Measles leaves Israeli comatose in coma



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The 43-year-old woman has encephalitis or brain inflammation, a well-known and potentially deadly complication of the virus. She was healthy before taking measles.

"She has been in a deep coma for 10 days and now we expect the best," said Dr. Itamar Grotto, director general of the Israeli Ministry of Health.

The flight attendant, who works for El Al, the Israeli airline, may have contracted the virus in New York, Israel, or a flight between the two, Grotto said. Health officials do not believe it spreads the virus to anyone on flights.

She is unable to breathe alone and on a respirator at the intensive care unit of Meir Medical Center in Kfar Saba, near Tel Aviv.

She developed a fever on March 31 and entered the hospital on the same day.

Outbreaks of measles in progress in the United States and Israel began with parents who chose not to vaccinate their children, according to health authorities. Authorities believe the flight attendant was vaccinated as a child, but the vaccine is not perfect and, in her case, did not work.

"I knew this would happen sooner or later," said William Schaffner, an infectious disease specialist at Vanderbilt University and a consultant with the US Centers for Disease Control and Prevention on vaccines. "We have the reintroduction of a serious viral infection with a population that retains the vaccine of their children and is now spreading beyond this population."

One dose of non-optimal vaccine

Like many others of her generation around the world, the unidentified flight attendant received only one dose of the measles vaccine as a child.

It was not discovered until later that a dose is only 93% effective. More recently – in the United States, starting in 1989 – children received two doses, about 97% effective, according to the CDC.
What you need to know about measles as the virus spreads across the country

It is not known why most people who get measles recover fully, while others have devastating complications.

About 1 in 1,000 children who get measles will develop encephalitis, according to the CDC. This can lead to convulsions and leave a child deaf or with an intellectual disability.

In addition, 1 or 2 in every 1,000 American children who get measles will die. Across the world, the disease is fatal in 1 or 2 out of every 100 children.
No fatality has been reported in the United States of measles this year or last year. In Israel, a child and an elderly woman died in the last year of the disease. In the European Union, 35 people died of the disease in 2018, according to the European Center for Disease Prevention and Control.

Measles in Israel

There were 3,920 cases of measles in Israel from March 2018 until April 11, said Grotto, who is also a professor of epidemiology and public health at Ben-Gurion University in the Negev.

In the United States, there were fewer than 1,000 cases in the same time period.
In Europe, there were 34,383 cases of measles based on data reported to the World Health Organization from April last year to April this year.

Ukraine has had the highest number of cases in the last 12 months, with more than 72,000, followed by Madagascar and India, with more than 69,000 and 60,000 cases, respectively. The WHO warned that there are delays in reporting and that this data may be incomplete.

Ultra-Orthodox Jews, many from Israel, gathered in Uman, Ukraine in September on a religious pilgrimage. Ukraine had more than 72,000 cases of measles last year.
Grotto said there was a wave of cases in Israel last year when a large number of ultra-Orthodox Israelis traveled to Ukraine on a religious pilgrimage during the Jewish New Year. Ukraine has had more than 72,000 cases of measles this year, more than any other country, according to the World Health Organization.

About 85-90% of Israeli measles cases are among ultra-Orthodox Jews, Grotto said.

There is nothing in Judaism that teaches against vaccination; on the contrary, rabbis encourage vaccination according to Jewish teachings on how to protect their health and the health of others.

Ultra-Orthodox Jews tend to have large families, and Grotto said that those who do not vaccinate tend to have practical rather than ideological reasons.

"Sometimes they vaccinate their first or second child, but with so many children, they do not always have time to vaccinate everyone," he said. "They are not against vaccines. They have nothing against them ideologically."

To reverse the tide in the outbreak, Israel's public health authorities increased vaccine clinic hours, opened mobile clinics in religious quarters, and posted newspaper ads in religious communities.

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