Measles: Historical Highlights

Episode Transcript
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Speaker 1 (00:01):
Welcome to Stuff You Missed in History Class, a production
of iHeartRadio. Hello, and welcome to the podcast.

Speaker 2 (00:13):
I'm Tracy V.

Speaker 1 (00:14):
Wilson and I'm Holly Frye.

Speaker 2 (00:17):
Right after I got back from that trip to Philadelphia
to see that Marine Laura sign exhibit, there were some
headlines about a measles outbreak happening there, and then right
at the same time also warnings about a potential measles
exposure for travelers who had passed through Dulles or Reagan
Airports in Washington, d C. So measles was declared eliminated

(00:42):
in the United States more than twenty years ago, meaning
that there is no longer sustained transmission of the disease
happening here. But outbreaks do obviously still happen. They're usually
related to travel to and from places where it's a
lot more common. Outbreaks can spread really quickly if they
reach an area where a lot of people are unvaccinated. So,

(01:05):
of course I do not like that there are measles
outbreaks happening anywhere. It's a highly contagious virus. It can
put people in the hospital. An estimated one hundred and
thirty six thousand people died of it worldwide in twenty
twenty three, and in the years just before vaccines for
it became widely available, measles killed an estimated two point

(01:29):
six million people around the world every year. Uh but
as a vaccinated person living in a highly vaccinated area,
I am not at a lot of risk for measles myself.
So these headlines for me, they sparked more curiosity than fear,
and they also reminded me a little bit of the

(01:50):
things that led me to write an episode on scarlet
fever last year. People seem to really like the scarlet
Fever episode, so I thought I would take a look
at the history of measles heads up. They we will
have just a little bit of questionable slash unethical research
stuff happening this episode, and a tiny bit about ways

(02:13):
that we used to inoculate people that's potentially gross. Neither
of these are very long discussions, but they are there.

Speaker 1 (02:21):
In the US, there are two different diseases that are
commonly called measles. One caused by the measles morbilivirus also
called rubiola, is usually just called measles. The other is
caused by the rubella virus, and it is sometimes called
German measles. These diseases have some similar symptoms, and they're

(02:41):
both targeted by the measles mumps rubella or MMR vaccine,
which is used in much of the world. But measles
and German measles are different illnesses caused by different viruses.
This episode is primarily about the one caused by measles morbilivirus,
although German measles will come up occasionally as we're talking

(03:01):
this through. The virus that causes measles is highly contagious.
Between eighty five and ninety percent of people who are
exposed to it and are not already immune will contract it.
It's also something that can spread really easily before people
realize they have it. Measles causes a characteristic rash, but

(03:22):
it is also contagious for up to four days before
that rash actually appears, and before that happens, people might
just think they have something like a cold. In most cases,
it takes about two weeks between exposure to measles and
the development of that rash, and the virus can linger
in the air and on surfaces for a couple of hours.

(03:43):
This can make outbreaks really challenging to track, since health
officials have to try to piece together who a person
had contact with about two weeks before, or who may
have moved through a space that person had even briefly
been in day.

Speaker 2 (03:58):
That's why these warnings about Dulles and Reagan Airports were
on specific days for like a six sish hour window
when a person might have been exposed had they gone
through there. If you are Hollies in my age or younger,
and you're from the United States or Europe, which is
most of our listeners, you probably have not seen a

(04:20):
case of the measles in person, even though it has
become more common in these places over the last several years.
And as is the case with a lot of illnesses,
there is some variation and exactly what symptoms people experience,
but most of the time, measles starts with a fever
and cold like symptoms like a running nose and a cough,

(04:41):
possibly accompanied by pink eye. Most people, but not all,
then develop white spots in their mouth, known as Coplic spots.
These are named after American physician Henry Koplick, who first
described them in eighteen ninety six. Then that's followed by
the rash, which usually starts on the face and the neck,
and then progresses to the rest of the body. On

(05:03):
people with light skin, this rash is usually red and flat,
although there may also be raised bumps. The rash can
be harder to see on people who have darker skins.
Sometimes it appears as a darker shade of that person's
regular skin color. Usually the person's fever spikes after the
rash develops, and the rash usually peels as it goes away.

Speaker 1 (05:27):
There's no treatment for measles. It's just rest, supportive care
and treatment of specific symptoms if needed, like oatmeal bass
if a person's rash is itchy, which it may or
may not be.

Speaker 2 (05:39):
Obviously, this is not medical advice. If you think you
have measles.

Speaker 1 (05:42):
See darker.

