Fort Worth, Texas,
13:32 PM

Pediatricians Remember Experiences with Measles

Two Cook Children's doctors explain why the anti-vaccine movement is especially difficult to understand

It’s been nearly two decades since measles was declared eradicated in the United States, but due to a shift in attitudes about vaccines the virus is back.

More than 500 people spanning 20 states have been diagnosed with measles this year already. According to the Texas Department of State Health Services, 15 of those cases were in Texas.

For the rare remaining physicians who have treated measles, the news is like déjà vu.

“We learned a lot from the 1989 measles epidemic,” said Deborah Susan Hucaby, M.D., an emergency room physician at Cook Children’s Medical Center. “We got to a point where anyone who came into the pediatric emergency room or clinics with a fever was presumed to have measles until proven otherwise.”

Dr. Hucaby was a resident at Ben Taub Hospital in Houston in 1989 when the worst measles outbreak in recent history occurred. That year, 17,850 measles cases were reported in 47 states with 3,201 of those in Texas.

“At the time, the MMR vaccine was recommended for children at 15 months,” Dr. Hucaby explained. “Due to the high number of unprotected children we were seeing with measles, that recommendation was lowered to 12 months of age. We also started giving the single measles vaccine at 6 months of age.”

Measles is one of the most contagious diseases known to exist. According to the Centers for Disease Control and Prevention (CDC), the virus can live for up to two hours in the air where an infected person coughed or sneezed. If other people breathe the contaminated air or touch a surface that’s been infected, they risk infection.

For this reason, Dr. Hucaby says a doorbell was installed outside of the pediatric clinic where she worked during the outbreak.

“Parents were asked to ring the bell if their child had a fever, with or without other symptoms,” she said. “A nurse would go out into the hallway to look at the patient. If they appeared to have a risk factor for measles, we would take them straight into an exam room. We didn’t sit them in the waiting room.”

In Houston alone that year, 1,434 children under the age of 5 were diagnosed with measles. Dr. Hucaby says it’s frustrating to interact with parents today who refuse to vaccinate their children against diseases such as measles, mumps and rubella.

“So many of these parents have never seen these diseases. I’m 40 years older than most of them and I have. I have seen kids die from them,” she exclaimed.

Dr. Hucaby says there’s one child she will never forget. The little girl was only 6 months old when she arrived at the hospital with measles and pneumonia. She was too young to have been immunized and died as a result.

“Parents who decide they are OK with their children becoming infected with diseases probably frustrate me the most,” added Dr. Hucaby. “We didn’t see that during the Houston epidemic. Truly, people were willing to vaccinate their children. I don’t remember a single parent saying ‘no’ to a vaccine.”

She said in the 1980s, children often weren’t up to date on their immunizations mostly because parents didn’t see the importance or they had difficulties with transportation or finances. Today, vaccines are more accessible than ever in the U.S. with programs providing low-cost vaccines in every state.

Another Cook Children’s physician, Britt Nelson, M.D., remembers a time when seemingly every hospital had an area dedicated to infectious diseases. Dr. Nelson is the medical director of the Physician Network at Cook Children’s, but in the early 1980s he was just starting his career.

“Every place I worked before Cook Children’s had an infectious disease ward where patients could be isolated,” said Dr. Nelson. “But as infectious diseases became better controlled, particularly the ones that are so contagious like chicken pox and measles, we didn’t need to have a special ward anymore.”

The reason for the decline in such quarantined areas is simply vaccines.

“I have lived through the era where I’ve seen vaccines come and save children’s lives. I have stood in line to get the polio vaccine,” Dr. Nelson explained. “I grew up with a great deal of anxiety about all of these diseases. That’s the piece that is missing in our society now, no one is anxious about these diseases.”

Dr. Nelson had good reason to be anxious. Not only did he know people who fell ill with polio, he himself lived through infections of measles, mumps and chicken pox.

“I had measles when I was a little boy, before I even started school. I remember having to stay in a dark room for four days because they thought light might increase your chances of losing your vision, which was not true, but that was the belief back then,” he said. “I didn’t want to eat. I didn’t want to do anything. I just wanted to die. It was that horrible.”

When vaccines for measles and mumps came along, Dr. Nelson said he felt relieved. He believed that he’d never have to worry about children becoming ill or dying from them again. Unfortunately, that hasn’t been the case. Currently, the CDC reports there are 626 measles cases in 12 states with vaccine exemption rates continuing to rise.
Dr. Nelson says the fact that parents are refusing vaccines for their children, despite scientific proof that they are safe and effective, is difficult for him to comprehend.

“As a physician, I’ve seen a ton of children die when there was nothing I could do about it. There was nothing anyone could do about it. So it does make me incensed that a parent would put a child at risk for a disease that could kill them based on emotion,” he said. “A parent that has never lost a child doesn’t understand the emotion that they are going to feel if they do.”


Resources Available at Cook Children's

There's so much misinformation on the Internet and television about the dangers and risks of immunizations, that it can be hard for a parent to separate the facts from the fears. Visit our website to learn more about our recommmendations regarding vaccines and how to make the best decision for your family. 

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Terri Andrews
Thank you for so much great information. I too grew up in the days of lines for polio vaccines & watched my siblings suffer with Measles, mumps and rubella. Thankfully my children received MMR but they did suffer with chicken pox including high fevers & lasting scars. My grandchildren are all vaccinated including the cancer preventing HPV vaccine. I do continue to as a volunteer supporting the facts that Vaccines are Safe & Effective! Be Wise—Immunize!