Measles: A Rising Public Health Threat

The Disneyland case illustrates both the fast spread of this virus and the urgent need for public health policies that can help boost vaccination rates and eradicate this disease once and for all.
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Earlier this month California lawmakers pushed ahead on a bill that would ban most of the loopholes that allow parents to avoid requirements to vaccinate their children before entering public school, a move taken in response to a measles outbreak that began back in December.

Those lawmakers should be applauded for moving forward on this legislation. As the Michael and Lori Milken Dean of the Milken Institute School of Public Health, I believe we need more such public health measures to protect the public from this potentially deadly disease.

The current measles outbreak, which has been linked to the Disneyland amusement parks in California, got its start in December, and by April 10, 2015 the Centers for Disease Control and Prevention reported that 159 people from 18 states and the District of Columbia had the disease.

The Disneyland case illustrates both the fast spread of this virus and the urgent need for public health policies that can help boost vaccination rates and eradicate this disease once and for all.

The United States eliminated measles from the country back in 2000 but since then a small but growing number of parents have refused or failed to get their children vaccinated. Many parents in the anti-vaccine movement mistakenly believe the mumps, measles and rubella (MMR) shots are linked to autism. The link was first reported in a 1998 paper but subsequent research, including a review by the Institute of Medicine, dismissed any connection between autism and the vaccine.

The anti-vaccine movement comes along with a rising danger: Measles is highly contagious and is spread by inhaling droplets of virus that can stay in the air for hours after an infected person coughs or sneezes.

And since measles is common in other countries, an infected plane passenger can arrive in New York or any city in the world and pass the disease on. One person can infect up to 18 others in an outbreak that can grow rapidly, if not curtailed. In fact, health officials believe the current outbreak started with a traveler who became infected overseas with measles and then visited the Disney theme parks.

This outbreak shows that if we do not take action measles will make a comeback both here and in other parts of the world. The CDC has already warned of a resurgence, saying that in 2014, the United States experienced a record number of measles cases, with 644 cases from 27 states -- and this year promises to be no exception.

And lest we forget how serious a disease this can be consider this: Before the U.S. started a routine vaccination program in 1963, virtually every child in the nation came down with measles. And every year 450 to 500 people died and 1,000 developed permanent brain damage or deafness from this disease.

That's an unacceptably high toll and one that we could return to if we don't work together to eliminate this threat.

What can be done? First, we need to ensure that the majority of the population is immunized against this disease. Here in the United States, children typically are required to get the MMR vaccine before they enter public schools, but some states have allowed many exemptions to this rule. The vaccine is safe and effective but to protect the public, a large number need to be vaccinated. Thus, more states should follow California's lead and consider laws that make it tougher for parents to opt out of the vaccine requirements.

Second, to sustain a high vaccination rate we need more research to find out why some parents refuse to get their children vaccinated. We don't know why some parents, including those who are highly educated, doubt or dismiss the science behind the safety of the vaccine. We need to identify the root of the distrust and address it before we can develop effective public health messages aimed at boosting and sustaining a high vaccination rate for all.

Third, we need to partner with global organizations to ramp up vaccination rates for measles around the world. And we need to improve surveillance systems for this disease and others that can easily jump from one time zone to the next. In the United States we have a relatively fast response to outbreaks but we should be moving toward interconnected global systems that can detect diseases in real time -- allowing action that can stop an outbreak in its tracks.

To protect children everywhere -- not just in U.S. theme parks -- we must mount a global response to measles, one that could -- if we all join the fight -- save millions of lives around the world.