Speaker 2 (05:45):
Most people recover from measles without any apparent issues, but
there's increasing evidence that the virus causes immune system damage
that can last for at least two years. This is
described as immune amnesia, meaning the body kind of forgets
how to fight pathogens that it previously knew how to handle,
and between five percent and fifteen percent of people who

(06:08):
contract measles also develop some kind of more immediate complication.
Some of these are relatively mild like, since measles can
lower a person's resistance to other pathogens. Ear infections and
sinus infections are common, but others are more acutely serious,
like pneumonia and inflammation of the internal organs, including the heart.

(06:31):
One of the most serious complications of measles is encephalitis,
or inflammation of the brain, which can develop weeks after
a person seems to have recovered. This is fatal in
ten to fifteen percent of people who develop it, and
it can also cause long term issues like seizures and
cognitive disabilities. There is also a very rare fatal complication

(06:53):
of the central nervous system called subacute sclerosing panacephalitis, which
can develop seven to ten year years after recovering from measles.
Measles can also be particularly dangerous during pregnancy, and that
includes carrying a risk of low birth weight, pregnancy loss,
and stillbirth. German measles or rebella, is also particularly dangerous

(07:16):
during pregnancy, and congenital rebella syndrome is associated with heart problems,
hearing loss, developmental delays, and other issues. Today, measles outbreaks
in wealthy countries make a lot of headlines but that
isn't where measles is most common. There's a very effective
vaccine for measles, one that's about ninety six percent effective

(07:36):
with two doses, with that immunity lasting for a person's
whole life. So places that have a robust healthcare system
with broad vaccine coverage aren't likely to see huge outbreaks
of measles, and even if there are outbreaks in communities
that have religious or cultural or philosophical objections to vaccines,
health officials are more likely to be able to respond

(07:58):
to them effectively. But places without that infrastructure, without the
resources to coordinate widespread vaccination campaigns, and places that are
experiencing some kind of civic unrest or war are a
lot more likely to see large outbreaks of measles and
also less likely to be able to respond to them effectively.

(08:21):
People who are already malnourished or sick, or aren't able
to get enough food or water or rest while they're
recovering are just more likely to develop measles complications. This
means mortality rates from measles can really vary from country
to country, with the countries that are facing the most
poverty and unrest seeing the worst outcomes from measles, so globally,

(08:45):
measles is still a leading cause of childhood death. So
that is the basics of measles, and we're going to
get into more about its history after we pause for
a sponsor break. Measles more bili viruses than the pyramics.

(09:07):
The virus family of viruses, and that also includes the
viruses that cause para influenza, mumps and rsv rsv I
feel like has been in the headlines so much over
the last few years. That stands for respiratory sensicial virus.
This family also includes a number of viruses that primarily
affect animals, including the viruses that cause canine distemper and

(09:31):
render pest. Two prevailing theories about the origin of measles
have been that it evolved from canine distemper as people
started domesticating dogs, or that it diverged from render pest
as people started domesticating cattle. Measles morbilivirus is most closely
related to render pest, and most of the recent research
into this has focused on render pest. Render pest was

(09:54):
declared eradicated in twenty eleven, and we are going to
have our episode on that as an upcoming Saturday Classic.
A lot of this research into the question of exactly
where measles came from and when has involved molecular clock analysis.
That's basically looking at mutations over time to try to
pinpoint when two organisms diverged from one another. Studies conducted

(10:18):
in the twenty teens concluded that measles diverged from render
past quite recently, it's just the eleventh or twelfth century CE,
but then research published in twenty twenty suggests that it
was centuries earlier than that, possibly as early as the
sixth century BCE. A lot of papers written in the

(10:39):
twenty teens framed the idea of like the eleventh or
twelfth century divergence of measles is basically settled knowledge, but
then that twenty twenty research called that timeline into question.

Speaker 1 (10:53):
This, of course, makes it tricky to pin down some
of the early history of measles. There are a lot
of illnesses that cause fever and a rash, and a
lot of historical accounts just aren't specific enough to say
for sure whether they're describing smallpox, scarlet fever, measles, or
something else. Measles is one of the diseases that has
been proposed as the cause of the Antonine plague, also

(11:15):
called the plague of Galen, which took place between the
years one sixty five to one eighty CE. If measles
didn't diverge from render pest until the eleventh century, it
couldn't have been the cause. But if that divergence really
took place around the sixth century BCE, it could have been.
There are also clinical descriptions of measles that date back

(11:36):
to before the eleventh or twelfth centuries. The most well
known is by Abu Baker Mohammad ibn Zakaria. Al Razi,
known in some Western accounts as Ross Alrazi, was a
physician during the Islamic Golden Age. He lived from about
eight sixty four to nine thirty five CE. Alrazi wrote

(11:56):
at least two hundred medical and philosophical tree, including his
Catab Alhawi, or Comprehensive Book on Medicine, and one of
these treatises was a treatise on smallpox and measles.

