Measles Parties” Are a Myth

Anti­vac­cine pro­pa­gan­da has been spread­ing. As a result, so has the measles. Anti­vac­cine zealots are not wor­ried by measles out­breaks. Instead, they want even more peo­ple to catch the measles. These anti­vaxxers believe that measles is a harm­less dis­ease that boosts the immune sys­tem. (In real­i­ty, measles is dan­ger­ous main­ly because it dam­ages the immune sys­tem.) Late­ly, anti­vaxxers have been spread­ing the myth that in the old days, par­ents would send their chil­dren to “measles par­ties” at the home of a measles patient. In real­i­ty, some­one from the local board of health would post a quar­an­tine sign on the patient’s home, to pre­vent any “measles par­ty” from tak­ing place.

Measles Quarantine

Measles quarantine sign

A 1941 measles quar­an­tine sign from Clifton Heights, Penn­syl­va­nia warned that no one but a doc­tor or nurse was per­mit­ted to enter or leave the house or take any­thing from the house with­out writ­ten per­mis­sion from the Board of Health. Any­one who broke that rule or tam­pered with the sign could be fined up to $100 (which was a lot of mon­ey back then) or jailed for up to 30 days. For this rea­son, “measles par­ties” would have been rare, if they occurred at all.

My Mother’s Measles

My moth­er got measles as a kinder­garten­er in Penn­syl­va­nia in the 1940s. She does not remem­ber the measles quar­an­tine sign on her apart­ment; but she was very sick by the time the measles was diag­nosed, and she had not yet learned to read. She does remem­ber the quar­an­tine sign from chick­en­pox, which she got a few years lat­er. While she was sick, none of her friends were allowed to vis­it. A cousin vis­it­ed before it was clear that my moth­er had measles. This cousin then got the measles.  My moth­er also remem­bers being ter­ri­bly sick from the measles. While she had the measles, her bed­room was kept very dark to pro­tect her eyes. Her par­ents knew that measles could cause blind­ness.

Why Is Measles So Contagious?

Unfor­tu­nate­ly, quar­an­tine is not enough to pre­vent the spread of measles. That’s because at first, a case of measles looks and feels exact­ly like a com­mon cold. It makes the per­son cough. Each cough pro­duces a spray of droplets that can car­ry the virus to oth­er peo­ple. You could catch the measles from sim­ply being in a room where an infect­ed per­son had coughed two hours ear­li­er. Measles is con­ta­gious for about four days before the rash appears and the diag­no­sis of measles becomes obvi­ous. So even though measles patients were quar­an­tined, they were often quar­an­tined too late to keep the dis­ease from spread­ing. For this rea­son, near­ly every­one who was born before 1957 even­tu­al­ly got the measles.

Measles Damages the Immune System

An ordi­nary cold runs its course in about a week, as the immune sys­tem learns how to make anti­bod­ies to that strain of cold virus. But instead of get­ting bet­ter at that point, some­one with measles starts to get much sick­er. That’s because the measles virus infects some of the cells of the immune sys­tem. Instead of killing the measles virus, many of those cells make many new copies of the virus and then die. In oth­er words, the immune sys­tem is bad­ly dam­aged while it is mak­ing the measles infec­tion worse. The lin­ger­ing effects of this dam­age can last for 2 years.

The Measles Vaccine

I was lucky. As a child in the ear­ly 1960s, I was among the first wave of chil­dren to be vac­ci­nat­ed against measles. One of our neigh­bors got measles just before the vac­cine came out. I remem­ber how relieved my moth­er was that we had not been at that girl’s house while she was con­ta­gious and how grate­ful my moth­er was for the vac­cine. In 1971, the measles vac­cine was com­bined into a triple vac­cine that immu­nizes chil­dren against measles, mumps, and rubel­la (MMR). Thanks to the heavy use of this cheap, effec­tive, and remark­ably safe vac­cine, the Unit­ed States was declared free of measles in 2000. Unfor­tu­nate­ly, measles has not yet been erad­i­cat­ed world­wide, so we still see out­breaks that result from import­ed cas­es.

Controlling Measles Outbreaks

Today, a measles out­break is a pub­lic health emer­gency. Measles may spread like the com­mon cold, but it sup­press­es the immune sys­tem like HIV. For this rea­son, most of the deaths due to measles are due to sec­ondary infec­tions, such as pneu­mo­nia. Even with the best of mod­ern med­ical care, measles kills one or two out of every thou­sand patients. The death rate is much high­er among peo­ple with sup­pressed immu­ni­ty, includ­ing can­cer patients. Up to a quar­ter of those peo­ple may die of measles.

Today, when a measles out­break occurs, pub­lic health author­i­ties race to find and help every­one who may have been exposed. If non­im­mune peo­ple can be found with­in 72 hours of expo­sure to measles, they may be giv­en a dose of the MMR vac­cine. Vac­ci­na­tion dur­ing that time peri­od may pre­vent the dis­ease or at least weak­en it. If an unvac­ci­nat­ed per­son can­not be found with­in 72 hours or is preg­nant, is too young for vac­ci­na­tion, or has a sup­pressed immune sys­tem, they can be giv­en a dose of immune glob­u­lin instead. Immune glob­u­lin is a dose of anti­bod­ies from human blood donors. It can be giv­en up to 6 days after expo­sure. Exposed peo­ple who show signs of ill­ness are quar­an­tined, to keep them from spread­ing the dis­ease to any­one else. Dur­ing a measles out­break, chil­dren who have not been or can­not be vac­ci­nat­ed may be banned from pub­lic school or day care facil­i­ties.

Wipe Out Measles, Don’t Spread It!

So “measles par­ties” are a myth. They would even be a crime. The MMR vac­cine is cheap, and it is safe and effec­tive when used as direct­ed. How­ev­er, it is a “live” vac­cine and thus can­not be giv­en to preg­nant women, infants, or peo­ple with a dam­aged immune sys­tem. To pro­tect them, we need to make sure that prac­ti­cal­ly every­one else is immu­nized. If we vac­ci­nate enough peo­ple world­wide, measles will go extinct. After a vac­cine-pre­ventable dis­ease is erad­i­cat­ed, we will not need to vac­ci­nate any­one else against it. Mean­while, anti­vaxxers pose a seri­ous threat to pub­lic health. They are keep­ing the vac­ci­na­tion rate low enough to allow dis­eases to spread, and they con­gre­gate in com­mu­ni­ties and net­works that make it eas­i­er for dis­eases to spread.