Measles isn't the Brady Bunch

Anti vaxxers have been citing an episode of The Brady Bunch as supposed proof that measles vaccination is unnecessary. In the Season One episode "Is There a Doctor In the House?", all six Brady kids come down with the measles, suffer no worse than raised temperatures and spots, and have a joyous time staying home from school to play board games and never go to the toilet.  Anti vaxxers cite this as proof that measles was just a normal childhood illness until vaccination came along and ruined the whole party. 

However inconsequential a bout of measles was to childhood memories or sitcom scriptwriters of the 1960s, if you want to know how horrid measles can really be, read on about a measles infecting all five children of the last Tsar of Russia. They were in their teens and twenties, well nourished without any processed foods or pesticides - and they nearly died. Yes, it was over a century ago but the scary thing is, we don't have any better treatments for viruses today - only prevention. Vaccination.

Despite what Hollywood says, measles isn't that much fun

Anti-vaxxers cast their nets far and wide looking for evidence to back up their claims of vaccines being dangerous and unnecessary. The false claims of danger have been covered extensively in the media, but anti-vaxxers state that along with vaccines being full of toxins, heavy metals and the ground up embryos of the cutest baby chickens you can imagine, that we don't even need them. Their argument is that most of the diseases we vaccinate against today were once just normal childhood illnesses, a right of childhood passage that would cause most kids to feel a bit yuck for a few days until they recovered, no harm done and lifelong, natural immunity confirmed.

And as proof of this, they cite the Brady Bunch. Anti-vaxxers are linking to this episode of the Brady Bunch to prove that until recent hysteria, measles was no big deal. They'll use a fifty five year old episode of a sitcom presenting a sacchrine view of an eternally happy family, who all had the measles and all got over it, as proof that that's how it was before measles vaccination; everyone got the measles and everyone was okay. Well, if you want to take your medical advice from a sitcom where a single salary supported six kids, a stay at home wife and a live in maid along with annual trips and plentiful after school activities (I guess they saved a lot of money on clothes, though), and no one ever went to the toilet, then I'm not sure I can convince you of anything in the real world.

And for what it's worth, actress Maureen McCormack, who played Marcia Brady, is furious that the episode is being used as proof of anything. The now adults who played the Brady kids have spoken extensively of their frustration as child actors at how unrealistic the show was. It annoyed them then, but they see the danger in this episode being used as an argument against vaccination now, as McCormack explained:

"As a mother, my daughter was vaccinated. Having the measles [as a child] was not a fun thing. I remember it spread through my family." 

 

People who remember their own mild bout of measles as a kid necessarily have survivor bias. The kids who, back in the old days, did not survive measles - along with the kids who didn't survive riding in the back of Dad's ute, being bullied and flogged at school, playing outside in the hot sun, and whatever else baby boomers like to pontificate about on Facebook, are not here to tell us about it. And just like how hazy memory allows us to think how much better music was in the 90s, whilst forgetting all about the Cotton Eye Joe, 2 Unlimited and Bewitched, so we can forget how horrid measles used to be and the deadly toll it took.

How awful is measles, really? Meet Grand Duchesses Olga, Tatiana, Maria and Anastasia, who along with their brother the Tsarevich Alexei were the children of the last Tsar of Russia.

The sisters in 1916, shortly before their experience with measles

Like many people I was fascinated by the Grand Duchesses as a young girl; their regal beauty, their deaths at the hands of the Bolsheviks, and especially what was then the mystery of Anastasia; did the Tsar's youngest daughter survive, per the many claimants who popped up across the twentieth century?

Of course we now know that neither Anastasia nor anyone else survived; the entire Imperial family, along with several of their close family servants, were murdered in 1918 at the height of the Russian revolution and Civil War.

But the children nearly didn't make it to the cellar in Ekaterinberg where they were shot. The year before, as the Russian Revolution commenced, they all had the measles. History could otherwise have turned out very differently. But I'm not writing this to play what if; but to show that measles is fucking horrible.

At the time the Romanov children contracted measles in early 1917, Olga was 21, Tatiana 19, Maria 17, Anastasia 15 and Alexei 12. Aside from the stresses and strains of World War One, then raging for three years, and the added burden of the nursing work carried out by the older two sisters, the young women were all in good health, robust, well nourished, and with access to the best medical care available at the time. Alexei famously suffered from severe haemophilia; with few treatment options at the time he had already experienced several medical crises where it was feared death was imminent.

Due to his haemophilia, doctors had forbidden Alexei from vigorous physical activity, a great blow to the boy, who loved anything to do with the army; drilling, marching, exercises. And so one day in February 1917, a group of young cadets from the military academy came to play with Alexei at the palace. One of these young men happened to have a flushed face and a bad cough. And a week later, starting with Alexei and his oldest sister Olga, the Imperial children all came down with measles.

Despite the constraints imposed by his haemophilia, Alexei was otherwise reasonably well in early 1917, and his healthy sisters, in adolescence and young adulthood, would seem to be exactly the sort of patient who'd quickly recover from a common viral infection like measles.

Instead what we see is the horror show measles actually is. As their mother, the Tsarina Alexandra, and her retinue devoted themselves to round the clock nursing care, Alexei actually fared the best of all the siblings; three weeks after developing a "great ugly rash" across his body, severe cough, headache, sore eyes and a temperature over 39℃, his temperature began to fall and he was deemed to be recovering.

