In the news

The 2024 measles outbreak.

            There is a rising fear, especially in the media, about several cases of measles, primarily in Florida but also noted recently in several other states.

As someone who has seen scores of children with measles, I’m very much aware of the seriousness of this disease. Before we had a vaccine, we lost about one child for every one thousand who were infected and about one in 500 suffered from measles encephalitis that left them seriously impaired. Those children who seemed to be unscathed by the disease were not. About one half of children with measles had abnormal cells in the spinal fluid that revealed a low-grade inflammation of the brain. As evidence of this, it was common for teachers to note that their kids were just not performing as well as usual in the months following a measles outbreak.

In the recent outbreak more than 90 percent of the victims had not received the measles vaccine, a tragedy considering that the vaccine has an effectiveness rate of more than 95 percent and almost no side effects – and no serious ones in my experience nor in published studies involving tens of thousands of vaccine recipients.   

The media are reluctant to report the incidence of measles among recent immigrants, especially considering that the number of measles cases number in the hundreds of thousands in developing countries, and that measles is a leading cause of death and childhood blindness in those parts of the world.

If you wonder why the vaccine is “only” 95 percent effective, there are several reasons. We delay giving the MMR (Measles-Mumps-Rubella) vaccine until 12 to 15 months because women who have been naturally infected by these viruses can transmit antibody during pregnancy to the fetus that will interfere with the performance of the vaccine. Note, however, that infants over six months of age should receive the vaccine if they are exposed to a case of measles. The reason: a woman who has never had natural measles, but has only received the weaker vaccine virus, will not have enough of the transplacental antibody to protect her infant.

Some vaccine failures are due to improper storage of the vaccine, and there are some children whose immune system simply does not respond adequately to the vaccine.

The worst tragedy of all: vaccine resistance among parents. This was sparked by the totally discredited Andrew Wakefield in the early 1990s who blamed the MMR vaccine for autism. He bears the blame for hundreds, perhaps thousands, of children who have suffered from diseases that could have been prevented by childhood immunization.

Lifestyle

Ow! That hurts! But it doesn’t have to.

            We’re very fortunate that having a tooth pulled, getting a crown or even a simple filling isn’t the ordeal that it was before the advent of dental anesthesia. But WOW! – the pain of the lidocaine injection into the gum – or even worse, the palate – is the worst part of the procedure.

Did you know that you can reduce or even eliminate the pain of the needle? Thanks to Dr. Geoff Bell of Carlsbad, I learned a simple technique that really works. As the dentist asks you to open wide so that he or she can inject the anesthetic, raise one leg a few inches and rotate your foot in a circle until the medication has been administered. I know – it sounds like voodoo, but there’s a reason why it works. When you rotate your foot it sends an impulse to your brain that interferes with the pain pathway. Don’t ask me for the details. I’m a pediatrician, after all, not a neurologist.

You can use the same method to reduce the pain of a venipuncture the next time you give a blood sample at the laboratory or donate at the blood bank.