Epidemiologist Dr. Jeffrey Band shares his insights on the measles outbreak in Michigan.
By Rochel Burstyn
Ever since Dr. Jeffrey Band graduated medical school at University of Michigan in 1973, he has been busy saving lives. Now semi-retired, the former chief of infectious diseases and international medicine at Beaumont, spends time traveling and enjoying his family, but still makes plenty of time for his passion: seeing patients periodically, consulting with the health department and teaching medical students at Oakland University and Wayne State. We got the chance to ask him some questions about the measles outbreak in Michigan.
1. What is your experience with measles?
I saw a few cases of measles in the United States between 1976-1978. Since then, with the exception of a couple of travelers over the years who’d visited parts of Europe during an outbreak and picked up the virus there, l hadn’t seen the measles again until recently. In fact, most infectious disease physicians practicing today have never seen a case of measles. Most don’t even recognize it when they do see it; at first glance, it just looks similar to other viruses that cause fever and a rash. However, measles is a very serious illness; it cannot be taken lightly.
2. What do you say to those who say, “but no one in Michigan has died because of the measles, so it’s hard to feel it’s really so dangerous.”
For every 1000-2000 cases of measles, there may be a death. In the pre-vaccine era, when there were a million or so cases of measles annually, there used to be several thousand deaths per year due to measles. At the last count, Michigan’s outbreak numbered 39. It’s a matter of numbers – hopefully we won’t get to those numbers.
In other countries with higher rates of measles you see the numbers of deaths accelerate accordingly. For example, you may have heard on the news recently that Madagascar is facing its largest measles outbreak in history, with cases beyond 115,000. More than 1,200 people have died there from measles in the past seven months.
3. Some people think the MMR vaccine is just as dangerous or more dangerous than the measles. What’s your opinion?
It’s almost unheard of for someone to die from the MMR vaccine. MMR is one of our safest vaccines. In comparison, 1 of every 1000-2000 people who develop the measles will die. I would think purposely exposing someone and deliberately trying to contract the measles is like playing with fire.
I am happy to talk to people, address any questions and concerns they have about the vaccination. My own children were certainly immunized. I had no hesitation whatsoever, of course I want to protect my family members to the best of my ability. Jewish law says to protect ourselves and our neighbors.
Except for people who cannot be immunized or who had a previous severe reaction to an MMR, I cannot think of a single reason not to immunize.
Some people seem to think that not vaccinating is a passive choice. I disagree; not immunizing is an active decision to remain susceptible to serious diseases.
4. Why are communities like Orthodox Jews the most prone to getting measles?
I believe that’s because of two main reasons. One, there’s a higher rate of vaccine refusal these days, in general. It’s not just these groups – you find it everywhere, in every community, in many select populations.
Most importantly, these populations are one big extended family, attend many common events and go to synagogues or places of worship as a daily part of their lives. There’s a lot more potential for spread in these close-knit types of communities.
5. Can the outbreak be contained and eradicated?
Absolutely. The local health departments have done a wonderful job identifying the sites of exposure, finding people who may be at risk and getting them evaluated. Some people then received a vaccine which is still effective within 72 hours after exposure and were isolated just in case to keep them from potentially spreading the disease to others.
I can’t predict when it will end, of course, and I do get nervous with Passover coming up and the family events that come with it, more people traveling, etc. But once we get past this period, I do think it will get under control. Its due to a diligent system of surveillance and intervention — it works. We eradicated measles once before in 2000, and I have hope we will do it again.
See an extended version of the interview with Dr. Band in the April 25 issue of the JN.