Measles: A Deadly Disease

December 23, 2009 at 8:07 pm (Anti-Vaccination) (, , , , , , , )

Measles is (literally) a deadly-serious disease. The recent outbreak in Zimbabwe is just one example of the dangers of this vaccine-preventable disease.

First, some anecdata:

A MEASLES outbreak continues to wreak havoc in Nyazura’s Nzvimbe area, killing at least 30 people, mostly vulnerable children and women members of Johanne Marange Apostolic Church, who are entrenching their resistance to vital life-saving interventions. [http://www.zimgossip.com/?p=1080]

CHILDREN are dying of measles in a remote part of eastern Zimbabwe, where a religious sect insists on using only holy water to treat the contagious disease. [...]

The families are members of the Johanne Marange Apostolic Church. The church’s leaders do not allow vaccination or allow followers to seek medical treatment. [http://news.scotsman.com/world/Measles-kills-children-of-antivaccination.5929748.jp]

Italy, 2002: 4 deaths, 594 hospitalizations.
California, 1989/90: 75 deaths, 3,390 hospital admissions.
Japan, 2000: 88 deaths.
Germany, 2006: 160 children hospitalized, 3 with brain inflammation.
Ireland, 2000: 3 children dead, 350 hospitalized. [http://layscience.net/node/198]

In the case of the Duisburg outbreak in Germany, measles had a high mortality rate of 1 in 307 as two of the three young people with encephalitis died. The two children who developed encephalitis and died were aged 2 months, and 2 years. The infant was too young for vaccination and would have relied upon herd immunity for protection. [PDF]

Coverage, Incidence, and Deaths

I’ve been looking at the WHO figures for vaccine coverage against measles in the UK and incidence of measles. I also looked again at the HPA figures for incidence and deaths.

First, the WHO data:

In the eight years of the 1980s for which data is available, protection against measles from a vaccine ran from 52% (in 1981) to 84% (1989), and 1989 was the only year in the 80s that saw a figure above 80% – the mean average for vaccine coverage was 66.75%.

The notifications of measles in the 1980s ran from 30,160 in 1989, when coverage was 84%, to 114,948 in 1983 (coverage had not reached 60% in that or the previous two years). The mean average incidence of measles for these eight years was 75,483.

In the nine years for which data is available for the 1990s, coverage was 89-92%. The mean average for vaccine coverage was 91.22%.

The notifications of measles in the 1990s ran from a low of 74 in 1998 to a high of 28,228 in 1990 (1991 was the year in which coverage first reached 90%). The mean average incidence of measles for these nine years was 12,068.

The difference between the 1980s and 1990s in terms of incidence of measles is notable – there were more than six times as many notifications of measles in the 1980s than the 1990s.  As vaccine coverage rose, the number of cases of measles plummeted.

In terms of the seriousness of the disease, it is expected that one in one hundred cases of measles leads to hospitalisation – that would mean we would expect to see around 6,000 people hospitalised during the 1980s when coverage was below 90% and around 1,000 during the 1990s when coverage averaged just over 90%.

We would also expect to see meningitis / encephalitis in one in one thousand cases – equating to roughly 600 people in the 1980s and roughly 100 in the 1990s. That’s quite a difference.

As for deaths – the figures in the “MMR the Facts” PDF suggest a death rate of 1 in 2,500 to 1 in 5,000. This would equate to around 20-40 deaths in the 1990s and around 120-240 deaths in the 1980s.

The figures from the HPA give us a total of 15 deaths in the 1990s and 89 deaths in the 1980s. This is slightly less than the figures I projected using the estimate from the MMR The Facts leaflet, but the ratio is still the same – six times as many people died from measles in the 1980s than in the 1990s.

This should not be a surprise, given that six times as many people contracted measles during the 1980s as compared with the 1990s – but it does help to illustrate (1) why vaccine coverage needs to be around 90% and (2) that measles is no less deadly now than it was in the 1980s when 90 people in this country died from the disease.

In a decade when vaccine coverage is too low:

  • Tens of thousands more people will contract measles and become ill.
  • Thousands more people will be ill enough to be hospitalised.
  • Dozens more people will die.
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31 Comments

  1. Tweets that mention Measles: A Deadly Disease « Stuff And Nonsense -- Topsy.com said,

    [...] This post was mentioned on Twitter by jdc 325, jdc 325. jdc 325 said: Measles: A Deadly Disease: Measles is a deadly-serious disease. Literally. The recent outbreak in Zimbabwe is just … http://bit.ly/5tI9Q6 [...]

  2. jdc325 said,

    The Zimbabwean story was also covered by Becky over at Jabs Loonies.

