MEASLES is a rapidly transmissible disease caused by infection with the measles virus. Causing fever and cold-like symptoms as well as a characteristic rash, it has plagued the human race for centuries. There are Aztec drawings of people with measles (with the recognisable rash) from the 16th century, when Europeans first set foot in central and South America and brought measles with them.
 
The majority of people are infected with measles as children, after which they have lifelong protection against any future measles infection because their immune system recognises the virus in future.
 
Measles can cause further complications, and even kills a relatively small number of people. The proportion of measles cases that result in death depends on the quality and availability of local healthcare. A child treated quickly at a hospital in the Western world has a much higher probability of survival than a child in impoverished parts of Africa.
 
In Britain, children are routinely vaccinated against measles as part of the MMR (measles, mumps, and rubella) vaccine. The proportion of the population that has been vaccinated is around 94.5 per cent, which has so far thankfully only decreased slightly in the face of increased anti-vaccine conspiracy theories.
 
This vaccine coverage is high enough to prevent any large-scale measles outbreaks in Britain, since any child that is infected with measles is only likely to come into contact with vaccinated children. Individual cases of measles therefore can’t easily give rise to outbreaks.
 
The real burden of measles lies in countries where routine vaccination is patchy or sometimes unavailable. The Democratic Republic of Congo (DRC) has recently seen a huge measles outbreak sweep over every part of the country, where the proportion of people vaccinated usually varies between 50 and 70 per cent.
 
In 2019 the DRC has recorded 250,000 cases and 5,000 deaths, more than the Ebola outbreak that is simultaneously happening in the eastern part of the country. There have also been outbreaks in Ethiopia, Georgia, Kazakhstan, Kyrgyzstan, Madagascar, Myanmar, the Philippines, Sudan, Thailand and Ukraine, and most recently in the Pacific islands state of Samoa.
 
On November 17 a state of emergency was declared in Samoa, where there have been over 5,000 cases in a country with just under 196,000 inhabitants. Similar states of emergency have also been declared in Tonga and Fiji.
 
Unfortunately, measles has knock-on effects, making it more deadly than it might initially appear. Where measles vaccines have been successful, childhood mortality from other causes has also decreased.
 
Studies that compared cohorts of children who had been infected with measles to similar children who had not been infected confirmed a similar finding: mortality from all causes is higher in children after measles infection. This is true in both low-resource countries, where measles and other infections circulate persistently and increase and decrease together, as well as in high-resource countries.

This is because even in the absence of other diseases, measles also increases the likelihood of opportunistic bacterial infections after infection, where bacteria which usually pose no threat to health take advantage of the weakened immune system.
 
These results all point to one conclusion: measles infection has a lasting negative effect on the immune system of children, even after infection. In November, scientists published research that showed we have finally understood precisely how this happens.
 
Firstly, a quick background on our immune system: we fight off invading bacteria, viruses, and parasites by producing proteins called antibodies that are specific to each new infection. Some cells in the immune system have a long memory. They serve as a library of all the pathogens that our body has previously experienced.
 
This means that, in theory, our body is better equipped to fight the same kind of infection in the future. This works for some pathogens such as the measles virus, or chickenpox, but some pathogens have tricks to prevent our body from recognising them and responding appropriately.
 
The flu virus mutates so quickly that there are many different strains of the flu, and these strains vary year on year. That’s why there is a new flu vaccine each year which tries to predict which strains will be common in the upcoming year. Vaccines work by introducing our immune system to inactive versions of pathogens, so you can build a library of antibodies without all of the deadly effects of a disease. 
 
Contrastingly, the malaria parasite swaps between many different proteins on its surface over the course of an infection, similar to a chameleon trying out many disguises. It will take a while for your body to recognise all of these different proteins and it therefore takes several parasite infections for your body to develop a decent immune response.
 
In measles, scientists measured the presence of thousands of different antibodies in the blood of children before and two months after measles infection. They found that measles destroyed between 11 and 73 per cent of the children’s antibody library, leaving children susceptible to re-infection with pathogens that were now missing from their antibody library.
 
Crucially, this ransacking of the immune library does not happen in children whose exposure to measles is through the MMR vaccine. Preventing this ransacking, as well as preventing deaths from complications due to measles, has made the MMR vaccine one of the most effect public health interventions ever conceived.
 
There is however no time for self-congratulation. Many children across the world do not receive the vaccine and measles remains the highest vaccine-preventable cause of death. In Western countries, where some people are beginning to reject vaccines as an unnecessary medical intervention, we are starting to take for granted that we live in a country that is not frequently beset by epidemics.
 
Vaccination presents a clear challenge to capitalist and libertarian positions, as the evidence is so clear that even on the right, very few have the gall to argue against it. As a new majority Conservative government continues the ongoing stealth privatisation of the NHS, with obvious and insidious threats to health and our common good, the arguments for universal healthcare provided by the state are more important than ever.