Life List

Life List

I have yet to see a case of measles and, along with smallpox and ebola, it is one of the diseases I have on my 'Never Want To See' list.

In a perfect world measles should have gone the way of smallpox and rinderpest, eradicated from the world. Rinderpest is, simply, the measles of cattle. Actually, measles is the rinderpest of humans, having, like many infections, jumped from cattle to humans as a result of domestication and abandoning a hunter-gatherer existence in favor of agriculture. Raising cows maybe not a great idea from an ID perspective.  If we can get rid of rinderpest we should have been able to get rid of measles in humans with vaccination. I am not surprised we eradicated in the virus in cows first; I always have this nagging suspicion that people care more about animals that other humans.

In the 1950’s there were half a million cases of measles a year and 400 deaths. Then they developed a vaccine and now there are a handful of cases a year and no deaths. Amazing. Decreasing the morbidity and mortality of any infectious disease is always multifactorial. Nutrition, hygiene, understanding, and interfering with, transmission all play a part in decreasing disease spread. But it is hard to beat a good vaccines for wiping a disease off the face of the earth. I am sure the anti-vaccine contingent see no parallel between the eradication of rinderpest in cows and the potential to do the same with measles in humans. Rinderpest was falling before the vaccine was introduced and rinderpest still exists, they just call it blue tongue. Or some such nonsense.

2013 saw 175 cases of measles in the US a record number in the vaccination era. Due to vaccination rates falling in some embarrassing states (like Oregon at 94%), and with the numbers at risk even higher due to vaccine failure, we are primed for 2014 to be a year where we could have enough cases of measles I might be able to see one in the wild. Measles is still common in other parts of the world and is only short plane ride away from starting an small outbreak.

California is having measles:

15 statewide cases, three of the victims had traveled to the Philippines, which is experiencing a significant measles outbreak, and two had traveled to India, where the virus is endemic. The 15 victims range in age from 5 months to 44 years, and seven of them had deliberately not received the measles vaccine.

And now:

New York City health officials warned unvaccinated New Yorkers that they should get shots after identifying 16 cases of measles in Manhattan and the Bronx. Nine of the cases are children, and seven are adults. Four people have been hospitalized as a result of the outbreak, according to the New York City Department of Health and Mental Hygiene.

And that is just the tip of the spear, there are a smattering of cases all over the US this year and we are barely into 2014.

It is just a matter of time until we get a case in a susceptible population like a Waldorf School and it will really spread.

Measles is one of the most contagious viral diseases known; secondary attack rates are >90% in susceptible household and institutional contacts.

I always figure that what can happen, will happen if there is a proper confluence of risks. We are there. A world filled with very infectious measles, an at risk population thanks to declining vaccination and jet travel. I always remember that influenza went around the world three times in 1918–19, long before current rapid travel and  there are so many more people to pass an infection along (1.8 billion in 1918 vrs 6.8 billion now).  The opportunites for spread of contagion are so much greater in 2014.

I expect I may well see a case of measles this year. Lucky me.

Alabama Acupuncture
Points of Interest: 3/07/2014