  3. uberVU - social comments said,

    Social comments and analytics for this post…

    This post was mentioned on Twitter by jdc325: Measles: A Deadly Disease: Measles is a deadly-serious disease. Literally. The recent outbreak in Zimbabwe is just … http://bit.ly/5tI9Q6

  4. Cybertiger said,

    You are a teazel, jdc532!

    http://www.quotesandpoem.com/poems/poeticworks/milne/A._A._Milne_Poetry_Collection_3/3

    The ‘famous physicians’ said,

    “If you teazle
    A sneezle
    Or wheezle,
    A measle
    May easily grow.
    But humour or pleazle
    The wheezle
    Or sneezle,
    The measle
    Will certainly go.”

    Isn’t it odd how the humourous teazles (expert physicians) of today tell us that the wheezle or sneezle and then the measle … will almost certainly turn into mumps … and kill us by the million.

  5. jdc325 said,

    Insightful as ever, Cybertiger.

    Are you really trying to say that doctors are claiming that measles will lead to mumps and kill millions, though? I have to say, that’s something I’ve only ever seen or heard claimed once – in your comment above. What an odd thing to say…

  6. The Truth About Vaccines: Alternative Schedule « Stuff And Nonsense said,

    [...] illness to which we had adapted successfully” – something I would certainly argue with. Measles is no less deadly now than it was in the 1980s when 90 people in this country died from the … Possibly related posts: (automatically [...]

  7. Nash said,

    And how many of those that haven’t died have become deaf?

  8. jdc325 said,

    Comment left on Daily Mail piece about Wakefield:

    In response to Pat Rattigan’s claim that “No child has ever died from mumps or measles”, I would like to point out that measles is a deadly disease. According to the HPA figures, there were 126 deaths in the UK in the 1980s that were due to measles. There have been at least five deaths from measles in the UK since 2000. People do still die from measles, whatever you choose to believe.

    There is also the Duisburg outbreak in Germany in 2006 where two children died. One was an infant too young to have received the vaccine and would have relied on herd immunity. Italy, California, Japan, and Ireland have also seen outbreaks of the disease in recent years. On each occasion, there were deaths reported due to measles infection and in Nyazura’s Nzvimbe area (in a remote part of eastern Zimbabwe) it was reported that members of a church that does not allow vaccination or medical treatment were dying following a measles outbreak.

    Link.

    Note: I refer to the total deaths from measles in the 1980s as 126 in my comment in the Mail. The 89 deaths in my blog post refers to the deaths in the 1980s in the years for which vaccine coverage data are available.

  9. Cybertiger said,

    jdc532: have you nothing to say about the MailOnline article you refer to?

    Did you read Andrew Wakefield’s quoted words in the last paragraph?

    “What has happened to me has taught other scientists that it’s safer never to rock the boat. Doctors are scared to speak for fear that what happened to me may happen to them. And that can’t be good for science.”

    Are you interested in real knowledge, real facts … or only the manufactured stuff? Are you interested the truth? Are you a dupe, jdc352? Are you interested in what’s good for science … or only in ‘bad science’?

  10. jdc325 said,

    Andrew Wakefield is up before the GMC because of ethical concerns. He failed to obtain ethical committee approval for the work, obtained funding for it improperly, and subjected children to “unnecessary and invasive investigations”. He is not being persecuted for making an inconvenient discovery, but is being investigated for unethical behaviour.

    I am interested in the truth and I don’t believe that doctors (or anyone) should be afraid to voice their fears. I don’t believe, though, that doctors or scientists have cause for concern over speaking out.

  11. Cybertiger said,

    How sweet! jdc523: you’re really one of life’s innocents, a cute, naive little bunny, a sweet, innocent, teeny-weeny-wabbit. Aaah …

  12. Cybertiger said,

    As for Pat Rattigan: isn’t it curious how the very first comment the Mail posts is patently absurd … and absolutely nothing to do with the article? You ‘ave to larf. And then you get the likes of jdc352 in reply … and you ‘ave to blubber and scream … all at the same time. jdc325: you’re worse than any attack of measles could ever be. But ever so cute … aaaahhhhh, arrhhhh.

  13. Cybertiger said,

    jdc532 pathetically uttered,

    “I am interested in the truth and I don’t believe that doctors (or anyone) should be afraid to voice their fears. I don’t believe, though, that doctors or scientists have cause for concern over speaking out.”

    Perhaps jdc325 hadn’t read this piece in the Guardian of May 2009 (reproduced in the Socio-Economics History blog) on Merck’s ‘hit list’ of doctors.

    http://socioecohistory.wordpress.com/2009/05/12/mercks-hit-list-of-doctors/

    “We may need to seek them out and destroy them where they live,” said one email, from a Merck employee.”

