November 19, 2019

Measles may be even more dangerous than you think

Daily Briefing

    Measles outbreaks in the United States have garnered less media attention in recent months, but that doesn't mean they've ended. CDC this week announced 11 new measles cases recorded in the United States from Oct. 7 to Nov. 7, bringing the total number of measles cases reported in the United States so far this year to 1,261. That's the highest number of measles cases reported in the country in a single year since 1992, according to CDC.

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    And while it might seem easy to dismiss measles as a harmless, "childhood" disease from which people can recover, for many individuals, that's simply not the case. New research shows measles can wreak havoc on your immune system, making you much more susceptible to future viruses and infections of all sorts. Further, across the world, thousands of people are dying from measles infections. Let's take a closer look.

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    Measles is 'a wrecking ball to the immune system'

    Recent research shows that, while you might survive a measles infection, the ordeal could make you significantly more vulnerable to other viruses and infectious bacteria in the future—even ones your body already had developed antibodies against.

    For one study, published in Science, researchers examined the antibodies in blood samples from 77 unvaccinated children in the Netherlands taken before and two months after a 2013 measles outbreak in the country. The researchers found that measles infection essentially erased 11% to 73% of antibodies that the children's immune systems had developed to protect against bacteria and viruses, including antibodies against influenza, herpes, pneumonia, and other infections. In comparison, the researchers found children who had received the measles, mumps, and rubella (MMR) vaccine, and therefore did not contract measles, didn't lose any antibodies.

    Stephen Elledge, the senior author of the study, said the results showed that "[t]he measles virus is like a car accident for your immune system." While some children can survive the virus with little damage, others can sustain serious damage that can take months to years to resolve, Elledge said.

    A second study published in Science Immunology, for which researchers also analyzed blood samples from unvaccinated children in the same Netherlands community, similarly found that children who had developed measles lost immune memory cells that had protected them against infectious diseases.

    The Washington Post's Lena Sun writes that the research builds on previous studies with similar findings and, overall,  that "a measles infection … takes a wrecking ball to the immune system" by "destroy[ing] up to half of the existing antibodies that protect against other viruses and bacteria." Sun notes, "That means people, especially children, who get measles become much more vulnerable to other germs that cause diseases such as pneumonia and influenza that they had previously been protected against."

    Measles is killing thousands of people

    To protect against measles, CDC officials recommend at least 95% of communities be fully vaccinated against the infection. However, vaccination rates in many states fall below this benchmark, CDC data show. That's in part because vaccine hesitancy has grown in the United States and abroad. In fact, in 2019, the World Health Organization (WHO) named vaccine hesitancy as one of the top 10 threats to global health.

    Despite those warnings, public health officials note that some people in the United States have a complacent attitude towards measles because the country in recent years has seen very few measles deaths—and public health experts have said vaccine hesitancy is partly why the country is seeing a resurgence in measles cases.

    But around the world, thousands of people are dying from measles. WHO noted that there have been tens of thousands of measles infections and thousands of deaths in the Democratic Republic of the Congo, Madagascar, the Philippines, Sudan, Thailand, and Ukraine, among other countries. Further, WHO in August revoked four European countries'—Albania, the Czech Republic, Greece, and the United Kingdom—statuses as countries that had eliminated measles.

    According WHO, reported cases of measles worldwide were up by 300% during the first three months of this year when compared with the same period last year. Kate O'Brien, a department director at WHO, last month said, "The impact of these outbreaks is really devastating, … causing not only widespread loss of life, but also preventable disability that is affecting family livelihoods and national economies, and straining health care systems."

    Experts say it's important to get vaccinated

    Researchers and clinicians have said the developments highlight the importance of getting the MMR vaccine to protect against measles.

    Researchers in the study published in Science noted that the MMR vaccine this year would prevent more than 120,000 measles-related deaths, and also could "avert potentially hundreds of thousands of additional deaths attributable to the last[ing] damage to the immune system."

    Michael Mina, an author of the study published in Science who was a postdoctoral researcher at Harvard Medical School and Brigham and Women's Hospital, told Sun, "The big thing we show here is that even if a child gets through measles—and you have to be lucky to get through the measles infection—you're setting your kid up to be at increased risk to all these other infectious diseases that they could encounter on any given day."

    And Elledge told the Los Angeles Times' Melissa Healy, "We know how to prevent injuries in car accidents—by wearing seatbelts. The [MMR] vaccine is like a seat belt for your immune system, and parents should buckle their kids up."

    On the global scale, experts have recommended that governments make encouraging and facilitating MMR vaccination a high priority. Noting that the vaccine is low-cost, Robin Nandy, chief of immunizations at Unicef, last month said, "The cost of vaccines is nothing compared to the cost of treatment if you end up in [the] hospital with measles and complications."

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