Florida measles outbreak is a warning on how, and how not to, handle infectious disease | Opinion
Americans are paying the price for an irresponsible Florida state health official and a slow-to-act CDC amid a measles outbreak, where the ignoring of early warnings and the flouting of science-based guidance echoes what we see in the COVID-19 pandemic. This time, though, the virus is well known and has an incredibly effective vaccine. Yet most of the country seems to be in a watch-and-wait mode — all while we are stumbling into a looming disaster with measles.
Florida officials are providing scant details on the size and scope of the measles outbreak, deeply worrying experts, and leaving everyone in the dark. State and local health officials and health professionals should lead regardless of action by the U.S. Centers for Disease Control and Prevention, because what is happening in Florida will most assuredly not stay in Florida.
The Florida outbreak is a reminder that complacency and lack of proactive measures can lead to devastating consequences. It’s important to realize that even a small pocket of unvaccinated individuals can help trigger a widespread outbreak.
Vaccines from over 10 years ago also do not guarantee 100% immunity, as protection wanes in a significant fraction of people. Nevertheless, only 13 of the 50 U.S. states have a 95% level of two-dose MMR vaccination, the minimum level needed for herd immunity protection. Furthermore, measles’s high degree of airborne contagiousness can leapfrog over herd immunity.
Outbreaks can still be possible in any state because vaccination levels are not uniformly high. Why? Even if a state achieves a 95% vaccination “herd immunity” threshold overall, large outbreak clusters are still possible in places where individuals aren’t vaccinated. For example, 95% vaccination coverage can mean 99% in some areas but only 20-50% in other communities — which could allow for explosive outbreaks.
The global experience with measles should not be ignored. Measles infections have spread across London with almost 1,000 cases in England and Wales in the first few weeks of the year, even though the UK had previously eliminated measles in 2017. If it can happen in the UK, measles can get much worse in the U.S.
The immediate effects of a measles infection can include high fever, cough, runny nose, red/watery eyes, and a characteristic rash that starts on the face and spreads down the body, and in severe cases, can lead to pneumonia and even death.
There is also long term risk. Notably, measles may also induce “‘immunity-amnesia” — wiping out part of a body’s immune system memory archives of how to fight previous infections. As a result, measles survivors could become more vulnerable to other infections.
Florida leaders are largely ignoring the measles outbreak, with calls for Florida surgeon general’s resignation over inaction towards measles. Meanwhile, waiting for the CDC to recover its professional voice is not an option. It is imperative that state and local officials, and healthcare professionals, take immediate action to stop measles.
State and local officials should mobilize vaccine drives and must issue stronger guidance to quarantine when necessary. Health systems should provide education for professionals and community members to recognize cases clinically and stress immediate isolation. A laissez-faire attitude towards measles is essentially reckless endangerment.
The lessons learned from the early days of the COVID-19 pandemic should remind us of the importance of swift clear warnings and decisive action to prevent the spread of infectious diseases nationwide.
Kavita Patel, M.D. MSHS, is a professor of medicine at Stanford University and former White House health policy director in the Obama administration. Eric Feigl-Ding, Sc.D., is an epidemiologist and chair of the public health department at the New England Complex Systems Institute. Yaneer Bar-Yam, Ph.D. is president of NECSI and co-founder of the World Health Network.
