'Surge' in measles Q&A

Behind the Headlines

Friday November 28 2008

Measles is most common in children between one and four years

The BBC has reported that measles cases have “reached a 13-year high” with 1,049 cases in January to October 2008, more than the whole of last year. The latest figures are from the Health Protection Agency (HPA) and show that this is the first time the number of cases has topped 1,000 since 1995.

The increase has been linked to poor uptake of the MMR vaccine caused by the claim of a link with autism (which has proved not to be true. The increase is worrying as measles can lead to serious complications and, in rare cases, death. About one in four children has not had the jab, raising the danger of a measles epidemic.

The government's head of immunisation, Dr David Salisbury, is quoted on the BBC News website as saying: “This is something we have worried about for a considerable period of time. We saw a lot of measles in London and we are now seeing it spreading further around the rest of the country. Measles is about the most infectious virus we know. It just spreads like wildfire.”

What is the problem?

The increase in measles has been caused by a reduction in the number of children receiving the MMR vaccine over the past 10 years. Although more children are now receiving the vaccine, children who did not receive it in the past are still at risk.

It is estimated that about 90% of children need to be vaccinated in order to stop the spread of measles, and about 95% need it to stop the spread of mumps and rubella. Currently about 84% of children in the UK have had the first dose of the MMR vaccine and only 76% have had both doses.

Will there be a measles epidemic?

Not necessarily. However, it is a serious risk unless the number of children being vaccinated increases. The HPA has carried out research using computer modelling that suggests there is a risk of a large measles outbreak of between 30,000 and 100,000 cases. The majority of these would be in London, but the epidemic could be nationwide, even in areas where the MMR vaccine uptake is high, such as Northern Ireland and Scotland.

Dr Mary Ramsay, an immunisation expert at the HPA, said, "Over the last few years we have seen an unprecedented increase in measles cases and we are still receiving reports of cases across the country.

"1,049 is the highest number of measles cases recorded in England and Wales since the current method of monitoring the disease was introduced in 1995.

"This rise is due to relatively low MMR vaccine uptake over the past decade and there are now a large number of children who are not fully vaccinated with MMR. This means that measles is spreading easily among unvaccinated children.

"There is now a real risk of a large measles epidemic and these children are susceptible to not only measles but to mumps and rubella as well."

What is being done to prevent the possible epidemic?

The chief medical officer has started an MMR catch-up programme, in which GPs and primary care trusts identify children who have not received the recommended two doses of the MMR vaccine. These children will be offered catch-up immunisation.

People can help by ensuring that their children have had the MMR vaccine.

Is the measles jab safe?

Yes. The research that suggested a link between the MMR vaccine and autism has been discredited, and a large body of research has shown that there is no evidence that the MMR vaccine causes autism.

What is measles and how is it contracted?

Measles is one of the most infectious diseases known. It is caused by a virus, which is spread by coughs and sneezes, as well as by direct contact. People who catch measles usually develop a high temperature and skin rash, and feel unwell. One in 15 children who get measles will develop serious complications such as chest infections, fits, encephalitis (swelling of the brain) and brain damage. Such complications can lead to death if they are very severe. In 1987, before the MMR vaccine was introduced, 86,000 children had measles and 16 died.

Who is at risk?

Anyone who has not had measles and has not been immunised can catch measles, but it is most common in children aged one to four. Because measles is so infectious, there is a good chance that a child will get measles if they are not protected. About 90% of people who are not immune to measles and are sharing a house with somebody who is infected will develop the condition.

Children under six months of age will usually be immune if their mother has had measles in the past, because the mother's protective antibodies will have been passed to the baby in the womb. The MMR vaccine can be given to children from the age of six months.

If you have had measles once, it's unlikely that you will have it again as your body will have built up an immunity to the virus.

How do I protect my child against measles?

You can protect your child against measles by ensuring that they have received the recommended two doses of the MMR vaccine. The first dose is usually given to children at 13 months of age but can be given from six months onwards. The second 'booster' dose is given before they start school at three years and four months.

However, even if your child is past the age at which they would usually receive the vaccine, they can and should still be vaccinated. Your GP will be able to arrange these vaccinations.

Analysis by Bazian

Edited by NHS Choices

Links to the headlines

Measles cases reach 13-year high. BBC News, November 28 2008

Links to the science

Measles figures soar. HPA press release. November 28 2008

Confirmed measles cases in England and Wales – an update to the end of October 2008. Health Protection Agency 2008

Further readingDemicheli V, Jefferson T, Rivetti A, Price D. Vaccines for measles, mumps and rubella in children. Cochrane Database Syst Rev 2005, Issue 4


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