Why America only cared about measles once it hit Disneyland

There’s a big measles outbreak going on right now that originated at "the Happiest Place on Earth": Disneyland in Orange County, California. Since December, the insanely contagious, airborne infection has spread to thirteen other states and Mexico.

Health officials have linked 67 of these cases back to Disneyland, and they're calling this episode a "wake-up call" and "watershed year." In total, 84 people have been diagnosed since January 1. That's more cases in January than we see in most years.

Except for 2014.

Last year, we had 644 measles cases — the most in about two decades. More than half of these originated with an Amish missionary from Ohio. He traveled to the Philippines, where the disease was circulating in a massive outbreak involving tens of thousands, and got infected. He was unvaccinated, and so were many of his Amish family and friends. So when he returned to Ohio last April, the disease quickly spread through his community there.

Hardly anyone paid attention, despite the fact that measles affected 382 people in the state by the time the outbreak was declared over last August. His one case led to nearly 400 others. That's nearly five times the size of the current outbreak.

So why do we suddenly care so much about measles now? We talked to Paul Offit, an infectious diseases doctor and world-renowned vaccine expert based in Philadelphia, for some perspective.

Julia Belluz: Why all the attention on the Disney outbreak?

Paul Offit: I have been trying to educate people about vaccines for the last 20 years and I've never seen a moment like this. You even see someone like Bob Sears [a doctor known for his vaccine skepticism] saying he is vaccinating more people than ever. That says something. There are parents saying, "Can I vaccinate my child earlier." I think this is a tipping point. I have never seen so much media coverage.

JB: But why now? Last year should have been the wake-up call, yet we hardly heard about measles.

PO: That's right. We had more than 640 cases last year in the US. I don't think it was striking communities that struck a chord with people. But when there’s a Disney outbreak, it's different. It's Eden. We have soiled Eden. It's Biblical now.

JB: So basically, you're saying, we didn't care about measles when it hit Ohio's Amish but we care when it strikes Micky Mouse, and a place many people love, in the Golden State?

PO: That is a striking contrast. I think it's in combination with the fact that we don't celebrate the rich in this country. People are angry that those people — in Southern California or wherever — made a decision not to vaccinate their kids. Also, with the Amish, we see them as "the other." They're isolated, an unusual sect.

JB: What should people do now to protect themselves?

PO: If you were born before 1957, you had measles so you don't worry about getting the vaccine. After 1963, that’s when the first measles vaccine came out. If you're around 30, you were born in the 1980s. We had a single-dose recommendation for the MMR [measles, mumps, rubella] vaccine for 12 to 15 month olds. The second dose recommendation came out in about 1990. But that was mainly to make sure people got one dose. Either way, you're covered: if you got one dose, it's 92 to 94 percent effective. If you got two doses, it's 98 to 99 percent effective.

One dose induces lifelong immunity. It's a highly effective vaccine. We went from three to four million cases before the vaccine to about 27,000 cases right after.

JB: What if you don't know whether you got the vaccine?

PO: If you're not sure, get another dose. There’s no downside, other than a bit of pain at the site of the shot.

Read more:

• How an Amish missionary caused 2014's massive measles outbreak
• The scariest fact about the Disneyland measles outbreak
• 9 things everybody should know about measles

Correction: An earlier version of this story incorrectly identified California as the "Sunshine State." While it is quite sunny there, that is actually Florida's nickname.