Every time you gather children – or adolescents, or young adults – together, there is a possibility for some of the contagious childhood illnesses to take advantage of the predispositions. This was true in the First World War, where lifeboat and freight transport contributed to the virulent spread of influenza from 1918, which, unlike most flu strains, was more deadly than healthy young people than older people.
Many colleges require a specific immunization list before students move to the dormitories, including a meningococcal vaccine to prevent bacterial meningitis. But the measles-toothache and rubbish vaccine is always at the top of the list. This is because the measles are so contagious that if the immunity of the herd – when a high percentage of the population is protected by immunization – falls even by several percentage points, the measles virus can take full advantage.
"The first things you see, cracks in your public health system," Dr. Ratner said, will be infections like these, "measles, contagious through the airways and a good transition from sensitive people to sensitive people."
When my own daughter went to college, someone carefully looked at the immunization records, which was always accepted without questions at her school and found her first MMR received several months before her first birthday and hence did not take it; she had to go get another dose before she took up residence in her sleeping room.
I asked about this early MMR because we needed to travel to the country where there was a risk of measles (not, not Brooklyn) at that time. You can give MMR for 6 months if the child is exposed to increased risk of measles, and it provides some protection, but you have to repeat the shoot when the child turns 1. I forgot it and no one ever noticed it. As a pediatric mother of a child with an incomplete record of the vaccine, I was somewhat confused, but mostly impressed.
Dr. Stimson noted that those World War One soldiers who grew up in more isolated, usually rural circumstances were less likely to have immune systems in childhood illness, and "when thousands of these rural youths collect military camps together, infectious diseases can be very common, "he said. This was also recorded in the American civil war, when the measles were particularly devastating, and recruits from the farm were particularly vulnerable.
Young men from 1918 were in dire dangers (Dr. Stimson was wounded in action in Flanders, serving with British soldiers) but were also in danger because they were exposed to viruses and bacteria to each other.