Recently, the Samoa measles epidemic has been in the news, with at least 60 individuals who have died as the result of the virus (as of 4 December 2019). The vast majority of these deaths could have been prevented with the extremely safe measles vaccine.
Of course, those of us on the science side are appalled what is going on there. Children (and some adults) have died from a disease that should have been exiled to history books as a result of vaccines.
Once this Samoa measles epidemic hit the news, the vaccine deniers came out of their putrid swamps to use the epidemic as some sort of condemnation of vaccines. Their twisted logic would be the envy of pretzel manufacturers worldwide.
This article is going to review what’s going on in Samoa. And we are going to take a look at a couple of responses and lies from the usual anti-vaccine pseudoscience.
A measles primer
Measles (also called rubeola, not to be confused with rubella, or German measles) is a respiratory disease caused by the Measles morbillivirus. This virus normally grows in the cells that line the back of the throat and lungs.
The virus is spread through respiration (contact with fluids from an infected person’s nose and mouth, either directly or through aerosol transmission), and is highly contagious — 90% of people without immunity sharing living space with an infected person will catch it.
There are no specific treatments for the disease. There are no miracle preventions – except, of course, for the MMR vaccine (for measles, mumps, and rubella). And just to be clear, there is no link between the vaccine and autism – this is settled science.
The oft-repeated, and highly inaccurate, claim that vitamin A supplements can cure or prevent measles completely misses the mark. It’s important to supplement with vitamin A to prevent blindness as a result of measles, but it doesn’t reduce mortality or prevent some neurological issues unless there is chronic vitamin A deficiency.
According to the CDC, some of the many measles complications are:
- About 30% of measles cases develop one or more complications.
- Pneumonia, which is the complication that is most often the cause of death in young children.
- Ear infections occur in about 1 in 10 measles cases and permanent loss of hearing can result.
- Diarrhea is reported in about 8% of cases.
- As many as 1 out of every 20 children with measles gets pneumonia.
- About 1 child in every 1,000 who get measles will develop encephalitis, an inflammation of the brain that can lead to convulsions, deafness, and other long-term neurological deficits.
- A measles infection can result in short- and long-term immune system dysfunction which can leave the child susceptible to other diseases early in life (which is in direct opposition of claims by anti-vaccine activists that it helps “boost” the immune system).
- About 1-2 children, out of 1000 who contract measles, may develop subacute sclerosing panencephalitis (SSPE), a rare chronic, progressive encephalitis that affects primarily children and young adults– it is caused by a persistent infection of the measles virus. The disease starts with measles infection, usually before the age of 2 years, followed by approximately 6-15 asymptomatic years. Some researchers think the asymptomatic period is around 5-8 years after the initial disease. Gradually, the disease progresses with psychological and neurological deterioration, which can include personality changes, seizures, and coma. It is always ultimately fatal.
- And sadly, for every 1,000 children who get measles, 1 or 2 will die from it.
I’m not here for fear-mongering – but real science tells us that measles is a dangerous, debilitating disease that has both short and long-term consequences.
Samoa measles epidemic – a brief history
This isn’t the first time that measles has been in the news with respect to the Pacific nation of Samoa. In 2018, two Samoan children died soon after receiving the MMR vaccine, a story which, predictably, was abused by the anti-vaccine religion based on zero legitimate information
In 2019, two Samoan nurses pleaded guilty to manslaughter and obstruction of justice charges. The children’s deaths resulted from improper reconstituting of the vaccines (the MMR vaccine is shipped in a lyophilized form and must be reconstituted with a buffer solution, called diluent).
Before the Samoan government uncovered the negligence of the two nurses, the country suspended its MMR vaccine program which I suppose was prudent, given the lack of information at the time. Unfortunately, that meant a large group of children lacked immunity to the dangerous disease, and it probably contributed to the current Samoa measles epidemic.
Unfortunately, the negligence of these two nurses was combined with a decreasing MMR vaccine uptake in the country.
