A new study says a complication of measles that kills children years after they have been infected is much more common than previously thought, spurring one Calgary doctor to push for mandatory vaccinations for all Canadians and visitors to Canada.
The disease is subacute sclerosing panencephalitis (SSPE). University of California Los Angeles Dr. James Cherry told MedPage Today that in the pre-vaccine era, investigators thought it occurred in about one in 100,000 measles cases.
“But analysis of 17 cases — most related to the California measles epidemic in 1988 through 1990 — suggests the rate could be as high as one in 600, depending on the patient’s age at the time of infection,” Cherry told reporters at the annual IDWeek meeting, according to MedPage Today.
The Infectious Diseases Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA) and the Pediatric Infectious Diseases Society (PIDS) attended the meeting.
Measles commonly causes a fever, runny nose, cough, red eyes, sore throat and a distinctive rash.
The virus responsible for the infection is usually cleared from the body within 14 days. But in rare cases it spreads to the brain, where it can lie dormant for years – sometimes decades.
“I think the study is confirming that complications from diseases like measles are probably a little more common and definitely more severe than we had previously appreciated,” said Dr. Craig Jenne, who studies immunology and infectious diseases at the University of Calgary.
“It really points at things like vaccination to prevent the disease probably have a bigger impact than what we understood before.”
“This is big,” said Dr. Ellen Burgess, a professor at the faculty of medicine at the University of Calgary said on Monday. She is calling for mandatory measles vaccinations for all Canadians.
“This really solidifies that for me. This is a risk to the most vulnerable. I’ve done a lot of work and ethics over the years and I’m all for autonomy, but there comes a point where the rights of the of society outweigh the rights of the individual. And this is one of those situations,” Burgess said.
Immunization is not required by law in Canada and it is not mandatory for parents to immunize their children. However, Alberta’s Public Health Act states children and adults who aren’t immunized can be ordered to stay home after being exposed to vaccine-preventable illness.
“I think it’s our responsibility to say, ‘your child does not go to school unless they are vaccinated,'” Burgess said. “There are certain privileges that you get but there are certain responsibilities that you have as a citizen.”
“I think it should be required and I think the federal government would all be well within its rights to say to people who wish to come here and visit that if you’re going to come here to visit, these are the vaccinations that you require.”
Watch below: Global’s ongoing coverage related to measles
According to the Alberta Health website, people new to Canada lacking adequate documentation of immunization should be considered un-immunized and started on an immunization schedule appropriate for age or risk factors.
Burgess warns about people bringing in disease to Canada. She refers to outbreaks of measles in Alberta where the source was traced back to travellers returning to the province who were not vaccinated.
“It was people coming from countries where they aren’t vaccinated and they bring the illness here and then it spreads through the community where non-vaccination rates are high,” Burgess said.
“I think we would be well within our rights to say, ‘I’m sorry but this is the way it is.’”
But Jenne doesn’t think mandatory vaccinations are likely to happen.
“The concept of a mandatory vaccine is probably a pretty sticky idea. I’m not sure if it would ever be appropriate to make vaccines mandatory. There are a lot of personal choices and ethical issues involved,” Jenne said.
He says what is clear is that government should be strongly recommending vaccination and that parents should be sure of the risks and benefits.
“The one thing that doesn’t really get discussed though is when the individual’s right to choose a vaccine or refuse a vaccine–that influences the person beside them,” Jenne said. “Measles is an excellent example of this. Unless we have more than 95 per cent of the population vaccinated, the disease will spread and it will hit people who want to be vaccinated but for various reasons (like immunosuppression, things like that), they’re not allowed to be vaccinated. So they may want the protection but they can’t get it and then their neighbour gives them the disease.”