The Past Is Never Dead—Measles Epidemic, Boston, Massachusetts, 1713

he recent measles epidemic in the United States has aroused public disbelief that a disease well-controlled for decades is reemerging to threaten children in the United States. Controversy surrounds measles vaccination in the United States; some parents have even avoided vaccinating their healthy children by exposing them to measles-infected children. However, measles has repeatedly reemerged in the United States during the past 3 centuries or longer (1,2), and its emergence patterns and means of preventing and controlling it are well understood. Until measles is globally eradicated—a goal within reach—it will continue to reappear, sicken, and kill almost anywhere, and we must energetically control each outbreak. When we consider modern measles prevention, it is worth recalling what epidemics were like before vaccines and organized public health systems. One vivid account of measles describes the disease's deadly spread through a prominent Boston household >300 years ago. In 1713, America's first important medical figure (3), Puritan minister Cotton Mather (1663–1728), called by one authority " the Dr. Spock of the colonial New England " (4), wrote about a measles epidemic in the American colonies, describing not only its epidemiology and devastation but also the fear it elicited. Mather's account reminds us of the need for such modern medical and public health tools as vaccination, patient isolation, and prevention policies in saving families from the once-unpreventable diseases that compelled us to develop effective medical advances in the first place. The following account, condensed from Cotton Mather's personal diary (5), focuses on illnesses in his own household, including those of his wife, 9 children, and a maidservant, over the course of 6 weeks during October– November, 1713. Diary Excerpts [18 October] …The Measles coming into the Town, it is likely to be a Time of Sickness… [19 October] [I must]… lay hold on the Occasion to awaken Piety, and Preparation for Death, in the Souls of the children. [24 October]… [on ≈18 October] my Son Increase fell sick… [26 October] I must quicken the preparation of my Do-mesticks… [27 October] My desirable Daughter Nibby, is now lying very sick of the Measles… [28 October] … a very sensible Calamity is begun upon the Town… [with] some Degree of Mortality. [30 October] The Spreading of the Measles… [is much worse in] Families, where they conflict with Poverty… This day, my Consort [wife], for whom I was in much Distress, lest she should be arrested with the …