A flight attendant with Israel’s El Al airlines was believed to have contracted measles on a flight from John F. Kennedy International Airport in New York to Tel Aviv on Mar. 26, 2019. Rotem Amitai, 43, developed a fever on Mar. 31 and was admitted to Meir Medical Center near Tel Aviv that same day. She had trouble breathing and was transferred to the hospital’s intensive care unit where she was placed on a respirator. Amitai fell into a coma the following week and reportedly remained unconscious for five months until she died on Aug. 13.1 2 3 4 5 6
Amitai was diagnosed with meningoencephalitis—inflammation of the brain and meninges, which are the layers of thin tissue that surround the brain and the spinal cord. It has been reported that Amitai had been given one dose of measles vaccine as a child during the 1980s.5 7 8 9 10 11
The one measles vaccination recommendation was based on the mistaken belief that one dose of live attenuated measles vaccine would reliably block infection with the wild measles virus and provide “life-long protection” against the disease. That turned out not to be true.12 In 1989 after measles outbreaks in the U.S. and around the world, the CDC’s Advisory Committee on Immunization Practices (ACIP) added a second dose of measles vaccine to the childhood vaccine schedule using the combination MMR (measles, mumps, rubella) vaccine, which had been licensed for use in the United States since 1971.13
According to The Times of Israel, “Blood tests revealed that [Amitai] had been vaccinated with only one shot against measles instead of the two inoculations recommended for her age group. Consequently, El Al instructed all flight attendants at the time to get measles shots.”11
It is unclear if Amitai was given a second or perhaps even a third dose of the measles vaccine after she was diagnosed with measles, notably when she was admitted to the hospital. While meningoencephalitis is a complication associated with the measles virus, it has also been linked to the MMR vaccine, which is a live attenuated (weakened) virus vaccine.14 15 16 17 18
In April, Israel’s Health Ministry ordered all El Al crew members to receive measles vaccinations. A Health Ministry directive stated, “Due to the continued spread of measles and the exposure of air crews, we recommend that all your workers be vaccinated. Make sure that your workers receive two inoculations and place a special emphasis on the air crews that come into contact with travelers.”19
El Al set up a clinic at Ben Gurion Airport in Tel Aviv to administer the vaccinations.20
(photo source: family photo)
1 Cole B. Flight Attendant Dies After Contracting Measles on Plane from New York. Newsweek Aug. 13, 2019.
2 TOI Staff. El Al flight attendant hospitalized in serious condition with measles. The Times of Jerusalem Apr. 3, 2019.
3 Zawa C. Flight Attendant Contracts Measles And Slips Into A Coma. Shared.com
4 Cohen E. Israeli flight attendant in coma after getting measles. CNN Apr. 17, 2019.
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6 Israel D. El Al Flight Attendant Dies 5 Months After Contracting Measles. The Jewish Express Aug. 13, 2019.
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8 Meningoencephalitis. Right Diagnosis.
9 Meninges. Encyclopaedia Britannica.
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13 Cáceres M. How Come the “Settled Science” People Keep Moving the Goalposts? The Vaccine Reaction June 6, 2019.
14 Hong JM, Jung KY. An adult case of mumps brainstem meningoencephalitis with a past measles-mumps-rubella (MMR) vaccination. Korean J Intern Med June 2006; 21(2):1 54-7.
15 Lynn RM, Pebody R, Knowles R. Twenty years of active paediatric surveillance in the the UK and Republic of Ireland. British Paediatric Surveillance Unit of the Royal College of Paediatrics and Child Health, Health Protection Agency Centre for Infections and Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, UK.
16 Maguire HC, Begg NT, Handford SG. Meningoencephalitis associated with MMR vaccine. CDR (Lond Engl Rev) May 24, 1991; 1(6): R60-1.
17 Mäkelä A, Nuorti JP, Peltola H. Neurologic Disorders After Measles-Mumps-Rubella Vaccination. Pediatrics November 2002; 110(5).
18 Ramsay ME, Rao M. Meningoencephalitis after measles-mumps-rubella vaccine. Arch Dis Child November 1991; 66(11): 1365.
19 TOI Staff. Health Ministry orders Israeli airlines to vaccinate crews against measles. The Times of Israel Apr. 22, 2019.
20 Oster M. El Al sets up special vaccination clinic at Ben Gurion Airport. Arutz Shiva 7 Apr. 23, 2019.