Vaccine hesitancy is behind the resurgence of disease—but measles is not, as anti-vaccine activists claim, a short-lived respiratory virus whose effects are over in days. Scientists now understand that measles’ primary target is in fact the immune system. In addition to causing rare but slow-burn, fatal neurological disorders that can kill a child years after a measles infection, the virus can also wipe the immune system’s memory, destroying cells that fight off other infections.
Measles spreads through the air and is highly contagious: Up to 90% of unvaccinated people exposed to someone with measles will get it. It was once common for millions of people—most of them children—to die every year from the disease. In 1963, the first vaccine for the illness was released, and rates in the U.S. plummeted. Measles was declared eliminated in the U.S. in 2000.
That same year, biologists in Japan identified a receptor on the surface of cells that the measles virus uses to break in. Although measles spreads through the air, this receptor, called CD150, wasn’t primarily found in nose and lung mucous membrane cells. It was somewhere quite a bit more insidious: immune cells. “This receptor is especially expressed on memory cells of the immune system,” says de Swart. “That means that the virus predominantly infects, and then kills, memory cells of the immune system.” These are the cells that remember pathogens you’ve encountered in the past and help protect you when you meet them again.
Measles is deadlier than most people think
Epidemiologists have found that the effects of measles infection might last for years. In 2015, Dr. Michael Mina, de Swart, and colleagues discovered that measles infections raised children’s risk of death for two to three years after they had apparently recovered. "We were effectively saying measles was associated with as much as 50% of all childhood infectious disease deaths not officially having to do with measles,” says Mina.
Using blood samples from unvaccinated children both before and after measles infection, they found that the source of this effect seemed to be a serious decline in the body’s ability to recognize common pathogens, thanks to missing memory immune cells.
Will we see a return to the pattern of serious childhood illness?
Measles used to frequently pop up in children’s literature and nursery rhymes, and catching it could mean a long convalescence.
It was also often the reality of catching a disease like measles back then—a fact that should alarm parents, says Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “If we continue along our current path, where more and more parents are choosing not to vaccinate their children, this phenomenon will become even more evident,” he wrote in an email. “Tough times ahead.”
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