Out, Red Spot

The Federal Government last week declared its determination to eradicate measles from the U.S. in 1967. Up the chain of command from Surgeon General William H. Stewart of the U.S. Public Health Service to President Johnson went the word: from 8,000,000 to 10,000,000 children aged one to seven will be vaccinated this year, largely with the aid of federal funds funneled through 42 state and 61 city-county programs.

The Government's ambitious plans apply only to the common "seven-day" measles, or rubeola—not to be confused with the three-day "German" measles or rubella, for which a vaccine has not yet been perfected. Though rubella early in pregnancy has gained an evil reputation as a killer and crippler of the unborn, it is otherwise a mild and almost harmless infection. Not so with common measles. "Of all the childhood diseases that remain," says Dr. H. Bruce Dull of the National Communicable Disease Center, "measles is the one with the most risk."

No Reservoirs. Perhaps because measles always seemed to be an unavoidable part of childhood, it has not loomed as threatening as other diseases, and its characteristic red spots have long been the butt of comic-strip jokes.* There were almost 4,000,000 cases a year in pre-vaccine days. In more than 500,000 of the annual cases, according to Dr. Dull, there were complications such as middle-ear infections; in 4,000 cases, there was encephalitis often with resulting mental retardation, deafness or blindness. In 400 to 500 cases, the disease ended in death.

Though the disease fighters were hampered by the public's unconcern, they were helped by some characteristics of the measles virus. There is only one type, as against three for polio. One shot of vaccine made from live but attenuated virus confers lifelong immunity. And the wild virus has no reservoir, like that of rabies in animals or polio in sewage. It lives only in man. Wipe it out in man, and it is wiped out, period—except for sporadic outbreaks among unvaccinated children, caused by virus imported by a traveler.

Last year vaccination drives in Rhode Island, Massachusetts, New Hampshire, Detroit and South Dakota paid off handsomely. New Hampshire has not had a single case since September. Elsewhere there have been scattered cases but no epidemics. In all, more than 18 million doses of vaccine have been injected, most of them with the needle, by physicians in private practice. In mass campaigns, where 50 or more children can be vaccinated at once, it is more economical, as well as better psychology, to use an air gun that gives a shot so fast that it's all over before most kids start to howl.

Two-Thirds Majority. The vaccinators' targets this year will be some 4,000,000 babies, plus 4,000,000 children in first and second grades who have so far escaped the needle, and about 2,000,000 in kindergarten, nursery and

Sunday schools. These are not all the susceptible children. But it is not necessary to inoculate every child to end epidemics. Explains Dr. Dull: When two-thirds or more of the children in any community are immune, through having had either the disease or vaccination, the measles virus simply dies out.