Nastasia has made a spectacular recovery. Just a year ago she was in a coma after contracting measles. The 16-year-old who lives in Valence, in southeastern France, suddenly complained of a sore throat, red spots appeared and she had a high temperature. After one week at 41°C, she was hospitalised, diagnosed with encephalitis.
Nastasia was in a coma for 12 days. It took her four months to recover.
“The first things I remember are the physiotherapy sessions, because I was tetraplegic. After three weeks of physiotherapy, I could walk again, I could even climb the stairs. For one week, I could not speak. My first words were ‘Hello mummy!’”
“I still have urinary problems, because of the paralysis. Also all my muscles have shrunk: I went from 50 to 39 kilos. I often urgently needed to go to the toilet.“
Nastasia is one of many victims of the measles epidemic that has been thriving in Europe over the past few years.
The highly contagious disease can lead to serious complications: pneumonia, otitis (a middle ear infection), diarrhoea and neurological problems.
Over the past three years, in about a quarter of cases, hospitalisation has been necessary.
In 2011, more than 30,000 people contracted measles in Europe. There were as many cases in 2010, that is four times more than in 2009.
Eight patients died of measles complications, six in France, the hardest hit country. Ninety percent of the cases in Europe have been reported in five countries: France, Italy, Romania, Spain and Germany. The vast majority were not vaccinated or not sufficiently so.
Two doses of the vaccine are necessary to ensure optimum protection – the World Health Organisation says that is the only way to reach its target of a measles free Europe by 2015.
Pierluigi Lopalco heads the Vaccine Preventable Disease Programme at the European Centre for Disease Prevention and Control.
“If 95 percent of the population is vaccinated, the remaining five percent who for whatever reasons cannot be vaccinated, like for example the newborn and immuno-depressed subjects, can be protected.”
Scientists call it “herd immunity”. Once 95 percent of a population has received two doses of the vaccine, the virus cannot circulate anymore. An indirect protection is hence provided to the most vulnerable: that is immuno-depressed subjects, the rare individuals for whom one dose of vaccine would not be sufficient and babies under 12 months of age, who are too young to be vaccinated, according to European recommendations.
Measles in the first year of infancy can have tragic consequences. Max was too young to be vaccinated.
“Max fell ill when he was six months old. He was still a baby. He probably contracted measles at his brother’s kindergarten. He got really sick. But after one week, the symptoms disappeared and after that, he developed normally. It was all forgotten, everything was back to normal. That’s what we thought,” explained his father Rüdiger Schönbohm.
Measles had however triggered a subacute sclerosing panencephalitis, or SSPE, a rare chronic, progressive and fatal neurological pathology. One case in 25,000 throughout all age groups, rising to one in 8,000 in children infected under the age of two.
The first symptoms appeared 10 years after the infection. His mother, Anke Schönbohm a trained nurse, explained: “He has been in a persistent vegetative state since April 2006.”
Max will soon turn 18. His parents, Anke and Rüdiger have had a purpose built house constructed near Stuttgart, South Germany, adapted to his disability.
“When people say that they don’t vaccinate on purpose because the vaccine could trigger SSPE – which was categorically proven to be wrong – it makes me angry. Or when they say in a romantic way that having measles is important for the evolution of the child. When I hear that, I’m furious! Because when I look at my son, I think: how has this disease been in any way useful? What evolution? He has regressed and he is going to die,” Max’s mother said.
The main reason for non-vaccination in Europe is that people simply forget about it. Others are concerned about the vaccine’s side-effects, short lived high fever, temporary rash and skin redness and extremely rare allergic reactions.
Nastasia was not vaccinated. Her mother Corinne, a nurse and physiotherapist, explained the reasons for her choice.
“I didn’t have Nastasia vaccinated because I think that one builds one’s own immunity. I treated her with homoeopathy, I helped her build her immunity. Before contracting measles, Nastasia was never ill. I have nothing against the principle of vaccination, because I think that prevention is important. However, in vaccines, there are many additives, aluminium among them. We know now that aluminium might be one of the causes of Alzheimer’s disease, it can trigger many other ailments. After all, I would have liked her to catch childhood illnesses when she was little. I didn’t think I was taking a risk. I thought it was not necessary to have her vaccinated.“
If some multiple vaccines are stabilised by aluminium or mercury derivatives, ECDC is adamant this is not the case for the measles vaccines in MMRs in Europe.
“The vaccines we use today in Europe – that is to say the MMR vaccines - Measles – Mumps – Rubella, contain none of these elements. They have no mercury, they have no aluminium. This is a completely unfounded fear,” explained Pierluigi Lopalco.
A study conducted by Erfurt University in Germany shows the choice to vaccinate is increasingly influenced by information found on the internet.
Cornelia Betsch, a psychologist at the university, said: “Three out of four people who search the web find at least one anti-vaccination website. Concerning measles vaccination, we found out that five to 10 minutes spent looking at anti-vaccination sites can deter measles vaccination because it is then perceived as dangerous.”
In order to reverse that trend, the French Ministry of Health is on an information drive. France had more than 15,000 measles cases last year. Half the patients were between 15 and 30 years old, an age when the disease can be particularly severe and lead to complications. It is these non vaccinated or insufficiently vaccinated young adults and adolescents who are being targeted by prevention campaigns.
Marie-Hélène Loulergue, Deputy-Director of infectious risks prevention at the French Health Ministry explained: “Concerning measles vaccination, the World Health Organisation currently recommends two doses. Until 1985, only one dose was recommended. So we are now trying to catch up on two dose vaccination for that part of the population, who happen to be susceptible to measles. Making vaccinations compulsory is difficult today in a sociological context where citizens tend to be made responsible for their own health.”
According to Ole Wichmann, who heads the Immunisation Unit at the Robert Koch Institute, the MMR vaccine is a victim of its own success.
“Thirty or 40 years ago, we had so many cases of measles that everybody knew someone who had had measles, and not just measles but very bad measles. Nowadays, we hardly have any cases so people forget how serious a disease measles can be,” he said.
The health challenge is global: because of the insufficient vaccination rate, Europe is currently exporting the virus to regions that had managed to get rid of it, like North and South America.
Eliminating measles is also about preventing human tragedies. It is not only patients, families and loved ones also suffer the devastating effects of the disease.
“The damage caused by such a disease to a family is so deep that I’d rather take the risk of side-effects triggered by the vaccine than face such a fate,” said Max Schönbohm, the father of Max.
“I myself was not in favour of vaccination and I stuck to what I had decided. However, I think that if people think that vaccination is good for their children, they mustn’t hesitate to go for it. It’s important to act according to how you feel,” said Nastasia’s mother Corinne.
More information at:http://www.ecdc.europa.eu/en/healthtopics/measles/Pages/index.aspx