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Catherine Montantes was a 28-year-old student who was becoming a border patrol officer. He was recently diagnosed with an autoimmune disease.
When she entered the Lower Elwha Tribal Health Clinic in Port Angeles, Washington, she did not know that she had arrived within an hour of being touched by measles. at the age of 52. The virus is one of the most contagious and can survive up to two hours on infected surfaces.
Despite being vaccinated against measles, Montantes was killed less than three months later by the disease, her immune system being inhibited by drugs to control dermatomyositis autoimmune diseases.
His death on April 15, 2015 became the last measles death in the United States. At the time, nobody had died of measles in 12 years. Today, as an unprecedented measles epidemic is spreading across 28 states, with the majority of cases in New York City, her death shows how devastating diseases can devastate families away from communities that choose to live. to delay or refuse vaccines.
In an exclusive interview with The Guardian, the mother of Montantes, Ralphenia Knudson, describes how the disease, often described as harmless by the anti-vaxxers, cost the life of her daughter and upset her family.
"You do not have the right to play with other people's lives like that, you do not have to choose -" OK, we'll let him take his course, we'll make them difficult, "said Knudson. do not make them hard, you expose them to a deadly virus that their body will not be able to fight and that's what happened. "
Montantes is the first person to die from measles in the United States since 2003. Since her death, at least 1,655 people have been diagnosed with measles in a series of outbreaks in New York, California and Washington. Statistically, the US Centers for Disease Control and Prevention will likely find someone killed by the disease in 2019, a record year for measles with 1,077 cases.
"I understand the importance of vaccination. All my children have been vaccinated, "said the mother of Montantes, Knudson, a former long-haul tractor driver living in Juneau, Alaska. Montantes had three brothers and sisters. His sister, contacted by the Guardian, refused to comment on this story, claiming that her sister's death was still too difficult to tell.
The reluctance to be vaccinated was ranked among the top 10 global health threats by the World Health Organization this year. In April, measles cases had increased by 300%. In deciding to classify vaccine hesitancy as a global threat to health, WHO attributed the increase in the virus, in part, to the decrease in the number of vaccines or the delay in their administration despite the availability of their vaccines. vaccines.
Although the reasons for refusing vaccines are often multifaceted, in the United States the multiplication of misinformation transmitted by social media to anti-vaxxers has played a leading role in one of the worst measles outbreaks in the world. 10 years.
Most cases are concentrated in conservative Orthodox Jewish communities in New York and surrounding areas. Prominent anti-vaxxers, who targeted a close-knit Somali community in Minnesota, traveled to the city to spread propaganda and misrepresentations about the dangers of vaccines.
Unvaccinated children and those with suppressed immune systems – such as Montantes – are the most vulnerable to measles, which kills between one and two in every 1,000 people it infects. The virus can also cause brain inflammation, called encephalitis, and permanent brain damage at about the same rate. According to the World Health Organization, in 2017, measles killed 110,000 people, mostly children under five.
On the other hand, it is possible – although this has not been proven – that the MMR vaccine component against measles can cause encephalitis in less than one patient. In other words, the vaccine is at least 1,000 times less risky than not to vaccinate, according to the World Health Organization.
"[Measles exposure] is dangerous, especially for those who have no immune system when it is inhibited by drugs, "said Knudson. "The law states that you are supposed to vaccinate your children, that's what the law says. If you can not follow it, it should have consequences. "
A dermatomyositis was diagnosed in Montantes only a few months before his death by measles. In November 2014, Montantes, a native of Mexico and Alaska, was studying criminal justice at Peninsula College in Port Angeles, hoping to change careers to become a dental hygienist and become a border police officer. . That month, she was traveling with her mother on her itinerary as a long-distance tractor driver.
"One thing Cathy and I were able to do," said Knudson on a trip, was to settle many things between his childhood and what I was wrong on … We ended up with a very close relationship close.
The two men were at the Fedex hub in St Paul, Minnesota, when Montantes began to feel bad, initially thinking that she was suffering from a urinary tract infection. After arriving at St John's Hospital, she began having trouble breathing.
"They could not understand why Cathy was so sick," Knudson said. Then the doctors took a tissue sample from his left arm. "That's how they discovered [the disorder]"Knudson said.
In January, while taking the immunosuppressive drugs often used to treat dermatomyositis, Montantes went to the Lower Elwha Clinic in Port Angeles and was exposed to measles.
Montantes was sick for months before dying at a Port Angeles hospital, still trying to get up from bed during the last hours of her life while she was coughing up blood.
"Probably 36 hours before her death, I have a video of her and she was still trying to stand up," said Knudson, unprepared and unable to pronounce the words. "Even then, when we arrived at the University of Washington [hospital] and put it in the [critical care] Unity, they did not say that she was dead.
"It was not until they said I had to ask my other kids to come here if they wanted to see her," Knudson said.
Knudson described Catherine as the hard and lucid "glue" of the family, always calling her three siblings to make sure they stay in touch with her parents.
"It's something I always teased her about. She had a great sense of humor – this girl was fast, "Knudson said. "I just loved it in pieces."
The death of Montantes sent his mother into an "emotional collapse". Unable to continue his route from Bismarck across Texas, Utah and Indiana, Knudson settled in Juneau to care for his mother. The brothers and sisters of Montantes continue to fight against defeat.
The identity of Montantes was revealed for the first time in the Seattle Times a year after his death. The Guardian has confirmed his identity in the state's death records. Health authorities have never unveiled the name of the 52-year-old man behind the outbreak. And although Montantes was the only person to die, the epidemic did not stop at the Lower Elwha Clinic.
The man may have exposed up to 149 people, according to the Seattle Times, including a five-year-old girl whose infection resulted in the closure of a private Christian school.
The girl has brought the virus back to her school. The Christian Olympic Academy has hosted 115 students, including about 18 unvaccinated, according to state registers and the Seattle Times, which report on the epidemic.
Christian Olympique still has a "group of parents who do not believe in vaccination," said Tiffany Gillespie, director and teacher during the outbreak. Gillespie said that parents believe in the common lies conveyed by anti-vaxxers, including the lie that vaccines "may be related to learning disabilities, and there is not enough research on this subject to say that they are not related to autism or other disabilities. "
"Some say that they contribute to Alzheimer's disease when they are older," said Gillespie. "I did not personally take the time to do the research, I just got vaccinated." Vaccines are one of the safest and most widely tested medical interventions in the world. human history.
The case of Montantes shows not only the negative consequences of this type of death on families, but also the difficulty of grasping the balance sheet of a disease such as measles. His infection was diagnosed only after death, at an autopsy. US states are responsible for measles investigations and then report them to federal authorities.
"Cathy just loved life," said Knudson. "She loved life and she wanted to live."
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