Article content continued

An earlier, landmark study in the American Journal of Epidemiology by the Center for Disease Control’s Roger Barkin found similar disturbing results of measles’ toll on the disadvantaged. Here race entered the picture because black children were disproportionately victimized, not by the measles virus per se but by poverty. A poor black child and a poor white child had the same high chance of dying from measles, but because white children rarely lived in abject poverty, measles claimed the blacks.



Measles didn’t only discriminate by income — in another study, Barkin found that children with underlying diseases were particularly vulnerable, and that the “majority of this group were physically or mentally retarded, or both.” The realization that measles was selective in whom it killed led Barkin to emphasize that vulnerable populations, rather than the general population, should be targeted for measles vaccination.



In the pre-vaccine era, when the natural measles virus infected the entire population, measles — “typically a benign childhood illness,” as Clinical Pediatrics described it — was welcomed for providing lifetime immunity, thus avoiding dangerous adult infections. In today’s vaccine era, adults have accounted for one quarter to one half of measles cases; most of them involve pneumonia, one-quarter of them hospitalization.



Also importantly, measles during pregnancies have risen dangerously because expectant mothers no longer have lifetime immunity. Today’s vaccinated expectant mothers are at risk because the measles vaccine wanes with time and because it often fails to protect against measles.



A study in Houston of 12 pregnant women and one who had just given birth, all of whom had measles, found one died, seven suffered pneumonia and seven hepatitis, four went through premature labour and one lost her child in a spontaneous abortion. A study of eight measles pregnancies in Japan found three ended in spontaneous abortions or stillbirths while four babies were born with congenital measles; two mothers endured pneumonia and one hemorrhagic shock. A Los Angeles study of 58 such pregnancies found 21 ended prematurely (three induced abortions, five spontaneous abortions and 13 preterm deliveries); 35 of the 58 mothers were hospitalized, 15 contracted pneumonia, and two died.



The danger extends to babies, whose bodies are too immature to receive measles vaccination before age one, making them entirely dependent on antibodies inherited from their mothers. In their first year out of the womb, infants suffer the highest rate of measles infections and the most lasting harm. Yet vaccinated mothers have little antibody to pass on — only about one-quarter as much as mothers protected by natural measles — leaving infants vulnerable three months after birth, according to a study last year in the Journal of Infectious Diseases. HIV-infected children, who may account for most recent measles-related child deaths, also suffer when their mothers have been vaccinated, since HIV further reduces the antibodies they inherit.



Factors such as these increased the death rate for adults and the very young, helping to reverse the decline in deaths seen in previous decades, according to a 2004 study in theJournal of Infectious Disease, authored by researchers at the Centers for Disease Control and Johns Hopkins Bloomberg School of Public Health.



Vaccines for measles have had spotty safety records. Soon after their introduction, the Vital Statistics of the United States began recording deaths from the measles vaccine, along with deaths from other vaccines. By 1970, one of the two original measles vaccines was withdrawn in Canada and the U.S. after causing atypical measles syndrome, a harsh disease triggering high rates of pneumonia. In 1975, the second original vaccine was withdrawn due to 103-degrees-plus fevers, among other severe side effects. Two variants of this vaccine also proved unsatisfactory. A measles vaccine then became part of the combination MMR (measles, mumps, rubella) vaccine in the 1980s, only to be withdrawn in 1990 by Canada and in 1992 by the manufacturer after reports from Canada, the U.S., Sweden and Japan blamed MMR for febrile convulsions, meningitis, deafness and deaths. A second version of MMR, now in widespread use, is believed safe by government officials.