Paradoxical measles

Since the introduction of measles vaccine in England and Wales in 1968, and particularly measles, mumps, and rubella (MMR) vaccine in 1988, the notification of cases of measles has shown a marked decline.

Localised outbreaks of measles in older children are an increasing problem in the UK.

The appearance of those contrasting observations in consecutive papers in Epidemiology and Infection (1994; 113:355 and 67) is timely, as this month's measles immunisation campaign gets under way. There is, however, no real conflict between the statements, penned respectively by the investigators of recent outbreaks in Crowborough (East Sussex) and Gwynedd (North Wales). What they do reflect …