Measles is one of the most contagious infectious diseases known to science – more contagious than Ebola, smallpox or COVID-19. Declining vaccination rates over the past few years, plus a recent outbreak in West Texas, have public health experts concerned. Here's what to know about the science of this virus — plus how to protect against it. For the latest, host Regina G. Barber talks to NPR health correspondent Maria Godoy.Interested in other stories about public health? Tell us what you want to hear about by emailing [email protected]!Listen to every episode of Short Wave sponsor-free and support our work at NPR by signing up for Short Wave+ at plus.npr.org/shortwave.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy
Chapter 1: What is causing the recent measles outbreak?
Like I've heard of cases as far away as Alaska, Pennsylvania and Kentucky.
Chapter 2: How are cases of measles spreading across the U.S.?
Although just to clarify, Gina, those cases have been tied to international travel and not to the Texas outbreak.
Right. And you're here to help us like make sense of all this. Hey, Maria. Hi, Regina. You're a health and science correspondent for NPR. So I know you've been keeping track of all of this, including the nuances between these like individual cases versus the outbreak in Texas. So what is the difference there?
So every year, the U.S. reports cases of measles. Even though the disease was declared eliminated here in 2000, that just means there wasn't sustained transmission in the country for at least a 12-month period. But, you know, measles is still a big problem globally. So an unvaccinated person or child who travels to a country where measles is spreading can bring the virus back home.
You mentioned Alaska. That was a case where an unvaccinated adult had traveled abroad. And there were also cases in Maryland and Kentucky involving people who were returning from international travel.
So reports from a bunch of places around the U.S., but an outbreak is different, right?
Right. So that's when the virus starts spreading locally, like it's doing now in West Texas and just over the border in New Mexico. And that's what concerns public health officials right now. The outbreak is still pretty much spreading in very remote rural areas where vaccination rates are low. But measles is highly contagious.
So if an infected person travels to another community with low vaccination rates, they could potentially seed another outbreak there.
So today on the show, what you need to know about measles. We're covering the signs and symptoms of this illness, the ways officials are working to stop it from spreading, and what you need to know to stay safe. I'm Regina Barber. And I'm Maria Godoy. You're listening to Shortwave, the science podcast from NPR.
I'm Tanya Mosley, co-host of Fresh Air. At a time of sound bites and short attention spans, our show is all about the deep dive. We do long-form interviews with people behind the best in film, books, TV, music, and journalism. Here our guests open up about their process and their lives in ways you've never heard before. Listen to the Fresh Air podcast from NPR and WHYY.
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Chapter 3: What are the key symptoms of measles?
Well, so measles is airborne, right? So you walk into a room, you cough, you know, you talk, you spread infectious particles. They hang there in the air for up to two hours. You leave the room. Somebody else comes in. They're not vaccinated. An hour later, they could get infected. And when we say it's highly contagious, it's probably the most contagious infectious disease known to mankind.
Like more contagious than Ebola, more contagious than polio, more contagious than chickenpox. Wow. It's so contagious. I think this is really worth hammering home. In an unvaccinated world, every person infected with measles on average would go on to infect as many as 18 other people. Wow.
Yeah.
And just for context, when COVID first appeared, the estimate is that for every person infected with COVID, they went on to infect roughly three other people. And we saw how COVID spread. So yeah, it's highly, highly contagious.
Wow. So how do we usually keep it from spreading then?
vaccination. That is the key, right? The measles vaccine is super effective. So one dose is 93% effective, which means 93% of people will have an immune response. Two doses is 97% effective. And you really need that because the estimates are that you need about 95% of people in a community affected to stop outbreaks from occurring, right? You need high vaccination rates.
Once you have an outbreak, you want to go and vaccinate anyone around who is not vaccinated. And then you also need good contact tracing, which means you need the people to be figuring out who was exposed and contacting them right away before they go and expose others and spread this.
I mean, I think many of us have heard that some parents are concerned that the vaccine is more dangerous than the virus. Like, what do doctors say to that?
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Chapter 4: How contagious is measles compared to other diseases?
The vaccine is... Mm-hmm. But it used to kill 400 to 500 people every year in this country. And even today, measles can have serious consequences. As many as 1 in 20 cases result in pneumonia. 1 in 1,000 kids will die or end up with severe brain swelling called encephalitis. And it can also lead to blindness.
