One of the largest outbreaks in a generation

The Times has a long crushing despair-inducing piece by Eli Saslow on vaccine denialism and the return of measles. Very worth reading.

Twenty-five years after measles was officially declared eliminated from the United States, this spring marked a harrowing time of rediscovery. A cluster of cases that began at a Mennonite church in West Texas expanded into one of the largest outbreaks in a generation, spreading through communities with declining vaccination rates as three people died and dozens more were hospitalized from Mexico to North Dakota. Public health officials tracked about 1,200 confirmed cases and countless exposures across more than 30 states. People who were contagious with measles boarded domestic flights, shopped at Walmart, played tuba in a town parade and toured the Mall of America.

But what frightened Kiley more than the potential spread was the severity of the disease: About one in five unvaccinated people with measles will be hospitalized, according to the Centers for Disease Control and Prevention. As many as one in 20 children contracts a secondary pneumonia infection. More than one in 1,000 dies. Measles stops spreading when 95 percent of a community is immune, but national vaccination rates for children have fallen to less than 92 percent. In parts of West Texas, they’ve dropped below 80.

Measles is no joke.

“I feel like I’ve been lied to,” Kiley told his wife as his fever rose to 104 degrees. He tried to manage his symptoms at home with cod liver oil and vitamin D, supplements endorsed by Robert F. Kennedy Jr., the U.S. health secretary. He isolated himself in the living room to avoid infecting his four children and coughed and dry-heaved his way through the night.

“I’m just trying to breathe at the moment,” he texted one relative.

One morning about a week into his illness, Carrollyn walked into the living room and saw Kiley lying on the couch. His head was almost purple. A rash was blooming across his chest, and his mouth was dotted with dozens of white sores. She tested his oxygen level. It read 85 percent — low enough to endanger his vital organs. She tucked the monitor away to keep Kiley from panicking. He was hazy and confused, so she helped him into a fresh shirt and drove him to the emergency room, where he was quarantined and given oxygen, breathing treatments and X-rays to monitor his stomach cramps.

Does that sound like fun?

For more than a decade, Kiley and Carrollyn had debated whether to vaccinate their children. Each time, they decided against it.

The vaccine was considered both safe and 97 percent effective by the Food and Drug Administration. For generations, every credible American health official had recommended the M.M.R. vaccine, to prevent measles, mumps and rubella, as a basic obligation to society. Almost all parents in Texas had consented to the recommended two doses for their children, effectively eliminating measles transmission within the United States. But that success also meant the disease had gradually become an abstraction, a distant threat. Only three Americans had died of measles since 2000, and Kennedy rose to political prominence as a vaccine skeptic. He testified to Congress about the risk of rare vaccine injuries, and later fired all 17 experts on a vaccine advisory panel. “People ought to be able to make the choice for themselves,” he said in a March interview on Fox News.

No, they oughtn’t. Not unless they plan to live in a sealed house for the rest of their lives. That’s because it’s not possible to make the choice just for oneself. The choice is also for everyone else.

And all the while, Edwards continued to release his weekly podcast, hosting a rotation of authors, doctors and activists who minimized the danger of measles and spoke instead about the benefits of being unvaccinated and the risks of rare vaccine injuries.

“The body’s designed to kill measles,” Edwards said, as it spread into New Mexico and Oklahoma.

“I would encourage you to seek a higher authority, a spiritual authority, and let peace guide you,” he said, as the disease stretched into Kansas and Nebraska.

“Don’t be scared of anything,” he said, when the total number of reported measles cases rose above 1,000, almost all among people who were unvaccinated, as the virus continued to spread in Colorado, Pennsylvania and finally into the remote corners of North Dakota, arriving in the state for the first time in 14 years.

There’s much more. There is no happy ending.

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