Speaker 2 (12:09):
This is the first known medical text to clearly differentiate
between these two diseases.

Speaker 1 (12:16):
Of course, this was also written during a time when
medicine was focused on the idea of humors and keeping
those humors in balance. So Alrasi's thoughts on the causes
of smallpox and measles don't align with today's evidence based
ideas of medicine. As translated into English in the nineteenth century,
he wrote, quote, every man, from the time of his

(12:37):
birth till he arrives at old age is continually tending
to dryness. And for this reason the blood of children
and infants is much moister than the blood of young men,
and still more so than that of old men. Now
the smallpox arises when the blood putrefies and ferments so
that the superfluous vapors are thrown out of it, and

(12:58):
it is changed from the blood of infants, which is
like must, into the blood of young men, which is
like wine perfectly ripened. And the smallpox itself may be
compared to the fermentation and the hissing noise which take
place in must at that time.

Speaker 2 (13:13):
So this offered an explanation for why it seemed like
most people contracted smallpox before reaching adulthood, because under this
arose from the process of transforming the blood from the
blood of a child into the blood of an adult.
He thought adults were only likely to contract smallpox if
they were exposed to quote pestilential, putrid, and malignant constitutions

(13:36):
of the air in which this disease is chiefly prevalent.
He also claims that quote bodies that are lean, bilious, hot,
and dry are more disposed to the measles than to
the smallpox, and quote when the summer is excessively hot
and dry, and the autumn is also hot and dry,
and the rains come very late, then the measles quickly

(13:57):
seize those who are disposed to them, that is, those
who are of a hot, lean, and bilious habit of body.
In terms of symptoms, Selrazi wrote that quote inquietude, nausea,
and anxiety are far more frequent in the measles, and
he recommended treatments for measles that included barley water mixed
with acid, pomegranate juice, as well as expectorants to make

(14:21):
it easier for people to cough up any chest congestion.
But Arazi also understood that smallpox was a more serious
disease than measles, and a lot of this volume is
devoted to recommendations for the treatment of smallpox, regardless of
the questions around exactly when measles may have diverged from

(14:41):
render pest. It was clearly widespread in Europe, Northern Africa,
and much of Asia by the medieval period, especially in
places where cities were large enough to sustain ongoing epidemics.
Measles was introduced into the Americas through colonization in the
fifteenth and sixteenth centuries. Although smallpox gets a lot of

(15:01):
the focus in terms of introduced diseases and their devastating
impact on the continent's indigenous peoples, other diseases, including measles,
proved to be deadly as well. There were huge deadly
measles outbreaks described in Cuba, Honduras, and Brazil in the
fifteen twenties and thirties. The first written record of an

(15:22):
outbreak in North America was in Boston in sixteen fifty seven.
A lot of medical writing in Europe and North America
in the seventeenth and eighteenth centuries focused on both measles
and smallpox, as al Razi had done back in the
ninth century. Doctors and other researchers wrote about how to
tell these two diseases apart, and how to treat each

(15:43):
of them. One example is Englishman Thomas Sydenham, who had
a chapter on the measles in his sixteen ninety three
complete Works, which was followed by a chapter on smallpox.
Sydonham's description of measles is thorough, describing it as generally
attacked children with chills, followed by fever, loss of appetite,

(16:04):
running eyes and nose. And then on the fourth day
or the fifth quote, there appear on the face and
forehead small red spots, very like the bites of fleas.
These increase in number and cluster together so as to
mark the face with large red blotches. They are formed
by small papules so slightly elevated above the skin that

(16:25):
their prominence can hardly be detected by the eye, but
can just be felt by passing the fingers lightly along
the skin. The spots take hold on the face first,
from which they spread to the chest and belly, and
afterwards to the legs and ankles. On these parts may
be seen broad red macule on but not above the

(16:46):
level of the skin. This is so much more detailed
than so many ancient historical texts that are sort of
like the Great plague passed through the town, bringing a
rash and death and it's like, okay, what rash though.

Speaker 1 (17:00):
Them.

