Doctors, talk tough on measles

The deserted graveyard called Vunivesi sits silently by a small brook obscured by a mangrove canopy on the South Sea Island of Fiji. The mass gravesite, abandoned decades ago, is unknown even to most Fijians. No one knows how many are buried there, but many of the dead likely spent their final moments lying in the nearby water for relief from fever and suffering.

Across the Pacific Ocean, 5,000 miles away, are the trendy West Los Angeles enclaves of Santa Monica, Brentwood and Beverly Hills, among the world’s wealthiest communities.

What could these affluent neighborhoods possibly have in common with the quiet graveyard of Vunivesi?

Measles.

In 1875, one of deadliest outbreaks of measles in modern history devastated Fiji, killing one-third of the island’s 100,000 inhabitants. Ironically, measles was Fiji’s first gift from Great Britain upon becoming a member of the British Empire. To celebrate Fiji’s entrance into the Commonwealth, a British ship escorted Fijian leaders for a state visit to Sydney, then the closest British government seat. The entourage stayed at Sydney’s finest hotel, amazed by the conveniences of the modern world. Unfortunately, they were also infected by a measles epidemic coursing through eastern Australia.

They carried the disease back to Fiji and within weeks, measles swept over the island, killing thousands.

One medical historian wrote, “Death drums sounded incessantly in seemingly deserted villages. So many die so quickly that timely burial became impossible. Graves were only half dug because no one had the strength to dig.”

Lacking the strength to find food, thousands more died of starvation. After the outbreak, one British missionary described the eerie stillness of the deserted villages.

One-hundred and forty years is not that long ago. Many baby boomers’ great-grandparents, and some grandparents, could have been born around 1875. Among America’s greatest achievements in that time has been the near eradication of vaccine-preventable diseases. The numbers for measles are impressive; in the pre-vaccine year of 1958, there were 763,094 cases and 552 deaths. In 2004, 37 cases — a historical low — and not a single measles death was reported.

But measles is making a comeback, and the “hot zone” is Southern California. Researching the story, The Hollywood Reporter found, “the local children statistically at the greatest risk for infection aren’t, as one might imagine, the least privileged — far from it. An examination by The Hollywood Reporter of immunization records submitted to the state by educational facilities suggests that wealthy Westside kids — particularly those attending exclusive, entertainment-industry-favored child care centers, preschools and kindergartens — are far more likely to get sick (and potentially infect their siblings and playmates) than other kids in LA. The reason is at once painfully simple and utterly complex: More parents in this demographic are choosing not to vaccinate their children as medical experts advise. They express their noncompliance by submitting a form known as a personal belief exemption instead of paperwork documenting a completed shot schedule … (in some schools) numbers are in line with immunization rates in developing countries like Chad and South Sudan.”

The current anti-vaccine movement had its roots in a 1998 study by a British doctor, Andrew Wakefield. His now-discredited study was published in the world’s most prestigious medical journal, Lancet. Lancet retracted the paper after discovering Wakefield’s methods were sloppy and unethical, his conclusions unwarranted, and he had failed to disclose significant financial interests. The UK General Medical Council declared he acted dishonestly and irresponsibly. Despite this, celebrities including Jenny McCarthy, Kristin Cavallari, Donald Trump and Robert Kennedy Jr. have spearheaded the anti-vaccine movement.

This marks a dramatic reversal from a time when Hollywood celebrities enthusiastically endorsed the fight against polio. In 1956, at the height of his popularity, Elvis Presley posed for his polio vaccination. Parents, witnessing the tragedy of death and paralysis, lined up to have their children inoculated with the still incompletely tested polio vaccine.

The medical community must exert greater leadership. The new surgeon general, Vivek Murthy, having been out of residency for less than a decade, may lack historical perspective. He has been on-point but tentative: “The most important message I have is to please, please, please get your child vaccinated … I recognize that some of the concerns parents have about vaccinations come from a place of wanting to do the best to protect their children … I believe that on this topic, the science is very clear.”

No mention of the lax immunization requirements in states like California.

Murthy’s comments, like those of Republican presidential hopefuls Rand Paul and Chris Christie, may be tempered by political concerns. But Murthy should look for example to one of his predecessors, C. Everett Koop.

Koop, surgeon general during the early years of the AIDS epidemic, infuriated many conservative supporters with candid, medically accurate statements about HIV. He was forceful and undeterred by politics. “Everything I ever said caused controversy,” he said. “That’s the nature of the job … It’s a controversial job and you have to have a very thick skin, and you cannot let yourself be pushed by political pressures about what is politically correct and what is not.”

Right now, that type of candor is needed. Those unfortunate Fijians at Vunivesi were victims of something they were unaware of and could not control. If future Americans fall victim to a severe strain of measles or another vaccine-preventable disease, the fault will not be in our stars but in ourselves.

Dr. Cory Franklin resides in Wilmette.