Doctor explains how the measles outbreak killed healthy kids

SALT LAKE CITY — During a press conference on Tuesday, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. said measles should not kill healthy children. A Utah doctor disagreed. 

“Healthy children should not die of measles and there’s no reason they should,” Kennedy said. “If the doctors know how to treat [it] at the hospital, that will not happen.” 

Two children have died during a measles outbreak that began in West Texas in January. Both of the children were healthy before contracting the infectious disease. Both of them were also unvaccinated. 

According to Andrew Pavia, a pediatric contagious disease doctor at University of Utah Health, measles is a highly contagious illness, specifically among unvaccinated people. 

Although it is more dangerous for immunocompromised or malnourished individuals, it still claims the lives of those who were healthy before contracting it. 

“The biggest and most dangerous myth about measles is that it’s not a dangerous disease, that it’s just like any other childhood illness. It’s not,” said Pavia. “It’s a potentially deadly illness and even when it’s not deadly, it’s miserable.” 

According to the Centers for Disease Control and Prevention, it’s spread by coughs and sneezes. Measles can live in the air for up to two hours and spread for as many as four days before symptoms appear. 

Pavia said approximately 90% of the unvaccinated people who live in a home with a measles patient will be infected. 

“One patient with measles surrounded by susceptible people, on average, will infect an additional 12 to 15 people,” said Pavia. 

He compared it to COVID-19, saying someone carrying the virus would only infect two to five people. Those with the flu are only likely to spread it to two people. 

Kennedy has voiced support for measles vaccination. However, his claims that the vaccine wanes over time have been disputed by medical professionals. 

Per the CDC, the MMR vaccine, which protects against measles, mumps, and rubella, protects against measles and rubella for life. However, Immunity to mumps may diminish over time.

FILE – In this Jan. 29, 2015, file photo, pediatrician Dr. Charles Goodman vaccinates 1-year-old Cameron Fierro with the measles-mumps-rubella vaccine, or MMR vaccine, at his practice in Northridge, Calif. (AP Photo/Damian Dovarganes, File)

Can measles kill healthy people? 

Both of the West Texas children killed during the measles outbreak lacked pre-existing conditions.

Pavia explained that the illness mainly attacks the body’s cells. 

“It attacks cells of the immune system and destroys them,” Pavia said. “It creates what we call immune amnesia, where you lose some of the specific immunity that you’ve gained over time to different pathogens.”

The attack doesn’t stop there — Pavia said it targets cells that line organs. For example, red, watery eyes are caused by attacks on the eyeball. Some cases lead to the destruction of the cornea and vision loss. 

In some instances, the infectious disease attacks the brain. 

“One way is that measles virus can enter the central nervous system and kill cells in the brain itself. That’s called encephalitis,” Pavia said. 

Or, an immune response can be triggered, causing the body to target white matter that insulates the brain and helps it function. 

“That has the fancy name of acute disseminated encephalitis or ADEM,” Pavia said. 

Although it’s very rare, subacute sclerosing panencephalitis, or SSPE, can occur, taking action between six and 10 years after infection. SSPE causes progressive brain damage, which worsens until the patient dies. 

Per Pavia, SSPE is the least common consequence of measles. However, it usually happens to the most vulnerable patients — infants who are too young to be vaccinated. 

Why is measles making a comeback? 

In 2000, measles was declared eliminated in the United States. Over the past 25 years, outbreaks have been small and often linked to illnesses brought in from overseas. 

Pavia explained that the two-dose measles vaccine is 97-98% effective in preventing cases. 

“[That] means that your chance of being infected drops by 98%.” 

FILE – A measles, mumps, and rubella vaccine is displayed in Provo on Wednesday, Jan. 7, 2015. (Jeffrey D. Allred/Deseret News)

The illness has a greater chance of spreading in areas with low vaccination rates. West Texas is one of them. 

According to Scientific American, Gaines County, which is the epicenter of the measles outbreak, has a vaccination rate of 82%. Although that number expresses that a majority are vaccinated, an area needs a 95% vaccination rate to achieve herd immunity. 

You may remember the term from the pre-vaccine days of the COVID-19 pandemic — herd immunity is reached when enough of a population has gained protection from a virus, either through vaccination or infection. 

“If you bring one patient with measles into an area where you have more than 95% of people vaccinated and you have a good public health response, usually the outbreak can be stopped very quickly,” Pavia said. “But if that initial patient arrives in a place where there are many, many susceptible [unvaccinated] people, and when the response is delayed or there aren’t adequate public health resources, that’s when you see large outbreaks.” 

Some Utah areas vulnerable to measles outbreak

Pavia noted that some areas in Utah have lower-than-optimal vaccination rates, like southwestern Utah and Utah County. Therefore, they have a higher risk of a measles outbreak. 

According to the Utah Department of Health & Human Services’ Immunization Dashboard, the 2024 vaccination rate for children between 24 and 35 months in the Utah County Health District was 85.5%. The Southwest Health District’s rate was 81.3% for the same period. 

The state, as a whole, also sits below the target 95%, having recorded a rate of 87.3% of children receiving their first dose of the MMR vaccine. 

Despite the lower-than-optimal vaccination rate, health officials recently told KSL NewsRadio the likelihood of a Utah outbreak is low. 

The CDC recommends children receive their first dose when they are between 12 and 15 months old. The second dose can come as soon as 28 days after the first, but the organization recommends it be administered when a child is between four and six years old.