Speaker 2 (17:00):
Goes on to describe the way that this rash developed
over the days that followed, and then made recommendations for treatment,
including syrups of violet and maiden hair and a draft
made of black cherry water and syrup of poppies for
use at night. He also recommended bleeding for patients who
developed diarrhea after the rest of the disease had resolved.

(17:21):
In seventeen forty, German physician Friedrich Hoffmann differentiated rubiola from
rubella or German measles. It's not entirely clear whether the
German moniker came from the diseases description in German medical texts,
or if it's from the Latin germanus meaning similar. In
seventeen fifty seven, Scottish physician Francis Holme tried to develop

(17:43):
a vaccine for measles. He was inspired by the use
of variolation to prevent smallpox. That is, intentionally exposing someone
to smallpox in a more controlled way, with the goal
of giving them a milder case of the disease that
would leave them immune to it. Later. In Holmes's words,
quote considering how destructive this disease is in some seasons,

(18:06):
considering how many die, even in the mildest epidemical constitution,
considering how it hurts the lungs and eyes, I thought
I should do no small service to mankind if I
could render this disease more mild and safe, in the
same way as the Turks have taught us to mitigate
the smallpox. Here's the potentially gross bit, So hit that

(18:27):
skip ahead button if you are particularly squeamish. Smallpox produces sores,
and variolation involved introducing matter from those sores into another
person's skin, but a measle's rash doesn't produce anything comparable
that could be used in this way. So Home tried
to use the blood of sick patients to expose other people. Obviously,

(18:50):
there are other bloodborne diseases, so this is not aut
a medically safe thing to do, and people were hesitant
to try it at the time. In Homes's words quote
from the prejudices of mankind, I found it difficult to
get the blood as I wanted it, and much more
difficult to find subjects for inoculation. Okay, this was the

(19:11):
reasonable concern. It's like fancy that h Holmes experiments with
measles inoculation. They were limited. It's maybe fifteen total people
he tried this on, and they weren't particularly successful. Those
who did get sick with what seemed like it could
have been measles generally had a mild case of it,
but some of them later contracted measles from some other exposure.

(19:35):
Others did not get sick from Holmes's attempt to expose them.
But this experiment did lead Home to conclude that measles
was definitely caused by some sort of contagion, one that
could be carried in the blood in sufficient quantities to
cause the disease in another person, not by something like
miasma's or bad air, which was still a common idea

(19:59):
at the time. As we said earlier, measles is incredibly contagious,
and that can make it difficult to track the progression
of an outbreak. But in the nineteenth century, an outbreak
started in a remote location and researchers were able to
gain some insights by tracking how it moved, and we're
going to talk more about that after a sponsor break.

(20:24):
By the end of the nineteenth century, measles had been
introduced to virtually the entire world, including northwest North America
in the early nineteenth century, Australia and New Zealand in
the eighteen fifties, and more distant Pacific islands in the
late nineteenth century. In places where measles was already endemic,

(20:45):
there were typically major outbreaks every few years, so the
disease usually affected children under the age of five because
virtually everybody else still living had already gotten it in
an earlier outbreak. Babies also had some protection in their
first months of life due to antibodies that they got
in utero, but in virgin soil epidemics, meaning that when

(21:09):
the virus was introduced to places where nobody was immune,
the disease affected virtually everybody at the same time, no
matter their age. One such outbreak took place in the
Faroe Islands in the North Atlantic between Norway and Iceland
in eighteen forty six. It wasn't technically a virgin soil
epidemic since there had been an earlier outbreak in the

(21:32):
islands in seventeen eighty one, but the vast majority of
the island's residents had not been born when that earlier
epidemic took place. There were seven eight hundred sixty four
people living in the Faroe Islands in eighteen forty six,
and about sixty one hundred contracted measles. In this epidemic,
one hundred seventy people died, for a mortality rate of

(21:54):
about two point eight percent. The government of Denmark sent
physician and pathologists Peter Ludvigpayanum to the islands to try
to control the outbreak, and he personally treated about one
thousand of the sixty one hundred people who became ill,
and he also studied how the disease spread through the islands.
Unlike in a city where there are a lot of

(22:16):
people living very close together, continually interacting with people from
other neighborhoods through things like work and school and errands,
the pharaoh Islands were made up of small villages on
a collection of islands that were largely isolated from one another.
People did travel between the different villages and the different islands,
or people from multiple villages might all come together for

(22:39):
some reason, but this was not just like a continual
daily occurrence.

