Page last updated at 12:13 GMT, Tuesday, 19 May 2009 13:13 UK

Why the NHS is facing measles fight

By Nick Triggle
Health reporter, BBC News


Parent and district nurse Maria Perigott says some parents still have concerns about MMR

Public health experts in Wales refer to it as the newspaper effect.

During the height of the scare over the link between the MMR vaccine and autism local papers ran vociferous campaigns warning parents about the supposed dangers of the jab.

The research, by Dr Andrew Wakefield, has now been discredited, but the problem is the damage has been done.

With vaccination levels down to 15% in some schools, the region is seeing record numbers of measles cases.

It is still hard to convince people of the truth
Dr Mac Walapu
National Public Health Service for Wales

There are already more than 120 cases being investigated compared to just 39 in the whole of Wales last year. Back in 2005, there were none.

"Uptake rates for MMR are much lower than for other vaccinations," says Dr Mac Walapu, a measles expert at the National Public Health Service for Wales.

"Parents are taking a conscious decision not to get the MMR jab. We think that is down to the concerns that were raised when the research came out.

"The newspapers have admitted the research was wrong, but it is still hard to convince people of the truth."

Breeding ground

What seems to be happening in Wales - and across the rest of the UK for that matter - is that the children who were not vaccinated at the height of the MMR scare at the turn of the century are the ones who are now mixing in the school yard.

In Llanelli alone - a town with fewer than 50,000 residents - there are thought to be 800 primary school children and 2,100 secondary school pupils who are not vaccinated.

This creates a breeding ground for the virus to be passed on throughout the community.

Measles is a highly infectious virus. It starts with a fever and conjunctivitis before a rash develops
The rash often lasts about a week and other complications can include pneumonia and diarrhoea
The MMR jab is used to immunise children against the disease
Before the triple vaccine was introduced in the late 1980s, there were 20 deaths a year on average in the UK
But since the early 1990s there has just been two in total

For a number of years the UK has been struggling to get to a 95% vaccination rate, the level needed for herd immunity whereby even unvaccinated individuals are protected because the disease cannot take a hold.

Scotland has only just achieved the level, but in England and Wales even uptake of the first of the two courses of the vaccine is only at 85%.

The effect is clear. In 2008, there were 1,348 cases of measles in England and Wales compared to 56 a decade ago.

London has been particularly badly hit, although this week the north east announced it was seeing a dramatic rise with 37 cases confirmed so far in 2009 and another 100 suspected compared to just 17 last year.

The cases have been predominantly in children under 18 and have prompted health officials to run catch up campaigns to try to get more children and teenagers vaccinated.

In England, Chief Medical Officer Sir Liam Donaldson has given local NHS trusts between £30,000 and £60,000 to target the 3m young people who are thought to have missed out on inoculation.


A spokeswoman for the Health Protection Agency, which coordinates the vaccination programme in England and Wales, said: "We have reached the point where there are sufficient numbers of unvaccinated children in the population to sustain the spread of the disease.

"It has become very hard to stop. What is particularly concerning is that there are vulnerable people who have underlying medical conditions or are allergic to vaccinations who cannot be vaccinated.

"Measles can kill and it is especially risky for these people. That is forgotten."

But the UK is not alone in struggling with measles, which causes fever and can have serious complications including pneumonia and encephalitis.

Over the last two years there have been more than 12,000 cases across Europe with high rates in Italy, Germany and Switzerland in particular.

And to think that in the early 1990s experts thought they had seen the back of measles, prompting the World Health Organization to set a 2010 deadline to eradicate the disease.

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