Last week FlaglerLive carried a report that “Florida Surgeon General Joseph Ladapo has subverted a public health standard that’s long kept measles outbreaks under control. On Feb. 20, as measles spread through Manatee Bay Elementary in South Florida, Ladapo sent parents a letter granting them permission to send unvaccinated children to school amid the outbreak. The Department of Health “is deferring to parents or guardians to make decisions about school attendance,” wrote Ladapo, who was appointed to head the agency by Florida Gov. Ron DeSantis, whose name is listed above Ladapo’s in the letterhead. Ladapo’s move contradicts advice from the Centers for Disease Control and Prevention.
By David Higgins
“You don’t count your children until the measles has passed.” Dr. Samuel Katz, one of the pioneers of the first measles vaccine in the late 1950s to early 1960s, regularly heard this tragic statement from parents in countries where the measles vaccine was not yet available, because they were so accustomed to losing their children to measles.
I am a pediatrician and preventive medicine physician, and I have anxiously watched measles cases rise worldwide while vaccination rates have dropped since the early days of the COVID-19 pandemic due to disruptions in vaccine access and the spread of vaccine misinformation.
In 2022 alone, there were over 9 million measles cases and 136,000 deaths worldwide, an 18% and 43% increase from the year before, respectively. The World Health Organization warned that over half the world’s countries are at high risk of measles outbreaks this year.
The U.S. is no exception. The country is on track to have one of the worst measles years since 2019, when Americans experienced the largest measles outbreak in 30 years. As of mid-February 2024, at least 15 states have reported measles cases and multiple ongoing, uncontained outbreaks.
While this measles crisis unfolds, U.S. measles vaccination rates are at the lowest levels in 10 years. Prominent figures like the Florida surgeon general are responding to local outbreaks in ways that run counter to science and public health recommendations. The spread of misinformation and disinformation from anti-vaccine activists online further promotes misguided ideas that measles is not a serious health threat and measles vaccination is not essential.
However, the evidence is clear: Measles is extremely dangerous for everyone, and especially for young children, pregnant people and people with compromised immune systems. But simple and effective tools are available to prevent it.
Measles is a serious illness
Measles is one of the most deadly infectious diseases in human history. Before a vaccine became available in 1963, around 30 million people were infected with measles and 2.6 million people died from the disease every year worldwide. In the U.S., measles was responsible for an estimated 3 million to 4 million infections. Among reported cases, there were 48,000 hospitalizations, 1,000 cases of encephalitis, or brain swelling, and 500 deaths every year.
Measles is also one of the most contagious infectious diseases. According to the Centers for Disease Control and Prevention, up to 9 out of 10 people exposed to an infected person will become infected if they don’t have protection from vaccines. The measles virus can stay in the air and infect others for up to two hours after a contagious person has left the room. Measles can also hide in an unknowing victim for one to two weeks and sometimes up to 21 days before symptoms begin. Infected people can spread measles for up to four days before they develop its characteristic rash, and up to four days after.
CDC/Heinz F. Eichenwald, MD
The initial symptoms of measles are similar to those of many other common viral illnesses in the U.S.: fever, cough, runny nose and red eyes. Several days after symptoms begin, characteristic tiny white spots develop inside the mouth, and a facial rash spreads to the rest of the body.
While most people’s symptoms improve, 1 in 5 unvaccinated children will be hospitalized, 1 out of every 1,000 will develop brain swelling that can lead to brain damage, and up to 3 of every 1,000 will die. For unvaccinated people who are pregnant, measles infection can lead to miscarriage, stillbirth, premature birth and low birth weight.
The risk of severe complications from measles persists even after a person appears to be fully recovered. In rare cases, people can experience a brain disease called subacute sclerosing panencephalitis that develops seven to 10 years after infection and leads to memory loss, involuntary movements, seizures, blindness and eventually death.
Beyond these individual health effects, the financial cost to society for containing measles outbreaks is significant. For example, a 2019 measles outbreak in Washington state is estimated to have cost US$3.4 million. Necessary efforts to control measles outbreaks pull millions of dollars’ worth of critical resources away from other essential public health functions such as ensuring food safety, preventing injuries and chronic diseases, and responding to disasters.
Vaccines protect against measles
Why put communities at risk and allow these societal costs from measles when effective and safe tools are available to protect everyone?
Measles vaccines have been so effective, providing lifelong protection to over 97% of people who receive two vaccine doses, that they are victims of their own success. Initial widespread measles vaccination had reduced measles cases by 99% compared to before the vaccine was available, and consequently, most people in the U.S. are unaware of the seriousness of this disease.
Paul Hennessy/NurPhoto via Getty Images
Despite the success of highly effective vaccination programs in the U.S., anyone can still come into contact with measles in their community. Measles is most often brought into the U.S. by unvaccinated American travelers returning home and sometimes from foreign visitors. For people traveling out of the country, the threat of measles exposure is even greater, with widespread outbreaks occurring in many travel destinations.
Public health leaders who embrace and promote vaccination and follow simple, proven infectious disease containment measures can help prevent measles disease spread. Every single preventable illness, complication, hospitalization or death from measles is one too many.
David Higgins is a Research Fellow and Instructor in Pediatrics at the University of Colorado Anschutz Medical Campus.
The Conversation arose out of deep-seated concerns for the fading quality of our public discourse and recognition of the vital role that academic experts could play in the public arena. Information has always been essential to democracy. It’s a societal good, like clean water. But many now find it difficult to put their trust in the media and experts who have spent years researching a topic. Instead, they listen to those who have the loudest voices. Those uninformed views are amplified by social media networks that reward those who spark outrage instead of insight or thoughtful discussion. The Conversation seeks to be part of the solution to this problem, to raise up the voices of true experts and to make their knowledge available to everyone. The Conversation publishes nightly at 9 p.m. on FlaglerLive.
