The madness of measles
Alexander Marshall discusses the plight of the measles virus, and outlines the problem now facing Europe.
An army, dispersed through the air, riding a thousand minuscule droplets of mucus. Millions of viruses scatter through the area, spread from a cough, sneeze, or even spittle ejected during conversation. A virus which has a 90% chance of infecting vulnerable people, measles is a completely preventable, but growing, blight upon modern Europe.
Recently, the World Health Organisation (WHO) has stated that the number of measles cases has reached a record high in Europe. In 2016, WHO reported 5,273 cases; the following year this had increased nearly five times to 23,927, and within the first six months of this year, over 41,000 cases have already been reported.
The virus nestles within the nose and throats of the infected individual, replicating and spewing forth. Once cast out into the fray, one of four things will occur. The droplets could land onto counters, handrails, pens, keyboards – any object – where it will wait, ready to pounce upon an unsuspecting victim with whom it comes into contact. If the virus is left undisturbed for long enough, then it will die out. However, the virus is persistent, willing to bide its time for hours before surrendering to death.
Those who are infected become the battlefield for the next skirmish. For lucky individuals, antibodies can swarm upon the intruding virus, battle-hardened, trained against a weaker foe that was injected into the host as a vaccine. The swarm of antibodies are prepared and ready to strike, making short work of the virus before it can claim ground.
The outlook is not as promising for the unprepared host. In those unlucky few who have not been vaccinated, the virus will silently infect and occupy, unnoticed for up to two weeks, co-opting cellular tools to produce more viruses to fuel the army. Once the armies have their masses, it is time to find another host. Like many flus, the symptoms start off generic: a runny nose as your body tries to flush out the mucus, a fever as it tries to burn the virus away, and fatigue and aches as the body succumbs. The conditions are hostile, but the virus can use it to its advantage, spreading with a sneeze or a cough.
It is only after several days of generic conditions that the severity of the situation reveals itself. The face breaks out in splotchy red spots and bumps which will carve a path across the body, down the trunk, arms, legs and feet. As if to match the redness of the body, a dangerous fever rages, reaching up to 41°C.
However, the complications from measles can be far more severe than just a fever, as two out of every 1,000 patients will probably die. Those who are most likely to suffer severe complications are teenagers and children, especially concerning this current outbreak which is thought to be a consequence of the drop in vaccination levels associated with the autism-MMR scare in 1998.
One of the most serious complications is localised swelling. As the virus spreads it can cause swelling, and one of the conditions, known as encephalitis, involves swelling on the brain. The mounting pressure places a terrible force upon the brain, reducing blood flow, and can be so severe that the patient can change personality, become unable to speak, suffer seizures, and have long lasting brain damage. The other, more common but equally dangerous risk, is the chance of developing pneumonia. As the lungs inflame and swell, fluid seeps in, producing a watery barrier which stops the lungs from taking in fresh oxygen. The result is a terrible mixture of drowning and suffocation if the condition is not brought back under control.
Measles ran riot across the world, killing over six million people every year before the vaccine was first introduced in 1971, and now the world watches as the hard-fought progress against its onslaught is eroded. The fear and mistrust which surrounds the MMR vaccine may never heal, with countries like Serbia and Ukraine at the forefront of the biological war playing out across the continent, but the truth could not be put plainer than by Dr Pauline Paterson from the London School of Hygiene and Tropical Medicine: “With a vaccine preventable disease, one case is one too many.”