Measles is a highly contagious infectious disease caused by measles virus. Childhood diseases include pertussis, poliomyelitis, diphtheria, measles and tetanus. This is a vaccine that covers measles and rubella but not mumps. Contagious diseases such as measles, typhoid and dysentery were endemic. Wider coverage was achieved in the 1980s with the measles, mumps and rubella, MMR vaccine. Among the plethora of diseases that caused childhood death were measles, influenza and smallpox. Many were killed by infectious diseases such as smallpox and measles. Acute measles encephalitis is another serious risk of measles virus infection. Epidemics accidentally introduced by the Spanish included smallpox, measles and influenza. These include typhus, smallpox, measles, and toxic shock syndrome. Native Hawaiians had no resistance to influenza, smallpox, measles, or whooping cough, among others. Native Hawaiians had no resistance to Eurasian diseases, such as influenza, smallpox and measles. Vaccination rates have been high enough to make measles relatively uncommon. For instance, a nationwide plan for eliminating measles and rubella began in 2001. The clinical distinction between measles and smallpox was described during this time.