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Sunday, 10th of January 2010 Print

         CSU 04/2010: MEASLES IN 1845, MEASLES IN 1964, MEASLES TODAY


Good reading.







In 19th century America, measles was cosmopolitan in its distribution and, especially in remote areas, struck  adolescents and even adults. The Civil War, 1861-1865, chronicles measles outbreaks in both the Union and the Confederate forces.


Mark Twain tells in Chapter 16 of his Autobiography about the outbreak which struck Hannibal, Missouri in his  youth. The following extract is from the edition published by Harper Perennial Books. Notice the author’s efforts to ‘catch the  measles and be done with it,’ presaging the 20th century ‘measles parties,’ where the neighbors of the infected  children visited them to contract the disease and thereby acquire lifetime immunity.


 Measles parties are a thing of the past, but they persisted into the 1950s.


The then medical practice of heating the patient, especially in summer, is quite contrary to the present practice of applying wet cloths and towels to bring down the fever.


‘In 1845, when I was ten years old, there was an epidemic of measles in the town and it made a most alarming  slaughter among the little people. There was a funeral almost every day and the mothers of the town were  nearly demented with fright. My mother was greatly troubled. . . .Will Bowen was dangerously ill with the  measles and I thought I would go down there and catch them. I entered the house by the front way and slipped  along through rooms and halls, keeping sharp watch against discovery, and at last I reached Will’s bedroom in  the rear of the house on the second floor and go into it uncaptured. . . When I heard his mother coming I  covered up my head, but that was a failure. Mrs. Bowen snatched me out of that bed and conducted me home  herself, with a grip on my collar which she never loosened until she delivered me into my mother’s hands along  with her opinion of that kind of boy.


‘It was a good case of measles that resulted. It brought me within a shade of death’s door.  It brought me to the  point where I no longer felt any interest in anything, but, on the contrary, felt a total absence of interest – which  was most placid and tranquil and sweet and delightful and enchanting. I have never enjoyed anything more in  my life than I enjoyed dying that time. I was, in effect, dying. The word had been passed and the family  notified to assemble around the bed and see me off. I knew them all. There was no doubtfulness in my vision.  They were all crying, but that did not affect me. I took but the vaguest interest in it and that merely because I  was the center of this emotional attention and was gratified by and vain of it.


‘When Doctor Cunningham made up his mind that nothing more could be done for me he put bags of hot ashes  all over me. He put them on my breast, on my wrists, on my ankles; and so, very much to his astonishment, --  and doubtless to my regret – he dragged me back into this world and set me going again.’  




Writing in 1964, David Morley and colleagues reviewed the disease burden of measles in a

Nigerian village and the prospects for measles vaccination. licensed two years before. In the early years, the vaccine was given with immune globulin, a practice now decades out of date.


Authors’ abstract:


 Measles and measles vaccination in an African village*


Over the last five years, a number of reports have appeared drawing attention to the serious results of measles in young West African children. This is borne out by observations over a three-year period on children in the village of Imesi, which showed measles to be a severe and often fatal disease. The original live attenuated measles vaccine developed by Enders has been shown to give good protection and, in combination with immune serum, has been widely used in the USA. However, the need to combine it with immune serum severely limits its usefulness, owing to the small quantities of serum available and the high cost. In the present study, the reaction produced by the original vaccine with immune serum was compared with the reaction produced by a further attenuated vaccine without serum. The latter gave significantly fewer and less severe reactions, but produced a satisfactory serological response. This new vaccine should facilitate large-scale immunization of children in areas such as West Africa where protection against measles is urgently required 


Full text at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2554995/?tool=pubmed





Full text, with graphics, at http://www1.voanews.com/english/news/health/Global-Measles-Deaths-Drop-Dramatically--78555137.html


Global Measles Deaths Drop Dramatically

A new study by the Measles Initiative, a coalition of U.N. and international organizations finds measles deaths worldwide fell by 78 percent between 2000 and 2008.

Lisa Schlein, Voice of America | Geneva 04 December 2009

 A new study by the Measles Initiative, a coalition of U.N. and international organizations finds measles deaths worldwide fell by 78 percent between 2000 and 2008.  But, the agencies warn of a resurgence in measles deaths if vaccination efforts are not sustained. 

The study finds measles deaths dropped from an estimated 733,000 in 2000 to 164,000 in 2008.  It says all regions, with the exception of South-East Asia, have achieved the United Nations goal of cutting measles deaths two years ahead of target.

One of the biggest success stories is found in Africa, where measles-related deaths have declined by 92 percent since 2000. 

Jean-Marie Okwo-Bele is Director of Immunization, Vaccines and Biologicals at the World Health Organization.  He says the measles vaccine has saved about 4.3 million children's lives in less than a decade.

Despite this rapid progress, he warns the momentum in the worldwide vaccination drive appears to be stalling, putting children's lives at risks.  He notes global measles deaths leveled off in 2007. 

"And, if this trend is not reversed, our projection shows that the combined effects of decreasing political and financial commitment from national governments and donors could result in an estimated 1.7 million measles-related deaths between 2010 and 2013, with more than half a million deaths in 2013 alone," he said.  

Measles is among the world's most contagious diseases and one of the leading causes of death among children worldwide.  The Measles Initiative notes even healthy and well-nourished children, if unvaccinated, are at risk of the disease and its severe health complications.  These include pneumonia, diarrhea, and encephalitis.

Executive-Director of the U.N. Children's Fund, Ann Veneman, says of the estimated 164,000 measles related deaths in 2008, 90 percent were among children under five.

"Much remains to be done.  Measles still kills more than 400 children every day," she said. "This is an unacceptable reality when a safe, effective and inexpensive vaccine to prevent the disease exists and the poorest children continue to pay the highest price in terms of lives and opportunities lost." 

Walter Orenstein is Deputy Director for Vaccine-Preventable Diseases at the Bill and Melinda Gates Foundation.  He applauds the success, which has been achieved and says it is important not to slip back.

"Each day children are born and if they are not immunized as recommended, they accumulate in the population to the point that they can fuel a major resurgence of disease," he said. "That would certainly be a tragedy for children and families and for all those countries that have come so far." 

The Measles Initiative says countries must continue follow-up vaccination campaigns every two to four years to eliminate the risk of resurgence.  It says this must be done until their healthcare systems can provide two doses of measles vaccination to all children and provide treatment for the disease.  The agencies say they need $59 million to achieve this goal.