Experts are urging health authorities to implement a national "catch-up" campaign to prevent measles, which has spread dramatically in Wales, from affecting the rest of Britain.
Half of the children who were not vaccinated ten years ago live in London.
Dr. Helen Bedford, Senior Lecturer at the Institute of Child Health Paediatric Epidemiology Unit, University College London, is warning that the current Welsh measles epidemic may spread to London.
Dr. Bedford said:
"There is a potential for more outbreaks. Children are going to get measles. There are about two million children who are susceptible because they haven't been vaccinated. London is a particular case of point."
Doctors in Wales say that it is only a matter of time before a child dies, suffers serious eye disorders, brain damage, or becomes deaf.
Dr. Wakefield's 1998 fraudulent study triggered a scareDr. Andrew Wakefield published a study in the The Lancet in 1998 suggesting that the MMR vaccination increased a baby's risk of developing autism. The BMJ (British Medical Journal) later described the research as "an elaborate fraud".
Investigative journalist, Brian Deer, revealed in the BMJ in 2011 that Dr. Wakefield's falsified studies in 1998 had a multimillion-dollar motivation behind them.
The Lancet, a prestigious British medical journal, eventually retracted Dr. Wakefield's paper from public record. On its website, The Lancet wrote "It has become clear that several elements of the 1998 paper by Wakefield et al are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were 'consecutively referred' and that investigations were 'approved' by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record."
The 1998 study scared parents for several years. From 1998 to 2003 millions of young children in the UK did not receive their MMR vaccinations because their parents refused.
Millions of 11 to 12 year-olds unvaccinatedChildren normally receive their first MMR injection at the age of one year, and then a booster vaccine before they start primary school. There are approximately two million schoolchildren aged 11 and 12 who were not immunized a decade ago, and their parents have not caught up, said Dr. David Elliman, from the Royal College of Paediatrics and Child Health.
These children are starting secondary school, which have more children, making these kids more vulnerable. There are large groups of unimmunized children in UK secondary schools.
When about 90% of children are vaccinated against measles, the disease cannot spread easily. Unfortunately, a decade ago about nearly half (45%) of five-year-old children in London had not received their initial MMR vaccine plus the booster dose. Dr. Elliman says most of these kids will remain unvaccinated in their teens unless measures are taken now.
London has still not fully recovered from Dr. Wakefield's scare. While about 90% of 5-year-olds in the UK today are immunized against measles, only 81% are in London.
Dr. Bedford urges parents to find out what their children's MMR vaccination status is, and to make sure they are immunized.
Swansea has 808 cases of measlesHealth officials in Swansea, Wales' second largest city (pop. 270,000) say that the number of measles cases in the current epidemic has risen to 808. From Tuesday to Thursday this week there were 43 more cases.
Seventy-seven children with measles have been hospitalized since the beginning of the outbreak in November 2012.
In parts of mid and south Wales MMR vaccines are being offered in schools.
Director of public health for Abertawe Bro Morgannwg Health Board, Dr Sara Hayes, in an interview with BBC Radio Five Live, explained that it was too early to assess the level of uptake following Wednesday's first day of vaccinations.
Dr. Hayes said "You can imagine vaccinations being given in general practice and in drop-in sessions as well as in schools, so it's a moving target basically. But we think it's probably only about 30 to 40% uptake so far. We'll be doing much more analysis over the next few weeks but, yes, we are disappointed we didn't get a higher uptake on our first day so we're meeting today and tomorrow to see what we can do about it."
Dr Marion Lyons, PHW director of health protection, said:
"We can't bring this outbreak to an end unless the parents of unvaccinated children either arrange vaccination with their GP, call in to one of the weekend drop-in sessions or ensure that if their child attends a school where vaccinations are being offered, they have signed a consent form for them to be vaccinated."
A figure of 808 measles cases in Swansea with a population of 270,000, is equivalent to 56,000 kids with measles in the metropolitan area of New York City (population circa 18,800,000). In the whole of the USA, in a typical year there are between 50 and 60 reported cases of measles. In 2011, America had 222 cases, most of whom were visiting foreigners or Americans who had become infected abroad.
What is measles?Measles, also known as morbilli or Rubeola, is an extremely infectious illness caused by the rubeola virus.
Historically, measles has been an endemic disease - a disease which is continually present in a community and many people build up resistance. If measles enters an area with many people who have never been exposed, the results can be tragic.
In 1592, a measles outbreak in the island of Cuba killed two-thirds of the native population. In 1594 measles killed half the native population of Honduras.
One fifth of Hawaii's indigenous population died from measles in the 1850s.
According to the World Health Organization, measles has killed over 200 million people over the last 150 years.
What are the signs and symptoms of measles?
Signs and symptoms generally appear about 9 to 11 days after infection and may include:
- Fever - this may be mild to severe and can reach 40.6C (105F) for some days. The fever may come down, and then rise again as soon as the skin rash appears
- Runny nose
- A dry hacking cough
- Swollen eyelids, inflamed eyes (conjunctivitis)
- Watery eyes
- The eyes are sensitive to light (photophobia)
- Koplik's spots - small grayish-white spots with blue/white centers in the mouth, insides of cheeks, and throat
- Aches all over the body
- Rash - within three to four days of initial symptoms, a red/brown spotty rash appears, which can last for over a week. It typically begins behind the ears and spreads to the head and neck. Within a few days the rash spreads to the rest of the body. As the tiny spots grow, many of them join together.
What are the complications of measles?Measles complications are quite common, especially so for patients with weakened immune systems, such as those with leukemia, diabetes, HIV/AIDS, and vitamin deficiencies. Very young children are also at risk of complications. A healthy adult has a higher risk of complications than a healthy children aged 5 years or more.
Complications affect about 1 in every 5 measles cases, and may include:
- Eye infection
- Febrile convulsion - fever-related fits. Affects about in 1 in 200 cases. They may look alarming, but children usually make a full recovery
- Laryngitis and bronchitis - about 1 in every 25 people with measles have difficulties breathing
- Otitis media - inner ear infection/inflammation
- Pneumonia - measles patients with weak immune systems are vulnerable to an very dangerous type of pneumonia (Streptococcus pneumoniae) which can be fatal
- Encephalitis - affects about 1 in every 1,000 measles patients. Encephalitis may occur soon after measles, or several years later
- Thrombocytopenia - low platelet count, which makes it harder for the blood to clot. Patients bruise easily
- Neuritis - optic nerve infection. Patients can become blind
- Heart complications
- Subacute sclerosing panencephalitis (SSPE) - affects 1 in every 100,000 cases. This is a brain disease which can occur several months or years after measles infection, it causes convulsions, motor abnormalities, mental retardation and death
- Other nervous system complications - retrobulbar neuritis, toxic encephalopathy, transverse myelitis, and ascending myelitis
The following complications are also possible (less common):