Speaker 1 (22:44):
Paynham pinpointed how measles was introduced to the Pharaohs in
eighteen forty six writing quote. The first person on the
Pharaohs who took the measles was a cabinet maker now
living in Thorsham. He left Copenhagen on the twentieth of
March and reached Thorsham on the twenty eighth. On the way,
he had felt quite well, but was attacked by measles

(23:05):
early in April, on what day he did not know.
Shortly before his departure, he had visited some measles patients
in Copenhagen. About fourteen days later, his two nearest associates
were attacked, so.

Speaker 2 (23:18):
Painam acknowledged that these men's accounts weren't entirely accurate, like
one of them was saying, I don't remember what day
this started, and they were also just trying to reconstruct
where they had been two weeks previously. But their description
of the basic timeline quote determined me to give attention
in my travels about the islands to the length of

(23:39):
the stage of incubation.

Speaker 1 (23:41):
Paynam was able to identify the index case in fifty
two villages in the Faroe Islands, that is, the first
person to develop measles. From there, he traced when and
where they had been exposed to the disease, and how
long it had taken other people in their village to
get sick. With these observs, he narrowed down the illness's

(24:02):
incubation period to about fourteen days on average. That was
a far more precise estimate than had been in use before.

Speaker 2 (24:10):
He also found that there were ninety eight people in
the islands over the age of sixty five who had
survived that earlier seventeen eighty one outbreak. None of those
ninety eight people got measles in eighteen forty six. There
were already doctors and others who thought that people were
immune to measles after recovering from it, but there were
also various reports of people getting it a second time.

(24:33):
So Paydam thought that what he observed in the Faral
Islands outbreak offered clear evidence that there really was lifelong
immunity to measles. So he thought that these other reports
where people seem to have gotten measles more than once,
the people involved may have actually contracted some other illness.
Painam reported one village in which people believed a midwife

(24:55):
had carried measles. She herself had previously had it in Debat,
but she had spent several days taking care of measles
patients and everyone she came into contact with. In the
next village she visited developed measles fourteen days later. That
included the girl who laundered the clothes that the midwife
had been wearing. Painam's account included a list of communities

(25:18):
that were spared from measles because they had kept a
strict quarantine. About fifteen hundred residents of the island's avoided
measles because their communities cut off all contact with the
ones where measles was circulating. This outbreak happened just as
European medicine was starting to move toward the germ theory
of disease, and there was still debate about exactly what

(25:42):
caused measles. Painam's report on this outbreak concluded, quote, if
among six thousand cases of which I myself observed and
treated about one thousand, not one was found in which
it would be justifiable on any grounds whatever to suppose
a miismatic origin of measles, because it was absolutely clear
that the disease was transmitted from man to man and

(26:04):
from village to village by contagion, whether the latter was
received by immediate contact with a patient, or was conveyed
to the infected person by clothes or the like. It
is certainly reasonable, at least to entertain a considerable degree
of doubt as to the miismatic nature of the disease.
By the early twentieth century, researchers had concluded that measles

(26:25):
was caused not by just some contagion, but specifically a virus,
and they were trying to learn about and isolate it.
That finally happened in nineteen fifty four, when John F
Enders and Thomas C. Peebles collected samples from patients during
a measle's outbreak in Boston. They isolated the virus from
samples collected from an eleven year old patient named David Edmonston.

(26:48):
The next step was to try to weaken or attenuate
this virus into a form that would confer immunity to
measles without making the people who received it sick. Enders,
Peebles and their collaborators went through a process that involved
human kidney cells, human amniotic cells, and chicken eggs. Researchers
tested the vaccines on monkeys before moving on to human trials,

(27:12):
and the first humans they tested the vaccine on were themselves.
This is probably more of a safety check because presumably
all of them at this point had already had measles
when they were children. In October of nineteen fifty eight,
the team tested their vaccine on eleven children, and all
of them developed antibodies to measles morbilivirus, but nine of

(27:34):
them also developed a rash, and they did not want
this vaccine to cause any kind of illness in people,
so after working to further attenuate the virus, the team
started larger trials in the nineteen sixties.

Speaker 1 (27:47):
There are ethical questions around these larger trials. Some of
them were carried out at institutions for disabled children, the
Walter E. Fernald State School in Waltham, Massachusetts, and Willow
School in Staten Island, New York. Both of these institutions
were also home to research that was obviously and inherently unethical.

