What is measles?

Measles is a highly contagious disease caused by a virus. It infects the respiratory tract and then spreads throughout the body. It can cause severe disease, complications, and even death. While measles can affect anyone, it is most common in children. Complications can include chest and ear infections, diarrhoea, encephalitis (infection of the brain) and brain damage. Complications are more likely to occur in certain groups including people with weakened immune systems, babies under one year old and pregnant women. Those who develop complications may need to be admitted to hospital for treatment.

How do you catch it?

Measles is caught through direct contact with an infected person. It spreads easily when an infected person breathes, coughs or sneezes.

What are the symptoms?

Measles usually starts with cold-like symptoms, followed by a rash a few days later. Typical symptoms include a high fever, cough, runny nose and a rash all over the body. Some people may also get small spots in their mouth. Symptoms usually develop nine to 11 days after becoming infected and last up to 14 days from the first signs to the end of the rash. There are no specific drugs for measles, so treatment is to help relieve symptoms and address complications.

How infectious is measles?

Extremely. Each patient typically passes the viral infection on to 20 others. If you are not protected and have even passing contact with someone who has measles, the chances are that you will be infected too. If someone has either not been vaccinated or become immune through natural infection and they live in the same household as someone with measles, there is a 90 per cent chance that they will develop it themselves.

Why are people concerned?

Cases of suspected measles cases have doubled in a year, with outbreaks currently reported in London and the West Midlands. UK Health Security Agency (UKHSA) figures show there were 1,603 suspected cases of the disease in England and Wales last year, up from 735 in 2022 and 360 in 2021. The suspected cases are based on official notifications by doctors making a diagnosis from clinical symptoms. Not all are later confirmed to be measles by laboratory tests. But it is clear cases are rising. Levels in the West Midlands are now the highest since at least the mid-1990s, with 57 suspected cases reported in the last four weeks of December alone – a quarter of the total of 217 for the whole of England and Wales. On Friday, Birmingham Children’s Hospital said it had treated 50 children for measles in the past month, the highest in years. In the West Midlands, at least 167 laboratory confirmed cases have been reported and a further 88 likely cases. Meanwhile, London reported 44 cases of the same period with cases reported throughout the year. It comes after the UKHSA warned earlier this year that London faced an outbreak of between 40,000 and 160,000 because of low vaccination coverage. For every 1,000 people infected, between one and three will die with those under 5 and with weakened immune systems most at risk.

Why is this happening?

The UK lost its measles-free status three years after virus transmission was eliminated in the country, due to falling vaccination rates. In the late 1990s and early 2000s there had been a fall in uptake due to false claims that the MMR vaccine was linked to autism. But efforts to boost vaccination rates worked and led the World Health Organisation to declare the UK measles-free in 2016. But this has not been maintained, meaning measles is now circulating within our communities again. The pandemic led some children to miss out on routine vaccinations, with numbers still not caught up. Uptake of both doses of the MMR vaccine is at about 85 per cent nationally – well below the 95 per cent needed for herd immunity. This figure drops far lower in some areas with greater ethnic minority populations, making them more susceptible to outbreaks. Vaccine hesitancy may also be a contributing factor, while pressure on primary care and a reduction in health visitors are also likely to be leading to lower uptake.

Cases of suspected measles cases have doubled in a year

Cases of suspected measles cases have doubled in a year

How do we protect against measles?

Measles is extremely contagious. To reach herd immunity against measles, it requires at least 95 per cent of people to be immune to the disease, usually through vaccination. Immunisation programmes are essential to prevent measles and there is a highly effective vaccine available as part of the measles-mumps-rubella (MMR) jab. Babies are offered the first dose at 12 to 15 months and a second dose is usually given from three to three-and-a-half years onwards.

I’ve not had mine, what should I do?

If missed, it can be given at any age. Anyone who has not had two doses of the MMR vaccine should ask their GP surgery for a vaccination appointment. The NHS recommends anyone planning a pregnancy, travelling abroad, starting university or working in the healthcare sector should check that they have had both doses. Definite past infection will also protect against future infection. Pregnant women or those with weakened immune systems should not be immunised.

How soon should a child be back at school after measles?

Measles is most infectious from four days before the appearance of the rash until four days afterwards. Doctors recommend that a child should be kept off school for four days after the onset of the rash.

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