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Measles cases in Europe tripled from 2017 to 2018

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l634 (Published 07 February 2019) Cite this as: BMJ 2019;364:l634

Rapid Response:

Re: Measles cases in Europe tripled from 2017 to 2018

Cooper’s advice to parents about the measles vaccination, in the early nineteen seventies, may have been appropriate for those times, in some settings. My memories of measles in a Welsh valley practice, in the same era, suggest that hospital admission was a rare exception.

Who wished, without excellent reason, to admit a hot, coughing, infectious child to the children's ward in our GP hospital?

Were our experiences unusual?
A retrospective survey of the 15 years from 1948 to 1962, revealed “157,300 notified cases of measles. A total of 4874 patients with measles were treated in hospital.” (1,2)
Does that 3% hospitalisation rate, compared with the current figure of 61%, reflect changes in symptom tolerance, good neighbourliness, the proximity of extended family, as well as the general health of children, then and now?

Are there other explanations?

Thornton’s BMJ article may reflect personal, public health, or corporate need, to engender fear about the lurking presence of the measles virus, ready to pounce on the unvaccinated, without making any attempt to educate your readers, so that we in turn may present that well rounded and comprehensive account of the advantages and possible side effects, that must legally be presented to UK parents, to allow fully informed consent, before any vaccination.

How often does such dialogue occur?
How often is the Patient Information Leaflet (PIL) given to patient or parent, opened, and read?
(The MMR vaccine PIL is headed, “Read all of this leaflet carefully before you or your child is vaccinated because it contains important information for you.”)
How often is a UK practice’s financial interest in its vaccination rate discussed?

Thornton’s article explains that community protection requires that “at least 95% of every population needs to be immune, through two doses of vaccination (sic) or prior exposure to the virus,” without adding the essential proviso that immunity following vaccination may be comparatively brief, while immunity from natural infection is lifelong.

Earlier responses of mine, relevant to this topic, attempted to explain that high vaccination rates do not prevent measles, (5) and how the “fundamental question” posed by Dr David Oliver (6), in earlier exchanges, deserves a simple reply. (7)
No one has demurred.

1 Tidstrom, B. (1968), Acta med.scand., 184, 411.
2 The Medical Annual 1970. Wright, Bristol. p 257
3 https://www.bmj.com/content/362/bmj.k3976/rr-4
4 https://www.bmj.com/content/362/bmj.k3596/rr-22
5 https://www.bmj.com/content/362/bmj.k3976/rr-4
6 https://www.bmj.com/content/362/bmj.k3596/rr-17
7 https://www.bmj.com/content/362/bmj.k3596/rr-22

Competing interests: No competing interests

15 February 2019
Noel Thomas
retired/ part time GP
Bronygarn, Maesteg, Wales CF34 9AL