Measles cases in England and Wales rise sharply in 2008

BMJ 2009; 338 doi: (Published 10 February 2009) Cite this as: BMJ 2009;338:b533
  1. Lynn Eaton
  1. 1London

    The number of measles cases in England and Wales rose by a third last year, the latest figures show.

    There were 1348 confirmed cases of measles in 2008 compared with 990 in 2007, says the Health Protection Agency. The London region had the largest number of cases (662), followed by the North West (180). The South West (38) and Wales (39) had the fewest.

    “The majority of these cases could have been prevented as most were in children who were not fully protected with MMR [the combined vaccine against measles, mumps, and rubella],” said Mary Ramsay, an immunisation expert at the agency.

    But now that fears about the MMR vaccine, which began with Andrew Wakefield’s paper in the Lancet in 1998, have been quashed, parents have begun to accept the triple vaccine, she said.

    “We are glad to see that public confidence in the MMR vaccine is now high, with more than eight out of 10 children receiving one dose of MMR by their second birthday. However, children who weren’t vaccinated many years ago are still at real risk. Measles should not be taken lightly as you can never tell who will go on to develop the more serious complications of pneumonia and encephalitis,” said Dr Ramsay.

    She added that parents could still vaccinate a child who missed out initially. “It’s never too late to get your child immunised,” she said.

    The uptake of the MMR vaccine between July and September last year, for children aged up to 2, was 84.5%. The proportion of children immunised with both doses of MMR by their 5th birthday was 77.9%.

    Although most cases of measles were in children, almost one in five (252) were in adults.

    Speaking on BBC Radio 4’s Today programme, David Salisbury, head of immunisation at the Department of Health, said he accepted that the overall number of cases was low. But he added, “We shouldn’t be having 1300 cases; we should be having no cases.”

    He said that there was one death last year and added that the French press had recently reported the death of a 12 year old girl there from measles.

    The statistics for England and Wales come as researchers in Germany, which had an outbreak of 614 measles cases in the city of Duisburg in 2006, found that at least 80% of these cases were in unvaccinated children.

    In their paper for the World Health Organization Bulletin, the researchers say that the main reasons for the outbreak were that parents either forgot to take their children to be vaccinated or rejected the vaccine, for various reasons including the mistaken belief that it was dangerous (2009;87:108-15, doi:10.2471/BLT.07.050187). Two of the children died of encephalitis, and 95 were admitted to hospital.

    The researchers state that stringent measures to control measles are needed to eliminate the disease from Europe. The United States was declared free from endemic measles transmission in 2002, but Europe has had large outbreaks in the Ukraine (>44 000 notified cases in 2005-6), Switzerland (>1400 cases in 2006-8), and Austria (>200 cases in 2008).

    In August 2008 England’s chief medical officer gave GPs additional funding to identify children who had not yet received their measles vaccine and to offer a catch-up vaccine.


    Cite this as: BMJ 2009;338:b533