Johns Hopkins Master of Science Student
Individualized Genomics and Health
On February 21, 2019, the CDC reported 159 confirmed cases of measles virus across ten states–California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New York, Oregon, Texas, and Washington–representing a staggering 835% increase compared to the 17 confirmed cases across the United States in 2018.1 Healthcare officials have attributed the recent spike in outbreaks to the rise of non-vaccinated populations. For decades, the Measles-Mumps-Rubella (MMR) vaccine has significantly decreased morbidity, mortality, and the economic burden of measles infection, however recent social ‘anti-vax’ movements have ignored evidence-based science and rejected inoculation, posing a significant threat to public health safety. The measles, also known as rubeola, is a virus clinically known to cause systemic infection with acute disease manifestations involving the skin, brain, lymphatic and respiratory systems.
The virus’ structure consists of a nucleocapsid containing a single-stranded, negative-sense RNA genome that transfers during viral transcription and replication.2 Transmission of the pathogen into a host’s system begins through contact with airborne viral droplets or fomites carrying the virus within respiratory tract secretions. Measles symptoms express a severe, red spotted rash known as Koplik spots, which indicate an early sign of infection. Other initial symptoms include high fever, runny nose, and bloodshot eyes which become prominent after a 10-12 day incubation period.
People are contagious on average for six days, while the total disease state with the rash and other ailments can last 7-10 days. In some cases, the virus may persist silently within a host for years.2 Severe complications with the illness can lead to a permanent hearing loss while extreme cases with onset pneumonia or acute encephalitis can be fatal, especially in young children or those who are immunocompromised. Since public availability of the vaccine in the 1960s, scientists, and healthcare professionals have accomplished herculean feats in eradicating measles from the global population, however, we have recently witnessed a deadly resurgence of outbreaks due to the decrease of vaccinations.
Many have pinned social media platforms as a culprit for the spread of medical misinformation that has spurred an aggressive anti-vax movement and consequent rise in measles cases. In response to the rising backlash, large technology companies such as Facebook, Pinterest, YouTube, and Google announced recent efforts to curb vaccines search results that contradicted medical guidelines. By manipulating their algorithms, technology companies can limit or prohibit access to health-related information in the category deemed anti-vaccine.3 YouTube individually has removed ad content from anti-vax channels.4 Though the efforts could minimize the spread of misinformation, they raise ethical dilemmas and controversies surrounding censorship and freedom of speech.
Nonetheless, the viral spread of vaccination misinformation has become highly evolved, propagates unsubstantiated medical claims, and ultimately poses a new significant public health challenge. Education is vital to offset this threat. It’s an important reminder that there is minimal natural resistance to the measles virus other than cell-mediated immune response.2 Vaccination is the safest, most efficient, and cost-effective form of preventing infection from measles and many other illnesses.
If you or a loved one show signs of infection, please consult a medical professional immediately and avoid contact with the elderly or immunocompromised who are highly at risk of mortality from the virus. You may also visit the CDC for more information on the measles virus, vaccination, and way to protect against the latest outbreak. Measles can be fatal; don’t risk it, get vaccinated.
1) Centers for Disease Control – Measles Cases & Outbreaks. Access from: https://www.cdc.gov/measles/cases-outbreaks.html
2) Enders, G. Chapter 59: Paramyxoviruses. (1996). University of Texas Medical Branch at Galveston. Galveston, TX. Accessed from https://www.ncbi.nlm.nih.gov/books/NBK8461/
3) McMillian, Robert., Hernandez, Daniela. “Pinterest Blocks Vaccination Searches in Move to Control the Conversation.” The Wall Street Journal. 20 Feb. 2019. Web. 27 Feb. 2019.
4) “YouTube takes ads off ‘anti-vax’ video channels.” BBC News. 25 Feb. 2019. Web. 27 Feb. 2019.
5) https://kval.com/news/local/measles-case-confirmed-in-hood-river-county Photo Courtesy January 2019