This sounds horrifying. And I know from the news that there's been two recent deaths, an unvaccinated child and an unvaccinated adult. But Maria, since we're talking about these like long-term effects, I've heard that measles can basically wipe out your immune system's memory. Is that right?
Correct. So this is something that happens to some extent in every single measles infection. I talked to Stephen Elledge. He's a researcher at Harvard. And he explained that it's kind of like your immune system gets amnesia.
Not only does your brain have a memory, but your immune system has a memory of all the pathogens it's encountered in the past.
Basically what happens is the measles virus can destroy the cells that retain the memory of how to fight pathogens that your body has previously defeated.
And the more severe your case of measles is, the longer it lasts, the more of your immune system is destroyed.
And this amnesia, like the extent of it can vary widely. His studies of unvaccinated kids who were recovered from measles found that anywhere from like 11 to 73 percent of their antibodies had been wiped out after an infection. Wow. And this effect can last two to three years.
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Chapter 5: What vaccination strategies are effective against measles?
Right. So like how worried should people be about this ongoing outbreak?
Yeah, at this point, there's really no need to panic. Vaccination rates are still high enough in most of the country to stop a major deadly outbreak from spreading widely.
But if vaccination rates continue to fall as they have been for several years now, experts I've spoken with say in 5 to 10 years, we could be back to the days where measles outbreaks regularly infected thousands of people and killed kids every year. Yeah.
How is the federal government responding to this outbreak specifically? Like what are officials recommending people do?
It depends on which officials you're talking about. The CDC issued an alert recently in response to the measles outbreak urging people who aren't vaccinated to get vaccinated, especially if you're traveling abroad. And that includes any baby six months and older. And by the way, I should note it's traveling abroad anywhere.
But when we're talking about Robert F. Kennedy Jr., the head of the Health and Human Services Department, his messaging is a little bit more mixed. He wrote an editorial earlier this month that's gotten a lot of attention. He did say that, you know, vaccines are an important tool to keep children safe and create community immunity to protect everyone.
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Chapter 6: What are the common misconceptions about the measles vaccine?
But he also kind of focused on some other things that left some public health experts, actually, that left every public health expert I've spoken with puzzled. One of the things he said was that good nutrition is the best defense against infectious diseases. That's puzzling because the best defense against measles is vaccination. That's what stops an outbreak. That's what stops the infection.
And, you know, Kennedy called vaccination a personal choice. He didn't outright say, go get vaccinated. Right. And the other thing is RFK Jr. spent a lot of time talking about treatments like vitamin A. Yeah, what's with vitamin A? Well, okay, so the vitamin A does have a role in the treatment of measles.
Both the World Health Organization and the American Academy of Pediatrics recommend supplementation with two doses of vitamin A for kids who have measles. That's because there are studies done in low and middle income communities countries several decades ago now that found that when kids are malnourished and are vitamin A deficient, they can have worse outcomes, right?
So vitamin A supplementation can decrease the risk of death and severe disease with measles. There's also some evidence that even if you're not vitamin A deficient beforehand, measles seems to deplete your vitamin A stores. But here's the thing. Vitamin A cannot prevent measles. That's a piece of misinformation that anti-vaccine
promoters have been circulating for years and it's still out there on social media. Okay. Some of these people wrongly promote the idea that if you give your kids vitamin A supplementation for a long period of time, that can protect them from measles.
Like you can forego the vaccine, which is not true.
Exactly. Exactly. And it's actually dangerous potentially because vitamin A builds up in your body and it can be toxic to the liver. So how can people then protect themselves? Get vaccinated if you haven't been already and get your kids vaccinated.
You know, parents can talk to their pediatricians about getting younger kids vaccinated early if they're traveling abroad or if they live in an outbreak area. I've talked to doctors in New Mexico and in all parts of the U.S., actually, who are seeing vaccine enthusiasm, you know, where people are are asking, can I get the shot early for my kid, please?
Because they're taking this outbreak seriously. If you are an adult who was born after 1957 and were vaccinated before 1968, you may want to get revaccinated. Early versions of the measles vaccine weren't as effective. And, you know, if you're not sure about your vaccination status, you can check your records.
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