Most parents of young children today never, in their own childhoods, witnessed siblings and friends fall ill with measles. Many doctors in the U.S. have never seen a case. Five decades of vaccination efforts virtually eliminated the virus from this country.
The measles vaccine, which became widely available in the U.S. in 1963, has protected millions of children from illness and saved thousands of lives. But now many experts say the current measles outbreak -- which has so far sickened more than 150 people -- demonstrates what happens over time when the frightening realities of a contagious disease fade into history.
"We are victims of our success; people don't remember how bad measles was, how frightening it could be," Dr. Nat Litman, a professor of pediatric infectious diseases at Albert Einstein College of Medicine and vice chair of clinical affairs at The Children's Hospital at Montefiore in New York City, told CBS News. "People say, why should I bother, it's not around. But it's not further than a plane ride away."
Litman, now 68, had the measles himself in 1956 when he was 10 or 11 years old -- seven years before the vaccine made its debut in the U.S. "I had a fairly mild case of measles," he told CBS News. "In that era children in the U.S. didn't get through childhood without having measles."
Back then, most children contracted the illness by their tenth birthday and most cases didn't get reported, he said. Like losing one's baby teeth, the virus was part of growing up. Litman and his two brothers all had measles around the same time, since household exposure was common, and the three boys simply stayed home until they got better.
But not every child was so lucky. One or two out of every 1,000 children who contracts measles dies from complications related to the virus. Measles can cause a sometimes lethal secondary infection such as pneumonia. The virus also puts a child at risk for encephalitis, a potentially fatal infection of the brain. Children who developed encephalitis were often left with brain damage, loss of sight or hearing. In the 1960s as many as 4,000 children who developed encephalitis from measles became wards of the state.
In a public letter written in 1988, children's author Roald Dahl recounted the heartbreaking loss of his 7-year-old daughter to measles encephalitis in 1962, a year before the vaccine became available. The little girl seemed to be getting better until one night he noticed she was no longer thinking clearly. "In an hour, she was unconscious. In twelve hours she was dead," he wrote.
The situation vastly improved with widespread vaccination campaigns. A paper published in 1985 in the journal Pediatrics found measles, related complications from encephalitis and deaths declined more than 99 percent from the pre-vaccine era. The first two decades of routine measles vaccination prevented 52 million cases, 5,200 deaths, and 17,400 cases of intellectual and cognitive disability. This all resulted in a savings of more than $5 billion in health care expenses, according to the report. The World Health Organization estimates that vaccination efforts reduced deaths from measles worldwide by 75 percent between 2000 and 2013.
"If you talk to younger doctors they will tell you they've never seen a case of x, y, or z, things that were actually run of the mill generations ago. If you don't see something you assume it's gone," Dr. George Wohlreich, president and CEO of the College of Physicians of Philadelphia, told CBS News.
But that doesn't mean the vaccine was an easy sell in the beginning. There was plenty of public skepticism when vaccines for measles and other once-endemic illnesses such as polio first became available. Karie Youngdahl, project director for the Historyof Vaccines.org, a history and information website created by the College of Physicians of Philadelphia, told CBS News that many families viewed the concept of vaccines as "playing God." "There was also the kind of personal liberty reasoning that we hear today," said Youngdahl, who recalled lining up at her school's gym as a child to receive her own vaccines.
Lingering suspicion of vaccines gained ground after a report in 1998 claimed immunization may make a child more likely to develop autism -- even though the study turned out to be falsified and was later retracted. The British Medical Journal called it "an elaborate fraud," and the doctor who wrote it was stripped of his medical license.
False information and unproven theories widely available on the Internet continue to fuel some parents' fears.
"Parents want a la carte. That's sort of like saying I'm going to use my seat belt every other block," said Wohlreich. "There's also a degree of rider-type of mentality. If somebody is really taking care of what's going on, I don't have to worry about it and I'll have the benefits of herd immunity."
But the current outbreak indicates that this way of thinking is false -- and dangerous.
"Think of Elizabethan England," said Wohlreich. "From what we know it was really, really filthy, dirty and dangerous. But when sanitation people came in that changed. Vaccination is like having a great sanitation department. You're not aware of what it's doing until you don't have it."