The Royal College of Paediatrics and Child Health (RCPCH) has issued national guidance for doctors to be on high alert for measles as uptake of the Measles, Mumps, and Rubella (MMR) vaccine has dipped to a 10-year low.
As vaccine rates among young children have dropped, there is an increased risk of measles outbreaks.
The RCPCH is worried the UK could see a “devastating resurgence” of measles, a disease that had virtually been eliminated due to the childhood vaccination programme.
Measles is a highly contagious viral disease, spread by contact with infected nasal or throat secretions (coughing or sneezing) or by breathing the air that was breathed by someone with measles.
The virus remains active and contagious in the air or on infected surfaces for up to two hours.
The virus remains active and contagious in the air or on infected surfaces for up to two hours. Only 15 minutes of direct contact with someone who has measles is enough to catch it.
As measles is highly contagious, at least 95 per cent of children need to be vaccinated to achieve so-called ‘herd immunity’, which is when enough of the population is vaccinated against a disease that the virus cannot readily spread in a community. Herd immunity then protects those within the community who cannot have the vaccine for medical or ethical reasons.
All children are offered the MMR vaccine as part of the childhood vaccine programme and are generally double vaccinated by the age of five. Currently, the UK vaccination rate is well below the 95 per cent level, with the latest figures showing only 84.5 per cent of children have received the second MMR vaccination; this is the lowest it has been since 2010–2011.
Measles infects the respiratory tract and then spreads throughout the body, making you feel very ill. The main symptoms are a fever and a red rash, runny nose, cough, and red, sore eyes. However, in some children, it can lead to more serious complications, such as ear infections, pneumonia, and meningitis. In some cases, complications can be fatal.
While measles cases in the UK are still low, there are concerns that the numbers are increasing significantly. From the start of the year to the end of September, there were 149 laboratory-confirmed measles cases in England, an almost 3-fold increase compared with 53 confirmed cases in the whole of 2022.
Many cases were in London, Wales, and Leicester. In July, the UK Health Security Agency (UKHSA) warned that the risk of an outbreak in the capital was “primarily due to low vaccination rates over several years,”, particularly in some areas and groups where coverage of the first MMR dose at 2 years of age is as low as 69.5 per cent.
In an unprecedented move, the RCOCH is asking health professionals to check the vaccination records of all children arriving at the hospital. Any showing symptoms of the disease, such as fever and cough, should be immediately isolated, and staff ought to wear personal protective equipment.
The RCPCH is urging doctors to use “every opportunity” to check a child’s vaccination status and offer the MMR jab to those who have not had two doses. Similarly, parents are advised to check their child’s vaccination records, which should be recorded in their child’s red book; if they are uncertain, they can check with their GP. If a dose has been missed, it is never too late to get the vaccination.
RCPCH president Dr. Camilla Kingdon said: “Having to consider measles in our national guidance for the first time in decades is a disappointing but necessary move. Many paediatricians live in fear of measles outbreaks this winter; they could bring our already fragile NHS to its knees.”
Helen Bedford, Professor of Children’s Health at University College London, said, “If we get more cases, we’re going to see a lot of very ill children and a lot of hospitalisations.People still die from measles in the UK, but if numbers come to fruition, then we will see a lot of deaths. It’s not just some mild childhood illness.
“The challenge with measles is that you can’t just get a high uptake and then let it drop; it has to stay there. It’s considered to be the most infectious disease there is.”
During the COVID pandemic, many appointments may have been missed or delayed, so parents are urged to come forward if their child has not received their MMR vaccine yet or has received the second dose.
Anyone with measles symptoms is advised to stay at home and phone their GP or NHS 111 for advice before visiting the surgery or A&E to prevent the illness from spreading further.
Rachel Kayani