(28:09):
This included children at Fernaud State School being fed oatmeal
containing radioactive trackers in the late nineteen forties and early
nineteen fifties, and children at Willowbrook being intentionally given hepatitis
in the nineteen fifties and sixties to study the progression
of the disease and efficacy of gamma globulin injections. Neither

(28:31):
of these studies had the potential to benefit the children involved,
and the full nature of the experiments was not explained
to the parents who gave permission for their children to participate.
So these early measles trials were conducted on an inherently
very vulnerable population and a group that doctors often perceived
as less than human at institutions that were also already

(28:54):
involved in unethical research. That said, there were a couple
of different between those studies and the measles vaccine trials.
Being immune to measles would benefit the children involved. Since
they lived in close quarters with other children in facilities
where disease outbreaks were common, they were at an even

(29:16):
greater risk for measles than a lot of other kids
would be. A severe measles outbreak had started at Willowbrook
in the spring of nineteen sixty and so the vaccine
was given to children who were actively at risk from
this ongoing outbreak, and Enders and the rest of his
collaborators seemed to have been ahead of their time around

(29:37):
ideas of informed consent, explaining the vaccine to the parents
getting their permission and administering the vaccine only when that
permission was actually given. Other trials were carried out in
Nigeria through the University of Ibadan. At that time, the
university hospital was seeing more than one thousand measles cases

(29:57):
annually with a mortality rate of about percent, so measles
was a particular threat there as well. One phase of
these trials was on the children of the university's faculty
and staff, who were invited to participate.

Speaker 2 (30:12):
The trials in the US and Nigeria demonstrated that this
vaccine was highly effective at preventing measles, and it was
licensed for use in the US on March twenty first,
nineteen sixty three. A team led by Maurice Hillman developed
a more attenuated version of the vaccine in nineteen sixty eight.
This more attenuated strain became known as the Edmonston Enders strain,

(30:35):
and it ultimately became the only measles vaccine distributed in
the US.

Speaker 1 (30:41):
The development of a measles vaccine marked something of a
shift in how vaccines were approached in most of the world.
Prior to this, the focus had been on diseases that
were extremely serious and deadly, including smallpox and polio, but
especially in the US and Europe, measles had come to
be seen as a root disease of childhood and not

(31:02):
a deadly scourge that needed to be stopped. On top
of that, people typically only got measles once in their lives,
and many people had fears about the safety of the vaccine,
as has been the case with every vaccine, so this
made it harder for health officials to convince people to
have their children vaccinated. But even with those challenges, measles

(31:23):
cases dropped dramatically in the United States after the start
of a coordinated vaccine campaign. In nineteen sixty seven, there
were four hundred and fifty thousand cases of measles reported
in the US. It was a reportable disease.

Speaker 2 (31:39):
Health officials were required to report all the cases, but
in nineteen sixty eight, just a year later, there were
only twenty two thousand. But there were also some clear
disparities and who had access to this vaccine. It was
mostly being administered by doctors who were working in private practice,
meaning that most of the people who were getting it

(31:59):
were middle or upper class. So while the total number
of measles cases dropped precipitously, cases became really clustered among
the populations that were underserved by the medical community, including
non white communities and people living in poorer areas. It
did not take long after the introduction of measles vaccines

(32:20):
for nations to start looking at the idea of eliminating
the virus entirely, especially as it became clear that the
vaccine conferred long term immunity, and initially researchers thought it
might be possible to eradicate measles if as little as
fifty five percent of the population was vaccinated. That turned
out to be way too low a target. Measles is

(32:41):
so contagious that roughly ninety to ninety five percent of
the population needs to be immune to keep it from spreading,
but nations started efforts to eliminate the disease pretty quickly.
In nineteen seventy eight, the US Centers for Disease Control
announced a plan to eliminate measles in the US by
nineteen eighty two. That did not happen, but the number

(33:02):
of measles cases in the US did drop another eighty
percent between nineteen eighty and nineteen eighty one. That was
so ambitious of a goal to me, especially considering like
living through however, many years of like COVID nineteen pandemic response,
the idea of like, we're going to eliminate this in

(33:23):
three years, and like that's wild.

Speaker 1 (33:26):
Uh.

