Fourteen years after the local transmission of measles was halted in the United Kingdom (UK), the disease has once again become endemic, according to the Health Protection Agency (HPA), the public health body of England and Wales. In an update on measles cases in its weekly bulletin last week, the agency stated that, as a result of almost a decade of low mumps-measles-rubella (MMR) vaccination coverage across the UK, ‘the number of children susceptible to measles is now sufficient to support the continuous spread of measles’ .
In an earlier update, the HPA reported that all recent indigenously-acquired cases with a genotype in England and Wales had been found to have the same D4 sequence (MVs/Enfield.GBR/14.07), a genotype first identified in April 2007 and which is now endemic in the UK . In May, a 17-year-old with underlying congenital immunodeficiency died of acute measles infection, the first such fatality in the UK since 2006. The strain was also MVs/Enfield.GBR/14.07, genotype D4. The total number of confirmed measles cases in England and Wales so far this year is 461. In Scotland, there have been 68 cases of measles reported in 2008, of which 51 have been laboratory-confirmed . All of the cases in Scotland were either not immunised or of unknown immunisation status. Only two of the cases were imported from abroad, both from Pakistan.
The HPA has recommended that health services exploit ‘all possible opportunities’ to offer MMR vaccine to children who have not received two doses. The agency also stressed the necessity for all healthcare workers in contact with vulnerable patients to have documented immunity to measles.
Europe is facing a measles epidemic, with large ongoing outbreaks for instance in Switzerland, Austria and Italy.
- Health Protection Agency. Confirmed measles cases in England and Wales – an update to end of May 2008. Health Protection Report (serial online). 20 June 2008. 2;25. Available from: http://www.hpa.org.uk/hpr/news/default.htm#meas0805
- Health Protection Agency. Confirmed cases of measles in England and Wales – an update. Health Protection Report (serial online). 23 May 2008. 2;(21). Available from: http://www.hpa.org.uk/hpr/archives/2008/news2108.htm#measls
- Vaccine uptake, measles, mumps, rubella, whooping cough. HPS Weekly Report. Health Protection Scotland. 25 June 2008. 42;2008/26. Available from: http://www.documents.hps.scot.nhs.uk/ewr/pdf2008/0826.pdf