California had more philosophical exemptions for school children than the entire rest of the United States combined, with Oregon and Washington states close behind. Some schools on the coast had nearly 75% of kids unvaccinated. Only when ridiculous diseases like Whooping Cough resurged and spread inland did more sensible people revolt and our work to ban arbitrary exemptions, in support of legislator Dr. Richard Pan's long-time efforts, paid off and Governor Jerry Brown grudgingly signed a law forbidding non-medical exemptions.(1)
There were always scientific and medical reasons to be sensible, even if Berkeley residents said they don't matter. A new study details how the measles virus causes subacute sclerosing panencephalitis, a rare fatal neurological disorder, even years later. Measles is an RNA virus and spreads rapidly, it has a much higher R0 (pronounced “R naught”) - the basic reproduction number of an infectious disease - than something like coronavirus. If an infected person is around unvaccinated people the Susceptible-Infected-Removed (SIR) model looks bad - it will spread quickly.
No problem if it is a cold, and sometimes measles. Yet not getting vaccinated was never worth the risk. Ordinary measles don't infect the nervous system but nature is always mutating new ways to try and kill everything, just like happens with influenza and coronavirus. Though anti-science hippies decided that measles was harmless and vaccines were a Big Pharma conspiracy, measles causes over 120,000 deaths each year. When measles mutates a protein that controls how infections occur, they can even begin to invade the brain and cause encephalitis.
As the authors of the new paper write, "A virus infects cells through a series of proteins that protrude from its surface. Usually, one protein will first facilitate the virus to attach to a cell's surface, then another surface protein will cause a reaction that lets the virus into the cell, leading to an infection. Therefore, what a virus can or cannot infect can depend heavily on the type of cell."
When mutation happens, the virus goes beyond immune and skin (and other epithelial) cells and affect the nervous system.
The new work looked into how that happens. They found that mutations in the fusion protein lead to a "hyperfusongenic" state where it can latch onto synapses and infect the brain. They found that while some mutations increased fusion activity, others decreased it. Yet even ones that decreased activity were able to 'cooperate' with normal proteins and infect the brain.
"It is almost counter to the 'survival of the fittest' model for viral propagation. In fact, this phenomenon where mutations interfere and/or cooperate with each other is called 'Sociovirology.' It's still a new concept, but viruses have been observed to interact with each other like a group. It's an exciting prospect" says Professor Yuta Shirogane of Kyushu University.
The road map to therapy from here is a long and winding one, but at least they have a direction for this rare circumstance. And with newfound interest in being vaccinated by demographics once overwhelmingly opposed, there is hope that deaths due to measles will decline while therapies develop.
NOTE:
(1) What happened next was entirely predictable. Wealthy people in Marin County and San Francisco began to have their boutique pediatricians sign medical waivers and the new Governor, former San Francisco Mayor Gavin Newsom, showed no interest in signing any law that would anger his largest donors. Until COVID-19 came along and Republicans worked to take leadership of the anti-vaccine movement from Democrats, which put Gov. Newsom in a bind. He had hid his donors from scrutiny using personal choice yet now wanted body autonomy eliminated. Vaccines were mandatory.
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