Measles is a dangerous and highly contagious viral infection. These hazards can damage people, not only during the initial infection but possibly for decades afterwards. Health experts caution that nearly 9 out of 10 people who are vulnerable to infection can become infected simply by sharing an indoor space with someone who has the virus. Measles virus can linger in the air for two hours after an infected individual has left.
The tragic repercussions of measles go far beyond the sick child. A rare but catastrophic long-term consequence is subacute sclerosing panencephalitis (SSPE). It can manifest 7 to 10 years after a measles infection. This degenerative brain disease leads to dementia and can cause vision loss. It causes gait irregularities, eventually producing a lethargic posture and fatality within a matter of years. The lifetime risk of developing SSPE is estimated at 4 to 11 cases per 100,000 measles infections.
Along with SSPE, measles can cause severe complications during pregnancy, including pneumonia or encephalitis. Pregnant people are at increased risk, in part because pregnancy induces a state of immunosuppression. Only recently, Dr. Monica Gandhi called attention to a key issue. She went on to describe that during pneumonitis and measles in pregnancy, there is a higher risk of developing pneumonia or encephalitis, both severe complications of measles in pregnancy. The danger isn’t limited to mothers either — there is the risk of miscarriage, preterm birth, or developmental issues in the child.
Gandhi further elaborated on the concept of “immune amnesia,” where the measles virus impairs the immune system’s ability to protect against other infections. Somewhat horrifyingly, the measles virus is playing a game of active attrition against its new host’s old memory cells. It does this by generating new immune cells, notably lymphocytes that focus on the measles virus. The net result is that the healthy patient develops a strong immunity uniquely against the measles virus. With that has come an increased vulnerability to other pathogens, she noted. This leaves those who have had measles even more vulnerable to other infections such as pneumonia.
The public health implications of these findings are a stark reminder that vaccination is critical to preventing measles and its fatal complications. Preventive measures, which are inexpensive and effective, can greatly minimize the practical risk of infection and its serious long-term complications.
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