November 23rd marks the anniversary of the death of Roald Dahl, the beloved British storyteller. During his illustrious and prolific career Dahl penned several screenplays, nine collections of poetry, works of non-fiction, and nineteen adored children’s books. He dedicated two of his most famous novels to his oldest daughter, Olivia. He wrote the first, James and the Giant Peach, when she was still alive.
He dedicated the second book, The BFG, to her memory after she died from measles.
Olivia Dahl was seven years old in November 1962 when she came home from school with a letter from the headmistress notifying parents of a measles outbreak. At that time, this was not particularly alarming or unexpected. The measles virus, also known as rubeola, is extraordinarily contagious. Before the discovery of a vaccine in 1963, infection was a nearly universal childhood experience.
Three days later Olivia displayed the hallmark fever, runny nose, cough, and blotchy red rash that characterize a measles infection. After days in bed, her fever waned and recovery seemed imminent. The next morning however, Olivia started to complain of a headache and sleepiness. Her condition soon deteriorated rapidly—and later that night she died. Olivia had developed encephalitis (inflammation of the brain), a rare and sometimes fatal complication of measles.
When Measles Turns Scary
Although most patients will recover from measles on their own without any serious or permanent damage, the virus can be extremely severe and dangerous. Close to 30 percent of measles patients will experience complications, including ear infections, croup, diarrhea and pneumonia. Although rare, complications can lead to blindness, permanent brain damage, and death. In developed countries, one or two out of every thousand children who get measles will die; in the developing world the mortality rate is as high as 10 percent. According to the World Health Organization, measles remains one of the leading causes of death among children worldwide.
Following the introduction of the first measles vaccine in 1963, measles rates began a steady decline. By 1995 measles deaths had fallen by 99 percent in the United States and 95 percent worldwide. In 2000, U.S. measles rates hit an all-time low; the CDC declared that endemic measles had been eliminated.
But in recent years, the infection rate has started to rise. In 2011, there were 220 cases in America. So far in 2014, there have been 592 confirmed cases.
Why in a day and age where we have access to a vaccine that is safe and effective do we have an increasing number of measles cases in this country? In short, because a significant percentage of children in this country remain unprotected. Once introduced into a community, measles can rapidly spread to susceptible populations, including infants too young for the vaccine (the first dose is not given until 12 to15 months), people who can’t receive the vaccine because of underlying health issues, and those who have not been vaccinated due to parental objections.
After his daughter Olivia’s death, Roald Dahl campaigned ceaselessly for childhood vaccinations. In 1986, 24 years after Olivia’s passing, Dahl penned a pro-vaccination letter to parents entitled, “Measles: A Dangerous Illness.” He implores:
“There is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. They can insist that their child is immunized against measles… Today a good and safe vaccine is available to every family and all you have to do is to ask your doctor to administer it.”
As a pediatrician, I have seen the devastating effect that vaccine-preventable illnesses have on children, their families, and entire communities. I consider vaccinating a child to be the single greatest contribution I make to the health of children. This November, in memory of Roald and Olivia Dahl, talk to your physician about childhood vaccinations. As he concluded his letter, “I know how happy she would be if only she could know that her death had helped to save a good deal of illness and death among other children.”
Charlotte Brown Stork is a pediatrician in a community health clinic in the Colorado mountains.