Measles, COVID, and Disease X

Three Things Thursday

Jan 18, 2024

Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week. This week measles continues to be in the headlines. There are more cases and a new, unrelated outbreak; hospitals are alerting patients to exposures and airports are not monitoring for sick individuals —

This is all preventable with a safe and effective vaccine.

Additionally — numerous COVID studies were published this week focused on vaccine effectiveness and the prevention of long-COVID.

And at the World Economic Forum (in Davos, Switzerland), the WHO is talking about Disease X, a placeholder — so to speak — or the name given to an unknown pathogen that could cause the next pandemic.

Details are below. Long story short… the measles vaccine is safe, effective, and essential to prevent the further spread of this deadly disease. COVID vaccines are also safe and effective — they prevent death, hospitalizations, and long-COVID. And Disease X is nothing to fear. We should be encouraged that global public health leaders are taking steps to prepare for an unknown virus (or bacteria) that could be the cause of the next pandemic.

Hoping this post helps to educate and empower you
to be healthy and create healthy communities.

Measles Outbreaks

There are now TWO active and unrelated measles outbreaks among unvaccinated individuals in the United States. As I reported last week, the City of Philadelphia is facing a measles outbreak. The first case was imported into the city by an unvaccinated child and exacerbated by another family who sent their sick and unvaccinated child to daycare. To date, there are nine cases of measles; more than half of those cases are hospitalized.

In New Jersey, a resident of Camden County also has measles. And health authorities have confirmed that this individual visited two healthcare facilities — Cooper University Healthcare Pediatrics and Jefferson South Jersey Stratford Hospital — while contagious. Additionally, the resident attended daycare while contagious. Individuals who were exposed and are unvaccinated could incubate the disease inside their bodies for weeks and not show symptoms until as late as February 2 (basically two weeks from now).

Individuals who were exposed and are unvaccinated should quarantine.

Quarantines and vaccinations are the only way to stop the spread of measles.

And just a friendly reminder that — measles is the most contagious disease known among humans (one case of measles leads to 12-18 additional cases; yes, that is an R-naught of 18). Symptoms of measles include a high fever (as high as 105*), cough, runny nose (also known as coryza), red & juicy eyes (also known as conjunctivitis), and Koplik spots. The measles rash can last anywhere from 7-10 days.

Learning SO Much More About COVID-19

On Tuesday, a preprint — a completed but not peer-reviewed study was published online at medRxiv. Researchers reported that COVID vaccines reduced deaths from the SARS-CoV-2 virus by 57% — saving more than 1.4 million lives in Europe between December 2020 and March 2023. Not surprisingly, most of the lives saved were among those 60+, who were and continue to be at the highest risk for severe disease and death caused by the SARS-CoV-2 virus. Hans Kluge, Director of WHO’s European Regional Office, notes —

“We have constantly stressed the importance of the COVID-19 vaccines, particularly for older people and the most vulnerable. This study documents the result of countries implementing that advice. The evidence is irrefutable.”

Another COVID vaccine study — this one published (and peer-reviewed) in Pediatrics found that COVID vaccines have a protective effect against long-COVID in kids. According to senior study author Charles Bailey MD PhD (press release) —

“This study provides us with important data showing the protective effects of the vaccine against long-haul COVID and suggests that this protection is mostly from preventing visible infections. We hope this means that as vaccines are improved to be more effective against current strains of SARS-CoV-2, their protection against long COVID will get better, too.”

The study found that vaccine effectiveness was 41.7% against (diagnosed) long-COVID in kids. Adolescents and teens (12-17 years) saw even more protection against long-COVID with vaccination. Vaccine effectiveness against long-COVID was 50.3%.

Speaking of long-COVID — another study published in BMJ at the end of 2023 found that in adults there is a correlation between the number of vaccines received and the amount of protection an individual has against long-COVID. This is a positive dose-response relationship, where more doses of vaccine equate to greater protection against long-COVID.

What does this mean? If you are up-to-date on your COVID vaccines and have been getting vaccinated as recommended, you are less likely to develop long-COVID.

We still do NOT have a clear and effective treatment protocol for long-COVID, which is why primary prevention is essential.

Get vaccinated.

Disease X

At the World Economic Forum in Davos, Switzerland this week, the WHO and its global public health partners met to discuss and make plans for a pandemic caused by Disease X.

Disease X does NOT exist. It is a placeholder. An imaginary pathogen that could emerge and be the cause of the next pandemic. According to the Director General of the WHO —

The key to preparing for a pandemic caused by something unknown is to — improve disease surveillance, strengthen healthcare systems, and respond quickly when illnesses occur.

The world also needs to address workforce shortages in public health and healthcare. An estimated 115,000 healthcare workers died during the pandemic, and countless others have retired or quit due to fatigue, frustration, or burnout. According to Preetha Reedy, vice-chairperson of Apollo Hospitals —

“We just do not have enough doctors and nurses to health the world.”

On the public health side — state and local public health departments (in the United States alone) need an estimated 80% increase in their workforce to provide a minimum set of public health services. In short — we need to hire 80,000 more full-time public health workers to maintain the essential public health services. Worldwide even more trained professionals are needed.

There has never been a better time to become an epidemiologist, biostatistician, health educator, or environmental health researcher.

Careers in public health are the best.

That’s a wrap for this week. Do you have questions? Need to know more? Or want to discuss what a career in public health would look like? Leave a comment —

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