I’ve had some people not as interested as me ask why I am so rustled by this book. It’s because in 2005, Australia came the closest it’s ever been to eliminating this dreadful disease. We had 10 notified cases of measles in 2005. 10! In a country which at that time had a population of 20 million! That equates to 0.5 cases per 1 million people.
A fantastic result which was undone by an endemic outbreak in 2006, of which more than 50% of cases (54% to be exact) were the result of a unvaccinated person having gone overseas, bringing the disease back.
The 2002 measles serosurvey conducted by the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases (NCIRS) estimated that 94% of the Australian population was immune to measles.
94% of the population! We were almost there!! Measles is theoretically one of the few viruses we can wipe out completely, why? Well because the measles vaccine is one of our most effective vaccines, protecting 98% of recipients for life. Humans are the only reservoir for the virus – it does not live in, or get carried by animals. Once you eliminate enough reservoirs, there is nowhere for it to go. Like smallpox and polio, it disappears – with the exception of a few hot spots overseas.
Why is measles not marvelous? Why would we want to eradicate this disease if we could?
Measles is often a severe disease, frequently complicated by ear infections, pneumonia and diarrhoea. More concerning is that the possibility that the measles infection may lead to acute encephalitis. This is an inflammation of the brain, which can leave permanent damage or lead to death. Acute encephalitis occurs in 1 per 1000 cases, and has a mortality (death) rate of 10 to 15%, with 15 to 40% of survivors suffering permanent brain damage.
Even if an infected person recovers, a rare, but deadly late complication of measles called subacute sclerosing panencephalitis (SSPE) may occur years after the infection (average 7 years). SSPE causes progressive brain damage and is always fatal. SSPE occurs in 0.5 to 1 per 100 000 measles cases.
The fact is, measles kills. We have become relatively complacent in Australia for two reasons.
1. Measles almost completely disappeared. Except for an outbreak in 1993-4 which saw 10,000 cases, by 2005 we were down to 10 cases. Nobody my age knows what measles is. Is it one of those mythical diseases like polio that only old people had?
2. Death rates from measles declined rapidly after the introduction of the vaccine, and due to advances in intensive care. Encephalitis is still exceptionally scary, and can still cause permanent brain damage, but our knowledge of intensive care processes has increased dramatically, and medicine is now able to treat victims more effectively.
In 2010, there were 139 300 measles deaths globally
I certainly don’t sniff at 139, 300 deaths and neither should you. Measles kills. And if it doesn’t kill you straight away, there is a chance that you can develop SSPE. An untreatable, horrendous complication that is 100% fatal.
If you want to know more about how we came *this close* to eradicating measles, and what the disease actually is, I’ve got a few links at the bottom.
I award myself 3 rustled jimmies, due to the release of this dumb as hell book and because the ACA Facebook page has made me realise that Australia is full of idiots.