February 03, 2015

Measles, Technology, and Globalization

Headshot 3.13 cropcompressBy Karen Sternheimer

In 2000, measles was eradicated from the United States. The Centers for Disease Control and Prevention (CDC) notes that after decades of a successful vaccination program, which began in 1963, there were no more measles cases that originated in the U.S. This means that measles is no longer native to the United States.

The recent outbreak of measles reminds us that the disease can still infect people here in the U.S.  Once the disease was eradicated, it has re-entered the country through documented cases in Europe, Asia, and Africa. The CDC reports that the most recent outbreak likely came from those traveling from the Philippines, which is also currently experiencing a large outbreak.

  Measles-cases-616px

Source: http://www.cdc.gov/measles/cases-outbreaks.html

The spread of a once-eradicated disease teaches us about the importance of globalization as well as the multipronged effects of technology in both first eliminating the disease and enabling it to return.

Before the creation of a vaccine, the CDC estimates that between three and four million Americans suffered from measles each year. This led to approximately 48,000 hospitalizations, as well as an estimated 400 to 500 deaths per year. People who survive can suffer from major complications, such as pneumonia and brain swelling, which can cause brain damage and deafness. Besides those who have not been immunized, those with compromised immune systems can be particularly vulnerable to the infection.

As you can see from the graph below, the vaccine dramatically reduced the number of cases of measles in the U.S., to the degree that most doctors practicing today have not treated a patient with measles, and most people of child bearing age are unlikely to have ever known someone who contracted measles.

Measles in the United States, 1950-2009

  Meas_fig_02

Source: http://www.cdc.gov/vaccines/pubs/pinkbook/meas.html

The eradication of the measles in the U.S. happened during a time of many advances in medical technology. Other infectious diseases that threatened infant’s and children’s lives in the last century, like polio, whooping cough, and tuberculosis have also became far less common.

These medical advances have made it easy to take the importance of vaccines for granted. Melinda Gates, who along with her husband Bill Gates has worked to make vaccines available in developing nations recently noted that:

Women in the developing world know the power of [vaccines]. They will walk 10 kilometers in the heat with their child and line up to get a vaccine, because they have seen death. [Americans have] forgotten what measles deaths look like.

We have become so accustomed to advances in medical technology that many people no longer view infancy and early childhood as times of physical vulnerability. There was a time when children commonly died from infectious diseases. In 1907, the mortality rate for children ages one through four was 1,418.8 per hundred thousand (and much higher for infants). In 2007, that rate had declined dramatically to 28.6 deaths per hundred thousand. While nearly ten percent of children who survived infancy would die before the age of 15 in 1907, only three-tenths of a percent of children would die during that time span in 2007.

Some have come to believe that babies and children are naturally predisposed to be healthy, and believe that too much medical intervention is more dangerous than none at all, forgetting the role that medical intervention played in these dramatic reductions in childhood mortality.

Technology created the conditions that helped save lives by eradicating or dramatically reducing many deadly infectious diseases. Ironically, technology is playing a role in reintroducing infectious diseases as well.

Globalization, which essentially means interacting with those around the world through the exchange of commerce, ideas, and travel, is largely the result of a variety of technologies. The ease of traveling internationally—for those with the means to do so—makes spreading infectious diseases easier.

Technology also enables people to share ideas and information much more easily. Before the internet, information about health and medicine was far less accessible and doctors were the primary way that people (or at least those with access to doctors) learned about their health options. Now a multitude of sources can offer information on health issues—some of it based on science, some based on opinion, fear, or rumor.

This means that more people might use alternative forms of advice and may reject the recommendations of the medical establishment. Ironically, the success of modern medicine has given many people the luxury of rejecting it. At least temporarily.

(To learn more about mistrust of medicine and its consequences, check out this episode of PBS’s NOVA.)

Comments

The flip side of technology making information readily available, is it makes misinformation easy to spread. Hopefully, we can get everyone in the U.S. at least educated about vaccination.

It is a very interesting time in history that we have the luxury as Americans to accept the immunizations or reject them with out much thought of the consequences. I have children who have all been immunized and still ended up getting whooping cough when they went to school with children who did not get immunized. It was a mild case in comparison but still awful to hear them cough so hard they threw up and never got to rest.
My grandfather had polio and when the vaccine came out for that he took his children and waited outside the Doctors office before the doors opened...not unlike Americans wait outside for deals on Black Friday.
I think it is dangerous for us to forget the diseases and what they can do to people. I also think it's very dangerous for people especially celebraties to claim you can do more harm in immunizing your child,saying they can develop autism, when there is no scientific research to back that up.

great.

..and this is all part of technology. lets try and see the loop hole and seal them

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