Measles Reappearing in Montreal, QC

Measles making a come back in Montreal

Measles (rubeola), one of the childhood diseases rarely seen in Canada today, is making a come back. Currently, 14 cases of measles have been identified in Montreal: 12 in adults and two in children under five years old.

Why is this happening considering that we have childhood vaccines now? Two main reasons: the increase in international travel and people not vaccinating their children from childhood diseases like measles, mumps and German measles.

I know that there is a debate among some parents about childhood vaccinations like MMR (the vaccine against the three diseases) and the onset of autism, but time and time again, studies have shown that there is no link between the two. The anecdotal evidence that a child begins to show symptoms of autism weeks after an inoculation is just that: anecdotal. The thing is that the age when these children get the vaccination is precisely the age that the signs of autism begin to set in. According to the many studies that have been done, it’s a horrible coincidence.

It’s devastating to find out that a child is autistic. But it’s also devastating when a child dies of a common childhood disease – as they can from mumps, measles and German measles. The arguments that they're common diseases, that we lived through them, that they’ve been around for generations and we all lived just doesn’t cut it. The kids we know lived through the disease; we lived through the diseases, but many didn’t, or did but with life-long after effects.

According to the World Health Organization (WHO), the most serious complications affect children under the age of five years and adults over the age of 20. (WHO fact sheet)

The most serious complications include:
· blindness
· infection and inflammation of the brain, called encephalitis (1/1000 cases)
· severe diarrhea possibly leading to dehydration
· middle ear infections (5% to 15% of cases)
· severe respiratory infections and pneumonia, which can lead to death (5% to 10% of cases)

Measles cause death in up to 25% of those affected in developing countries and between 1% and 5% in developed countries.

If someone who is immunocompromised, meaning their immune system isn’t working properly because of a disease like HIV or treatment for a disease like cancer, the fatality rate is as high as 30%.

Measles is very contagious and an outbreak like the one in Montreal is very serious. According to the public health officials, people who received vaccinations in the 1970s are at risk and should be re-vaccinated. This is because people born before that developed natural immunity through having the disease and people born after were vaccinated because of the massive national campaigns to have children vaccinated. The children born in the 1970s may have fallen through the cracks.

There have always been parents who decided not to get their children vaccinated against childhood diseases and they were lucky that their children didn’t get the diseases. However, chances are this was because of the “herd immunity,” or the fact that almost all the kids around theirs were vaccinated, thus leaving them with no exposure. But, these kids are now adults and haven’t been vaccinated – and are at high risk of developing measles, mumps or German measles if they are exposed to them. As more parents decide not to vaccinate, this herd immunity will wane and these diseases will become more prominent again.

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Childhood diseases making a comeback

Measles, mumps, German measles and chicken pox: all are childhood diseases that may seem to be benign, but that’s only because we haven’t really seen them – and their effects – for a long time.

When the vaccines for mumps, measles and German measles (rubella) first came out, the medical community had to convince the general population that it was safe and beneficial to have children vaccinated against these diseases. As time went on, it became standard and people just did it. Unfortunately, that became a bit of our problem because since so many children were vaccinated, the number of these cases dropped drastically. With the drastic drop, there’s a whole generation of people who had no idea what it was like to have these diseases and there was a whole generation of people who didn’t know anyone who died or suffered severe disability because of them. Many parents began to choose not to vaccinate.

Add to that the onset of autism and the fear of a link between the vaccines and autism, now we have kids who are open to developing these diseases not just as children, but as they grow into adulthood.

Childhood diseases are not benign. According to the Centers for Disease Control and Prevention, in an article from the mid 1990s, (Measles) one in 10 children who get the measles get ear infections, as many as one in 20 develop pneumonia and about 1 in every 1000 children develop encephalitis, an inflammation of the brain. People who get encephalitis can have seizures, deafness or mental handicaps. Encephalitis can also cause death.

If a child is infected with mumps, about one out of every 10 develops meningitis (German Measles). While the children may not have the severe effects that measles and mumps can have, if a pregnant woman is exposed to German measles during the first trimester, there is a chance of miscarriage and as high as an 80% chance that the baby will be born either deaf or blind. They could also have other abnormalities with their heart or brain, and there could be brain damage.

Chicken pox is the most recent childhood disease to have a vaccine made available. This is particularly important because anyone who has had chicken pox can develop a painful condition later on in life called shingles, or herpes zoster. Having had shingles myself, I can assure you, it is no picnic.

While most children who get chicken pox come through relatively unscathed, save for some scars on the face or elsewhere, there are some who get significantly sicker. Although rare, encephalitis can occur, as can Reye’s syndrome and myocarditis, an inflammation of the heart muscles, pneumonia and even arthritis. Children with low immune defences can become quite ill, even die, if they get the chicken pox. Mothers who catch chicken pox while pregnant can deliver babies with congenital infection, meaning babies born with infection.

People who have shingles later on in life can develop a very painful condition called post-herpetic neuralgia. Seniors and people who are immunocompromised are most at risk of developing shingles. People who are vaccinated against chicken pox will not have the virus in their system and cannot develop shingles later on in life.

And now, in 2007, mumps is making the rounds in universities. A recent outbreak in a university in Canada has begun to spread as the students are making their way home for the summer. You can read this Globe and Mail article to learn more: Mumps outbreak moves from the Maritimes to Ontario.

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