For the 7-month-old baby from Brașov, who died in the measles epidemic declared by the authorities on December 5, 2023, Santa Claus never came. And it will never come again. He is the first death, and hopefully the last, of the current epidemic in which the number of registered cases has exceeded 2,000. Epidemiologists warn that, as the cohort of unvaccinated children will increase, the diseases of the past will mark their future. Measles, diphtheria, poliomyelitis, along with other vaccine-preventable infectious diseases, will no longer be just names passed down in treatises of infectious diseases, but realities that will demand their price. And this one will not be small at all.
Two more months of life and the baby from Brașov would have been eligible for the first dose of measles vaccine. And at least a chance of survival. The infection, which had as its source an older brother, who was not vaccinated against measles, caught him exactly at a moment when he was very vulnerable. That is, when the protection provided after birth by the mother’s antibodies had just expired. And his immune system was in its infancy.
Restricted access to babies
Prof. Emilian Popovici, primary medical epidemiologist, the vice-president of the Romanian Society of Epidemiology, explains: “Until the age of 6 months, the immune system of the newborn and the infant is practically inactive. Only after the age of 6 months does this system begin to activate. He becomes fully active, competent – if we can say so – after the age of 1 year.”
In the 6-month window, the baby is protected by antibodies from the mother, if she has previously had the disease or if she has been vaccinated. If not, the infant is completely exposed immune and can get the infection very easily. Complications can appear, such as pneumonia, the outcome of which can be fatal.
One thing less known or neglected by the family is that, in order to best protect the baby from infectious diseases, access to it should be restricted to the members of the restricted family. Respectively, mom and dad. Less seniors. Why? “Because, with them, due to the decrease in the activity of the immune system, various associated pathologies appear. And there is a risk of developing various more or less resistant germs, which they can pass on to a newborn whose immune system is inactive. The baby is exposed in this unnecessary way. I say this because I found that few people know”, adds the epidemiologist.
What is immune amnesia?
Parents who think it’s better to let their child get sick so they can get immunity that way should think again. This is because, at least in the case of the measles virus, the consequences of infection can be devastating.
And study published by the American Society for Microbiology, shows that the risk associated with measles virus infection is much greater than the sum of the observable symptoms. Immune memory is acquired by the body over many years of exposure to all kinds of germs. However, the measles virus is particularly dangerous in that it has the ability to erase this immune system memory of previous infections.
This immune amnesia that the measles virus can generate is a very little discussed topic here. What exactly is going on? In general, highly contagious diseases indicate a very aggressive pathogen attacking the body. When an organism is attacked by a virus, on one side we have the “invading army” – represented by the virus – and the “defense army” – which is the immune system. And we are witnessing a competition of the type that on that.
If the virus manages to multiply a lot and in a short time, overcoming the defense capacity of the immune system, the disease occurs. If the immune system reacts very competently and very promptly, producing the antibodies necessary for defense, it succeeds in destroying the virus. And the infection does not occur. Even if the virus has entered the body.
Prof. Emilian Popovici, primary medical epidemiologist
Major impact on the immune system
Or, in the case of a virus such as measles – whose contagiousness is 95%, measles being one of the most contagious diseases in the world – the aggressiveness of the virus is very high and so is the impact on the body’s immune system.
“The impact of the measles virus is so great that it causes the formation of lymphocytes specific for the measles virus, which replace the other lymphocytes and become dominant. The other lymphocytes are the ones that have the memory of the diseases recorded by the person in question in the past. By replacing the lymphocytes, the immune memory is deleted”, explains Prof. dr. Emilian Popovici the mechanism of action.
The cited study, the expert adds, was developed in the US, Denmark and the UK, with experts concluding that almost 50% of deaths from infectious diseases caused by a person a second time can be a result of this erasure of memory. the immune system by the measles virus.
That is, those people did some infectious diseases as a result of which they acquired a certain immunity to them. However, the measles they then contracted erased their immune memory, and in this way they developed illnesses a second time that they would not normally have if the measles virus infection had not intervened. The forms of the disease were serious and resulted in death.
A rare complication of measles virus infection is sclerosing panencephalitis. The disease can appear years after a person is infected. “What this means? It means that the virus remains confined in the body and, at a given moment, probably on a certain background, on a certain state of vulnerability of the body, it generates this condition. The disease has no treatment and leads to death”, explains Prof. Dr. Emilian Popovici.
What other epidemics do we risk?
At the moment, in Romania, vaccination coverage is decreasing for all vaccines. For measles, for example, it is 78% for the first dose and 62% for the second dose. A minimum of 90% would have been necessary for the epidemic to have been avoided.
Another vaccine-preventable infectious disease is diphtheria. A few days after the declaration of the measles epidemic, the authorities in Romania announced the detection of two cases of diphtheria with cutaneous localization, non-toxigenic.
We remind you that the toxigenic diphtheria bacillus strains that produce respiratory diphtheria are different from those isolated in the two cases. The last case of diphtheria with toxigenic strains was registered in Romania in 1989. This type of diphtheria can be prevented by vaccination. In the National Vaccination Program, this vaccine can be given free of charge, from the first year of life.
Even so, the appearance of the two cases should cause concern, the epidemiologist believes. Because, under certain conditions, non-toxigenic strains can undergo an induction process of toxigenesis: “They turn into toxigenic strains and stay that way. The fact that the two cases have now been found to be caused by non-toxigenic strains is a positive aspect of this negative situation. But let’s not forget that things are not nailed down! When you have two alarm signals squared: that is, lower vaccination coverage and you have these cases, things must be taken seriously,” he draws attention.
“There is no infectious disease without complications and without deaths”
For parents who hesitate to vaccinate their children, he has only one piece of advice: “Vaccinate your children, because in this way things that cannot be anticipated can be prevented. There are some parents who say that they let him get the disease, to immunize himself naturally. But those who say this forget one thing, or pretend to forget: there is no infectious disease that does not generate complications. And there is no infectious disease that does not cause death. Any person of good faith, if he takes a book on infectious diseases and reads, he sees that some percentages are passed there, higher or lower, both for the generation of complications and for deaths.”
Another recommendation is for parents to be guided by information obtained from specialists. “Being an influencer or a public figure without a clear and documented qualification in a field does not mean that you have expertise or authority in that field,” says Prof. dr. Emilian Popovici.
He warns that if vaccination rates remain low in the future, there will be other epidemics. “And not an epidemic, but epidemics. That is, for all diseases that were controlled until the moment when vaccination coverage fell below 60-70%”. From experience on a historical scale, it happens that when diseases reappear, people start vaccinating again until the diseases come back under control. After that, they start to refuse vaccination again. And the cycle starts again. “Because option C – in which you don’t get vaccinated and there are no diseases, doesn’t exist”, concludes the professor.
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2023-12-14 13:51:47
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