Fatal measles case highlights importance of herd immunity in protecting the vulnerable

November 1, 2018, Infectious Diseases Society of America
An electron micrograph of the measles virus. Credit: CDC/ Courtesy of Cynthia S. Goldsmith

Last year, a 26-year-old man receiving treatment for leukemia went to a Swiss hospital's emergency room with a fever, a sore throat, and a cough, and was admitted. His condition worsened, and 17 days later, he died from severe complications of measles. The man's weakened immune system was unable to fight off the disease, even though he was vaccinated against measles as a child.

A new report in Open Forum Infectious Diseases describes the man's case, highlighting the importance of maintaining high vaccination coverage in the community to help protect people with compromised immune systems from measles and other vaccine-preventable infections. "Measles is not harmless, it's a serious disease," said the report's lead author, Philipp Jent, MD, of Bern University Hospital and the University of Bern in Switzerland. "There is a responsibility to vaccinate yourself to protect others, not only to protect yourself."

Following the patient's admission in February of 2017, he developed additional symptoms over the next several days, including a progressive rash, mouth sores, and conjunctivitis, that suggested measles, although he had been fully vaccinated against the with the recommended two doses of the measles, mumps, and rubella (MMR) vaccine in the 1990s. A throat swab test confirmed the measles infection. Treatment with ribavirin (an antiviral drug), immunoglobulins (a type of antibody), and vitamin A did not improve his condition. He subsequently developed severe pneumonia and died.

The case illustrates how serious measles can be, particularly for people with compromised immune systems due to cancer treatment or other causes. It also underscores the importance of herd immunity in protecting these vulnerable individuals, the report's authors noted. When vaccination rates in a community are high enough, vaccine-preventable diseases like measles are less likely to spread, which helps protect those who cannot be vaccinated (such as newborns not old enough to be immunized) or, like the patient in this case, for whom vaccines are not as effective.

When the proportion of people in a community who are vaccinated drops below this threshold, however, as it has for measles immunizations in several European countries, outbreaks are more likely. More than 41,000 children and adults in Europe were infected with measles during the first half of 2018, according to the World Health Organization, exceeding the annual total of European cases reported in any previous year this decade. In the U.S., there had been 142 confirmed cases of measles in 2018 as of early October, according to the U.S. Centers for Disease Control and Prevention (CDC). Data released by CDC in October also showed a gradual but concerning climb in the numbers of U.S. children who reach their second birthday without having received any recommended vaccines.

"Ongoing efforts to raise confidence in vaccines and increase population immunity should be intensified," the authors wrote in the case report's conclusion. Physicians caring for people with compromised immune systems, the authors noted, should also ensure that those in close contact with these patients, such as family members and friends, are fully vaccinated.

Fast Facts

  • People with weakened immune systems are at risk for contracting vaccine-preventable diseases, such as measles, even if they have been vaccinated.
  • In this case, a 26-year-old Swiss man undergoing treatment for leukemia contracted measles and died from severe complications of the infection, despite being fully vaccinated against measles as a child.
  • Maintaining high enough levels of in the broader community, also known as herd immunity, can limit the spread of and other diseases and help protect those who are especially vulnerable.

Explore further: Drop in EU/EEA measles cases between March and July 2018

Related Stories

Drop in EU/EEA measles cases between March and July 2018

September 20, 2018
During the month of July, a total of 758 cases of measles were reported across seventeen countries in the EU/EEA, which is a decrease from the 1054 cases reported during the month of June.

Recent measles case in Santa Monica sheds light on risk of outbreak

August 30, 2018
The recent news about an international tourist with measles who visited Santa Monica raised anew concerns about the potential for an outbreak of the disease, which has been all but eradicated in the United States.

Florida urges vaccinations after 3 measles cases reported

August 16, 2018
Health officials are urging parents to make sure their children are vaccinated against measles after three cases of the disease were reported in a Florida county, among more than 100 cases throughout the U.S. this year.

Measles case reported in Minnesota

August 9, 2018
(HealthDay)—A Somali-American child in Minnesota has been diagnosed with the measles after returning from a trip to Africa, state health officials said Tuesday, adding that the unidentified 5-year-old in Hennepin County ...

Always-deadly measles complication more common than believed

October 28, 2016
A complication of measles that kills children years after they have the infection is more common than thought, according to a study being presented at IDWeek 2016. The research underscores the vital importance of herd immunity ...

Measles vaccine increases child survival beyond protecting against measles

February 12, 2018
In the largest study to date on children in a low/middle income country, new research in Ghana finds that the timing of a measles vaccine in an overall vaccination schedule can have a profound impact on child survival rates ...

Recommended for you

Infants born to obese mothers risk developing liver disease, obesity

November 16, 2018
Infant gut microbes altered by their mother's obesity can cause inflammation and other major changes within the baby, increasing the risk of obesity and non-alcoholic fatty liver disease later in life, according to researchers ...

New study shows NKT cell subsets play a large role in the advancement of NAFLD

November 16, 2018
Since 2015 it has been known that the gut microbiota could have a direct impact on nonalcoholic fatty liver disease (NAFLD), which affects up to 12% of adults and is a leading cause of chronic liver disease. In the November ...

Antibiotic prescribing influenced by team dynamics within hospitals

November 15, 2018
Antibiotic prescribing by doctors is influenced by team dynamics and cultures within hospitals.

Discovery suggests new route to fight infection, disease

November 14, 2018
New research reveals how a single protein interferes with the immune system when exposed to the bacterium that causes Legionnaires' disease, findings that could have broad implications for development of medicines to fight ...

Zika may hijack mother-fetus immunity route

November 14, 2018
To cross the placenta, Zika virus may hijack the route by which acquired immunity is transferred from mother to fetus, new research suggests.

New research aims to help improve uptake of hepatitis C testing

November 14, 2018
New research published in Scientific Reports shows persisting fears about HIV infection may impact testing uptake for the hepatitis C Virus (HCV).

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.