Measles is a highly contagious disease that was declared eliminated from the U.S. by the World Health Organization 25 years ago due to the success of vaccination efforts. Yet, Texas counties primarily in the South Plains and Panhandle regions, continue to deal with the state's largest measles outbreak in 30 years.
As of March 25, there were 327 confirmed cases since the first two were reported in late January, with more than 60 cases confirmed in just the last week. According to the Texas Department of State Health Services, at least 40 people have been hospitalized so far.
Erin Carlson, associate clinical professor and director of graduate public health programs at The University of Texas at Arlington's College of Nursing and Health Innovation, says the erosion of trust in the unequivocally safe and effective MMR (measles, mumps, rubella) vaccine is dangerous. She discussed the latest developments of the outbreak.
The U.S. declared measles eliminated in 2000 thanks to a successful vaccination program. What does "eliminated" mean in this context?
We define elimination as stopping disease transmission within a defined geographic area such as a country or a region, not globally. Even when a disease is eliminated according to the epidemiological definition, it doesn't mean that we can become lax in our interventions. It means that we must maintain those to continue the elimination of measles from the United States.
What factors have contributed to the current outbreak?
We have seen fewer people getting vaccinated compared to historical levels, which has allowed these outbreaks to take hold.
How effective and safe is the MMR (measles, mumps, rubella) vaccine?
It is unequivocally safe and effective. We have decades of research. There are devastating complications from measles, but we don't see these types of complications or side effects from the vaccine. It is 97% effective against measles.
Most know measles to be a highly contagious disease. What exactly is measles, and how does it spread from person to person?
If you wanted to design a virus to be as contagious as possible, you would design measles. It has the highest reproduction rate in the world. For every one person who has the disease, they spread it to 12 to 18 people on average. That's extraordinary.
With measles, a person is infected for four days before they ever get the rash. For four days, they are spreading the disease before they have signs that they're sick. Then, once the rash develops, they're contagious for another four days. So, there are eight days where they can be spreading the disease, eight days when they're highly contagious.
What are the potential health complications for those who contract it? How is it cured?
With measles, we tend to think of it as a rash, but it is a respiratory illness. Just like with influenza or COVID-19, pneumonia is a key complication that can develop.
Encephalitis, inflammation of the brain that can lead to seizures and brain damage, is another leading complication. There is also a very scary brain disorder called subacute sclerosing panencephalitis, which you should think of as Alzheimer's in young people. Measles also can lead to vitamin A deficiency, which can cause eye damage and blindness.
There is a misconception that measles can be treated with vitamin A, which is not true. Vitamin A supplementation helps reduce the chance of blindness, which can be a complication of measles infection.
There is no cure for measles. It's just palliative treatment, helping people be comfortable.
What advice would you give to parents who have not yet had their child vaccinated against measles?
Get vaccinated. Measles can be deadly or lead to serious lifelong health complications. This is a disease that is completely preventable.
Vaccinations also benefit our communities and our neighbors. Maybe your own child is very healthy and robust, but you may have another child in your community who cannot be vaccinated for medical reasons. We all can do our part to keep the most vulnerable from getting sick.
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