were not vaccinated. It’s because they were too young to receive the MMR vaccine, which is first given around one year old, along with a booster just before starting school.
Of course, Angelina and Clara both contracted the disease from another child or adult who was not properly vaccinated against measles. Whether by accident or intention, both children contracted measles because it was passed to them by someone who was infected by measles, which is something that just shouldn’t happen in this modern world.
Children with their parents who should also never experience measles complications. Credit: John-Mark Smith @mrrrk_smith at Unsplash.
Summary
Adults and children should both receive the MMR vaccine to prevent measles. Without it, they both can pass on the disease to those who are not vaccinated, like babies, which can lead to many serious measles complications – like SSPE, hospitalizations, and death.
The tropes and misinformation from the anti-vaccine world that “measles is benign” is so frustrating. It can be a dangerous disease, despite parents thinking that their children are genetically, nutritionally, and medically superior to all other children because of reasons. Measles is dangerous. Measles complications are deadly.
Get the measles vaccine. It’s the only choice for your children.
Notes
- One of the more ridiculous pieces of history denial from the anti-vaxxers is that somehow improved sanitation got rid of diseases and obviates the need for vaccines. Now, this may be true for some diseases in developed countries like cholera and typhoid, against which we no longer get vaccinated, but it is irrelevant for diseases that are transmitted by direct contact such as measles.
Citations
- Barrero PR, Grippo J, Viegas M, Mistchenko AS. Wild-type measles virus in brain tissue of children with subacute sclerosing panencephalitis, Argentina. Emerg Infect Dis. 2003 Oct;9(10):1333-6. PubMed PMID: 14609476; PubMed Central PMCID: PMC3033091.
- Buchanan R, Bonthius DJ. Measles virus and associated central nervous system sequelae. Semin Pediatr Neurol. 2012 Sep;19(3):107-14. doi: 10.1016/j.spen.2012.02.003. Review. PubMed PMID: 22889539.
- Moss WJ. Measles. Lancet. 2017 Dec 2;390(10111):2490-2502. doi: 10.1016/S0140-6736(17)31463-0. Epub 2017 Jun 30. Review. PubMed PMID: 28673424.
- Wendorf KA, Winter K, Zipprich J, Schechter R, Hacker JK, Preas C, Cherry JD, Glaser C, Harriman K. Subacute Sclerosing Panencephalitis: The Devastating Measles Complication That Might Be More Common Than Previously Estimated. Clin Infect Dis. 2017 Jul 15;65(2):226-232. doi: 10.1093/cid/cix302. PubMed PMID: 28387784.
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