http://www.eurosurveillance.org/edition/v13n15/080410_1.asp[*QUOTE*]
--------------------------------------------------------------------------
:: Home > Archives : Eurosurveillance edition 2008 > Volume 13 / Issue 15
Measles outbreaks in London, United Kingdom - a preliminary reportvolume 13
issue 15
publication date April 2008
Indexed in MedLine as: Euro Surveill 2008;13(15)
Published online April 2008
Measles outbreaks in London, United Kingdom - a preliminary report
R Heathcock (rachel.heathcock [bat] lambethpct.nhs.uk) 1, C Watts2
1. South East London Health Protection Unit, London, United Kingdom
2. Director of Public Health, Lewisham Primary Care Trust, London, United Kingdom
2007 saw the highest number of measles cases reported in England and Wales
since current surveillance began in 1995, with 971 confirmed cases
reported, compared with 740 reported in 2006 [1]. London was the region
with the highest number of cases, and a large outbreak of measles in
north-east London contributed to this high number of cases [2]. There were
several outbreaks of measles elsewhere in Europe in 2007, and case have
been reported this year in Switzerland [3], France [4] and Denmark [5].
Measles also continues to circulate in the greater London area during
2008. In Lewisham, a local authority area in south-east London, there has
been a marked increase in cases so far during 2008.
A total of 19 laboratory-confirmed and 63 probable measles cases have been
reported in Lewisham between 1 January 2008 and 8 April.
This compares with provisional figures of fewer than 20 cases for the
whole of 2007. There have been a number of outbreaks this year, including
one in the local hospital, where nine cases were linked to a child
admitted to the paediatric ward. This child subsequently developed
measles.
Cases are being seen in all age groups, although children younger than
five years old are particularly affected, with six confirmed and 18
probable cases.
There are ongoing outbreaks in two schools, reflected in the number of
cases in 10-19 year olds, with nine confirmed and 29 probable cases.
There have been four probable cases in people older than 20 years. A
representative strain has been genotyped, and is identical to
MVs/Enfield.GBR/14.07 genotype D4 (GenBank EF 600554) (Health Protection
Agency, Virus Reference Department, Centre for Infections).
Lewisham, along with many parts of London, has historically had a low
uptake of the measles, mumps and rubella (MMR) vaccine.
Coverage of the first dose of MMR vaccine in two-year-olds during 2006-07
was 67 percent [6] and for two doses of MMR in five-year-olds was only 48
percent. The recorded coverage for the September 2007 quarter was 64
percent. Although it is likely that the uptake is in fact higher than
this, due to problems in ensuring data accuracy, the uptake remains well
below the 95 percent target.
There are several factors likely to have contributed to the low uptake in
this area. Traditionally, these include socio-economic factors, such as
high population mobility, family size, chronically ill children in the
family, affecting access to services. Lewisham is an inner-city area with
high levels of deprivation. There are increasing signs that the middle
classes in the United Kingdom may also now be an at-risk group [7,8], due
to parents' active decisions not to immunise their children with the MMR
vaccine. Anecdotal evidence from the follow-up of individual cases in
Lewisham by the South East London Health Protection Unit suggests that
some parents of cases had also taken this decision.
Control measures
The local health authority, Lewisham Primary Care Trust, has declared a
major community outbreak and is putting in place a range of control
measures, supported by the Health Protection Unit. These include raising
awareness in the population; encouraging MMR uptake with proactive media
releases; dissemination of information to schools and nurseries in the
area, including advice on exclusion; alerting health professionals; and
offering MMR at additional community clinics. The overall aim is to
increase MMR uptake in children in Lewisham both in the short and longer
term.
References
HPA. Confirmed measles mumps and rubella cases in 2007: England and Wales.
Health Protection Report. 2008;[cited 9 April 2008];2(
.
Available from:
http://www.hpa.org.uk/hpr/archives/2008/hpr0808.pdf Ashmore J, Addiman S, Cordery R, Maguire H. Measles in North East and
North Central London, England: a situation report. Euro Surveill.
2007;12(9):E070920.2.
Available from:
http://www.eurosurveillance.org/ew/2007/070920.asp#2 Measles outbreak in Switzerland - an update relevant for the European
football championship (EURO 2008). Euro Surveill. 2008;13(
.
Available from:
http://www.eurosurveillance.org/edition/v13n08/080221_1.asp An outbreak of measles in Reims, eastern France, January-March 2008 - a
preliminary report. Euro Surveill. 2008;13(13).
Available from:
http://www.eurosurveillance.org/edition/v13n13/080327_1.asp A cluster of measles cases in Denmark following importation, January and
February 2008. Euro Surveill. 2008;13(9).
Available from:
http://www.eurosurveillance.org/edition/v13n09/080228_1.asp The Information Centre. NHS Immunisation Statistics England 2006-07.
Available from:
http://www.ic.nhs.uk/webfiles/publications/immstats2005to2006/Final%202006-07%20Immunisation%20Bulletin%20%28with%20copyright%29.pdfMcIntyre P, Leask J. Improving uptake of MMR vaccine. BMJ.
2008;336:729-730.
Cleverly I. Rash decisions. The Guardian [online version]. April 7 2008. Available from:
http://commentisfree.guardian.co.uk/ian_cleverly/2008/04/rash_decisions_1.htmlCitation style for this article: . Measles outbreaks in London, United Kingdom - a preliminary report. Euro Surveill 2008;13(15).
Available online:
http://www.eurosurveillance.org/edition/v13n15/080410_1.asp The opinions expressed by authors contributing to Eurosurveillance do not
necessarily reflect the opinions of the European Centre for Disease
Prevention and Control (ECDC) or the Editorial team or the institutions
with which the authors are affiliated. Neither the ECDC nor any person
acting on behalf of the ECDC is responsible for the use which might be
made of the information in this journal.
Eurosurveillance [ISSN] - ©2008 All rights reserved.
--------------------------------------------------------------------------
[*/QUOTE*]
More on this topic? Read
http://www.pharmamafia.de or
http://www.impfkritiker.de.
