Measles is not to be trifled with. Before a vaccine was introduced in the 1960s, 3-4 million Americans contracted the disease annually. About 4,000 of those developed encephalitis (swelling of the brain) yearly. About 500 died each year.
Thanks to aggressive vaccination programs nationwide, measles has all but been eradicated in the United States. There hasn't been a confirmed measles death in our country since 2003.
But the disease still flares up here and there. Most recently, an outbreak tracing to Disneyland in Anaheim, Calif., has caused more than 100 documented infections, spreading across 14 states. Thursday, five infants in Illinois were diagnosed with the disease.
Last year, 644 measles cases were counted in the United States, with more than half of those in an Amish community in Ohio, where unvaccinated missionaries returned after contracting the disease in the Philippines.
The Disneyland outbreak has gotten more media play than last year's Amish outbreak, which was confined to a single community. And the sudden attention to measles has rekindled a smoldering debate about whether the MMR (Measles, Mumps and Rubella) vaccine should be mandatory for all.
The MMR vaccine is required in every state, with the first vaccination after a child turns 1 and a second dose between the ages of 4 and 6. But all states allow medical exceptions for those whose immune system might be too weak to handle the vaccine. All but two states allow people to decline the vaccine based on religious beliefs. And 20 states, including California, allow exceptions for philosophical reasons.
In Indiana, religious objections are accepted but philosophical objections are not.
A small but vocal group nationwide fights against mandatory vaccinations on the grounds that the MMR vaccination might be linked to autism.
That link was suggested in a 1998 study that has since been thoroughly discredited. The publishing journal retracted the the study in 2010. The author of the study was stripped of his medical license.
The larger opposition to mandatory vaccinations now comes from a perspective of individual liberty. Should the government be able to force someone to take an injection to ward off potential disease?
Some say no.
But this is a case where public health consequences outweigh concerns about individual liberty. Those who choose not to take the vaccination are, essentially, volunteering to carry the disease and possibly infect others.
That matters because pregnant women, those with immune deficiency and children younger than a year old cannot take the vaccination and are therefore susceptible to contracting the disease through contact with a measles sufferer. These groups are also highly vulnerable to permanent damage from measles exposure.
And measles is highly contagious. Studies show that 90 percent of people in close contact with someone who has measles will contract the disease.
Religious and individual liberty are two of the pillars of America. But when those freedoms compromise public health, government must act to protect citizens.