The Measles Is Back But Doctors Don't Know How to Identify It

Thanks to an anti-vaccination movement, the measles is back, and doctors who have come of age in a post-measles United States don’t know how to identify it.

As the Centers for Disease Control noted yesterday, America’s childhood vaccination program has been extremely effective, saving upwards of 700,000 lives over the two decades since its implementation. It was so successful at controlling the measles, in fact, that the CDC declared the disease essentially “eradicated” in 2000. In the "post-elimination" era there have been been an average of about 60 cases of measles a year—a huge step down down from the 500,000 cases of American measles each year of the pre-vaccine era. But, a new paper published in the journal Annals of Internal Medicine notes that the number of measles cases is “steadily increasing” due to parents who refuse to vaccinate their children.

“As more parents decline to vaccinate their children, measles incidence is increasing—a fact that alarms me both as a hospital epidemiologist and as a parent of a vulnerable infant too young to receive the measles vaccine,” Julia Sammons of the University of Pennsylvania’s Perelman School of Medicine, wrote in the paper. “Since 2010, there has been an average of 155 cases per year. In 2014, 106 measles cases have been reported in the first three months alone.”

Sammons notes that most practicing clinicians have no real-world experience identifying and treating measles, which can lead to misdiagnosis and, ultimately, makes the disease much more dangerous. The CDC estimates that between 1 and 3 people per 1,000 who contract the disease will die, though severe complications are more common.

The disease is one of the most contagious ever discovered, which is why vaccination is so important. Sammons notes that most recent measles cases have been caused by an unvaccinated person who lives in another country, but that the disease quickly spreads through unvaccinated communities. According to the CDC, 82 percent of cases in 2013 showed up in unvaccinated people (and an additional 9 percent came in people who didn’t know their vaccination status).

“Because of the success of the measles vaccine, many clinicians have never seen measles and may not be able to recognize its features. It is crucial that providers become familiar with this deadly disease and apply the necessary control measures to contain it,” Sammons wrote.

Those who contract the disease often show signs of a rash, red eyes, a fever, and bumps on the inner lip.

Sammons also wrote that doctors need to do a better job of changing the minds of anti-vaxxers. If they don’t, the CDC might have to take the measles off the “eradicated” list sooner rather than later.