Measles at Disneyland: A predictable, avoidable public health nightmare
© 2015 Roy Benaroch, MD
On January 8, NPR reported “Measles makes an unwelcome visit to Disneyland.” Nine people who visited Disneyland theme parks in California over winter break had caught measles, almost all of them unvaccinated children. The next day, January 9, ABC reported that the number of cases has grown to 19. Of these, only two had been fully vaccinated. Some of the cases were too young to receive vaccines, others apparently chose not to get vaccinated. Since measles is one of the most contagious illnesses on earth—it can spread just through the air, with infectious particles floating around for hours after a victim has left the room—we can expect these cases to lead to dozens, or hundreds more. A lot of these sick people were probably traveling on planes all over the country. Who knows how many people have now been exposed?
Measles is a serious illness. Prior to widespread vaccinations, 3-4 million people caught measles each year in the USA; of these, 400-500 died, 48,000 were hospitalized, and 4,000 developed encephalitis (brain swelling, which can lead to death or permanent disability.) We’ve kind of forgotten that, because measles has become so rare. We do not want measles to come roaring back.
Measles vaccine itself is very, very effective—98% of people who’ve gotten the two dose series remain completely immune for life. That’s incredibly effective, and just as effective as “natural immunity” from the disease, but without the misery and risk of the disease itself. But 98% effective means that 2% of vaccinated individuals are still susceptible. In a huge Disney theme park with thousands of people wandering around in mouse ears, even a highly vaccinated crowd is going to include some people who are not well protected. And they don’t know who they are.
Some people can’t be vaccinated at all. Babies less than one (who have a high risk of complications from measles) can’t receive the vaccine; nor can many people who have immune deficiencies.
The only way to protect susceptible individuals (those who can’t get the vaccine, or those in whom the vaccine didn’t work) is to avoid contact with measles. If measles is very rare, even unvaccinated people will probably be safe. But once measles isn’t rare, well, we’re asking for trouble.
We had measles beaten—in the 2000’s, it had been completely eliminated from transmission in the US, thanks to a very safe and effective vaccine. Then one nutjob created anti-vaccine hysteria with one fraudulent study. He made the damn thing up. And we’re paying the price.
We can beat this. Parents need to make sure they’re vaccinating their kids, on time and on schedule. They need to let their neighbors know it’s the right thing to do. Parents who are genuinely afraid need honest, reliable information about the great wealth of information we have, which overwhelmingly supports the safely and effectiveness of vaccines. People who are just loudmouths and liars, fanning fear for their own twisted reasons, should be shunned. It is time to end the fake “vaccine controversy” to protect the health of our children and our communities.