The Moose (measles) is loose again - and this time antivaxers are having the finger pointed at them.

Once again the moose is loose. 

Measles showed up in Disneyland in mid-December 2014.  The bastion for middle class North American children, the hallmark of all our childhood and most importantly the icon of healthy and safe families.  Yes there is something wrong with the picture of Disneyland being the source.   While only 84 cases were reported to date, this outbreak has the makings of something that could irritate North American for months.

Moreover this time the antivaccination movement is taking it on the chin. Over half the cases were confirmed as unimmunized, and only 8% had received two doses of vaccine.  The strain can also be linked back to the Philippine outbreak March 2014 which was traceable back to sub-Saharan Africa endemic illness that spread to the Netherlands unvaccinated community, that spread to the Phillippines through aid workers post the devastating November 2013 typhoon Haiyan.  

As Mickey would say “It’s a small world after all”

Measles is targeted for elimination, but until international efforts of all stripes come together, this is a persistent plague that will stay with us for decades.  The reasons behind the challenge in control were documented following another point source spread in the US, the 2012 Superbowl February 2012 that was more readily contained as the exposed population a tad older than the typical Disneyland crowds.

What is so notable in this event is the spread is being driven by the unimmunized and underimmunized, for which sufficient susceptible populations exist that transmission has the potential to sustained in the right circumstances. The calls for tighter controls on personal choice exemptions, increased mandatory requirements, improved documentation will once again remain in public’s eye through the core of the outbreak.  The defining event will be tragedy associated with someone who is ill.

So back to the demographics of the first generations at Disneyland.  Middle class, mostly likely insured, well off enough to afford a trip to Disneyland, likely well nourished – these are not the children that will suffer irreparable damage and death from measles.  They will recover and their parents may be steadfast in their belief that measles is a mild illness.   If, the virus spreads to a lower income gradient, undernourished and uninsured children – it will be at arms length from the causative agents of spread.  Moreover the very agents of spread will be the most vocal on the issues of personal choice, having dissociated themselves from any negative repercussions.

Good on those that are taking the antivaxers to task, its time the collective voices speak up for the public good.