DR. BOB’S DAILY:
JUST HOW DEADLY IS MEASLES?
What makes measles so scary? What is it about measles that spreads fear and dread through our population? Three things, in my opinion, set it apart from most infectious diseases that make us afraid: 1. It’s untreatable, and it has a high rate of complications, so we are at it’s mercy, 2. It’s been virtually eliminated from the U.S., so we aren’t used to it anymore, and 3. It’s potentially fatal.
Now, let’s play two truths and a lie. Two of these statements are true, and one is not. Well, the one that is not is technically true, but it’s not true in all practical terms.
- Untreatable? Correct. There is no anti-viral medication that will help, so we just have to stand by as the disease runs its course. We are powerless, and that creates fear. We don’t want to take a risk with something which we have no way to mitigate or control. The only thing that may make measles less severe is high dose Vitamin A therapy (which is approved by the WHO). But that’s not an anti-viral med; it just helps us fight it off a little better.
Complications? Ear infection is the most likely complication - treatable. Pneumonia is next - also treatable. Ya, you don’t want those things to happen, but they are treatable. Encephalitis? That’s much worse. Fortunately it’s extremely rare in well-nourished people (see below).
So, the lie is that measles has a high rate of serious complications. It doesn’t. It CAN, but it rarely does.
- Eliminated? Virtually. Over the past 20 years we’ve sometimes only had 50 cases a year. Sometimes 150. Nobody knows measles anymore, and when we are ignorant of something unfamiliar, we fear it until we understand it.
Ask any Grandma or Grandpa (well, older ones anyway), and they’ll say “Measles? So what? We all had it. It’s like Chicken pox.” Ask a twenty-five-year-old mom with two young kids, and she’ll scoop up her kids and run away from you for even mentioning the M word.
If you understand measles, you wouldn’t fear it. Respect it.
I do acknowledge that it’s a public health nightmare in that it takes a lot of effort and money to contain these outbreaks. And it causes a lot of people to get tested, quarantined, or treated with preventive immune globulin shots. It’s no joke. But, those efforts are largely because we are trying to contain it, not because it’s going to kill everybody. So, not fear - respect.
- Potentially fatal? Technically true, but herein lies the lie. It’s been publicized as “the deadliest of all childhood fever/rash illness with a high rate of complications.” Deadly? Not in the U.S., or any other developed country with a well-nourished population. The risk of fatality here isn’t zero, but it’s as close to zero as you can get without actually being zero. It’s 1 in many thousands. Will someone pass away in the U.S. from measles one of these years? Tragically yes. That will likely happen to one person. It hasn’t happened here in at least ten years (or more - I don’t even know how many years we have to go back to find one). When that happens, it will be extremely tragic.
But will it spread through the U.S. and kill people left and right? No. Does measles do that in underdeveloped countries? Sadly, yes. It kills countless people worldwide every year. So, that’s how health officials can accurately say it’s so deadly. They don’t have to tell you the whole truth, just the part of the truth that they want you to believe.
Measles can also be serious for young infants, just as many diseases can. It can also be serious for immunocompromised people, just as all illnesses. It can also cause pregnancy complications, just like many infections can. Measles isn’t unique in these risks. But they are risks nonetheless.
So, fear measles? No. Not in the U.S… Respect measles? Yes. Take appropriate precautions with it. But don’t let anyone tell you you should live in fear of it. Let’s handle it calmly and without fear or blame.
I will keep you up to date in the weeks to come.
Dr. Bob
