Measles: the epidemic that never happened? Or final warning

What happened to the measles epidemic that the NHS has been warning us about since 2008? We were warned of thousands of cases, because of reduced numbers of vaccinations. An outbreak started. But only 69 cases were confirmed. The outbreak happened just as levels of vaccination were increasing. Surely that's wrong? Shouldn't measles cases go down as vaccination goes up? Probably just coincidence, but I wanted to know what was going on.

Which people developed measles? Does vaccination guarantee immunity? The NHS press office avoided my questons for months, so I made a freedom of information request, and when I got the results, wrote the article below.

I submitted my story to the Argus, hoping we might work together to get comment from NHS and alternate health practitioners, and maybe develop the story into a bigger feature along the lines of "Measles - the epidemic that never happened? Or final warning?" Then the Argus published a related article following the NHS line. I was disappointed that we didn't work together on the story to get alternate views. But I'm now looking at measles outbreaks in other countries where some parts of the population don't vaccinate, such as The Netherlands. More to come!

4-Dec-2009. A child with full MMR vaccination developed measles in the outbreak in Brighton and Hove earlier this year.

Brighton and Hove PCT statistics show the measles outbreak is over, for the time being. Measles was confirmed in 69 cases by end of July, and there have been no further cases since then.

Eighty percent (56 cases) of the 69 measles cases had no record of vaccination. Seven percent had only one of the two recommended vaccination doses, and the vaccination status of the others was not known. Twenty percent of the 69 cases required hospitalisation.

One child who developed measles had received both the recommended two doses of the MMR vaccination by the fifth birthday. A Brighton parent said: “It may not be a surprise to the experts, but if you take your kid to be vaccinated I don't remember anybody saying it might not work.”

The NHS immunisation website says about MMR vaccination: “After the first dose, between 5% and 10% of children are not protected against the diseases. After two doses of MMR, less than 1% are left unprotected.”

In August this year, the Department of Health launched the MMR catch-up campaign, and Brighton health officials said thousands were at risk from a measles epidemic. They said one out of ten cases required hospitalisation, and that one in 5,000 cases could be fatal.

There were no confirmed measles cases in Brighton and Hove in 2008, before this year’s outbreak.

The low take up of MMR vaccine was blamed for the outbreak in measles cases. MMR vaccination cover fell after the MMR-autism link scare of 1998. In 2004-2005, only 56% of children in Brighton and Hove had received the double dose of MMR vaccine by their fifth birthday, compared with 73% nationally. Although the numbers of measles cases remained low, the Department of Health said that an epidemic might occur. By 2007-2008, the number in Brighton and Hove with double dose MMR had risen to 62%. Following the launch last year of the MMR catch-up campaign, the 2008-2009 figures for five year olds with double dose vaccination rose to 69%. This compares with 78% nationally.

Swine flu vaccination starts in Brighton and Hove

Swine flu vaccination programme starts in Brighton and Hove
15-11-09. Priority patients in Brighton and Hove received an invitation to be vaccinated against swine flu over the weekend.
The invitation, received on Saturday November 14, was sent to patients who have the greatest risk of complications if infected by swine flu.
The number of vaccine doses in the initial delivery will be limited, and the vaccinations will be given on a first come, first served basis, to those invited by their GP practice.
It is not known when the next deliveries of vaccine will be received.
A Department of Health leaflet said the priority groups are: those with a long-term health condition; pregnant women; and those living with people who have immune system problems, such as cancer sufferers.

How serious is the Swine Flu Pandemic?
On November 12, the NHS said that new cases of swine flu in the UK fell by 24% to 64,000 cases, down from 84,000 the week before.
The number of people needing hospital treatment remained high, with 785 patients in hospital, including 173 receiving critical care.
The UK has also seen 28 more deaths related to swine flu, raising the total to 182: 124 in England, 33 in Scotland 14 in Wales and 11 in Northern Ireland.
Governments throughout the world have taken swine flu very seriously, remembering flu pandemics in 1918, 1957 and 1968, when millions of people died across the world. The UK’s September revision of planning assumptions for swine flu cut the estimated death toll in a worst-case scenario from 65,000 to 19,000, assuming that 30% of the population is infected.
But so far, most cases of swine flu have been mild. Only a small number have led to serious illness, and these have often been in patients with existing health problems, such as cancer, that already weakened their immune systems.
Antiretroviral drug Tamiflu is being used to treat swine flu (also known as H1N1 after the virus that causes the disease). This may not be necessary - in its latest advice, the NHS says many people with swine flu only get mild symptoms, and they may find bed rest and over-the-counter flu remedies work for them.

Adverse Reactions to Swine Flu Vaccines
The NHS says swine flu vaccinations are safe, and the European Commission has licensed them, but adverse reactions have been reported.
The Department of Health’s Medicines and Healthcare Products Regulatory Agency (MRHA) said it had received 188 reports of 460 suspected adverse reactions to the swine flu vaccines by November 5.
None were fatal, and most were non-serious injection site reactions such as pain, swelling, and redness, or the minor adverse effects of many vaccines, such as nausea, vomiting, dizziness muscle pain, fever, fatigue, headache, and swollen glands.
All adverse reactions are reported, even if they are only suspected, and the MRHA emphasised that the vaccine may not be the cause of the reaction reported.
The two vaccines in use in the UK are Celvapan and Pandemrix.
The MRHA said: “The balance of benefits and risks for Celvapan and Pandemrix remains positive.”
The European Medicines Agency (EMEA) issued licences to both Celvapan and Pandemrix under ‘Exceptional Circumstances’, when swine flu became a pandemic claiming lives. The EMEA says it has not yet been possible to obtain full information about the vaccines. The vaccine manufacturers will collect safety information while the vaccines are being used.
More information:
NHS: http://www.nhs.uk/news/2009/04April/pages/swineflulatest.aspx
MRHA: http://www.mhra.gov.uk/Safetyinformation/Safetywarningsalertsandrecalls/Safetywarningsandmessagesformedicines/CON062762
EMEA: http://www.emea.europa.eu/influenza/vaccines/pandemrix/pandemrix.html

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