Malta is not immune to measles, or ignorance

Ultimately, society must guard against ignorance, as much as against contagious diseases

Though Malta successfully eradicated measles, by introducing the mumps-measles-rubella (MMR) vaccine on the national health service in 1982, health authorities have seen a rise in measles infections cases.

The increase follows a worldwide trend seen of late.

Measles is one of the world’s most contagious diseases, with the potential to be extremely severe.

WHO notes that in 2017, it caused close to 110,000 deaths worldwide. Even in high-income countries, complications result in hospitalization in up to a quarter of cases, and can lead to lifelong disability, from brain damage and blindness to hearing loss.

Though deadly, the disease is almost entirely preventable through a safe and effective vaccine; yet WHO statistics indicate that measles cases have continued to climb into 2019.

Preliminary global data shows that reported cases rose by 300% in the first three months of 2019, compared to the same period in 2018. This follows consecutive increases over the past two years.

There are multiple reasons why this has happened, including a lack of vaccine coverage in poorer countries. (Global coverage of the measles vaccine stands at 85% - short of the 95% required to prevent an outbreak.)

But in many parts of the Western world, the return of measles can also be attributed to a vocal anti-vaccination campaign pushed by people who reject science.

In fact, the recent spike has mostly affected the children born at the time when now-disgraced British doctor, Andrew Wakefield, published a study that claimed a link between the MMR vaccine and autism in small children.

This study was debunked 12 years later, and Wakefield also lost his warrant. Yet the damage caused by his study continues to be felt: many people remain inherent suspicious of vaccinations, and the perception of a link between vaccination and autism persists to this day.

Malta is not immune to these developments. So much so, that measles cases shot up by 500% in Malta in the first half of 2019: a third higher than the global average.

Public Health Superintendent Charmaine Gauci this week confirmed that, although Malta had eradicated measles and rubella, the figures now emulate European trends.

“We expected this to happen because we are not immune to what is happening in Europe… the majority of cases recorded this year form part of the cohort of people who were born during the period when the anti-vaccine movement started and their parents may have refused or missed on vaccinating their children,” Gauci told MaltaToday.

She dispelled the suggestion that the problem was a result of the growing foreign population. Of the 31 cases reported by the start of August, only six were potentially contracted from abroad.

Moreover, the return of measles was predominant among adults aged 16 and over. These are the children born after 1998, when Wakefield’s study first emerged.

“Measles is highly contagious and the epidemiological picture we have points to a relatively small group of unvaccinated people; otherwise we would have seen the measles virus spread at a much faster rate,” Gauci said.

There are no statistics to suggest how many people born in the aftermath of the 1998 vaccine scare are not immunised against measles, though the situation suggests that the numbers are low.

Perhaps the most worrying aspect, however, is not the number of unvaccinated individuals… but their age and vulnerability.

Parents who resist vaccinating babies and small children are highly irresponsible, as babies are by far at the highest risk of mortality due to measles.

“It is not acceptable for a parent to leave their child unvaccinated unless there is a valid medical reason, such as a child undergoing cancer treatment,” Gauci reiterated.

She added that a recent Danish study of over half a million children showed there was absolutely no correlation between MMR and autism.

Clearly, Wakefield remains till this very day a point of reference for those who prefer conspiracies peddled on social media and the internet: and again, Malta is not immune.

It is both a pity and a threat, that the obstinate small-mindedness of some risks reversing Malta’s positive record in eradicating measles and rubella, on the strength of its vaccination programme for all babies.

Apart from the need for parents to vaccinate their children, Gauci has urged anyone under the age of 50 to get vaccinated against measles if they missed out on the jab in their younger days. It could well be life-saving advice.

As for those who still doubt the efficacy of vaccines, in spite of their clear history of success in eradicating diseases, it helps to discuss the matter with doctors rather than use Google searches as reference points.

Given the amount of evidence against the autism link, it is nothing short of criminal to expose children to the risk of infection on that basis; especially when science has established time and again that the measles vaccine has none of the alarmist side effects that Wakefield fabricated.

Ultimately, society must guard against ignorance, as much as against contagious diseases.

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