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Tuesday, March 24, 2015

March 24, 2015: American Epidemics: The Measles

[Inspired both by the recent events I’ll include in Monday’s and Tuesday’s posts and the historical anniversary on which I’ll focus in Friday’s, a series AmericanStudying epidemics, past and present.]
On three telling stages in the history of a frustratingly persistent disease.
In the mid to late 19th century, outbreaks of the measles devastated two different South Pacific paradises. Beginning with a series of deadly epidemics in 1848-1849 (including whooping cough and influenza as well as measles), and continuing through much of the next decade, the disease took roughly one-fifth of Hawaii’s population. In 1875, the disease was introduced to the tropical island of Fiji by King Cakobau, upon his return from a diplomatic trip to Australia, and before it was contained it had killed 40,000 Fijians, roughly one-third of the small nation’s population. As these and many other outbreaks make clear, measles, often perceived here in the United States as nothing more than a potential childhood annoyance, has been as deadly a worldwide epidemic as any, and remains so: it is estimated to have killed roughly 200 million people between 1855 and 2005, and the World Health Organization (WHO) estimated that 158,000 were killed in 2011 alone.
The fact that the disease has come to be perceived so differently in late 20th century America (and beyond) is due directly to two interconnected individuals. In 1954, medical study of David Edmonston, a 13 year old infected with the disease (one of many affected by an outbreak at a Boston private school), allowed for the virus that causes it to be isolated for the first time; the efforts of one young researcher, Dr. Thomas Peebles, were instrumental in achieving this success. Subsequent work over the next decade to develop a vaccine culminated in the 1963 successful creation of one by Maurice Hilleman, a researcher and vaccination specialist working at Merck; Hilleman’s vaccine (eventually folded into what is now known as the MMR [Measles Mumps Rubella] shot) has been estimated to prevent up to 1 million deaths each year. To my mind, few developments capture the best of the 20th century better than vaccines, and their combination of science, technology, research and collaboration, and international efforts to improve lives and communities; by any measure, Hilleman and the MMR certainly have to occupy prominent spots on that list.
Which brings us to now, and a particularly frustrating 21st century trend. As those WHO estimates indicate, measles has never been eradicated; but it has nonetheless made a striking recent return to our conversations, thanks in no small measure to a new American community: the anti-vaccinaters. This community has been around and making its controversial case for nearly two decades, aided and abetted by a fraudulent researcher and his hoax of a scientific study, but a recent outbreak of measles, caused it seems by the presence of unvaccinated and infected individuals at California’s Disneyland, has brought the community and the disease together in our collective consciousness. There are lots of ways to argue against this extreme and dangerous perspective, but to my mind chief among them would have to be a better understanding of each of these prior two stages: the long-term history and effects of measles, and the hugely destructive force of outbreaks such as those in Hawaii and Fiji; and the vital breakthroughs and successes of the vaccines, and the way they have turned measles into something manageable instead. It’s difficult for me to imagine anyone who would want a return to that earlier stage in the arc of this epidemic.
Next epidemic tomorrow,

PS. What do you think?

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