By Dr Ananya Mandal, MD
Measles in history was considered to be a life event that almost all children went through. References to measles can be found as far back as the 7th century A.D.
Early references to measles
Measles was described by Muhammad ibn Zakariya ar-Razi (860-932) or Rhazes – a Persian philosopher and physician, in the 10th century A.D. as a disease that is “more dreaded than smallpox”. Razes published a book entitled “The Book of Smallpox and Measles” (in Arabic: Kitab fi al-jadari wa-al-hasbah).
History of the causes of measles
A Scottish physician, Francis Home, demonstrated in 1757 that measles was caused by an infectious agent present in the blood of patients.
In 1954 the virus that causes measles was isolated in Boston, Massachusetts, by John F. Enders and Thomas C. Peebles.
The advent of the measles vaccine
The history of measles underwent a sea change in 1963 with the advent of the measles vaccine. The number of measles cases dropped by 99 percent. The vaccine was first licensed in the United States in 1963.
Measles before the vaccine
Before the vaccine, measles affected almost all of the population at some point in their lives. There were approximately three to four million cases, and an average of 450 deaths due to measles annually in the United States.
Every two to three years there was an epidemic of the infection affecting millions. Approximately 50 percent of the population had measles by the time they were six years old, and 90 percent had the disease by the time they were 15 years old.
The booster dose
It was between 1985 and 1988 that researchers found that many measles cases had occurred in children who had been vaccinated with the measles vaccine. This was particularly noted in children who received only one dose. These children were not always protected from the disease.
This led to the recommendation of a second dose for children between 5 and 19 years of age. The booster dose significantly increased the protection and children who did not develop immunity at the first dose developed one against measles with the second dose.
Measles outbreaks in the 1990’s
The cases of measles again soared between 1989 and 1991. For these three years 55,622 cases were reported. The cases were mostly children under five years of age and a high population of unvaccinated Hispanic and African American populations was noted among those affected.
During this time the number of measles cases for children under five years of age exceeded that of the group from 5 to 19 years old. There were 123 deaths from measles-related illnesses among the cases with 50 percent being less than 5 years of age.
Ninety percent of those who lost their lives had not been vaccinated. There were 64 deaths reported in 1990; this was the largest number that had been seen in almost 20 years.
Outbreaks were reported in 1993 in populations that refused measles vaccination. This included communities in Utah and Nevada, and in Christian Scientist schools in Missouri and Illinois. This changed with increased uptake of the vaccine yet again.
It was in March 2000 that an expert panel of the Center for Disease Control and Prevention (CDC) concluded that measles is no longer endemic in the United States. Due to an aggressive measles vaccination program by the Pan American Health Organization, measles incidence is now very low in Latin America and the Caribbean.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)