UK doctors fear measles outbreak

Main Category: Public Health
Article Date: 03 Jan 2004 - 0:00 PST


Joanne Embree has been a doctor long enough to recognize measles: the rash starting on the forehead and face that can lead to pneumonia or, in rare cases, a slow, fatal brain infection in which nerves and brain tissue break down.

'It's not mad cow disease, but it is an almost similar type of thing, where, several years after the infection, the child ends up having a fatal brain disease,' says Ms. Embree, head of medical microbiology at the University of Manitoba in Winnipeg.

Now, Ms. Embree and other Canadian doctors are nervously watching the United Kingdom, where experts are bracing for deadly outbreaks of measles this winter as a record number of parents refuse vaccinations for their children.

As SARS has proved, it takes just one person to spread an epidemic. And any major Canadian airport is just 24 hours away from any other place in the world. Scotland is already reporting a 20% to 30% surge in measles, mumps and rubella in children younger than 15.

Moreover, a new study published this week in the American Journal of Preventive Medicine suggests parents are more worried about vaccine safety than those of the past, with some flatly refusing certain vaccines over fears the needles may cause everything from pain and allergic reactions, to autism, multiple sclerosis, diabetes or even sudden infant death syndrome.

Whether the fears are rumoured, real, 'unsubstantiated or even disproved,' the U.S. authors caution, they point to a worrisome trend that could lead to new outbreaks of the once all-but-eradicated childhood illnesses.

Canada does so little monitoring of immunization programs that no one knows for certain whether vaccination rates are falling here, 'but I think there's a concern this could happen,' says Ms. Embree, chairwoman of the Canadian Paediatric Society's committee on infectious diseases and immunization.

What's more, many doctors practising today have never seen a case of measles, so there is a risk vaccine-preventable illnesses are going unreported.

Experts warn that a drop of as little as 10% in immunization rates could lead to a resurgence of diseases. Already, MMR (measles-mumps-rubella) vaccine rates have plunged to as low as 61% in parts of Britain.

Health Canada is preparing to launch a new survey to determine what proportion of children are being vaccinated. Meanwhile, doctors have been getting tips from groups such as the Canadian Paediatric Society on effective communication skills when dealing with anti-immunization issues.

Also, question-and-answer sheets for the media have been prepared that insist there is no evidence mercury in vaccines cause brain damage, that the measles-mumps-rubella injection causes autism, or that vaccines 'wear out' a child's immune system.

Groups such as the B.C.-based Vaccination Risk Awareness Network, however, beg to differ. The organization's Web site contains wrenching testimonials from parents convinced routine childhood vaccines sickened or killed their children.

Class-action lawsuits blaming vaccines for deaths and disorders such as autism have been filed in the United States and Canada, and anti-vaccination groups are raising fresh alarms about additives and preservatives used in vaccines.

The debate is leaving parents increasingly anxious, just as new shots are being added to the many vaccines children already receive.

In Canada, children are already routinely immunized against nine diseases -- polio, pertussis (whooping cough), tetanus, diphtheria, Hib (haemophilus influenza type B), measles, mumps, rubella and hepatitis B.

Before the MMR vaccine was introduced in Canada in 1963, there were 300,000 to 400,000 cases of measles each year. There are now fewer than 300 annually. Nine thousand Canadians contracted diphtheria in 1924; today, just two to five cases are reported each year, if at all.

Canada's National Advisory Committee on Immunization is also recommending vaccination against four sometimes deadly diseases: meningococcal and pneumococcal infections (the leading causes of bacterial meningitis), chicken pox and whooping cough in adolescents.

Some critics have argued that a child's immature immune system is being overwhelmed with vaccines and that it would be far safer to wait to immunize until they are older.

Ms. Embree says vaccines used today contain far fewer antigens -- proteins that trigger an immune response -- than those used 20 years ago.

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