    And Andrew Wakefield told Sally Beck of the Mail,

    “They cut me off at the knees and hoped that I would bleed to death.”

    Remember what Andrew Wakefield – and Professors Walker-Smith and Murch – have been put through. Go back now and read that article and then tell me that doctors or scientists have nothing to fear … about voicing their fears.

  14. draust said,

    Sally Beck, of course, is a long time fan of Saint Andy and is – like ShabbyTabby – convinced this is a story of A Dark Conspiracy To Hide The Truth.

    The alternative, of course, would be that it was a tale of shoddy and partial research, clouded by ambition, greed and conflict of interest, finessed into the Lancet by the Old Boy Network and various people’s desire for a “splash”, and over-sold to a credulous and sensation-hungry media. And then relentlessly fed and periodically stoked up, over a period of years, by a pack of credulous medically- and scientifically-ignorant journalists… many of whom wanted a Dark Conspiracy Story and were bloody well determined to have one, evidence be damned.

    This latter version is supported by all the scientific and clinical work that has come out since which has dismantled every last one of Wakefield’s supposed findings. To say nothing of Brian Deer’s digging into the “back story” of how the original Lancet paper came to pass.

    And in this version Wakefield “persecution” is simply what happens to scientists once they are shown to have been so shoddy in their work that nothing that comes out of their lab can be believed – see also JAc.

    But of course…. what is all that against the Unshakeable Faith of Saint Andy’s groupies… and the Conspiracy Mania of assorted anti-vaccine nuts, Contrarians and Celebs?

    As Bob Park said,

    “It is not enough to wear the mantle of Galileo: that you be persecuted by an unkind establishment. You must also be right.”

  15. draust said,

    Oops – the missing sentence at the end of the 4th para was meant to read “…see also Jacques Benveniste”

  16. draust said,

    Interested to see that the Daily Fail article still has only 4 comments, which has been the case since lunchtime, if not earlier.

    BTW, for more on Sally Beck, and some of the other Conspiracy! type journalists who have written about MMR, try here.

  17. Cybertiger said,

    What’s all this conspiracy twaddle, Herr Dreary? Yet another silly series of splenetic e-pistles from Dr Drippy Draust [1]. How do you know Wakefield’s wrong? You know good science from bad, any more than you can tell right from wrong? You’re ‘avin a larf! [2]

    Admin: I have removed abuse directed at other commenters. Any more abuse and I will start to disemvowel offensive comments. Please do not abuse other commenters.

  18. draust said,

    Hello Shabby. Thought you’d be back.

    “You know good science from bad?”

    Well, yes, actually, on a good day – since that is one of my jobs. You know, doing science, running a lab, interpreting experiments, referee-ing papers and grants, working with people in the clinical medical departments – that kind of stuff.

    Specifically regarding your hero’s work, the shoddiness of the molecular biology in the Wakefield lab and at Unigenetics, as comprehensively laid out in Steve Bustin’s testimony to the Autism Omnibus, would be instantly recognisable as “ineptitude” – or bad science, if you prefer – to anyone who knows anything about PCR, or has ever done any. Even to me, for instance. Same with not testing properly for false positives in the early PCR work by sequencing the PCR products. And the stuff about deep-sixing Nick Chadwick’s data that didn’t fit the measles-in-the-gut hypothesis speaks for itself.

    The other point is that anyone who can read with a modicum of understanding can see the red flags.They are all over the scientific and medical literature. The problems with likely biases in the patient selection were pointed out in the issue of the Lancet right after the paper. Or take the purportedly “pathological” endoscopy findings that all turned out to be normal, as judged by experts who knew more about paediatric GI endoscopy than AW. You don’t need an advanced degree to find that out, just to be able to read the abstracts of the reviews, or see the authors talking about them in Brian Deer’s TV programmes. Ditto the evidence from the Autism Omnibus testimony that for pretty much every molecular method relating to measles virus the Wakefield lab did, the labs that had worked out the methods reckoned the Wakefield crew couldn’t do them properly.

    It all adds up to a rather convincing story of shoddy science. The politest thing you could say would be “data torturing, telescope to the blind eye and a ton of wishful thinking”. Most people in science and medicine are far harsher that that in their verdict.

  19. Cybertiger said,

    Herr Draust: as might be expected of a Goldacre groupie, you’re a totally unconvincing toad. Even a kiss from Frau Draust would be unlikely to turn you into a prince of science – or a prince of anything else for that matter.

  20. Becky said,

    So, Dr Struthers – could you point out exactly where Dr Aust has got it wrong? (I will take another load of waffle, abuse and nonsensical rantings as meaning “no – I can’t find any flaws in his last post”).