According to WHO, the vaccine uptake had dropped to below 40% prior to this epidemic. So piling on the negligent nurses, the government delay in reinstituting MMR vaccinations, and the nascent vaccine refusal in Samoa lead to this epidemic.
Since Samoa is a tiny country, with less than 200,000 people, 60 deaths is a huge number. I, on the other hand, think that even one preventable death is too large, but many anti-vaxxers seem to ignore this.
Using the current number of 60 deaths in Samoa, an incidence rate of 306.4 deaths per 1,000,000 individuals.
- For the USA, this would translate to 100,182 deaths.
- For Canada, 11,521 deaths.
- For the UK, 20,682 deaths.
- For Australia, 7,813 deaths.
- For Germany, 25,431 deaths.
- For Japan, 38,698 deaths.
OK, I could go on and on for every country in the world, but that would take forever.
But there’s one thing that we’re overlooking with these numbers. If we actually had an epidemic that large in the USA (or almost any other country in the world), the healthcare system would be overwhelmed. The number of ICU beds per capita in the USA has dropped by 75% since the 1960s partially as a result of the reduction in numbers of children with infectious diseases.
That’s what we call irony.
As you might expect, these numbers aren’t what we would actually expect, because…wait for it…of the high measles vaccination rate in these developed countries.
But the mortality rate is actually worse than just raw population numbers. Those 60 deaths occurred among 4,052 measles cases in the country. That’s a mortality rate of 14.8 deaths per 1,000 individuals, approximately 14 times higher than expected by the CDC.
Samoa measles epidemic – here come the vaccine deniers
Let’s start with this Facebook post from Edwin Tamasese, a coconut farmer in Samoa. No, he is not a physician. He is not a vaccine scientist.
And Mr. Tamasese has been recently arrested by Samoan authorities for spreading false information about vaccines.
I’m sure that the anti-vaxxers will claim that this is some conspiracy by Merck to suppress The Truth™ about the MMR vaccine. Or Paul Offit called his friends in the Samoan government and offered them free Vaccine Shill Bucks™ to arrest him.
Or maybe, the facts are that he lied about vaccines putting children at risk of death in their country. Now, if only the FBI could deal with our anti-vaccine liars – one can dream.
Anyway, back to Tamasese.
He probably knows more about coconuts than I do, but infectious diseases and public health? Nope, not even close.
Many of his points are based on anecdotes or aren’t supported by any evidence whatsoever. For example, he claims that “several documented cases of fully vaccinated cases who are catching severe measles.” How would that happen?
Of course, if the vaccine actually caused these “severe measles,” we would expect that these children would present with the measles strain A, which are in vaccines. But real science tells us that nearly all of the cases are measles strain D8, the wild version of the virus.
That’s real science, instead of the babblings of a coconut farmer.
Vitamin C has zero effect on measles – I could find no reliable, repeatable, peer-reviewed evidence that it could be used to treat measles. In fact, there were studies that showed it did not have an effect.
The same can be said of his vitamin A claims. There are a lot of sources of vitamin A in the typical Samoan diet, which includes a lot of fish, as one would expect for an island nation. Unfortunately, the introduction of the “Western diet,” has reduced the consumption of vitamin A, although there isn’t a severe deficiency like in African countries where there are few sources of it.
Although vitamin A does reduce the mortality rate from measles, it does not eliminate it. And it doesn’t reduce the risk of complications like SSPE. Furthermore, the World Health Organization has a strict protocol for treating individuals who have measles, and the doses are much higher than what is being pushed by this coconut farmer.
And let’s remember another important point – it does not prevent measles.
Throwing a bunch of vitamin A supplements to the population is counterintuitive. Prevent measles, then you don’t have to rely upon treatments after the fact.
Ironically, the nearby Pacific island country of Tonga, which presumably has a similar diet as Samoa, but has a nearly 100% MMR vaccine rate. And guess what loyal readers? There is not a measles epidemic there, because the vaccine prevents measles!