The measles outbreak in West Texas is more than just a rash and fever. The situation, which is still growing, has resulted in 29 individuals, primarily young children, being hospitalized. Tragically, two people have lost their lives, including a 6-year-old child. While there have been at least 223 confirmed cases, experts suspect that hundreds more may have been infected since late January. Efforts are underway by public health officials to contain the highly contagious virus, with concerns raised about potential long-term complications.
Measles is a unique disease among childhood viruses, as it can lead to severe outcomes such as pneumonia. In some cases, approximately 1 in 1,000 patients may develop encephalitis, a brain swelling, with 1 or 2 deaths per 1,000 cases, according to the Centers for Disease Control and Prevention. The virus can also have a lasting impact on the immune system, known as “immune amnesia.”
When we fall ill to viruses or bacteria, our immune system forms memories that help it recognize and combat these pathogens upon future encounters. Measles specifically targets cells in the body, like plasma and memory cells, which store these immune memories, potentially eradicating some of them in the process.
Dr. Michael Mina, a vaccine expert and former epidemiology professor at Harvard T.H. Chan School of Public Health, highlights how a measles infection can significantly deplete a person’s antibody reserves, making them more susceptible to other illnesses. This phenomenon, termed “immune amnesia,” weakens the immune system’s ability to remember and combat previous infections.
Akiko Iwasaki, a professor of immunology at Yale School of Medicine, explains that this immune amnesia leaves individuals vulnerable by erasing their immune system’s recognition of past threats. While everyone infected with measles experiences some degree of immune suppression, the impact can vary from person to person.
Prior to vaccinations, measles was linked to a considerable number of childhood deaths from infectious diseases, indirectly through illnesses like pneumonia, sepsis, diarrheal diseases, and meningitis. Research has shown that measles infection can swiftly suppress the immune system, potentially lasting for several years.
To combat these risks, the most effective defense is the measles vaccine. Administered in two doses, the vaccine is 97% effective in preventing measles infection.
In conclusion, the consequences of measles extend beyond its immediate symptoms, highlighting the importance of vaccination in safeguarding public health and immunity.
If individuals are exposed to the same strain of a virus causing diarrhea a second time, they are likely to experience milder symptoms on the subsequent exposure. This phenomenon, known as immune amnesia, implies that the body’s response to the virus is reset, lacking the previous level of protection. Consequently, immunity developed over time against various pathogens like the common cold, flu, pneumonia-causing bacteria, and others can be compromised by the measles virus.
The impact of measles on the immune system can be likened to the long-term immunosuppression seen in untreated HIV patients. Measles targets crucial components of the immune system, such as plasma cells in the bone marrow, which produce antibodies guarding against foreign invaders. The virus also attacks memory cells responsible for recognizing and combating pathogens, diminishing the body’s ability to mount a swift immune response upon subsequent encounters.
The measles virus enters the body through inhalation and is carried to the lymph nodes by macrophages, where it impairs and destroys memory cells. This depletion of immune memory renders individuals susceptible to a wide range of infections unrelated to measles. The immune system can gradually rebuild its memory by encountering other pathogens, although this process may render individuals more susceptible to infections immediately following a measles episode.
Additionally, measles can lead to severe complications such as subacute sclerosing panencephalitis (SSPE), a fatal brain disorder that can manifest a decade or more after recovering from measles. SSPE causes progressive brain damage, cognitive decline, and often ends in coma or death. Recent data suggests that SSPE cases, previously considered rare, may be more prevalent, particularly among unvaccinated children.
Dr. Bessey Geevarghese, a specialist in pediatric infectious diseases at Northwestern Medicine, explained that the disease known as SSPE can initially present with subtle changes in personality and behavior in children, such as declining performance in school. As the disease progresses, it can lead to seizures, abnormal movements, and damage to parts of the brain responsible for regulating vital signs like breathing, heart rate, and blood pressure, ultimately resulting in death. Unfortunately, there is no cure for SSPE, and it is almost always fatal, with patients typically surviving one to three years after diagnosis. While there are usually four to five cases reported in the United States annually, this number may be an underestimation, according to Ratner from NYU Langone Health, who believes that SSPE may be more common than currently recognized due to underdiagnosis. With the increasing frequency of outbreaks, it is anticipated that more cases of SSPE will come to light in the future.
