Richard Smith: A baby dies of measles

richard_smith_2014I had measles as a child. My brothers had measles. Everybody, as I remember, had measles as a child in Rotherhithe in the 1950s. But I don’t remember anybody dying, but children did die and still do—despite the development of a vaccine in 1963.

The writer Jessica Mitford lived in Rotherhithe in the 1930s, and her baby died of measles. I was shocked as I read her sparse account of the death in her marvellous book Hons and Rebels. I’m reading it to my demented mother, who was born in 1929. I wonder if she knew children who died of measles. I wonder if she worried about us, her sons, dying of measles.

Mitford is famous partly because of her book The American Way of Death but more for being part of a remarkable family of six girls and one boy. Nancy became a first class novelist; Diana, whom I met, the wife of the British fascist leader Oswald Mosley; Unity a fanatical follower of Hitler; and Deborah Duchess of Devonshire and restorer of Chatsworth. Only Pamela disappeared into upper class rural life.

Driven mad by the stifling atmosphere of upper class England in the 30s, Jessica ran away to the Spanish Civil War with the wild Esmond Romilly, nephew of Winston Churchill. (My father was in Colditz with Esmond’s brother Giles.) When they returned to England Jessica, who was always left wing and later investigated in the McCarthyite era in the US, and Esmond lived in Rotherhithe beside the river and joined the Bermondsey Labour party.

In 1938 there was a measles outbreak in Rotherhithe. There was, of course, no NHS and no antibiotics, but the Labour party had opened clinics across East London. Jessica had a four month old daughter whom she was breastfeeding. She was assured by a nurse in the clinic that her daughter would not get measles because Jessica’s immunity would be passed on in the breast milk.

But Jessica was again a victim of her upper class upbringing. She had never had measles. She writes:

“When she was four months old, the baby came down with a terrifying, flaming case of measles, and within a few days I caught it from her. Esmond frantically engaged nurses to look after me day and night; my temperature rose alarmingly, until I became lightheaded and delirious. I recovered to find that the baby was dying of pneumonia.

“She lived for a few horrible days, gasping for each breath under an oxygen tent. Nurses came and went, their standardised cheeriness concealing horror like a smile in a bad dream, then it was all over.

“Esmond and I fled like people battered into semi-consciousness in a street fight . . . the day that the baby was buried we left for Corsica. There we lived for three months in the welcome unreality of a foreign town, shielded by distance from the sympathy of friends, returning only when the nightmare had begun to fade.”

I was abashed reading this with my mother on a quiet Sunday morning in the empty café in the grounds of what was once the Surrey Lunatic Asylum. I thought of the many children who still die of measles in low and middle income countries—about 100 000 a year, many of the deaths unrecorded, I learn from the web. I thought too of the children in rich countries who die because the scare over the MMR vaccine has left them unprotected.

Together with my mother I rang my brother, perhaps almost to reassure myself that he hadn’t died of measles. “Oo was that bloke who published all that crap on the vaccine causing autism?”

“Andrew Wakefield.”

“You must have met him.”

“I never met him, but he rang and harangued me after we published a piece criticising some of his research on bowel disease.

“‘ow can he believe he’s right when all them doctors have proved him wrong?”

I give my brother a short lesson on the difficulty of proving negatives.

We end our call. I’m reassured that my brother has not died of measles. But I think of Mitford’s baby—unnamed to minimise the recurrence of grief as she wrote the book in 1960—and of all the other children who have died of measles. I think too of the grief of their parents, most of whom can’t afford to take off abroad for three months to protect themselves from the sympathy of friends. I wonder if Wakefield thinks of them.

Richard Smith was the editor of The BMJ until 2004.

Competing interest: None declared.