Revealing the Reality of Measles Virus

An editorial illustration revealing the pathology and consequences of measles virus

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Overview

Lack of awareness regarding measles pathology may contribute to growing apathy towards the disease and rising non-vaccination rates. I researched and designed this two-page public health pathology piece to visualize the infection, microscopic effect and gross symptomatology of measles virus for the lay public. This project was completed as part of a graduate pathology course at BMC taught by Drs. S. Wall and J. Wong. 

Date: Winter 2018​

Format: Print / Digital

Skills: Illustration, research & content development.

Tools: Procreate, Adobe Photoshop, Adobe Illustrator, Autodesk Maya.

Render close-ups

 
 

Design Challenge

Create a visually striking educational piece that has strong didactic quality and communicates the pathology of a disease.

Target audience: lay patients.

Problem

The increasing number of measles outbreaks in the west due to non-vaccination is alarming; these outbreaks are also entirely preventable. Measles is one of the most contagious diseases known to humankind, and is much more contagious than many diseases like smallpox, ebola, SARS, and etc:

“Measles is so contagious that if one person has it, 90% of the people
close to that person who are not immune will also become infected”

- Centres for Disease Control and Prevention (CDC)

Despite its dangers and systemic consequences, most individuals are not aware of measles' seriousness; many wrongly assume that measles is similar to chickenpox in severity and effect. Thus, the goal of this piece was to illustrate measles virus' systemic damage and potentially life-threatening consequences for the lay public. I chose to design this piece with a public health education goal in mind. 

 

Research & Design Strategy

Based on my review of the literature and public health research regarding measles virus, I singled out a handful of problems that I could target for my pathology piece:

  • Misinformation spread and a false belief that measles is similar in severity and contagiousness to chicken pox.

  • A general lack of knowledge about how the disease works, and a lack of knowledge about the severity of the consequences.

  • A feeling of apathy and emotional distance from measles. We don’t hear about measles in the news the same way we’ve heard about HIV or ebola, hence some individuals may not feel afraid of increasing their child's risk for contracting it.

With these problems in mind, I created the following design goals to base my communication piece around (in addition to the goal of simply communicating the pathology of measles virus):

  1. To emphasize the severity/long-term/potentially life-threatening consequences of measles infection.

  2. To break the misconception that measles is similar to chickenpox.

  3. To call not only upon audience logos, but also appeal towards pathos (creating an emotional response to the visual story).

  4. And, to tie in how vaccination plays a role in this process.

 

Pre-visualization

In preparation for my final illustration, I completed a number of illustration studies to better understand how to capture the pathology of measles virus.

Above: "landscape study" of measles' target tissue (lung, alveolar cells, and lymph node networks within the lung).

Below: "tissue study" of measles' pathology within the skin (one of the side effects and visible symptoms of measles virus infection).

I also did some experimentation with layout, and different ways of telling my story. Because of the pathos I wanted to evoke with my communication piece, I already knew that I wanted a young child with measles (part of the most at-risk populations) to be a point of focus in my illustration. I designed my layouts with this goal in mind; the third thumbnail layout (pictured below) became the basis for my final comprehensive sketch:

 

Final comprehensive sketch

This design was chosen because it best reconciled the three levels of representation I needed (organ/gross anatomy-level, tissue-level, and cellular-level), and best captured the progression of measles in a linear story-telling format. I also thought it drew a nice correlation between what you see with your naked eye (the measles rash on the skin) with what was actually going on inside your body (mass inflammation and tissue damage).

Revealing the Reality of Measles Virus

References: Buchanan R, and Bonthius D. (2012) Measles virus and associated central nervous system sequelae. Semin Pediatr Neurol. 2012 Sep;19(3):107-14. doi: 10.1016/j.spen.2012.02.003. De Swart RL, Ludlow M, de Witte L, Yanagi Y, van Amerongen G, et al. (2007) Predominant infection of CD150 lymphocytes and dendritic cells during measles virus infection of macaques. PLoS Pathog 3(11): e178. doi:10.1371/journal.ppat.0030178. Griffin DE, Lin WH, and Pan CH. (2012) Measles virus, immune control, and persistence. FEMS Microbiol Rev. 36(3):649-62. doi: 10.1111/j.1574-6976.2012.00330.x. Hall WC, Kovatch RM, Herman PH, and Fox JG. (1971) Pathology of measles in rhesus monkeys. Vet. Path. 8: 307-319. Histology of the Lymph Node. (n.d.). Retrieved from https://www.apsubiology.org/ anatomy/2020/2020_Exam_Reviews/Exam_2/CH20_Histology_of_the_Lymph_Node.htm. Laksono BM, de Vries RD, McQuaid S, Duprex WP, and de Swart RL. (2016) Measles Virus Host Invasion and Pathogenesis. Viruses: 8(8). pii: E210. doi: 10.3390/v8080210. Lemon K, de Vries RD, Mesman AW, McQuaid S, van Amerongen G, et al. (2011) Early target cells of measles virus after aerosol infection of non-human primates. PloS Pathog 7(1): e1001263. doiL10.1371/journal.ppat.1001263. Ludlow M, McQuaid S, Milner D, de Swart RL, and Duprex WP. (2015) Pathological consequences of systemic measles virus infection. J Pathol. 235(2):253-65. doi: 10.1002/path.4457. Perry RT, and Halsey NA. (2004) The clinical significance of measles: a review. J Infect Dis. 2004 May 1;189 Suppl 1:S4-16. Sidhu HK, Lanoue J, Nazarian R, et al. (2015) Histopathology of measles: report of 2 cases with new findings. Am J Dermatopathol 37(7). White RG and Boyd JF. (1973) The effect of measles on the thymus and other lymphoid tissues. Clin. Exp. Immunol. 13: 343-357.

 © Shirley Long 2019