The Bell Tolls for a Measles Death

The Bell Tolls for a Measles Death

Potentially fatal? Technically true, but herein lies the lie. It’s been publicized as “the deadliest of all childhood fever/rash illness with a high rate of complications.” Deadly? Not in the U.S., or any other developed country with a well-nourished population. True the risk of fatality here isn’t zero, but it’s as close to zero as you can get without actually being zero. It’s 1 in many thousands. Will someone pass away in the U.S. from measles one of these years? Tragically yes. That will likely happen to one person. It hasn’t happened here in at least ten years (or more – I don’t even know how many years we have to go back to find one). When that happens, it will be extremely tragic.

But will it spread through the U.S. and kill people left and right? No. Does measles do that in underdeveloped countries? Sadly, yes. It kills countless people worldwide every year. So, that’s how health officials can accurately say it’s so deadly. They don’t have to tell you the whole truth, just the part of the truth that they want you to believe.

Measles can also be serious for young infants, just as many diseases can. It can also be serious for immunocompromised people, just as all illnesses. It can also cause pregnancy complications, just like many infections can. Measles isn’t unique in these risks. But they are risks nonetheless.

So, fear measles? No. Not in the U.S. Respect measles? Yes. Take appropriate precautions with it. But don’t let anyone tell you should live in fear of it. Let’s handle it calmly and without fear or blame.

Dr. Bob Sears. Famous-ish Pediatrician

The CDC gives the death rate from measles as 1–2/1000 cases. In the bad old days

3 to 4 million people got measles each year in the United States. Of those people, 400 to 500 died, 48,000 were hospitalized, and 4,000 developed encephalitis (brain swelling) from measles.

So often in medicine death from infection is a long odds version of the Deer Hunter. Eventually, if the measles trigger is pulled enough times, someone, another human, dies.

It has happened in Germany. Their measles outbreak is worse than the US, now at 574 cases and today an 18 month old child died of the measles, about 1.7 deaths per thousand.

 

It is often said that measles will not be as severe a disease in the US thanks in part to good nutrition. In the Philadelphia outbreak of 1991 the

... overall case-fatality rate was 1.2%. The case-fatality rate was 2% for females, 0.4% for males (P = 0.22)

I would suspect the nutritional status of Germans is equal to that of the US and maybe better.

As the cases in the US mount it is, unfortunately, just a matter of time before a child needlessly dies of measles. Measles isn’t like the Brady Bunch episode.

It is doubly sad since we have been able to eradicate Rinderpest, the measles of animals, but the world has more will and compassion to save cows over our own species.  

Roald Dahl’s daughter died of measles in 1962, a year before the vaccine:

Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of colored pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything.

“Are you feeling all right?” I asked her.

“I feel all sleepy,” she said.

In an hour, she was unconscious. In twelve hours she was dead.

And from his diary:

Got to hospital. Walked in. Two doctors advanced on me from waiting room. How is she? I’m afraid it’s too late. I went into her room. Sheet was over her. Doctor said to nurse go out. Leave him alone. I kissed her. She was warm. I went out. ‘She is warm.’ I said to doctors in hall, ‘Why is she so warm?’ ‘Of course,’ he said. I left.

To repeat the first sentence of the post

"Potentially fatal? Technically true, but herein lies the lie." 

Don't grieve, your son is only technically dead.

Real death can be the truth of measles and is what the vaccine prevents.

Vaccines are remarkably safe, far safer than the diseases they prevent. I spend most of my time in acute care medicine, taking care of hospitalized patients who often die of their illness. I can never think of a death, especially a preventable death in the young, as technically dead or as an 'only'. Instead I remember Jonn Donne

No man is an island entire of itself; every man

is a piece of the continent, a part of the main;

if a clod be washed away by the sea, Europe

is the less, as well as if a promontory were, as

well as any manner of thy friends or of thine

own were; any man’s death diminishes me,

because I am involved in mankind.

And therefore never send to know for whom

the bell tolls; it tolls for thee.

Points of Interest: 02/24/2015
Points of Interest 02/23/2015

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