DaleL says
David Higgans left out another potentially deadly feature of a measles infection, Immune Amnesia. Research has shown that the measles virus wipes out a high percentage of the different antibodies that protect a person from other viral and bacterial strains that a person was previously immune to. This “amnesia” can last for several years. Thus a person can get measles, fully recover and then get numerous other diseases that they otherwise would have been immune to.
Senior author Stephen Elledge, the Gregor Mendel Professor of Genetics and of Medicine in the Blavatnik Institute at HMS and Brigham and Women’s, said this: “We now understand the mechanism is a prolonged danger due to erasure of the immune memory, demonstrating that the measles vaccine is of even greater benefit than we knew.”
https://hms.harvard.edu/news/inside-immune-amnesia
Pogo says
@DaleL
Thank you.
Elected Republicans’ unethical, unprofessional, unconscionable conduct in service of pandering to, and too frightening, the hoi polloi… are nothing less than a crusade against medical science and human reasoning; Pasteur, Lister, Semmelweis, to name a few, must be spinning in their graves.
Real physicians
As stated
https://www.google.com/search?q=Pasteur
As stated
https://www.google.com/search?q=Lister
As stated
https://www.google.com/search?q=Semmelweis
Toto says
It’s wrong to call Dr Lapdog a “prominent surgeon general of Florida” ! This guy is a disgrace to the profession. He’s more concerned with pleasing DuhSantis than honoring the hepatic oath. Shame on him and the BS he spews!
Tired of it says
Unbelievable. It is thei rMAGA, unvaccinated followers that are most likely to get sick. Karma.
JW says
We are suffering in this country from a sickening belief in freedom. This has resulted in the anti-vaxxers movement and antisocial behavior in general (see the behavior of Congress). The GOP and some religious leaders are behind this movement. Please educated yourselves. There should be no exemptions for mandatory childhood vaccination in schools.
Mr. Ladapo should be replaced! And Mr. DeSantis should apologize for this appointment and correct it.
Sherry says
JW. . . Right On, Thank You!
DaleL says
I agree; there should be no exemptions for mandatory childhood vaccination. How is it that a parent who does not properly secure their child in a car can be criminally charged, while a parent who refuses to have their child vaccinated cannot?
“Dr.” Ladapo seems to suffer from the Dunning-Kruger Effect. People with limited knowledge, not only reach mistaken conclusions and make regrettable errors, but their incompetence prevents them from realizing it.
Ed P says
Good news is that this is actually a problem for the unvaccinated. Unlike Covid.
Why is it always referenced as an unvaccinated “traveler” who came in contact with measles? Is it possible the flood of illegals pouring over our borders and fanning out among our might also be a source? Of course not, you bigot.
Most of citizens born before 1957 had measles and are naturally immunized unless a compromised immune system exists. Mandatory vaccination of school aged children in the US was put in place in 1980.
And yet it’s estimated that 33 million children have not received both of the 2 step vaccines. Children under 1 are too young and about 11 million haven’t got the second shot yet.
Some people believe the government is already overly obtrusive in our lives’. Who didn’t mind producing an covid vaccine card to leave your home? Based on the negative side effects of the masking, shut downs, and isolation that was imposed on children during Covid, the “scientific expertise” was far from perfect.
So who’s quaffed to determine if Dr Ladapo is correct? Where’s Fauci?
Laurel says
Anthony Fauci (born December 24, 1940, Brooklyn, New York, U.S.) is an American doctor and scientist who, as director of the National Institute of Allergy and Infectious Disease (NIAID; 1984–2022), played a key role in diagnosing and treating a number of contagious illnesses, notably AIDS and COVID-19.
– Britannica
Being that Dr. Fauci has been successfully researching, and fighting diseases since 1984, and the fact he is 84 years old, and he and his family have received death threats from the most ignorant of Americans, I figure he’s earned a retirement.
Justbob says
We would expect nothing less from this bone-headed Surgeon General, a former member of America’s Frontline Doctors, who among other insanities claimed that demon sperm was responsible for many illnesses.
Jack Howell says
I am amazed at Ladapo’s ignorance! Notice that I did not address him as a Doctor. Since 2004, I have been an instructor in Prepare Florida for Weapons of Mass Destruction. I have also attended numerous schools addressing Weapons of Mass Destruction throughout my military career and while instructing at the Jacksonville Sheriff’s Academy. I currently teach in this subject area at the undergraduate and graduate levels at several colleges and Universities. I am considered a Subject Matter Expert. That said, my position is that Ladapo is deadly wrong in his guidance on measles. Measles can be deadly if exposed. The history of this disease bares this out. Unfortunately, those who refuse vaccinations will enable measles to spread and kill. Ladapo’s inappropriate and ignorant guidance will have a hand in this!
By the way, I bet our half-assed governor and his family are vaccinated against measles!
Atwp says
Continue to vote Republicans. They have bad results, even deadly results.
Backatya says
Send this dipshit packing along with his buddy desanctimonoius.. Bunch of dumbass maga asswipes.
Sherry says
This charlatan of a doctor should have his license revoked immediately! He is an actual danger to the citizens of Florida!
Instead of spreading fear and hatred of migrants and their exposure to diseases, we should be doubling down to insure that we are vaccinated. Our governments should also require that all migrants be vaccinated against the contagious diseases they may have been exposed to.