How bad could it become?

Texas health care personnel rushes to vaccinate infants against measles as a epidemic in the Spreads state. Credit: Jan Sonnenmair / Getty

In the United States, an epidemic of measles is developing, endlessly in sight. As of March 18, 279 cases had been reported in Texas, 38 to the neighboring New Mexico and up to 4 in Oklahoma, which also borders Texas. Measles killed a six-year-old unaccompanied child in the county of Gaines, Texas, the center of the epidemic, and is the suspected cause of death of an adult not vaccinated to new-mexic.

We have not yet seen signs of slowing down the epidemic, explains William Moss, an epidemiologist of infectious diseases at Johns Hopkins University in Baltimore, Maryland.

Even if health officials are trying to stop the epidemic, the American secretary for health and social services, Robert F. Kennedy Jr, who has a long history of anti-vaccination activism, only offered lukewarm support for the measles vaccine, a safe and powerful way to prevent infection. Kennedy has also promoted treatments, including cod liver oil, steroids and antibiotics, none of which is known to be effective against measles. (Kennedy said he did not oppose vaccination, but that it should be a personal choice.)

Nature asked specialists how things could get bad.

What is the size of the epidemic?

It is difficult to predict. An epidemic of measles is like a forest fire throwing sparks, says Moss. If a spark landed in a state like Maryland, which has a 97%measles vaccination rate, it goes out. But if the sparks of this initial fire end in the communities where the vaccination rates are low, then would have several major epidemics, says Moss.

I think that could reach thousands and thousands of cases, explains the virologist Paul offered at the children's hospital in Philadelphia in Pennsylvania.

Why is measles so incredibly contagious?

Measles is the most contagious disease that is transmitted directly between people. Epidemiologists use a metric called R0 to indicate the number of people, on average, a person with a given disease should infected. The R0 for measles is a huge 1218. In comparison, the R0 for COVID-19 at the start of the pandemic was estimated at around 1.42.5, and the R0 for the flu is around 12.

The measles is so contagious that in 1991, a single athlete with measles in a sports stadium infected 16 other people, including 2 seats at least 30 meters (about the length of a gymnasium).

Particles of the measles virus (artificially colored), one of the most infectious known pathogens. Credit: Cavallini James / BSIP / SPL

The measles is contagiously contagious partly because the dose necessary to infect someone is very small. In addition, the measles virus spreads through airborne droplets when an infected person breathes. If someone with measles passes into a room, infectious droplets can hang in the air or rest invisible on surfaces for two hours after.

What could be more, in the first 24 days, the disease often presents symptoms such as a fever, a cough and a flowing nose that can deceive people thinking that they have a cold. As a result, people with measles may not isolate when they are very contagious. Diseases revealing diseases generally only appear several days in the disease.

What are the long -term effects of measles?

Measles can kill: between one and three cases out of 1,000 non -vaccinated children is fatal. About 56% of infected people develop pneumonia, which is the most common cause of death in young children with measles. Measles can also cause a hearing aid or loss.

One of the strangest long -term effects is a rare, almost always deadly complication called sububigular sclerotic panencephalitis. It develops years after infection of measles and is characterized by a cognitive decline, personality changes and dementia.

Another long -term effect is immune amnesia. Measles can erase a large number of antibodies that store body memory in the way of fighting other diseases. There is evidence that measles could leave the immune system more sensitive to other diseases for about 23 years after infection1.

Even the acute symptoms of measles can be very unpleasant. They include oral ulcers, ear infections, rump, laryngitis and diarrhea.

The way we stop this is to vaccinate, says Moss.

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