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Editor's note: This story was published in 2015 and has been updated.
In 1962, Roald Dahl, author of children's books, lost his eldest daughter, Olivia, to measles. She was 7 years old.
Twenty-six years later, Dahl wrote a letter to parents about what had happened:
"While the illness was following its usual course, I remember reading it often in bed without feeling really alarmed.And one morning, while she was well on the way to healing, I was sitting on her bed showing her how to fashion small animals with colored pipe cleaners, and when she wanted to make one herself, I noticed that her fingers and mind were not working together and that She could not do anything.
"Do you feel good?" I asked him.
"I feel quite sleepy," she says.
"In an hour she was unconscious, and in twelve hours she was dead."
Olivia had what is called measles encephalitis. The virus had spread to his brain. His immune system has rushed to fight him. His brain has swollen.
At the time, writes Dahl, "no reliable measles vaccine has been discovered".
Today there is a vaccine for this extremely contagious disease. But some parent groups have chosen not to vaccinate their children – which has caused outbreaks in countries like Italy and Israel, and recently in Washington State, where the governor has declared it to be the only way to immunize their children. state of emergency with 41 confirmed cases.
"Many people think that measles is not a big problem, it just causes a rash and fever," says Dr. Alice Ackerman, professor emeritus at Virginia Tech Carilion School of Medicine. "In the majority of cases, it's true."
But in about 1 in 1,000 cases, the infection becomes systemic and spreads to the brain.
"It causes behavioral changes, potential brain swelling, and seizures," says Ackerman. There are few doctors can do. Children can be left deaf, blind or mentally retarded – if they recover.
In some cases, the brain infection can settle quickly, as with Dahl's daughter. According to Dr. Ackerman, however, it is unlikely that 7 to 10 years after measles, subacute sclerosing panencephalitis, or SSPE, will occur in children.
"During my four decades of practice, I have seen children admitted to my intensive care unit with horrible brain events where they could have seizures, start drooling, lose their ability to do so. interaction, "she says. "It's heartbreaking."
The only way to prevent these potential problems, she says, "is to prevent you from getting measles in the first case" with the vaccine.
The SSPE study is very rare: one study reveals that only 1 in 5,000 people with measles will develop it. But other serious complications of measles are not so rare.
The most common is pneumonia.
Measles usually infects the upper respiratory tract, such as the flu or colds. But when measles moves to the lower respiratory tract, it becomes pneumonia – and much more problematic.
"Pneumonia impairs the body's ability to harness oxygen from the air," says Dr. Amesh Adalja, an infectious disease specialist at the Johns Hopkins Health Safety Center. "Children do not get enough oxygen in the lungs to feed the body – some find themselves under a fan."
Worldwide, up to 1 in 20 children with measles get pneumonia, says the Center for Disease Control and Prevention. This is one of the most common causes of 110,000 children worldwide murdered in 2017 by measles, most of whom are under five years old.
And there is no way to predict which children will develop serious complications from measles, Adalja says. "For everyone [intents and] anyone can contract pneumonia as a result of measles or encephalitis ".
But people with weakened immune systems are at higher risk, says Adalja. This includes people who are undergoing cancer treatments, organ donors, the elderly, and babies.
Malnourished children in poor countries are also vulnerable to measles encephalitis and pneumonia, says Ackerman. "Their immune system can not build an appropriate response against the virus."
In many cases, parents of these children do not have access to vaccines or treatment for the complications of measles. These parents live what Dahl and his family knew half a century ago: losing a child to measles.
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