Each time you massage children – or young people, or young adults – together, there is an opportunity for some of the more infectious childhood diseases to benefit from those who are receptive. It was true during the First World War, where baracklife and troop transport contributed to the virulent spread of the 1918 flu, which, unlike most influenza, was more lethal to the healthy young than the elderly.
Many colleges require a special list of immunizations before students move into dorms, including meningococcal vaccines to prevent bacterial meningitis. But measles-honey-rubella vaccine is always on top of the list. This is because measles are so contagious that the amount of immunity – when a high proportion of a population is protected by immunization – drops even a few percentage points, the measles virus can take full advantage.
"The first things you see, the cracks in your public health system," says Dr. Ratner, will be infections like this, "measles, infections through the respiratory tract and good moving from susceptible people to susceptible people."
When my own daughter went to college, someone carefully watched her immunization record. She was always undoubtedly accepted at school and discovered that her very first MMR had received a few months before her first birthday and did not count on it; she had to receive an additional dose before taking her residence in her dormitory.
I had asked for the early MMR to travel her in a country where there was still a risk of measles exposure (no, not Brooklyn). You can give MMR as early as 6 months if a child is at increased risk of measles exposure and it gives some protection, but you have to repeat the shot when the child becomes 1. I had forgotten to do it, and no one had ever noticed. As a child's midwife with the incomplete vaccine record, I was a little embarrassed, but most impressed.
Dr Stimson continued to note that World War II soldiers who grew up in more isolated, usually rural circumstances, were less likely to be immune to childhood diseases and "when thousands of these rural young men first gather in armies, infectious diseases are common to be very common, "he said. This was also noted in the American Civil War, when measles were a particularly devastating disease, and the recruits who came from the farm were particularly vulnerable.
The young men in 1918 went into horrible danger (Dr. Stimson himself was hurt in action in Flanders, serving the British troops) but they were also at risk of being exposed to each other's viruses and bacteria.