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What If The Measles Outbreak Was Worldwide?

VO: Ashley Bowman WRITTEN BY: Caitlin Johnson
The Measles outbreak in America has sparked massive debate about vaccines... and whether you should or shouldn't be vaccinated? With more and more people choosing not to vaccinate against Measles with the MMR jab, the disease could be on the brink of making a devastating comeback.

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What if the Measles Outbreak Was Worldwide?

Thanks to increasingly advanced science and medicine, we’ve prevented and almost eradicated various deadly contagions that have historically killed millions of people. But even the best science isn’t foolproof, and outbreaks of old diseases we thought we’d conquered may indicate a backwards step.

This is Unveiled, and today we’re answering the extraordinary question; what if the measles outbreak was worldwide?

In the year 2000, the Centers for Disease Control – the CDC – declared measles was completely eradicated in the United States. Fast forward to 2019, though, and by late April it had already become the worst year for measles outbreaks since 1994. Within four months, the number of measles cases in the US doubled on figures for the whole of 2018, with similar trends seen in Europe. The US has an estimated 2.5 million unvaccinated children, while European countries including Serbia and Ukraine also post extremely high rates of measles infection. In the US, the Pacific Northwestern Measles Outbreak is the worst offender, but there have been reports of other major outbreaks in Rockland County, Brooklyn, and parts of Texas and Arizona.

The main cause of the influx in measles cases is the anti-vaccine movement gaining traction in both Europe and North America, which the World Health Organization listed as one of the top 10 global health threats of 2019. A major catalyst for the movement was a study from 1998 carried out by struck-off and discredited doctor Andrew Wakefield who, from a sample of only 12 people, drew a false link between vaccines and autism. Despite zero scientific evidence for this and Wakefield having his medical license revoked, the study sparked fears in parents and has slowly led to more and more children not getting vital vaccinations as infants.

Since 2001, the number of children under the age of two who aren’t getting the MMR vaccine – which also protects against mumps and rubella – has quadrupled in the US, with similar results in Europe. The measles vaccine is needed to create herd immunity (a widespread resistance across an entire population), with a minimum of 95% of people needing to be vaccinated for it to work.

But, Wakefield’s misguided warning plus fears about vaccines giving other adverse side-effects, especially anaphylactic shock, have spurred many parents to refuse to have them administered. It’s a deadly situation because it puts those who can’t be vaccinated – that is, new-born babies, people with autoimmune disorders, and those who do have adverse reactions to vaccines – at huge risk were they to contract measles. The threat levels even for those who are vaccinated have also increased. And, while the effectiveness of the jab is as high as 97%, the contagion is still unpleasant and highly infectious.

But there have been various versions of the jab, and immunity wanes over time. Those vaccinated before 1989 – going back to the original vaccine’s introduced in 1963 – are encouraged to seek medical advice about being re-vaccinated. Second vaccinations may be a key first step in curbing a worldwide outbreak, serving to essentially ‘top up’ our herd immunity. In fact, even those who got the jab after 1989 should double-check with their doctor that they’re up to date.

Regardless, measles remains a deadly and very common threat in developing countries, particularly across Asia and Africa. Even in a world where vaccines are available, it’s estimated that roughly 20 million people contract measles every year, and around 100,000 of them die, primarily unvaccinated children. In the case of a global contagion, unfortunately it’d be young children and babies at the highest risk. Even when measles sufferers survive it can lead to other serious and equally fatal conditions like pneumonia and meningitis. In a worldwide catastrophe, we’d see general disease and sickness on the rise and infant mortality rates skyrocketing to levels comparable to before modern medicine.

We only need to glance at deadly past cases to see what an outbreak in the future could look like. First described in the 9th century by a Persian doctor, measles didn’t affect areas outside of Europe and Asia until the 1500s, when European colonists invaded the Americas. It was just one of many diseases the settlers brought with them, with devastating effects. Upwards of 50% of the Native American population may have been wiped out because of European diseases, and as recently as 1951 a Danish traveller mistakenly brought measles to an isolated settlement in Greenland. The result was a 99.9% infection rate, with only 5 of the 4,262 natives showing no signs of illness. The last major measles outbreak in the Americas was in 1997 in Sao Paulo, where there were 42,000 recorded cases. But, it’s feared that similarly severe outbreaks could be close for as long as the number of unvaccinated children continues to rise.

Quarantines are usually the first method employed when trying to contain any contagion. For example, in a 2007 measles outbreak in Tokyo, schools and colleges were closed to avoid it spreading. If the problem in the US worsens, then screening methods could soon be put in place to at least try and control it. In April 2019, in Rockland Country New York, unvaccinated children were barred from public spaces. It’s also been suggested that unvaccinated kids shouldn’t attend school, while in some countries there are already various jobs where vaccinations are compulsory for all workers.

In a worst-case scenario, we’d also see strict regulations when crossing borders between countries, as every airport in the world vets for vaccines. But, there are ongoing ethical concerns here as well, as we could then see a world where unvaccinated children are forced into isolation. Mandatory vaccines are common in lots of European countries, but efforts to force parents in the US into vaccinating their sons and daughters haven’t always been well-received - with claims it would violate personal freedom.

Regardless, mandatory jabs have proven to work well as a short-term solution to other epidemics - ensuring a lot of people are immunised quickly. So, it could simply become a law and order matter, with governments enforcing vaccinations - no exemptions, no opting out. It’d be another controversial move, made in an increasingly tense and active situation.

No matter how fast or firm the response was, though, should measles become a global epidemic, it would result in hundreds-of-thousands possibly millions of people dying. The 100,000 deaths a year current figure would quickly spike upwards, not least because the doctors and nurses striving to stop the outbreak could be most at risk of an incredibly infectious condition. With hospitals turning into hotbeds, even the best medical care could fall short, because the unsettling reality is that measles doesn’t have a standard ‘cure’. Much like the various strains of the ‘common cold’, the body needs to fight it off for itself. Which is why the anti-vax movement is so dangerous, because that’s so much harder to do if you aren’t immunized.

A measles outbreak would be a huge backwards step away from so many medical advancements made over centuries. It’d be history repeating itself in terms of human suffering, only this time it’d be in-part the consequence of a choice not to vaccinate. Perhaps, in the long-term, it’d convince people to once again trust the MMR jab. But, not before some very dark times. And that’s what would happen if the measles outbreak was worldwide.

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