Speaker 2 (33:26):
In nineteen ninety eight, though, efforts to eradicate measles worldwide
faced a huge setback when The Lancet published an article
by Andrew Wakefield and various co authors which claimed that
the measles mumps rubella or MMR vaccine caused a form
of colitis that then caused autism. This paper was not
just wrong, it was fraudulent, and Wakefield had been funded

(33:48):
by an attorney who was representing parents who were trying
to sue vaccine manufacturers. The Lancet retracted this article in
twenty eleven after in depth reporting on the many many
problems with it, and Wakefield was ultimately struck from the
medical register in the UK. Numerous follow up studies since
then have concluded that there's no link between the MMR

(34:11):
vaccine and autism, and autism advocates have also noted that
it's extremely offensive to suggest that it's better to risk
a potentially fatal disease than to be autistic. Measles was
declared eliminated in the United States in the year two thousand,
but there have been outbreaks since then when measles has
been reintroduced from other places. One of the most high

(34:31):
profile outbreaks was connected to Disneyland in California. The first
case of measles associated with this outbreak was reported to
the California Department of Public Health on January fifth, twenty fifteen.
Four other measles cases were reported to the department on
the same day, and two were reported in Utah. Everyone

(34:52):
involved had been to Disneyland or a neighboring park between
December seventeenth and twentieth, twenty fourteen. Most cases involved in
this outbreak were in southern California, but there were also
cases in sixteen other states, Canada, and Mexico. Under vaccination
was cited as a key factor in this outbreak. Of

(35:14):
the unvaccinated patients in California, twelve were infants who were
too young to be vaccinated, but almost seventy percent of
the patients who got it and were eligible for the
vaccine had not been vaccinated because of their personal beliefs.
This outbreak contributed to the passage of a law in
California that removed personal beliefs as a reason for people

(35:36):
to be exempt from vaccine requirements to attend schools and
daycares in California.

Speaker 1 (35:42):
On September twenty seventh, twenty sixteen, the Pan American Health
Organization declared measles to be eliminated in the Americas, but
this only lasted for a couple of years. Venezuela lost
its measles free status in twenty eighteen and Brazil in
twenty nineteen in the wake of civil unrest and an
anti vaccine movement.

Speaker 2 (36:04):
I'm just sort of continually waiting for the US also
to lose its measles free status, because we just keep
on having outbreaks and at some point they're they're going
to call it stopped. According to a report from the
Centers for Disease Control, as of twenty twenty two, there
were eighty three countries around the world that have achieved

(36:27):
measles free status, most of them in the Americas and Europe.
But deaths from measles also increased forty percent worldwide in
twenty twenty two, with epidemics in thirty seven countries. That
is up from twenty two countries that experienced outbreak the
year before. In January of twenty twenty four, the World

(36:48):
Health Organization warned of a sharp uptick in measles cases
in Europe, with thirty thousand cases reported in forty of
the European region's World Health Organization members states. That is
up from less than one thousand cases in twenty twenty two.
The European Center for Disease Prevention and Control reported that

(37:10):
in twenty twenty two, only eighty nine point seven percent
of people in Europe had had their second dose of vaccine,
that is below the level needed to maintain heard immunity.
Health officials in various parts of the world has cited
the COVID nineteen pandemic is a big reason for this
increase in measles cases in epidemics, both because of people

(37:34):
not having access to routine medical appointments in the first
years of the pandemic and being fearful of going to
those appointments once they were available, and because of increasing
vaccine hesitancy in connection to the rollout of COVID nineteen vaccines.
There's also some conjecture about the impact that the SARS
CoV two virus, which causes COVID nineteen has had on

(37:57):
the immune system, and whether it is similar to the
immune amnesia that can follow measles infection. But there's a
pretty clear connection between an overall drop in vaccination rates
and increasing rates of measles. Yeah, we're still very early
in understanding long term effects of COVID nineteen on the body,
but the like, there's just obvious lines that can be

(38:19):
drawn in decreasing numbers of people who were fully vaccinated
for measles and increasing numbers of measles cases. It is
absolutely a disease that is possible to eradicate around the world.
But only but you gotta participate. Yeah, only with everyone vaccinated.

Speaker 1 (38:38):
Uh yeah, do you have contagious listener, ma'am?

Speaker 2 (38:42):
I have listener mail. I would not call it contagious.
It is about healthcare though.

Speaker 1 (38:48):
Uh.

Speaker 2 (38:48):
This is from Judy and Judy's subject line made me laugh.
It says you made me realize I'm old, not a
bad thing. In relation to mammograms, uh. And Judy wrote,
Dear Holly and Tracy, listening to the mammogram episode in
your Friday comments, I was amused by your amazement of
the changes in your lifetime then I started thinking and
realizing that I am too. I'm in my seventies and

(39:10):
remember when mammograms could not only squish your breasts but
cause burns from the X rays if the tech wasn't
careful and the texts were usually males back then then
you had to wait for days, sometimes weeks to get results.
The new digital machines with mostly lovely female texts as
a joy. Some differences with PAP exams actually general medical

