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The History of Measles and Vaccine Development
1Professor of Infectious Diseases Emeritus, University of Helsinki, Helsinki, Finland.
Abstract:
Measles is one of the oldest human diseases, but the fact that it was separate from smallpox, scarlatina and rubella was only disclosed a century ago. It is extremely contagious, as the infection may spread for up to 4 days before the first symptoms appear. One patient may infect 12-18 secondary cases, who then spread the infection further. Before the vaccine era, measles caused 2-3 million deaths a year, with remote populations facing chaotic consequences from epidemics. Safe and inexpensive live-virus vaccines, often combined with mumps and rubella components, have been available for 50 years. The global death toll first dropped below 100 000 per year in 2021, but setbacks have been seen in many countries, including Europe. High mortality is mainly due to immune amnesia, as previously acquired memory is partly disturbed because of the elimination of T and B cells. Impaired protection from pathogens other than measles recovers slowly in subsequent years. Measles is almost exclusively a human infection, which is potentially eradicable with vaccinations. It warrants two doses, especially when contacts with natural measles are minimal or lacking. The World Health Organization is running a measles and rubella elimination program, but current vaccination levels will make that difficult.
Insights
Measles is a highly contagious disease that can cause severe illness and death, particularly due to immune amnesia. While vaccines have reduced mortality, setbacks in vaccination rates threaten global measles eradication efforts.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- Measles, a historically significant and highly contagious viral illness, was only recently distinguished from other exanthems.
- Prior to vaccination, measles caused millions of deaths annually, devastating populations.
- Live-virus vaccines for measles have existed for 50 years, significantly reducing global mortality.
Purpose of the Study:
- To review the history, transmission, and impact of measles.
- To highlight the role of vaccination in controlling measles and the challenges to eradication.
- To discuss the immunological consequences of measles infection, including immune amnesia.
Main Methods:
- Literature review of historical and contemporary data on measles epidemiology and immunology.
- Analysis of vaccination impact on global measles mortality trends.
- Discussion of immunological mechanisms underlying measles pathogenesis and long-term effects.
Main Results:
- Measles remains extremely contagious, with potential for widespread outbreaks.
- Global measles deaths have decreased significantly due to vaccination but recent setbacks are concerning.
- Measles infection can lead to immune amnesia, impairing long-term immunity to other pathogens.
Conclusions:
- Measles is a potentially eradicable human infection through widespread vaccination.
- Achieving global measles and rubella elimination requires sustained high vaccination coverage, including two doses.
- Current vaccination levels pose a challenge to the World Health Organization's elimination goals.
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