Olga exhibited the same symptoms of fever, rash and pain as her brother; then, whilst Alexei was recovering, she developed ear abscesses, throat pain so severe she completely lost her voice. She then developed encephalitis, a common side effect of measles; it took her weeks to recover, and she remained weak and exhausted for months.

Tatiana, regarded as the strongest and leader of sisters, shared Olga and Alexei's rash, high fever and ear and throat pain. She also developed ear abscesses that required her head to be bandaged; the otitis left her temporarily deaf for several weeks, and she had problems with hearing in her right ear for some time after.

Maria and Anastasia, in their mid teens, fared the worst. They quickly developed temperatures of up to 41℃, with Maria developing pneumonia, drifting in and out of delirium. Anastasia required lancing of her eardrums due to the pressure in her ear canals; she also developed pleurisy, suffered from continuous vomiting and was temporarily deaf. Two weeks after the initial infection, the younger sisters were both in critical condition; their mother the Tsarina, with three years of experience as a Red Cross war nurse, believed the girls were dying, with only the oxygen administered by a doctor who arrived at the palace from Petrograd keeping them alive. Eventually the sisters' fevers broke, but they also remained weak and fatigued in recovery.

Whilst all this was going on, the Russian revolution was underway and Tsar Nicholas abdicated; several plans to evacuate the Imperial family from Russia were proposed, but the children were too ill to be moved; by the time they were all recovered sufficiently to be moved, some two months after the initial illness, it was too late.

A year after their horrible bouts of  measles, in July 1918, the Romanov children were murdered in Yekaterinburg. However the severity of their initial illnesses increased the chance of long term complications, such as subacute sclerosing panencephalitis (SSPE) - and trust me, this is a disease you really don't want to get. SSPE is a complication that arises anywhere from two to ten years after an initial measles infection, primarily in children and adolescence. Initial symptoms may include headache, depression, mood swings and personality changes. Things go rapidly downhill from there; as the disease progresses, patients develop uncontrollable muscle spasms, epilepsy, dementia and loss of vision. Patients begin to writhe and twist uncontrollably, between periods of rigidity. 

All this is happening because SSPE destroys the brain. Slowly. All this may play out over a period of a year or two, all while parents watch on helplessly. In the final stages of the disease, the parts of the brain that control breathing and heart rate are so damaged the young patient's heart stops, or they stop breathing. However death occurs, SSPE results in a slow, horrible and inevitable death - anti viral treatments may slow the progression of some symptoms, but there is no cure for subacute sclerosing panencephalitis - just as we have no cure for the initial measles infection.

Many people who eschew disease prevention in the form of vaccinations still put their faith in modern medicine when it comes to finding a cure. If the worst happens, if they or their children develop a severe form of the diseases they refused to be vaccinated against, they're sure that there's treatment to arrest the symptoms, stave off the disease, that all will be fine. We saw something of this during the Covid pandemic and the subsequent jarring reality for people who refused the Covid jab, became seriously ill with the virus, then realised that for all modern medicine could allieviate symptoms with ECMO machines and ventilators and anti virals, there was no cure for Covid - not because there was a conspiracy to kill vaccine refusers, but simply because as I explain below, modern science still struggles to develop methods to cure active virus infection in the human body.

But the point here is that measles is a really serious and horrible disease, and even fit healthy young people can develop the most terrible complications, and even die.

To which anti-vaxxers might well say "Yes, but that was 100 years ago! Medicine has improved since then."

The short answer to that is, if you've such faith in modern medicine, why not trust them on the vaccination thing? (I'm sure the Tsarina, after two sleepless months caring for her critically ill children, would have lined them up for a vaccine if it were available).

The slightly longer answer is that medicine still hasn't improved that much when it comes to measles or pretty much any other virus. As with whooping cough, there is no specific treatment for the disease. The symptoms can be alleviated through pain relief, intravenous hydration, oxygen, and bacterial infections that arise can be treated with whatever antibiotics still work after a century of over-use, but basically when it comes to measles, it's a virus, and you're on your own. Your unvaccinated child might develop measles, recover and be fine. Or they might develop encephelitis and brain damage, their hearing may be permanently affected, they could develop viral pneumonia, a high temperature, breathing problems. The best hospital care can provide intravenous fluids, ventilation, efforts to reduce body temperature in case of high fever, but all those are symptoms. With the measles virus itself, it's up to the human body to fight it off. And even young women eating the best diet in the world in an age before industrial agriculture couldn't fight off the virus's worst effects.

Of course, chances are if you don't vaccinate your kids and they develop a vaccine preventable disease, they'll recover and be okay. Same as how if you drive around without a seatbelt, you'll probably make it home without injury. If you take a commercial flight on an aircraft that hasn't been properly maintained, the chances that your flight is the one when the improperly fitted screws finally succumb to metal fatigue, causing an engine to detach and the plane to stall and crash just past the runway is vanishingly small. Board that plane back to Tulsa with confidence! It flew from La Guardia to Miami just fine. 

But in all the above scenarios, the odds that something will go drastically wrong have been greatly increased. Just like when you skip vaccinations. 

And the thing is, you just don't know what the outcome of a viral infection will be. But you do know one thing; you can't pretend that measles isn't a really fucking serious disease. And modern medicine does offer one thing that works - measles vaccine. So just do it, okay?  Get your kids vaccinated, and yourselves too (In Australia, adults born between 1966 and 1994 are strongly recommended to get a measles booster - you can find more info here. And yes, I have had the booster myself).

But take measles seriously. Life ain't the Brady Bunch, and trust me, a case of the measles is not A Sunshine Day.

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