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Writer's pictureChris Golden

“Measles Outbreak” and should we care?

“Measles Outbreak” and should we care?


Lately there has been a lot of talk and headlines about measles and outbreaks and how ‘anti-vaxxers’ are ruining the very fabric of health within our society, the question is, should we care?


In the news industry, there is a common saying, “If it bleeds it leads”, see, fear has always been the biggest motivator within human psychology and marketing followed by security, family, greed, creativity, and of course, curiosity, hence the “should we care?” in our headline. Media companies will often exploit these in order to get people reading or watching their news, and in the age of digital media, where literally every click, like, share, and engagement on an article and video can be tracked, nothing is more than true.


This means that stories and headlines that promote fear are far more likely to make it to the top of headlines, than the positive story about the man who helped an old lady across the street, a fundraiser to help kids go on a school trip, or a new business opening.


This is why over the years newspapers front pages have been generally dominated by negative news, with just enough information to get you to open a paper. Television, is no different than its paper counterpart, and will lead its news program with the negative story, and then make you wait till the end or near end of their program, or at very least, till “after the commercial break” to get the whole story and dispel some of the fear.


In the digital age, where front pages don’t exist, and you can fast forward through commercials, readers and viewers are still more likely to share the negative news with the scary headline. Any ‘good’ media company knows this, and uses it to their advantage.


You are much more likely to see a headline like ‘Stabbing in Acton’, than ‘Attempted stabbing in Acton, no injuries’, or to see ‘Bank robbery leaves two dead’ than ‘Bank robbery leaves two robbers dead, bank re-opens’ or ‘Terrorism rising in Canada’ as opposed to ‘Terrorist plot foiled’. The idea is phrased ‘the teaser’ which is designed to give just enough information without being false, while scaring or interesting people enough with the headline that they actually read the article. Certainly the idea is not to dispel fear through the headline. The term ‘clickbait’ comes to mind, and if there is something all media is guilty of, it is clickbait.


While it is hard to change human psychology and sociology, what news outlets should be doing is at least explaining the terms they use, and society and readers should be better arming themselves with these terms while looking past the headlines, and beyond one or two news sources, and even looking into references provided and God forbid, doing some of their own research. Reporters, writers and editors are human too, and prone to mistakes.


Media is likely to use buzzwords such as ‘rising’, ‘worst’ or ‘tripled’. However, these words are meaningless, unless you are aware of the information surrounding the topic. You could say for a hypothetical example ‘crime triples in Halton Hills’, which could be true, however, the question would be tripled from what?, or, how does this compare to other places? While the big, bold, scary headline could be true, it is less scary when actually analyzing the data, which could show we are still one of the safest places to live in Canada.


There is just simply not enough information in headlines to make an educated decision about anything, yet so little people take time to read a full article and even fewer research on their own.


With all the recent talk about measles. The latest media buzzword has been “outbreak”, but what does it mean?


Now when we think of the word ‘outbreak’, if you are anything like me, you think of zombies, or the Black Plague, or babies dying because of some communicable disease. But what does science actually mean by the word ‘outbreak’, the truth is actually far less scary.


The World Health Organization defines an outbreak as “the occurrence of cases of disease in excess of what would normally be expected in a defined community. An outbreak may occur in a restricted geographical area or may extend over several countries”.


We asked Dr. Hamidah Meghani, Medical Officer of Health for Halton Region, her assessment of the term outbreak which she concurs “An outbreak is defined as more than the expected number of cases in a particular place in a particular time period. Measles was eliminated in Canada in 1998 and in the Americas in approximately 2002.”


Therefore, an outbreak is simply more cases of a disease showing up in a particular place than expected, in a particular time frame. Beyond that, a outbreak can be shown in any geographical location. This year we have a measles outbreak in Europe, next year it can be Africa, or South Africa or Cairo, Egypt. You can look at any disease in any part of the world, and there will surely be an outbreak somewhere, as some years we will have more cases of a disease than average, and other years, we will have less cases of a disease or meet the average. This does not seem, by any means, a reason to strike fear, it is just the word used to describe more cases showing up than expected.


The term outbreak is far less scary than words like epidemic, which is affecting many people, or worse, a pandemic affecting all people.


If Halton Hills averaged one case of measles per year, and this year they get three (both hypothetical examples and less than what we usually see), that could result in a headline “Outbreak: Measles virus triples in Halton Hills” this would (hypothetically) be true, and could sound terrifying. On the other hand, if Halton Region usually gets five cases per year, but this year they got seven, this could also result in a headline “Outbreak in Halton, Measles on the rise”, but see when you read the facts, before the headline, it is far less likely to strike fear into you, generally our biggest fear, is that of the unknown.


In fact in Halton right now, if we got one case of measles it would be considered an outbreak, even one case in Canada could be considered an outbreak, Dr Meghani says “Even one case of measles in any jurisdiction in Canada is considered an outbreak, because it is potentially serious, it is rare and it can be so easily spread.”


In Halton we have gotten zero to one case of measles per year with the exclusion of 2013 where we saw six cases.




