HomeMy WebLinkAboutStop the hysteria over measles outbreaks OPINION - BGlobe & Mail - 10/03/2018 - BGlobe & Mail - 10/03/201810/3/2018 Stop the hysteria over measles outbreaks - The Globe and Mail
Stop the hysteria over measles outbreaks
NEIL RAU AND RICHARD SCHABAS
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Neil Rau is an infectious -diseases specialist and medical microbiologist based in
Oakville, Ont., and an assistant professor at the University of Toronto. Richard
Schabas is a former public-health physician and was Ontario's chief medical officer
of health 1987-97.
Measles outbreaks in Europe — particularly a current one in Ukraine — with
thousands of cases and dozens of deaths have focused attention on this disease.
Despite the availability of a highly effective vaccine, measles survives into the 21st
century courtesy, of a combination of disorganization, poverty and anti -vaccine
ignorance. Measles remains an important disease of children in developing
countries, with high infection rates and a real risk of serious complications and
death, killing almost 90,000 children in 2016. But what does all this mean for
Canada?
Measles is a highly infectious viral respiratory disease associated with a
characteristic skin rash. Historically, virtually every child born in Canada got the
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Stop the hysteria over measles outbreaks - The Globe and Mail
Put the triumph against measles in Canada into perspective. Without measles
vaccine, we would expect about 350,000 cases in Canada each year. Instead, we see
a few dozen reported cases. At current rates, Canada can expect to see a death from
acute measles about once every hundred years or so. The borderline hysteria, fuelled
by the media and public health, that greets a few cases is unwarranted.
Anti -vaccine sentiments are real but their numbers are small and not growing. In
Ontario, for example, all exemptions (both medical and philosophical) under the
school -immunization law have hovered around 2 per cent since legislation was
introduced 35 years ago — a small and stable number. Our current levels of
immunization are more than adequate to achieve herd immunity, which means that
measles cannot spread in a sustained way. This protects everyone, even those who
have not been immunized.
Anti-vaxxers are infuriating because they freeload on the population herd
immunity. You can compare them to transit -fare evaders: The bus may run anyway,
but if everyone took this attitude, public transit would collapse. Ditto measles
immunization. However, the main harm anti-vaxxers cause is to their own children
who are not protected from sporadic imported cases. Fortunately, the risk they pose
to immunized children is negligible. While we regard anti-vaxxers with the
contempt they deserve, severe enforcement policies directed at this group (e.g.,
withdrawing social benefits as proposed in Australia) would do more harm than
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Stop the hysteria over measles outbreaks - The Globe and Mail
a free and open society that doesn't force people to be immunized. Canadian
measles outbreaks are nonetheless few, small and short because of our herd
immunity.
Travel — not immigration — is what continues to bring measles to Canada. This is an
important distinction in world where scapegoating immigrants is increasingly
commonplace. A traveller — be it a Canadian going abroad or a foreign visitor — is
just as capable of bringing measles to Canada as a susceptible immigrant. There are
far more travellers each year than there are arriving immigrants. Until global
eradication of measles is achieved, episodic measles importation will remain a factor
that we simply have to live with.
Canadians should be reassured that we are pulling our weight in measles
eradication at a domestic level. We have not had sustained spread here for decades.
We are not exporters of infection for other countries. But measles will remain a
reality here for years, even decades, to come. Fortunately, our high immunization
levels, our robust general health and our excellent health care mean that measles is
no longer an important public health threat here. Stay calm, get your children
immunized and carry on.
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Stop the hysteria over measles outbreaks - The Globe and Mail
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Stop the hysteria over measles outbreaks - The Globe and Mail
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