The measles epidemics are spreading. Medical misinformation continues to spread, too.

When I came to the United States for medical training after attending a medical school in Pakistan, there were certain diseases that I did not think I would ever see again. Measles was at the top of this list. Although Pakistan is one of three countries where vaccine-preventable disease, such as polio, is endemic, measles is very rare, especially in high-income countries. Yet today, measles epidemics are appearing in America – orthodox Jewish communities from New York to Washington State, where the state of emergency has just been declared an official emergency to prevent epidemic to spread. European countries are also witnessing the reappearance of a disease that should have been eradicated by vaccination.

Measles is a highly infectious viral infection that can cause fever, rash and flu-like illness. It can sometimes cause inflammation of the lungs or brain. The vaccination developed in the 1960s almost eliminated measles from the surface of the planet. However, rumors and conspiracies about the supposed side effects of the vaccine have led some parents to prevent the inoculation of their children, which has led to its resurgence in some parts of the country.

What allows these anti-vaccine rumors to spread? The outbreak of misleading medical information on vaccines and other evidence-based medical advances, activated and disseminated via the Internet, has probably contributed to this crisis. A recent report suggests that half of the parents of young children have been exposed to false information about vaccination in social media, including a worrying advertisement on Facebook suggesting that their children could die from the supposed toxicity of the vaccines. Medical misinformation is so prevalent that the World Health Organization recently declared vaccine resistance among the top 10 threats to global health in 2019.

In Clark County, Washington, 50 cases have been confirmed and 11 more are suspected in an ongoing outbreak. In the same state, groups like Informed Choice Washington have created online communities around vaccine skepticism. Officials believe such groups are one of the reasons for the spread of measles: "These outbreaks are due to the anti-vaccine movement," said Dr. Anthony Fauci, director of the National Institute of Allergy and Disease. infectious diseases, at CBSN.

Clark County Council Chair Eileen Quiring recently echoed Fauci in the Columbian: "For 25 years I know about vaccinations and controversy, there is information on the Web and organizations say vaccinations cause autism and that's why some parents are reluctant to vaccinate their children. children. "

Trust in institutions is deteriorating. This includes medicine.

In the course of recent human history, doctors have enjoyed immense confidence from those for whom they were responsible. Yet in recent years, some of this trust has collapsed, along with a loss of confidence in other institutions such as the government and the media. Increasingly, as health care consumers gained greater autonomy, the traditional relationship, which emphasized the power of physicians in decision-making, has been shaken. While many patients continue to trust their doctors, others seek a second opinion on the Internet.

Our health system has many features that prevent patients from easily accessing reliable health information. Trying to see a doctor can be time consuming, costly and impractical, and difficult to understand information. This helps to make the Internet an attractive source of information for many patients. Sites such as WebMD and UpToDate offer useful, intelligible, fast, non-judgmental and mostly free advice. Yet despite all his strengths, the internet can lead people to inaccurate medical information wormholes and conspiracy theories.

And vaccines have many features that make them a vulnerable target in case of misinformation.

The most important reason why misinformation about vaccines is so prevalent is ironically because of their effectiveness. I grew up in Pakistan and I have often seen children with polio. My parents would use it to make sure that I get all the vaccinations I could get. Yet, because of the effectiveness of vaccination campaigns in countries such as the United States, vaccine-preventable diseases such as measles, mumps, rubella, smallpox, diphtheria, whooping cough and Poliomyelitis have been largely relegated to history books.

Nowadays, almost everyone receives or sees other people getting vaccinated, but they are rarely witnesses to the diseases that they are so effective at preventing. And because of a kind of cognitive bias called availability bias, we can place disproportionate importance on what we see around us rather than look critically at the bigger picture.

This availability bias is so powerful that it even affects those who should be the most resistant to misinformation: doctors. A study conducted in 2013 found that recent medical graduates, who are much less likely to have treated patients with vaccine-preventable diseases, are more suspicious of the effectiveness of vaccines than older graduates.

Prevention is the holy grail of medical progress, as it promises to treat diseases even before they develop. Yet, I think, ironically, Advances in preventive medicine are most likely to be targets of medical misinformation campaigns.

This is reflected in the fact that drugs intended to prevent heart disease, especially statins, were the other major target of medical misinformers. Statins that reduce cholesterol levels and the risk of heart disease are probably the most studied drugs of all time and are also the safest. Yet, as in the case of vaccines, a tsunami of fake medical news exaggerating the risks badociated with statins has multiplied on the internet.

Preventive therapies treat diseases that a patient will never witness

Why? If effective, preventative therapies deal with events that a person will never witness. Thus, a patient who takes a statin may never feel the heart attack prevented, but may experience adverse effects or simply the inconvenience of taking a medication, sometimes without perceived benefit. This is different from treatments that are therapeutic for the symptoms or the obvious physical manifestations of the diseases after their development. For example, while many patients may overestimate the risks badociated with statins, the benefits of treatments such as coronary stents, which are used to increase blood flow in clogged or narrowed arteries supplying the heart to manage heart attacks and chest pain, are often exaggerated.

The outbreaks of measles in the United States, largely motivated by the refusal of a critical mbad of parents from a community to vaccinate their children, could be the result of this phenomenon. Rumors and fears that have invaded largely educated, concerned and well-meaning parents, connected via online networks, fuel the anti-vaxxer movement.

But maybe the answer to this modern disease that seems to have landed straight Black mirror This episode could also reside in the online networks that helped to foment this in the first place. A team of scientists successfully predicted the measles epidemic at Disney World in 2014 using machine learning to badyze social media posts and search engine behaviors two years in advance.

The most effective known strategies for preventing the occurrence of vaccine-preventable diseases are quite simple and have been implemented in states such as West Virginia, Mississippi and more recently in California: make vaccination mandatory except if there is a strictly medical contraindication to vaccination. Others argue that physicians and other health personnel should be trained in the use of social media to dispel misinformation and effectively interact with the public on medical issues.

"The vaccine misinformation campaign has become more complex now that research shows that a large number of social media publications are state-sponsored cyberwar, especially in Russia," said Robert. Califf, former Commissioner of the Food and Drug Administration. who now heads Forge, Duke University's Center for Health Sciences. The center is currently making efforts to understand and process the wrong information on the Internet.

Still, it will take more than one university to solve this problem. "If our tax-exempt institutions intend to discover the truth and disseminate it, misinformation on the Internet could be the issue of our era that demands the highest priority," he said, adding, " We must work together to find effective ways to provide people with truthful, reliable and actionable information about their health. "

For me, most of the suggested approaches target the symptom and not the underlying disease. To win the information war, we must regain the trust of people.

As a cardiologist, this means taking the time to help explain to patients the best way to take care of their heart and to put into context the risks and benefits of common cardiac medications such as statins. One of the reasons that doctors have lost patients' trust is that the evolution of health care has forced them to spend more time with computers and electronic health records than with patients at home. bedside of the patient. We need more doctors and nurses offline, interacting with people in the clinic and the hospital, as well as in communities and homes, sharing stories rather than just regurgitating facts.

Painting anti-vaxxers as a hysterical and unbalanced horde only intensifies mistrust and deepens divisions. Such tactics have left our politics in shambles and could very well turn the public health crisis into a catastrophic crisis.

Haider Warraich is a cardiologist at Duke University Medical Center and is the author of the upcoming State of the Heart: Exploring the History, Science and Future of Heart Disease.

First person is Vox's home for compelling and provocative narrative essays. Do you have a story to share? Read our submission guidelinesand show us [email protected].