Intended for healthcare professionals


Measles in the UK: a test of public health competency in a crisis

BMJ 2013; 346 doi: (Published 01 May 2013) Cite this as: BMJ 2013;346:f2793
  1. Felix Greaves, honorary clinical research fellow1,
  2. Liam Donaldson, professor of health policy2
  1. 1Department of Primary Care and Public Health, Imperial College London, London W6 8RF, UK
  2. 2Institute for Global Health Innovation, Imperial College London, London, UK
  1. felix.greaves08{at}

Can new agencies work effectively together to meet the challenge?

The recent surge in measles cases in south Wales signals a discomfiting failure by a G8 nation to control an easily preventable disease. Far from the measles virus being holed up in outposts in poor countries, the spectre of large outbreaks of measles in England is now looming large. By contrast, elimination of endemic measles in the Americas has been achieved by treating it as an emergency.1 Prevention of more measles cases in the United Kingdom, and avoidance of embarrassment for the government, will turn on the effectiveness of the public health delivery system.

In the north of England there have been 354 cases in 2013 so far.2 The pool of vulnerable children nationally is worrying: 8% of those aged 10-16 years have had no measles, mumps, and rubella (MMR) vaccine, and 8% have had only one of the required two doses.3 Susceptible children are distributed throughout the country, making the site of the next outbreak impossible to predict. In London, where immunisation levels for all vaccines are traditionally lower,4 there have been few cases so far. However, London is a prime location for …

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