Last Thursday, U.S. health officials reported that after a full decade of decline, Europe and Africa reported an increase in the number of measles cases in 2010. Because of concerted immunization efforts in those areas, total cases declined from more than 853,000 in 2000 to nearly 278,000 in 2008, and remained stable in 2009.

However, the number increased in 2010 to almost 340,000 — a jump of over 21%. Worldwide, measles remains a very serious problem, with over 20 million cases and 197,000 deaths each year. Over half of the cases and deaths are in India and China.

The somewhat alarming rise in the number of cases is felt partly due to an increasing reluctance on the part of many parents to have their children immunized against measles. Indeed, in what most physicians feel is a gross misrepresentation of the dangers, claims of severe reactions, including autism, have been used by some parents as an excuse to forego the measles vaccination for their children.

In truth, the incidence of serious side effects is very rare. Most children experience only mild local discomfort, fever, and rash. On the other hand, complications from measles such as ear infections (10%), pneumonia (5%) and brain damage from subacute sclerosing panencephalitis — an inflammation of the brain that can lead to convulsions, and leave the victim deaf or mentally retarded (0.1%) are much more common than unwelcome side effects of the vaccine.

Parents of unimmunized children reap the benefits of having the vast majority of the remaining pediatric population immunized, particularly in the United States. This “free ride” has its limitations, especially for those traveling abroad In January, four members of an unimmunized family from Kansas who had recently traveled to an undisclosed location overseas, were diagnosed with measles. Two other cases in unvaccinated persons were reported in the same community one week later.

Measles is very contagious and is characterized by high fever, cough, a runny nose, redness in the eyes and a characteristic pink rash that spreads from the face to the feet. Health officials worldwide are concerned that the efforts to eradicate measles will be stymied if parents continue to resist having their children immunized. Since the measles vaccine is almost always given in combination with mumps and rubella (German measles), these illnesses are likely to see an increase as well. Although the incidence of measles remains extremely low in the United States, parents with unprotected children going abroad, particularly to areas where the measles virus remains prevalent, should be aware of the risks involved.

Photo by Gates Foundation.


About The Author

Frank Gillingham, M.D. serves as Chief Medical Director for HTH Worldwide. Frank has led HTH Worldwide's international business development efforts in Europe and Canada and has been a guest speaker at international business conferences and has authored a series of articles on travel medicine, including pieces on travel information available on the Internet and the role of physicians working with travel insurers. Frank is a Board-Certified Internist and Emergency Medicine Specialist. He is also a private emergency physician in Southern California and a former emergency department director and member of the UCLA emergency department staff. Frank completed residency training at Los Angeles County/USC Medical Center, received his M.D. from Albert Einstein College of Medicine and his B.A. from the University of Pennsylvania .

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