Carnival of Contagion

by Matt Peters

In Carnival of Contagion, themes of horror and dark fantasy give a unique twist to educational storytelling. Produced as part of a science education project sponsored by the National Institutes of Health, Carnival of Contagion is a short graphic novel that covers the basics about measles, using a magic-wielding villain to explain the disease’s history, symptoms, and transmission.

The graphic novel follows a group of four teenagers as they encounter a malevolent antagonist named Boris “The Barker” Morbillius (a play on measles’ scientific name Measles morbillivirus). Morbillius initially visits the four teenagers in their dreams, but he later appears in their waking life to hypnotize them and transport them to another dimension, an uncanny world where children’s festivities merge with medical adversity.

The four teens get little in the way of character development or exposition, and all but one remain unnamed throughout the entire narrative. They essentially serve as stock characters who represent teens and young adults in general. Morbillius, on the other hand, is the centerpiece of the story and has plenty of time to put his personality on display.

Depicted as a fervid, wide-eyed blusterer with a menacing smile and chaotic disposition, Morbillius wears a suit, bowtie, and top hat in garish colors, primarily purple and green. He gives his villainy an artistic flair, embedding his malevolence in a carnival-like performance. He traps the four teenagers in a dimension where he uses a prize wheel, funhouse, and other amusements to disorient them. He then casts spells to subject them to measles symptoms, demonstrating how the virus can cause them to experience fever and coughing. He frightens them by summoning a troupe of mucus-spreading acrobats, as well as throwing a rash-covered doll at them—a toy to show how measles affects the skin.

Morbillius has a penchant for narrating the torment he inflicts, so in the midst of this twisted performance, he tells the teens about measles complications, focusing on blindness and encephalitis. He extols the disease’s power, telling them about the devastation it brought to the indigenous peoples of Hawaii and the Americas after contact with Europeans. He explains how the measles virus evades the human immune system by exploiting that very system, replicating inside the white blood cells that typically serve as the body’s main line of defense against pathogens.

With plenty of surreal imagery and nightmarish scenarios, Carnival of Contagion finds a memorable way to convey essential information about measles. In spite of the many stylistic cues it takes from the horror and dark fantasy genres, the book tells its story without pushing the boundaries of taste or creating something too unsettling for younger readers. Its contents are suitable for preteen and older readers.

However, the book does use shame-based language in one key scene, a creative choice that some readers might find questionable. In the scene, Morbillius gives his teen captives white mouth lesions, the Koplik spots that are common to people experiencing measles. The teens look into each other’s mouths and react with disgust. Stigmatizing people in that way comes with risks. It can deter them from seeking medical care or other professional help, making them reluctant to reveal conditions that they think are embarrassing or socially unacceptable.

That flaw aside, Carnival of Contagion is an accessible and entertaining work of awareness-building and prevention messaging. As it draws to a close, Carnival of Contagion embeds a call to action in its narrative, namely a message about the importance of preventive vaccination against measles. The book concludes with a six-page essay by science writer Carl Zimmer titled “Master of Contagion.” The essay describes Danish doctor Peter Panum’s early research on measles in the Faroe Islands in the 1840s. It then describes how medical and public health professionals have worked to eradicate the disease ever since. As Zimmer explains, because measles is so contagious, it requires a high vaccination rate (95%) within a population to eradicate, a challenge to maintain when people tend to let down their guard after long periods of minimal spread. Vaccine skepticism, driven by unfounded concerns about the measles vaccine’s side effects, is another major obstacle to achieving an adequate vaccination rate.

Informing the public about the measles vaccine’s safety, efficacy, and necessity will be critical to ending measles outbreaks. Carnival of Contagion is one tool that can support those educational efforts. The book is available in paperback from Bookshop.org and other retailers. A digital version is available to read for free on the World of Viruses website, a project of the University of Nebraska-Lincoln. The website hosts this and many other comics and graphic novels about human biology and infectious diseases.

Readers who are interested in the measles vaccine for themselves or others can find more information on the Centers for Disease Control and Prevention website. The measles vaccine is usually combined with vaccines for mumps and rubella, as well as varicella (chickenpox) in some cases. It is typically given in two doses and covered by most insurance.

Matt Peters is a program manager at Health Sciences Design, an interdisciplinary health innovation program at the University of Arizona Mel & Enid Zuckerman College of Public Health. He is also a longtime comic book reader and collector who can be found from time to time at his local comic book shops. Views expressed are his own.