I nev­er thought I would ever write an ar­ti­cle about measles. I haven’t seen a case of measles since 1980, over 45 years ago, when chil­dren were dy­ing like flies from pre­ma­tu­ri­ty and gas­tro and cas­es of measles were com­mon. Re­cent events with vac­ci­na­tion pro­grammes make it like­ly that we may see a case or cas­es soon.

Like me, par­ents have for­got­ten about the dis­ease. Be­fore the vac­cine was first giv­en in 1963, the US would have over 3 mil­lion cas­es with 50,000 hos­pi­tal­i­sa­tions and over 400 deaths an­nu­al­ly. Fright­en­ing.

The measles vac­cine has been an amaz­ing suc­cess.

We did not start our pub­lic health measles vac­cine pro­gramme un­til the 80s and it took the Pae­di­atric So­ci­ety years to per­suade the pub­lic health “ex­perts” in the Min­istry of Health that measles was a ma­jor prob­lem. Be­fore that, the an­swer by these “ex­perts” was that their child had had measles and it was “no big thing.”

There are many sto­ries go­ing around about measles, most of them false. Some par­ents think that be­cause they haven’t heard of a case, the dis­ease no longer ex­ists. That is un­der­stand­able but un­true. In the past, tra­di­tion­al me­dia played up the dis­cred­it­ed find­ings of an Eng­lish doc­tor to false­ly sug­gest that autism was linked to the measles vac­cine. That mis­take caused im­mense harm and even though it was cor­rect­ed, the first re­port of an event al­ways gar­ners more sup­port than the cor­rec­tion.

The im­per­fec­tions of the COVID lock­down ad­vice from pub­lic health ex­perts and their re­peat­ed false claims that the COVID vac­cines pre­vent­ed trans­mis­sion dam­aged con­fi­dence in vac­cines in gen­er­al. Since then, so­cial me­dia has gone bal­lis­tic, with ig­no­rant in­flu­encers giv­ing ad­vice about vac­cines which, com­bined with a num­ber of au­thor­i­tar­i­an cyn­ics in the present Amer­i­can gov­ern­ment, both at the fed­er­al and state lev­el, con­fuse peo­ple even more about vac­cines, es­pe­cial­ly the measles one.

Measles is bad. You re­al­ly do not want your child to get it. A shot at one year age and a boost­er at two years elim­i­nates the pos­si­bil­i­ty of get­ting it al­most com­plete­ly.

It is the most con­ta­gious of dis­eases and is trans­mit­ted through the air, ei­ther in a cough or sneeze or by di­rect con­tact with nasal se­cre­tions or sali­va. A sin­gle in­fect­ed per­son usu­al­ly trans­mits it to an av­er­age of 10 or 12 oth­er un­vac­ci­nat­ed peo­ple.

Un­like the COVID virus, which dies with­in min­utes of be­ing re­leased in­to the en­vi­ron­ment, the measles virus can live in the air of en­closed spaces (doc­tor’s of­fices, restau­rants, air­ports etc), for up to two hours. It is eeri­ly sim­i­lar to the words of Rolfie the tai­lor, in Lord Nel­son’s ca­lyp­so King Liar, of whom it was said, “He’s the bess!” and could make a per­fect suit for a man with­out see­ing him, “Doh show him the man; just show him the cor­ner where the fel­low pass!”

Apart from the very nasty symp­toms, one in every 10 cas­es of measles is com­pli­cat­ed by ear in­fec­tions, which, if not treat­ed of­ten, caus­es hear­ing loss. One in every 100 cas­es is com­pli­cat­ed by pneu­mo­nia, which re­quires hos­pi­tal­i­sa­tion. One in every 1,000 cas­es re­sults in a re­al­ly nasty brain dis­ease, en­cephali­tis, which can re­sult in con­vul­sions and neu­ro­log­i­cal dam­age, blind­ness, paral­y­ses etc. There’s al­so an­oth­er rare but fa­tal neu­ro­log­i­cal dis­ease, sub­a­cute scle­ros­ing pa­nen­cephali­tis, which can oc­cur years lat­er.

Measles can al­so sup­press the im­mune sys­tem for years, re­sult­ing in re­peat­ed vi­ral and bac­te­r­i­al in­fec­tions, which af­fect the growth of the child and can cause se­vere mal­nu­tri­tion. Un­der­nour­ished chil­dren get re­al bad measles, usu­al­ly com­pli­cat­ed by di­ar­rhoea which wors­ens the nu­tri­tion­al sta­tus and it can be­come a mer­ry-go-round of dis­eases.

It’s more se­vere in small chil­dren, un­der five years, im­muno­com­pro­mised adults and preg­nant women. The com­pli­ca­tions of preg­nan­cy are se­ri­ous: mis­car­riage, pre­ma­ture birth, low birth weight and still­birth. For­tu­nate­ly, most women of child-bear­ing age in T&T are im­mu­nised.

The ill­ness it­self starts off with high fever and what looks like a bad cold with a cough and run­ny eyes. Af­ter the usu­al three days of fever, in­stead of the fever de­clin­ing, it gets worse and a rash ap­pears. The child is mis­er­able, ap­a­thet­ic, sick and the usu­al an­ti-fever mea­sures help lit­tle. There’s no oth­er treat­ment. The eyes be­come red and swollen, the nose pours and the cough is con­stant. The rash is heavy and ap­pears first on the face and moves down­wards and out­wards. It itch­es. We used to use a lot of calamine lo­tion for the itch­ing but lit­tle helps and there is noth­ing new to­day. Af­ter three to four days it be­gins to dis­ap­pear. That takes a week. This is a two-week ill­ness and it’s ex­haust­ing for both child and par­ent. It’s not nice and it’s dan­ger­ous.