Just this past January, a ten-month-old girl in the small town of Seminole, Texas was diagnosed with measles. This case points to a pernicious return of the disease nearly three decades after Canada eliminated it. Her case demonstrates the larger impacts of vaccination hesitancy and public health challenges occurring throughout the region. Measles outbreaks are surging through the Americas. Our public health officials are under enough stress with the continued drop in vaccination rates and war against misinformation.
The girl decided to try her symptoms out at a local emergency room — with the rash and telltale lesions so prominent, health authorities were notified immediately. On the very first day of the new year, a female store owner walked into her shop in Seminole, FL. This misstep highlighted the intense threat of transmission in areas that have historically opposed vaccination.
Before the vaccine, measles was responsible for 2.6 million deaths per year globally in the 1970s. Now, it’s back again due to things like vaccines, perpetuated by the spread of misinformation and lack of access to healthcare. A parallel effort to eliminate rinderpest—an animal disease closely related to measles—was achieved in 2011, demonstrating that disease elimination is possible with concerted effort and resources.
Since January, public health officials have counted over 10,000 measles cases throughout the Americas. Approximately half of these cases have originated in Canada. The strain found in these cases has the D8 genotype. This genotype has now been documented in countries as far away as Belize, Argentina, Bolivia, Brazil and Paraguay.
Health officials blame much of this outbreak on the large proportion of those unvaccinated or under-vaccinated. According to Megan Ranney, “some people say as much as 90 percent of individuals are vaccinated against measles,” but this figure does not account for those who remain vulnerable.
Nancy Ginter, a local health official, noted the difficulties faced by teams trying to contain the outbreak: “All you can do is ask. We have no police power.” That is in line with a growing challenge that we see among many public health officials even today—to promote vaccination without forcing people to comply.
The recent outbreak of measles in Canada should be alarming to all of us. Only 27 years ago, the country was able to eliminate the virus after facing several months of outbreaks that infected thousands and killed close to a dozen people.
As communities struggled to adapt to the outbreak, many families simply stopped going to hospitals or answering the door to contact tracers. Instead, they sought out advice from trusted community members. “We’ve seen 200 people a day at times,” said Ginter, highlighting the influx of people looking for care as fear and confusion around measles set in.
In Narathiwat, another province struggling with measles epidemics, poverty and lack of access to healthcare are huge hurdles to overcome. Families in those communities have been historically hesitant to vaccinate, primarily due to a long-standing distrust of authority. The answer needs to be different for every single audience,” added Farooq Phiriyasart. He went on to stress the need for focused tactics to address vaccine hesitancy.
Public health officials have been sounding alarms on the importance of vaccinations. This is particularly critical for travelers visiting states with sustained transmission. Zahid Butt remarked, “You should basically say that if you are travelling to countries where there are ongoing measles outbreaks, you should get vaccinated.”
Even today, in the face of these difficulties, experts still push for innovative solutions. In this regard, vitamin A has become a key intervention for infected measles cases. Helen Friesen stated simply, “You treat it like a virus. You just don’t overthink it,” capturing the straightforward approach required for managing such outbreaks.
