Measles are still a threat

The 12-year-old utility player for Japan's top youth-baseball team carried a little extra baggage as he and his squad winged their way toward Williamsport, Pa., and the Little League World Series last August by way of Detroit and Baltimore.

Like tens of thousands of his countrymen each year, the youth with a sore throat and a blah feeling was coming down with the measles.

Disease trackers from several states and the federal Centers for Disease Control and Prevention now know that before he reached isolation in the Little League infirmary, the boy spread the virus to at least six other people in three states -- a Japanese spectator, one fellow traveler on the plane, an airport worker, a sporting-goods sales rep who visited Williamsport and two Texas college students who attended a sales event with the rep in Houston more than a week after the Little League World Series had wrapped up.

Officially, measles doesn't exist anymore in the United States, suppressed by more than three decades of routine childhood vaccination with the measles-mumps-rubella vaccine. The CDC says that for more than 10 years, the few dozens of Americans who have come down with measles have picked up the illness from foreign visitors or brought the illness back from overseas.

Still, none of the three middle-aged U.S.-born victims of the measles had apparently ever been vaccinated against measles -- illustrating that while a population may be protected, individuals still may not be protected against any particular disease.

The two Texas college students illustrate another hard lesson about vaccines -- they don't always work. Although both students apparently had gotten the recommended two doses of vaccines as infants and then in grade school, they still became ill.

Vaccines to prevent measles have been around since 1963, but coverage outside the developed world has been spotty, and the disease still kills hundreds of thousands of people -- mostly children -- each year. The last big outbreak in the United States came in 1991 and killed 120 and hospitalized more than 11,000.

Measles is so highly contagious that it normally infects 90 percent of unprotected people exposed to the virus in a home, office or classroom. It's rare for anyone past the 20s to get it, though, because anyone older is either immunized or has "natural immunity" from an earlier bout with the disease.

Japan became one of the least-immunized of advanced nations against measles when the government bowed to public concerns over side effects of the measles vaccine in 1994 and dropped mandatory childhood vaccination with the combination.

Only in 2006 did Japan return to a policy of ensuring that all children get the double dose of measles vaccine needed to provide strong immunity. The dip in coverage has resulted in regular large outbreaks over the past decade, including one last spring that closed many schools and universities.

Many American parents also have had concerns about the measles-mumps-rubella vaccine over the years. So while 92 percent of toddlers and children are getting the shots, there are still many people who are not protected.

CDC officials, in a report on the Little League outbreak published last week, observed that the episode was checked mostly because the first youth was isolated quickly and everyone else in the tournament village either had been vaccinated for measles, quickly got one or was tested to rule out infection.

Beyond Williamsport, health officials argue that the disease chain was kept short because most of the people who encountered the virus had either natural or induced immunity against it.

While officials are confident that only imported measles is likely to flare in the United States, the continuing outbreaks remind that any disease in the world -- whether measles, a new strain of flu or a drug-resistant bacteria like tuberculosis -- is only a plane ride away.

In particular, the CDC said that in light of the Little League experience, organizers of big international events, especially involving children, should consider requiring documentation of vaccination for all participants.

On the Net: www.cdc.gov/vaccines

(Reach Lee Bowman at bowmanl(at)shns.com