Measles was first detected in two children in western Texas. Then it spread quickly.
Now 660 people are infected in Texas. Two children have died. They were not vaccinated.
The first death occurred in February. The girl was six years old and had no underlying conditions.
The second girl died in April. She was eight years old and otherwise healthy.
Both children belonged to the Christian Mennonite community. They are sceptical of the authorities and modern society. Therefore, they do not trust public health advice, such as vaccination.
Preben Aavitsland, acting director of infection control at the Norwegian Institute of Public Health (NIPH), has been following the measles outbreak in the USA.
"The fact that the outbreak has been ongoing since January shows that the virus finds the unvaccinated. Unfortunately, this can continue for a long time," Aavitsland tells sciencenorway.no.
The 900 registered cases are just the tip of the iceberg, according to the infection control director.
"We have to assume that there are unreported cases. Infected children who get rashes, but don't become very ill, don't go to the doctor," he says.
People without health insurance either do not want to or cannot afford to spend 5,000 dollars at the emergency room, he points out.
Measles gives you a rash all over your body, but also fever and possible additional illnesses.(Photo: Shutterstock / NTB)
Lacks clarity
Health Secretary Robert F. Kennedy Jr. has long expressed scepticism towards vaccines, especially the MMR vaccine against measles. He has spoken about harmful side effects and possible links between the vaccine and autism.
Now he recommends the MMR vaccine.
In an op-ed on Fox News in March, Kennedy wrote that vaccination is the most important measure to prevent measles, but emphasises that it is a personal choice.
Despite this shift, Kennedy has faced criticism from doctors and public health experts, according to AP News. They argue that he responded too late to the outbreak and that his endorsement of vaccination lacks clarity.
Robert F. Kennedy Jr. was highly critical of the MMR vaccine before he became the Secretary of Health.(Photo: Alex Brandon / NTB)
During a recent visit to Texas, Kennedy criticised the media for being too focused on infectious diseases rather than chronic conditions like autism and diabetes.
Annonse
"Every child who gets measles gets a headline. When I was a kid, there were two million measles cases a year and nobody wrote about them," said Kennedy, according to The Texas Tribune.
"The CDC, our sister institute, provides completely adequate information about getting vaccinated. But we see that the health secretary's communication isn't as clear," says Aavitsland at NIPH.
Not in Norway
Aavitsland does not believe such a measles outbreak will occur in Norway.
"Our vaccination coverage is very high. The MMR vaccine protects not only against illness but also prevents transmission. That means unvaccinated individuals can’t spread the virus," he says.
Still, there have been minor outbreaks in Norway.
"They've been very limited, either in a family with unvaccinated children or in an immigrant community with a low level of vaccination," he explains.
The MMR vaccine protects against both illness and transmission, according to Preben Aavitsland, the director of infection control at the Norwegian Institute of Public Health.(Photo: Tor Erik Schrøder / NTB)
Such outbreaks have had up to five infected individuals, and then they quickly stop.
"When almost everyone is vaccinated, the virus hits a wall of immunity," says Aavitsland.
If a child or an adult contracts measles in Norway, the authorities have clear protocols.
Small outbreaks have been stopped
"There's a mandatory reporting requirement. The doctor notifies the municipal doctor and the Norwegian Institute of Public Health. Patients are isolated at home or in hospital if they are very ill," explains Aavitsland.
Then an investigation is carried out to determine who the infected person has been in contact with and whether any of them are unvaccinated. If so, they are offered a vaccine.
"If we find several unvaccinated people in the same community, we launch a vaccination campaign. That usually stops the outbreak. We’ve seen it work many times," says Aavitsland.
Aavitsland emphasises that the five per cent who are unvaccinated in Norway are not necessarily opposed to the vaccine.
"Some have medical reasons for not getting vaccinated, while others fall out of the system, for example by moving between countries," he says.
Vaccination against measles began in Norway in 1969. Before that, between five and ten children died each year. In addition, many experienced complications, such as pneumonia and ear infections (link in Norwegian). Up to 30 children suffered from severe brain inflammation each year.
The USA has a lower vaccination rate. 91 per cent of children and adolescents have been vaccinated against measles, according to the CDC. That's too low, since measles is extremely contagious.
