The 1990–1991 Philadelphia measles outbreak was a medical event in and around

Philadelphia Philadelphia, often called Philly, is the largest city in the Commonwealth of Pennsylvania, the sixth-largest city in the U.S., the second-largest city in both the Northeast megalopolis and Mid-Atlantic regions after New York City. Since ...

Pennsylvania Pennsylvania (; ( Pennsylvania Dutch: )), officially the Commonwealth of Pennsylvania, is a state spanning the Mid-Atlantic, Northeastern, Appalachian, and Great Lakes regions of the United States. It borders Delaware to its southeast, ...

, in which over 1,400 people, mostly children, became sick with

measles Measles is a highly contagious infectious disease caused by measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than , cough, ...

, and nine children died. There were two epicenters for this outbreak within the area: The Faith Tabernacle Congregation and the First Century Gospel Church. Both churches discouraged the use of not only vaccinations, but also all other forms of medical treatment, instead relying solely on

faith healing Faith healing is the practice of prayer and gestures (such as laying on of hands) that are believed by some to elicit divine intervention in spiritual and physical healing, especially the Christian practice. Believers assert that the healin ...

. Following an investigation into the first death from the outbreak, a

court order A court order is an official proclamation by a judge (or panel of judges) that defines the legal relationships between the parties to a hearing, a trial, an appeal or other court proceedings. Such ruling requires or authorizes the carrying out ...

was obtained to forcibly treat and vaccinate children whose parents would not agree to seeking medical care. __TOC__

History

Measles was likely imported into Philadelphia by a teenager who had visited Spain and later attended an April 1989 R.E.M. concert at the Philadelphia Spectrum arena. Other cases soon followed. The formally-defined outbreak began in October 1990, but the bulk of incidents of illness, and all of the related deaths and responses to them, occurred in 1991. From November 4, 1990, to March 24, 1991, 486 cases and 6 measles-associated deaths were reported to the Philadelphia Health Department from members of the two

fundamentalist Fundamentalism is a tendency among certain groups and individuals that is characterized by the application of a strict literal interpretation to scriptures, dogmas, or ideologies, along with a strong belief in the importance of distinguishi ...

church communities, Faith Tabernacle Congregation and the First Century Gospel Church. The two churches promoted "a reliance on prayer, not medical care, to cure disease". By June 1991, an additional 938 measles cases and three deaths from outside the two churches were reported to the department. During this period, "the

University of Pennsylvania The University of Pennsylvania (also known as Penn or UPenn) is a Private university, private research university in Philadelphia. It is the fourth-oldest institution of higher education in the United States and is ranked among the highest- ...

also reported seven cases of measles among its students". All 9 deaths were among children. In February 1991, it was reported that "Health workers are now going to the homes of all students in a frantic effort to monitor their conditions to prevent further deaths", and that local officials were "prepared to seek court orders to force the families to accept medical care if the children are in serious condition". Later analysis noted that "although measles is normally fatal in about 1 of every 300 cases, the fatality rate in Philadelphia was much higher, because only 1 child in the congregations received treatment for

pneumonia Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severit ...

and

encephalitis Encephalitis is inflammation of the brain. The severity can be variable with symptoms including reduction or alteration in consciousness, headache, fever, confusion, a stiff neck, and vomiting. Complications may include seizures, hallucinations ...

among the children". Dr.

Paul Offit Paul Allan Offit (born March 27, 1951) is an American pediatrician specializing in infectious diseases, vaccines, immunology, and virology. He is the co-inventor of a rotavirus vaccine. Offit is the Maurice R. Hilleman Professor of Vaccinology, ...

, director of the Vaccine Education Center at the

Children's Hospital of Philadelphia The Children's Hospital of Philadelphia (CHOP) is a children's hospital in Philadelphia, Pennsylvania, with its primary campus located in the University City neighborhood of West Philadelphia in the campus of the University of Pennsylvania. The ...

, noted that forced vaccination was used in response to the outbreak. With respect to the parents who had initially refused vaccination, Offit said: "They were a peaceful lot. Once it was the law of the city, they realized it and they were pretty placid about it".

History

References

See also