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Ongoing Measles in the Developed and Developing World
1Pediatric Infectious Diseases, David Geffen School of Medicine at UCLA, Mattel Children's Hospital UCLA, Los Angeles, CA.
Abstract:
Measles is a vaccine-preventable illness. Nevertheless, in recent years, measles is still endemic and epidemic in both the developed world and the developing world. The public perception of measles in the past was that it was not a big deal. However, measles is associated with a number of complications which can be places in three categories which are: acute(diarrhea, otitis media, pneumonia, encephalitis, seizures, and death) and delayed-subacute sclerosing panencephalitis (SSPE) and post-measles immune amnesia. Contrary to the beliefs of the anti-vaccine lobby, measles is bad. In acute measles, the death rate is 1-3 per 1000 and the risk of encephalitis is 1 per 1000. Relatively recent investigations indicate that SSPE is considerably more common than previously believed. The worldwide contribution of post-measles immune amnesia to morbidity and mortality is likely to be huge. In exposure situations, two doses of measles vaccine will prevent 99% of cases. Presently in the United States, the first dose is given at 12 through 15 months of age. The second dose is most often administered at 4 through 6 years of age. In my opinion, the second dose of measles vaccine should be given 4-6 weeks after the first dose rather than at 4-6 years of age. Children who don't have antibody to measles should not travel to risk areas.
Insights
Measles is a serious illness with severe complications, including death and encephalitis. Vaccination is highly effective, with two doses preventing 99% of cases, and prompt re-evaluation of the second dose timing is recommended.
Area of Science:
- Pediatrics
- Infectious Diseases
- Vaccinology
Background:
- Measles remains endemic and epidemic globally, despite being vaccine-preventable.
- Public perception historically underestimated measles severity.
- Measles is linked to acute and delayed complications, challenging anti-vaccine narratives.
Purpose of the Study:
- To highlight the severe complications of measles.
- To emphasize the efficacy of measles vaccination.
- To propose an optimized vaccination schedule.
Main Methods:
- Review of existing literature on measles epidemiology, complications, and vaccine effectiveness.
- Analysis of measles-related morbidity and mortality data.
- Evaluation of current and proposed measles vaccination schedules.
Main Results:
- Measles complications include acute issues (diarrhea, otitis media, pneumonia, encephalitis, seizures, death) and delayed sequelae (SSPE, immune amnesia).
- The death rate from acute measles is 1-3 per 1000, with a 1 per 1000 risk of encephalitis.
- Subacute sclerosing panencephalitis (SSPE) is more common than previously thought, and post-measles immune amnesia contributes significantly to global health burden.
Conclusions:
- Measles is a significant public health threat with severe consequences.
- Two doses of measles vaccine are 99% effective in preventing infection.
- The current US schedule for the second measles vaccine dose may need revision, with an earlier administration (4-6 weeks post-first dose) suggested over the current 4-6 year interval.
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