An Alarming Comeback for Measles

It begins with a runny nose, accompanied by a feeling of listlessness. Soon body temperature may soar as high as 40.5DEG C. (105DEG F.), and the patient develops the characteristic red rash of common measles, or rubeola.* Though this childhood disease seemed on the verge of extinction after the introduction of a vaccine against it in the early 1960s, measles has been making an alarming comeback. In recent months, there have been startling outbreaks in such widely scattered states as California, Iowa, Missouri, Minnesota, Texas and Virginia.

One obvious reason for rubeola's resurgence is the failure of many parents --as well as doctors--to insist on shots for youngsters. Though every state except Wyoming, Iowa and Idaho has regulations requiring measles protection, schools--the best places to screen children--do not always demand proof of vaccinations. Also, says Dr. Jean Lockhart, an official of the American Academy of Pediatrics in Evanston, Ill., if children are not inoculated early in life, they are likely to be left unprotected because they no longer see doctors as frequently. Adds Dr. Colette Rasmussen of the Cook County, Ill., public health department: "Too often the disease is looked upon as a sickness all children once had, as a kind of joke." Unfortunately, measles is no laughing matter. While the overwhelming majority of victims recover in a week to ten days, some develop pneumonia or encephalitis. If the measles virus spreads to the brain, it can cause convulsions, coma and brain damage, and sometimes death.

Paradoxically, although measles shots have been available for 14 years, more high school and college age youngsters are now susceptible to rubeola than ever before. In the past, this group was largely untouched by measles, but lately it has been hard hit. Reason: many teenagers were not exposed in childhood and thus did not develop antibodies against measles. Warns Dr. James Cherry, professor of pediatrics at the University of California in Los Angeles: "What we now have, for the first time in history, is a whole herd of older people who are not immune. I think it is a problem that will increase in magnitude."

Incomplete Immunity. Another complication is that many of today's teen-agers received shots before the age of one year, when their bodies still contained antibodies from their mothers that interfered with their developing complete immunity. For this reason, the U.S. Public Health Service is now recommending that vaccinations be deferred until 15 months, unless special circumstances like an outbreak of measles require earlier vaccinations. When such eruptions do occur, says the Public Health Service, shots should be given to all susceptible young people, even students on college campuses.

That may not be easy. After last year's abortive swine-flu program with its unexpected cases of paralysis, the public is understandably wary of any inoculations, whatever protection they may offer. In addition, many parents have mistakenly concluded, in the absence of any great epidemics, that youngsters no longer need vaccinations against such menaces of the past as poliomyelitis. Nonetheless, there are signs of a reawakening to the measles danger. In Los Angeles, thousands of youngsters turned up for shots after school authorities threatened to bar them from classes without proof of inoculations. In New York, health officials used circus clowns to lure youngsters to vaccination centers. Such gimmickry has the full blessings of the Carter Administration, which has set as a goal the inoculation by the fall of 1979 of 90% of all American youngsters--not only against measles but against five other avoidable diseases as well: polio, whooping cough, German measles, diphtheria and tetanus. Says HEW Secretary Joseph A. Califano Jr.: "Our national failure to protect our young from preventable diseases is shocking [and] a national disgrace."

*As distinguished from the milder German measles, or rubella.

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