“Then came the measles” from The Adventures of Tom Sawyer, Chapter XXII by Mark Twain (Samuel Langhorne Clemens, 1835-1910). In 2019, there were more than 1,300 cases of measles reported in the U.S., more than any year since 2000 when measles was declared eliminated in the U.S. The 2019 outbreak was linked to unvaccinated travelers who brought the disease here from other countries, with subsequent transmission to pockets of unvaccinated individuals. Most readers have never suffered from measles and therefore have no experience by which to judge how serious the disease was in the past. Perhaps the words and recollections of Mark Twain will enlighten us to how serious and potentially deadly the disease once was, and how it still is in some parts of the world.
Mark Twain and his most famous character, Tom Sawyer, both suffered from the disease. Concerning Sawyer’s measles infection, Twain wrote: “During two long weeks Tom lay a prisoner, dead to the world and its happenings. He was very ill, he was interested in nothing.” As a child, Twain witnessed an outbreak of measles and recalled the following: “In 1845, when I was ten years old, there was an epidemic of measles in the town and it made a most alarming slaughter among the little people. There was a funeral almost daily…” Twain deliberately infected himself by exposing himself to a sick friend. He described the experience as follows:
It was a good case of measles that resulted. It brought me within a shade of death’s door… The word had been passed and the family notified to assemble around the bed and see me off… They were all crying, but that did not affect me. I took but the vaguest interest in it and that merely because I was the center of all this emotional attention and was gratified by it and vain of it. When Doctor Cunningham had made up his mind that nothing more could be done for me, he put bags of hot ashes all over me. He put them on my breast, on my wrists, on my ankles; and so very much to his astonishment, - and doubtless to my regret – he dragged me back into this world and set me going again.
Today, we have an effective vaccine against measles, and we don’t treat it with hot ashes. The vaccine does not increase the risk of or cause autism. Very rarely, serious adverse events may occur following vaccination, for example serious allergic reactions (1 in 30,000 to 40,000 cases) and febrile seizures in children under seven (1 in 3-4000 cases). Those who foolishly refuse vaccination put themselves and those around them at risk. It is hoped that one day, with the help of vaccination, measles will be eliminated from the world and relegated to the history books and literature, such as Mark Twain’s beloved, The Adventures of Tom Sawyer.
For more information, go to www.cdc.gov/measles/cases-outbreaks.html
By Peter Galvin, MD
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