The past and present rebuke antivaccinationists who claim measles is “benign”

disneyvaccine

In the wake of antivaccine-pandering pediatrician “Dr. Bob” Sears’ attempt to paint the measles as no big deal, so much so that it totally escaped his notice that it might not be a bad idea to recommend that the unvaccinated get the MMR vaccine in the midst of an outbreak, the bad news about the Disneyland measles outbreak just keeps coming in. Hot off the presses yesterday:

There are now 67 confirmed cases of measles in an outbreak centered in California, health officials said.

The California Department of Public Health said there are now 59 cases in the state – 42 that have been directly linked to being at Disneyland Park or Disney California Adventure Park in December. Some people visited Disneyland Park or Disney California Adventure Park while infectious in January.

Measles outbreak update: 59 confirmed cases in California Measles outbreak update: 59 confirmed cases in California The 59 patients in California range in age from 7 months to 70 years. The vaccination status is known for 34 of the patients. Of those, 28 were unvaccinated, one had received partial vaccination and five were fully vaccinated.

And, there’s a direct rebuke to Dr. Bob’s attempt to downplay the seriousness of the measles, in which he echoed the utterly ridiculous but favored antivaccine trope that I have dubbed argumentum ad Brady Bunchium, or the appeal to an old Brady Bunch episode in which the measles was played for laughs. Basically, in the episode the Brady children all caught the measles, which was portrayed as not at all serious. Indeed, the children were shown happy to be staying home from school and playing monopoly to pass the time.

So what is the rebuke? This:

Of the cases in California, one in four sickened have had to be hospitalized.

I’d say that a disease that causes one in four of the people who get it to require hospitalization is not a “benign” disease. We don’t hospitalize people lightly these days anymore, given how insurance companies, HMOs, and other entities have been trying to crack down on cost and medicine has moved to treating as many cases as possible without hospitalization. Yet one in four measles victims in this outbreak required hospitalization.

Dr. Bob remains, as ever, a petulant idiot.

Moreover, as I pointed out before, the antivaccine brigade can’t even pull out the old trope in which they claim that more victims of an outbreak are vaccinated than unvaccinated, a claim that inevitably demonstrates innumeracy in that if you take into account the proportion of the population that is vaccinated and calculate the disease attack rates you’ll always find that the unvaccinated have a much higher risk of contracting the disease during an outbreak than the vaccinated. Always.

Meanwhile:

Disneyland Resort employees who had contact with measles-stricken coworkers have been asked to stay home unless they can show they’ve been vaccinated or take a blood test to show they’re immune, Disney officials told the Los Angeles Times.

On Tuesday, company officials confirmed to The Times that five Disneyland Resort employees had been diagnosed with measles. Two had been vaccinated, health officials said, and the vaccination status of the other workers is still being investigated.

All resort workers who could have been in contact with those five have been asked to provide vaccination records or submit to a blood test that shows they have built immunity to the disease.

Any employees who had not been vaccinated or could not confirm their immunity status were asked to go on paid leave until their status could be confirmed, Disney officials said.

This makes a lot of sense. I’m glad that Disneyland is doing the right thing for its employees and patrons in this case. Tell them to stay home on paid leave until enough time has passed to see if they are infected or not, or have them show proof of vaccination or evidence that they are immune.

At this point, I think it’s worth citing quotes that you, my readers, provided me with regarding what doctors really thought of measles. First, thanks to Todd, here is J. Mayer, MD addressing the 34th Annual Meeting of the State Society (California) in 1904 [emphasis added]:

It is hard to combat the old notion that measles is something akin to a common cold with a rash, and that there is nothing to be done but keep the patient warm. It is also difficult, as you know, to have people accept a new medical idea, which is not to be wondered at. The truth is that we, ourselves, too often encourage indifference by some such remark as “It is only measles.”

Gentlemen, experience has taught me that every case of measles should be looked upon by a physician as involving not only the question of the future usefulness and well-being of the subject, but even that of his life.

Dr. Mayer then quoted The Twentieth Century Practice of Medicine:

Measles is a dangerous disease-one of the most dangerous with which a child under five years of age can be attacked. It is especially apt to be fatal to teething children. It tends to kill by producing inflammation of the lungs. It prepares the way for consumption. It tends to maim by producing inflammations of the ears and eyes. Measles has carried off more than four times as many persons as enteric fever. It is therefore a great mistake to look upon measles as a trifling disease. Every child ill with measles ought at once to be put to bed and kept warm, for the mildest cases may be made serious by a chill. Measles is for this reason most dangerous in winter and spring. The older a child is, the less likely it is to catch measles, and if it does, the less likely it is to die. If every child could be protected from measles until It had passed its fifth year the mortality from this disease would be enormously decreased. It is therefore a great mistake – because as a rule children sooner or later have measles – to say, “The sooner the better,” and to take no measures to protect them, or even deliberately to expose them to infection.

So the sorts of arguments being made by antivaccinationists, Dr. Bob Sears, and, yes, Dr. Jay Gordon are very old arguments indeed. They are the same sort of “don’t worry, be happy” fallacies that have been around at least a century. Earlier than that, nearly 170 years ago, a very famous American writer had his own experience with the measles, an experience that he described in an essay entitled The Turning Point of My Life:

When I was twelve and a half years old, my father died. It was in the spring. The summer came, and brought with it an epidemic of measles. For a time a child died almost every day. The village was paralyzed with fright, distress, despair. Children that were not smitten with the disease were imprisoned in their homes to save them from the infection. In the homes there were no cheerful faces, there was no music, there was no singing but of solemn hymns, no voice but of prayer, no romping was allowed, no noise, no laughter, the family moved spectrally about on tiptoe, in a ghostly hush. I was a prisoner. My soul was steeped in this awful dreariness–and in fear. At some time or other every day and every night a sudden shiver shook me to the marrow, and I said to myself, “There, I’ve got it! and I shall die.” Life on these miserable terms was not worth living, and at last I made up my mind to get the disease and have it over, one way or the other. I escaped from the house and went to the house of a neighbor where a playmate of mine was very ill with the malady. When the chance offered I crept into his room and got into bed with him. I was discovered by his mother and sent back into captivity. But I had the disease; they could not take that from me. I came near to dying. The whole village was interested, and anxious, and sent for news of me every day; and not only once a day, but several times. Everybody believed I would die; but on the fourteenth day a change came for the worse and they were disappointed.

So, far from always having been viewed as a benign childhood disease that most children get and recover from without incident, which is the view that Dr. Bob and his fellow antivaccine minions would have you believe, the measles was actually feared as a scourge in the 1800s and even into the 1900s physicians recognized that it could cause serious complications. Even today, with all the modern medical care and supposed fantastic nutrition children in the U.S. now enjoy, it can cause one quarter of those who contract it to need hospitalization.

Pediatricians like Dr. Bob should know this. So should all doctors and patients. Thanks to the antivaccine movement, I fear we will be forced to learn old lessons again.