Courtesy of CDC Vaccination is the best protection against contracting measles, pediatricians say.

Measles is on the rise in Michigan and nationwide. So what? Measles isn’t that big a deal, is it?

“Measles is one of the most infectious diseases on earth,” says Dr. Rajanee Sripaipan, a pediatrician at the Upper Great Lakes Family Health Center. “A single person infected with measles can potentially infect 12-18 additional people, and the disease can lead to severe complication and death.”

Before an effective vaccine arrived in 1963, measles was epidemic. It was a rare child who didn’t catch it. After vaccination become standard medical practice, cases dropped dramatically, and by the year 2000, the Centers for Disease Control and Prevention (CDC) declared measles eradicated in the U.S.

Then many parents stopped vaccinating their children against measles, and cases began to increase. Some parents stopped because they heard that measles had been eradicated, so they thought it was no longer a threat. Others were afraid of vaccine side effects, or they simply opposed vaccination altogether. COVID also played a role. The CDC estimates that more than 61 million vaccinations were postponed or missed from 2020-2022.

Then people started traveling again, and travelers started bringing measles back from other countries. In fact, the first reported case in the U.S. after the pandemic was traced to an unvaccinated international traveler. Pockets of unvaccinated children started catching and spreading the disease.

Now measles is threatening to become an epidemic again. Outbreaks have been increasing since 2010. In 2019, more than 1,200 cases were reported nationwide, according to the American Academy of Pediatrics. By the end of February this year, 41 confirmed cases of measles had shown up in 16 states, including Michigan. The actual number is undoubtedly higher, since many cases are never reported.

Lowest Vaccination Rate

Michigan has the lowest immunization rate in the country, Sripaipan says, and Houghton County is among the lowest in the state. Houghton County’s rate of unvaccinated children is four and half times the national average, according to Dr. Robert Van Howe, medical director of the Western Upper Peninsula Health Department.

There are clusters of unvaccinated children in Houghton County, so measles would spread rapidly here, says Van Howe.

Measles infection is rife with dangers. Although most children come through it unscathed, some go on to develop complications. The most common complications are diarrhea, a middle-ear infection that can cause hearing loss, pneumonia and infection of the upper airway that can cause trouble breathing. Rarer complications include encephalitis–a serious brain infection that causes swelling and brain damage–and subacute sclerosing panencephalitis (SSPE), a rare but fatal condition that affects the central nervous system and can cause seizures, blindness, jerking movements, memory loss, changes in behavior and death, according to the National Institute of Neurological Diseases and Stroke.

Sripaipan has seen some of those cases. “Some children were very sick, with a fever as high as 105 degrees Fahrenheit, malaise, runny nose, cough, conjunctivitis and Koplik spots.” Koplik spots are small white or grey specks on the buccal mucosa, the soft, wet mucus membrane that covers the inside of the mouth.

“I saw a patient with SSPE when I was a third-year resident in pediatric neurology at Children Hospital of Michigan,” Sripaipan recalls. “She had all the characteristics of SSPE and a confirmed diagnosis with very high level of measles antibodies in her blood and spinal fluid. It was very sad to have a patient with this deadly complication.”

The complications can start to show up even before the rash that eventually covers an infected child from head to toe. Symptoms that appear before the rash make accurate diagnosis difficult.

Vaccination is the Answer

So measles is a problem. Vaccination is the solution. “Vaccination is the cornerstone of measles prevention,” says the CDC. “It is a safe, highly effective, and easy way to help keep your family healthy. It is always better to prevent a disease than to treat one after it occurs.”

Dr. Michael Verive, a pediatrician at the Upper Great Lakes Family Health Center in Hancock, urges vaccination, too.

“Since our immunization rates are low, we will have a very large number of children who are at risk for measles if it makes its way to the Upper Peninsula,” he says. “Because measles is very contagious and spread by respiratory droplets, it can rapidly spread, especially since travel restrictions and masking guidelines previously in place for COVID have been eased,” he says.

Vaccination is the most effective way to prevent the spread of measles, Verive goes on to say. “Many people refuse vaccination because they still believe the myth that vaccines cause autism, or that the risk of the vaccine exceeds the benefit,” he says. “However, the history of measles proves the opposite.”

Others believe that “herd immunity” will protect our area. Herd immunity means that as long as a high enough percentage of the population in a given area is immunized, transmission rates remain low.  However, measles requires 95% of the population to be immunized to achieve herd immunity.

“When immunization rates are low, as they are in Houghton County, a single infected patient can cause widespread illness by passing the virus to susceptible individuals,” Verive explains. “Then they get sick and pass it on. Measles can easily spread by this ‘chain reaction’ of infection.”

Two doses of the measles vaccine are recommended for children, one at 12 to 15 months old and the second at 4 to 6 years old. Two doses are 97.5% effective at preventing measles, the CDC says.

“Because of the severe and deadly complications that can happen, it is best to vaccinate your children to prevent sickness with measles and unforeseen deadly complications,” Sripaipan tells her patients’ parents.

The Western U.P. Health Department agrees. “The best protection against infection is vaccination,” says Dr. Robert Van Howe, health department medical director. “It will not only protect you, but it will also help protect your neighbor.”