Globe and Mail - Canada June 8, 2011
The return of measles: Where did we go wrong?
by André Picard
Welcome to the 1960s. Not in a cool, retro way but in the “how have we failed so miserably to make progress?” way.
Measles is back.
In recent weeks, there have been more than 250 cases of the dreadful childhood disease in Quebec. The outbreak was sparked by vacationers returning from France, which is in the midst of a measles epidemic, as is Britain.
As a result, there are small but ever-larger outbreaks popping up all over Europe and the Americas. Measles is highly infectious and easily spread. It could well be coming soon to a community near you.
This, of course, should not be happening. We’ve had a cheap and effective measles vaccine since 1963.
The disease had virtually disappeared in Canada and the rest of the developed world, and there were dramatic reductions in the developing world, to the point where last year there was beginning to be serious discussion about eradication.
Where did we go wrong?
The problem is that vaccines only work if people are vaccinated. But, increasingly, parents in the Western world are not getting their children vaccinated, or fully vaccinated.
Why would you deny your child protection against an unpleasant and potentially deadly disease?
Measles does kill; last year it claimed the lives of an estimated 164,000 children worldwide. That number has dropped dramatically since 2000, however, when it was close to 800,000. Why? Vaccination.
In the developing world, where they see the ravages of measles (and other infectious diseases) every day, parents are clamouring for immunization.
In the developed world, ignorance is bliss. We have grown unaccustomed to seeing the itchy red rash and forgotten that measles was once a leading cause of blindness, deafness and mental retardation. Before vaccination about one in 3,000 infected children died of measles, close to 100 a year in Canada.
Today, there is a small minority of parents who refuse vaccination for “religious reasons,” dubious interpretations of scripture. The handful of measles cases that usually occur in Canada tend to spring up in Hutterite communities or, as occurred recently, in some fringe Hasidic sects near the Quebec-New York State border. In Canada, we are too polite and politically correct to say so, but that’s the reality.
Yet, religious refuseniks are being eclipsed by a much more worrisome emerging group, parents in mainstream society who eschew routine childhood immunization for a number of half-baked reasons: fear that vaccines can cause autism, the belief that there are “natural” alternatives to Big Pharma products, a belief that their children are not at risk, and a romanticizing of natural immunity. (Read: Let kids get sick and develop antibodies instead of stimulating antibodies with immunization.) Virtually all the children infected in Quebec, like those in France, were not fully immunized against measles – meaning they did not get the recommended two doses of measles-mumps-rubella (MMR) vaccine.
To find the source of this problem, you can follow the itchy red dots back to Andrew Wakefield, the charlatan who concocted the bogus theory that measles-mumps-rubella (MMR) vaccination was responsible for the rise in autism. The ultimate irony, of course, is that Dr. Wakefield did so, in part, because he was trying to market his own measles vaccine.
But let’s not give Dr. Wakefield too much credit. He is merely a symbol and a by-product of a much more fundamental problem: ignorance borne of health illiteracy.
In modern society we are, paradoxically, increasingly reliant on science and technology but increasingly ill-informed about science.
Worse yet, in the midst of a communications revolution that has brought us Google, Facebook, Twitter and who-knows-what-else to come, we are not teaching people (our children in particular) how to process information and how to interpret evidence.
On our iPads, BlackBerrys and laptops, we have a virtual Library of Alexandria times 100 at our fingertips. Yet we don’t know how to sort the wheat from the chaff. As a result, there are educated people who routinely embrace theories that are biologically implausible and predicated on massive conspiracy theories.
That leaves us vulnerable – to measles and much more.
The education system is failing us in this regard. And so too is public health, which has failed to update its message and methods for communicating effectively in the 21st century.
It’s no longer enough to say “vaccination is good” and expect everyone to dutifully fall into line for shots.
You have to actively promote the benefits and, just as importantly, rebut the nonsense circulated by anti-vaccinationists and other promoters of so-called alternative treatments – usually costly, unproven and largely useless herbal concoctions.
Parents want the best for their children. They deserve the best public health information.
What they need to hear is this: Yes, there are occasional but rare reactions to vaccines.
But the disease is far worse. In a large post-Olympics outbreak of measles last year in B.C., about 60 per cent of those infected required medical care, including 20 per cent who were hospitalized; one person ended up in intensive care with a life-threatening swelling of the brain.
Measles is not a mundane illness. And failing to vaccinate children is not a victimless crime.
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