    Kind regards,

    Becky

  21. Neuroskeptic said,

    “So, Dr Struthers – could you point out exactly where Dr Aust has got it wrong?”

    I’ll answer for him – No, and I’m probably not actually a doctor, because I’ve never provided any proof despite Neuroskeptic’s repeated requests and offers to eat his hat if I can prove that I am.

  22. jdc325 said,

    Thanks for the comments all.

    Note: I have started editing the more abusive posts on my blog as I do not want to see other commenters being abused. Can we all please try to keep this discussion civil?

  23. Becky said,

    @Neuroskeptic

    Well – unless he’s stolen an identity (and if he has, he’s picked a really bad one) – he is, or at least *was* a doctor:

    http://www.bedfordshire-news.co.uk/bedsonsunday-news/DisplayArticle.asp?ID=419702

    Sacked now though. Couldn’t have happened to a nicer bloke.

    http://jabsloonies.blogspot.com/2009/07/cybertiger-loses-appeal-drinks-all.html

    Kind regards,

    Becky

  24. Cybertiger said,

    Birds of a feather usually flock together, so where are the rest of the 101 Airborne Lizards of the Goldacre Flying Corps? Has none of the bad-science-reptiles-formation-team … flying noisily out of room 101 … noticed that Oberleutnant Doktor Peter Flegg (aka TeeHee) has been getting his days mixed up …

    http://www.badscience.net/forum/viewtopic.php?f=3&t=14401#p297726

    … while giving Generalfeldmarschall Deer Brian (Flieger-Toad-Korps) a run for his money.

    http://www.timesonline.co.uk/tol/news/uk/health/article6999713.ece

    PS. Doncha jus luv it when Obersturmbannfuhrer jdc523 (Flying-Oink Division) gets all forceful and assertive.

  25. jdc325 said,

    I’m not entirely sure what you are trying to say here – perhaps that we’re your Lizard overlords, or that we’re Nazis? Could you possibly post a slightly more coherent response please?

  26. draust said,

    “where are the rest of the 101 Airborne Lizards of the Goldacre Flying Corps? “

    Shabby

    Perhaps they have decided you’re not worth their time, since it is abundantly clear that you don’t actually have anything to say?

    Just a thought.

  27. Cybertiger said,

    Mthnks thr my b sm cgntv bs n Dr Flgg’s w cmmnt.

    http://www.badscience.net/forum/viewtopic.php?f=3&t=14401#p298150

    nd th rshl thnks h’s s drl, TH!

    Admin edit: this comment has been disemvowelled due to abuse aimed at others. Please do not abuse my hospitality by hurling insults at people Cybertiger.

  28. The Daily Mail and Mr Andrew Wakefield « Stuff And Nonsense said,

    [...] minor risk to a healthy child in an advanced country”. It’s worth pointing out that in Duisburg in 2006 measles had a mortality rate of 1 in 307, as two of the three people with encephalitis [...]

  29. Daily Mail on MMR « Stuff And Nonsense said,

    [...] separate jabs is not only unnecessarily expensive – it also leaves children unprotected* from serious diseases (if not measles, then mumps or rubella) if the vaccinations are spaced [...]

  30. Rain said,

    This is all do dumb! 40,000 people day every year in car crashes in the USA. You’re saying dozens will die if they aren’t vaccinated for measles? Pffft, I’m way more worried about driving around with my kids in my car then not getting them a measles vaccine. Less then 400 people a year died of measles BEFORE there was a vaccine. You know how many children drown in swimming pools every year? 350! A whole lot of things can kill you if you’re already sick in a 3rd world country and don’t have food or clean drinking water. If you are healthy, strong, well fed & have access to healthcare you don’t need a measles shot which as negative side effects & doesn’t even gauruntee you’ll be immune with it!

  31. jdc325 said,

    @Rain,

    Yes, there are things other than refusing to vaccinate that carry risk. Personally, I don’t think that the fact that more people die from other causes means we shouldn’t discuss the very real risks of failing to vaccinate. You may disagree. You seem to be unconcerned that without vaccination, we would see hundreds of unnecessary deaths each year. I feel that hundreds of unnecessary deaths are worth worrying about.

    Re: “If you are healthy, strong, well fed & have access to healthcare you don’t need a measles shot which as negative side effects & doesn’t even gauruntee you’ll be immune with it!”
    This is untrue. Children too young to be vaccinated are among those most vulnerable to measles and some of these children might well die if exposed to infected individuals. The benefits of measles-containing vaccines far outweigh the risks – I suggest you read the CDC’s Pink Book chapter on measles. 99% of people fully vaccinated will be immune to measles. If enough people vaccinate, then herd immunity ensures that those who (a) cannot receive a vaccine or (b) do not not have immunity after two doses will be protected.

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