(39:33):
interactions for women. Now I now I'm thinking I should
make lists of things I've seen changed, usually for the better,
in my lifetime. It could be scary fun by the way.
This includes color TVs, email, walkman CDs and audio books,
a great thing for gardening, and backup cameras in cars.
All in all, things are better. I hope you can

(39:55):
make a similar list for your lives. Maybe everyone who
listens should do that and send it to you, and
miss in History could start a new segment changes in
our lives as you trace the technology or organization or person. This,
of course, is in addition to all the other research
you too. I've attached photos for pet tax in the

(40:15):
vein of history. I have attached a baby picture of JJ,
an abandoned neonate kitten I fostered. The second picture is JJ,
now still in my house as I couldn't give him
up as an eighteen pound cat. Enjoy. Thanks for all
the learning and joy and giving me a new way
to look at the world, Judy, So thank you Judy.

Speaker 1 (40:33):
This.

Speaker 2 (40:34):
I love this idea. Kitty What a tiny little kitty
cat face reminds me? I mean, my cats we brought
home at a reasonable age to bring kittens home, right,
but this little kitten face really reminds me of their

(40:54):
kitten faces, even though they were a bit bigger than
this one. And then of course this uh, very large
I moved I moved the picture to underneath my window
that it has Holly Holly's face on it. Uh. And
then of course adult black cat reminds me of my
adult black cats, especially because this one is on like

(41:18):
a fluffy bed type thing and we have a very
similar bed that uh. Sometimes kitty cats at my house
like sometimes not. Uh. So I love these cat pictures.
I love all these stories. I do think pretty often
having been born and starting to go to school at

(41:40):
an age where there was no email, there was like
prototype email, but like not not in the actual things
that consumers had.

Speaker 1 (41:51):
Actually we did, yeah, we were not using it.

Speaker 2 (41:53):
We were not. We were not in the worlds of
universities or the military who were like working on early
prototypes of what would become the World Wide Web. But like,
you know, having been a kindergartener when there was nobody
was emailing reports home, having not had a cell phone
as a child, carrying quarters to put in the payphone,

(42:16):
being dropped off at the mall, to walk around there
with a quarter to call my mom if I needed
her anyway, I think about these things all the time.
The world has changed so so so much in Holly's
in my lifetimes in memory. So yeah, one of my
favorite lists of this nature was not a list per se,

(42:38):
but Brian's aunt Beth, who I loved dearly, died three
weeks before her hundredth birthday. Oh goodness, and she was
really sharp and wonderful right to the end. And I
remember and I just had a soft spot for her.
We just I adored that woman.

Speaker 1 (42:54):
And I remember one point when she was in her
early nineties sitting down and talking about everything that existed
that was common that when she was like you know,
I know I'm old and that sometimes when I'm in
the car because she wasn't driving anymore and you and
Brian are driving, I get very nervous about the speed

(43:16):
and She's like, I remember when there weren't cars, and
I was like, whoa. Yeah, she was pretty amazing and
had an encyclopedic knowledge of the area she grew up
in and of the world, and she was world traveled,
so she was a great one for that. And I
wish I had written down that entire conversation or recorded it. Yeah,

(43:37):
but we have lots of great pictures of her doing
things that I'm like, Aunt Beth is the human encyclopedia
from like the late eighteen hundreds to you know, the
the I think I forget what year she was born.
I want to say it was nineteen oh four, but
they lived on a farm, so they did not have

(43:58):
a lot of modern stuff, so it was little. Yeah,
she was amazing, amazing.

Speaker 2 (44:05):
It's in my house somewhere, I'm pretty sure a video
of my grandmother and one of her sisters talking about
their childhood being raised in a rural parsonage during the
Great Depression reminds me of that a little bit. So anyway,
Thank you again, Judy for this email. Honestly, I love

(44:28):
this whole idea of thinking of ways that the world
has changed during our lifetimes, and I know that that's
going to be vastly different recollections for different people with
different experiences, But thank you so much for sending that
and sharing it with us. If you would like to
send us some notes about this or any other podcast

(44:50):
or history podcast at iHeartRadio dot com and we're on
social media's miss and History on Facebook and Instagram and
the thing that used to be Twitter. You can subscribe
to our show on the iHeartRadio app and wherever else
you'd like to get your podcasts. Stuff You Missed in

(45:11):
History Class is a production of iHeartRadio. For more podcasts
from iHeartRadio, visit the iHeartRadio app, Apple Podcasts, or wherever
you listen to your favorite shows.

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Tracy V. Wilson

Holly Frey

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