To Olivia, a new film on Sky Cinema, captures the year (1962) that author Roald Dahl’s daughter died of measles encephalitis. The death of 7-year-old Olivia almost tore the family apart. This terrible story will be new to many people, but it is nothing new to me. I first heard it 30 years ago from Dahl himself.
I was a junior doctor in Oxford and Dahl, 74, was my patient. He was hospitalized with a rare form of leukemia, and every third night when I was on call we would talk late at night. As the weeks passed and it became clear that he was not going to recover, he became more mindful of his own life.
He told me about Olivia one evening when I was sitting by his bed. She caught measles during an outbreak at her school. At first, it was just a mild illness.
“We thought she was above the worst,” Dahl explained. “We saw, you know, the usual sort of thing, fever, fatigue, spots. We even teased her for her peas.
The next day, she deteriorated.
Dahl smirked pale and his eyes began to open.
“I was sitting on her bed showing her how to shape little animals with colorful pipe cleaners,” Dahl later wrote, “and when it was her turn to make one herself, I noticed that his fingers and his mind didn’t work together. and there was nothing she could do.
Dahl asked Olivia if she was feeling well.
“I feel very sleepy,” she said.
An hour later, she was unconscious. Twelve hours later she was dead.
Doctors confirmed that the measles virus entered Olivia’s brain to cause encephalitis (inflammation). Dahl was distraught and spent years trying to figure out how it happened. Of all those who had measles, why had she suffered such a terrible outcome?
“I wanted to study it, set up a thorough investigation,” he told me. “I was ready to connect with every parent of every child in this country who had had serious complications from measles.
At the time, I thought it looked rather whimsical. He was, after all, a storyteller. And in our late night conversations, he would often tell me barely believable stories, especially about medicine. He mentioned a neurosurgical device he had invented and its role in founding the Stroke Association. There were times when I wondered if he was pulling my leg or if he might have gotten confused with some of the drugs he was taking. Years later looking for my book The wonderful medicine of Roald Dahl, I discovered that it was all true, and more.
After Olivia’s death, Dahl had in fact contacted British and American scientists to discuss measles and its complications. He corresponded with them for years, sharing his theories, while they shared their data. He even started planning a nationwide study, but once measles vaccines were available he figured the problem would be largely erased.
And he was right; measles cases have declined dramatically. But Dahl was horrified to learn that some parents have chosen not to vaccinate their children. He campaigned on the issue, contacting ministers and health officials in the 1980s. He wrote a letter, which was circulated widely, telling Olivia’s story and begging parents to immunize their children. It is still used today when there are outbreaks of measles.
Dahl understood parents’ concerns about the very rare serious side effects of the vaccine, but explained that the odds of this happening were around a million to one. “The likelihood of a child choking to death on a chocolate bar is probably greater,” he said.
Adoption of the measles vaccine increased for decades, but was delayed in the 1990s by publication in The Lancet from a fraudulent research article by Andrew Wakefield. This was skipped by the anti-vaxxers, who are passionately against immunizations, no matter what the science says.
If Dahl were still alive today, he would have been fascinated by rapid medical developments during the coronavirus pandemic, especially vaccines. I suspect he would be encouraged by their adoption as well.
Despite the understandable hesitation of some about new vaccines, and the malignant attempts of anti-vaxxers, the vast majority of people get the vaccine as soon as they can. Unlike measles, where most people now rarely see a case, with COVID-19 the risks are close and personal, and for most people the benefits of vaccination are immediately evident.
Tom Solomon is Director of the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, and Professor of Neurology at the University of Liverpool
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