The fact remains, for Canada we have had multiple measles outbreaks over the years, and none of them have been a big deal, at least when compared to other things that are more scary and receive less media coverage.


Canada’s last (yearly) measles outbreak was 2017 with 45 cases being reported, up a whopping four times since 11 confirmed cases ( in 2016) just the year prior, however in 2018 there were only 29 cases of measles, for all of Canada, a population of 36.71 million, yet, since seeing headlines in Canada about Europe’s measles outbreak, we have only seen one new case of measles for all of Canada (in 2019) according to the Government of Canada’s website.


Another thing that muddies the water when talking about outbreaks is geographical location. We could see zero cases of measles in Acton, yet Oakville could see a rise, thus making the headline “Measles outbreak in Halton” rather than the more accurate headline “Measles outbreak in Oakville”, this would surely scare Acton people, when they realistically may have less to fear than they did in times prior.


So lets look at Europe’s measles outbreak and decide whether it should be cause for concern. Europe has a population of 742.9 Million, and saw 80,000+ cases of measles in 2018. Obviously this is cause for concern of getting measles in Europe, however, remember what we said earlier about ‘outbreaks’? “An, outbreak may occur in a restricted geographical area or may extend over several countries.”


Europe’s outbreak has primarily been in Romania, Italy, France and Greece, with some other countries actually seeing less measles than prior years before, but Europe sounds more scary, so we will go with that.


Also to keep in mind while talking about Europe, even with how Monolithic the European Union may seem at times, is that Europe is a very diverse continent, with very different countries, some which have very different healthcare, nutrition, and overall wellness compared to ours in Canada.


You could argue some places have better or equal to Canada, while you can also argue some places have it much worse, but the fact remains is that we all have our differences in this category.


Another massive difference between Canada and the EU is Europe also has an open border policy which makes it far easier for people to travel from places with no health care, to places with good healthcare, thus making the transfer of communicable disease more rampant.


Dr. Meghani does stress the importance of vaccinations especially when travelling, saying; “Anyone considering travel to an endemic (measles transmitting) area or where measles cases have been reported should check to make sure they have two doses of Measles, Mumps and Rubella (MMR) vaccine. If they do not, they should see their doctor to get vaccinated.”


She also says the continuity of measles is the result of people coming from other countries, “ Despite elimination of measles in Canada, cases and outbreaks continue to occur as a result of importation.”


Despite measles being the ‘disease de jour’ for media to talk about, Halton region seems to be doing better than the rest of Ontario in regards to health, Dr Meghani explains; “There are no communicable diseases among Halton residents that regularly have higher rates compared to the rest of Ontario. Please see the 2017 Halton Infectious Disease Report for more information (https://www.halton.ca/Document/Health-Statistics/Halton-Infectious-Disease-Report/Halton-Infectious-Disease-Annual-Report). As highlighted in this report, the five most commonly reported infectious diseases among Halton residents in 2017 were Chlamydia, Influenza, Gonorrhea, Campylobacter and Salmonellosis. “


Dr. Meghani also states; “Many of the most dangerous communicable diseases have been eliminated or greatly decreased in Halton and in Canada, thanks to our excellent immunization programs. The largest causes of death now are chronic diseases such as cardiovascular disease and cancers, which stem from four major risk factors: tobacco use, unhealthy eating, lack of physical activity and alcohol use. Smoking cigarettes is still the leading preventable cause of death and disease, with over 15% of Ontarians still smoking regularly.”


So should you live in fear about measles? Out of the 80,000 people who were infected with measles in Europe, 35 died. That’s roughly one out of 2285 (who had measles, and died). In contrast, according to the National Safety Council you have a one in 1,188 chance of unintentional drowning and submersion, yet we still go swimming. We have a one out of 114 chance of dying in a motor vehicle accident, with a one out of 647 chance of dying as pedestrian and a one out of 645 chance of dying as a vehicle occupant, yet we still use cars. We have a whopping one out of seven chance of dying of heart disease or cancer, and we still remain to have unhealthy diet, allow unhealthy restaurants, and continue unhealthy habits.


So should we be afraid? Ultimately that decision is up to you. You could fear one out of 161,856 chance of dying by a lighting strike and never go outside, or fear your one out 9821 chance of death in air and space transport incidents and never go flying, or fear your one out of seven risk of heart disease and never eat fast food again. We should at least be aware of these things. But to fear or stress is a whole other issue.


President Franklin D Roosevelt said in his first Inaugural Address in 1932 “Only thing we have to fear is fear itself”, and while some or all of these things may be frightening to you, what is just starting to be tested in health is the negative effects stress has on you. There’s also a saying “stress will kill you” though the National Safety Council has not yet quantified this.


References


“What Are the Odds of Dying From..” - National Safety Council


“Infectious Disease in Halton” - Halton Region


Measles Surveillance in Canada:2015 - Public Health Agency of Canada


Measles and Rubella Weekly Monitoring Reports - Government of Canada


Measles - European Centre For Disease Control


Risk of measles transmission in the EU/EEA - European Centre for Disease Prevention and Control




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