To be confused about the measles epidemic in Wales?

[Reallynothappy]

I've started seeing some comments on news articles about the epidemic, that there are nowhere near as many actual confirmed cases of measles as were originally reported; many lab samples have returned a negative result for measles, and that the poor man who died from measles had an inconclusive post mortem, and apparently didn't have measles after all.
I don't doubt measles can have serious complications and is very unpleasant, before anyone thinks I don't understand that.
Has anyone on mn been affected by this current outbreak that can give us an idea what the situation is for them?
If many of these people who originally were thought to have measles turned out not to, then what did they have?
There is clearly an outbreak of something, but it doesn't seem to be just measles.

Could it be that parents in the epidemic areas have taken their children to the doctors with symptoms of illness - cold like, aches pains etc and without a rash (as this appears later on during the illness). The doctors may then suspect it could be measles as they are presenting other symptoms and so test to be sure. Kid ends up just having a cold etc in the end. Not all will have presented a rash for the doctor to test. This would explain why there are a lot of discrepancies between lab results and doc diagnosis.

I'm not in Wales but Measles is going through the school I teach in. In my form alone we've had 3 off and I know that is repeated across the year group. It appears to be tag-teaming with Chicken Pox which has taken out a number of children and staff and we have 2 pregnant staff signed off 'just in case'.

So is there an over estimate of measles as Dr's are diagnosing measles for any child with a rash in an area that has seen cases of measles?

Or, are Dr's underestimating cases as they are diagnosing measles as 'a rash' when its measles but the child has been vaccinated so they are unwilling to label it measles? (this is definitely happening)

Arabella I wonder how many of those that have been off with measles have been confirmed..? Reminds me of the swine flu epidemic when (certain people) took themselves off for a week with a runny nose!

Hah! I just asked DP again - apparently it's two people he was exaggerating for effect. They get a fortnight off though!

I thought hcp did have to be up to date on vax?

There may be rules around hep B, but otherwise no. They are offered flu vaccinations but do not have to have them & no checks are made on childhood ones.

I think I can explain the discrepancy between the laboratory confirmed cases and the actual notified cases.

If you see this page here www.wales.nhs.uk/sites3/page.cfm?orgid=457&pid=27920 it clearly explains that many of the Welsh measles samples get tested in England and therefore wouldn't show up in the Welsh laboratory confirmed numbers. However, the notification of the disease is always made to the HPA where the patient resides, hence the difference in figures.

HTH.

Not necessarily true saintly. I, along with everybody else at my induction was asked to produce record of child vax for Occ Health. They then decided what we needed based on what we'd had and our level of patient contact.

Excuse my irritation but a lot of people have already explained on this thread that it is only the doubtful cases that need blood tests to confirm diagnosis. The vast majority will be diagnosed clinically ie without blood tests hence the difference in figures

You do not have to have a lab diagnosis in order in order to notify a notifiable disease

Stop putting doubt in people's minds about the severity of this situation OP and read what all these sensible people have already said

Measles could be completely eradicated, like small pox, if people weren't scared to vaccinate.

I am not sure of the motivation behind your post. If it was genuine curiosity then you have had your question answered. This is not the time for conspiracy theories to put doubt in people's minds.

When I said about largest outbreak for one years, I wasn't referring to the total number cases across the whole of England and Wales (as in table linked by another poster). I meant outbreak in a particular locality. For example, in London (low vax rates, high population arriving from countries with inadequate accident programmes, general hub), the typical size of an outbreak is about 30 cases, and this happens every year without making the news.

According to the HPA, the number of notified cases in London since 1990* ranges between 339 and 1852 (mean 844). In Wales over the same period the range is 104 to 1640 (mean 345), or about three times the mean and 70% of the maximum since 1990 (which occurred in 1994).

I don't want to say that the outbreak is nothing but I went looking for these numbers about a month ago when I heard a (BBC Radio) news report in which a HCP repeatedly ducked questions about facts and simply said how vital it was to get everyone vaccinated. The same news report contained data which was clearly nonsense.

*I've ignored 1989 because it contains the highest figure for each of the regions, by a long way, which skews the numbers up.

All I know is that for over 20 years, teaching in many schools in several areas, I have personally never come across a case of measles. I have 3DCs who have not had measles and have never been in contact with measles. I went to mothers and babies groups secure in the knowledge that there was no danger of measles- unlike my friend last week. When I went to give blood it took a long discussion as to whether I could go ahead because they had never had someone who had been in contact with measles. Now, regardless of how many cases in Wales, measles is definitely in the community. I think it is highly irresponsible of the anti vaccine people to try and deny the fact or simply brush it off as being usual- it isn't usual.

But, exoticfruits, the plural of anecdote is not data. The HPA's figures show that the Wales outbreak is within normal limits and that it is usual to have (suspected) measles in the community.

I am not interested in anecdote. My area has not had a case of measles- now they have several and I know it to be true.

I can't see why either side need to use it as propaganda. I got the 'fake' link from someone who is very anti and someone who is quite influential - I think it highly irresponsible of her to further her views on the back of it.

That report shows no such thing, SDeuchars because it is talking about whole country annual totals. The number of cases, in geographically concentrated outbreaks, in three months only is quite a different thing, and the level so far is unusual and concerning.

I agree BTW that the London totals are greater than 30 if you add them up over the whole capital over the whole year. The 30ish refers to size of each clump of cases (which I termed outbreak) within those figures.

Basically, outbreaks are getting bigger. I agree they are being used to push the vaccination. But that is to spare DCs harm. Yes, it's not that bad a disease in many, and it's quite possible to not know anyone who has had it since say 1970s. But the complications rate is about 30% (hospitalisation likely in a third of those) which is much higher than many diseases.

And of course we no longer have a hospital infrastructure which would cope well with a major infectious diseas outbreak.

It seems sensible to use them to push vaccination- had they all been vaccinated we wouldn't had the cases- my friend wouldn't have been in danger of exposing her 7 month old baby to the disease by simply going to a mother and baby group.

would be interested to see if anyone can find figures on how many people who had confirmed cases and HAD already been vaccinated?

As I understand it, that's not true, exoticfruits. Vaccination would not mean that there would be no cases (see the figures of numbers of cases since 1940), just that they would be fewer and less severe.

lovemycrazykids, I don't think those numbers are available. Even in children going through the vaccination cycle, noone tests to see if it has "taken" - we just act as if it has not and give three doses anyway. A percentage of vaccinated adults do not retain immunity.

I find the whole thing annoying. If your child doesn't have a medical problem preventing vaccinations you should get them vaccinated!

To help protect the vulnerable and reduce the disease.

Sadly I don't think we will ever eradicate another disease again because people are now scared to do it. There is a load of scaremongering out and about

If enough people were vaccinated, there would be no cases. The target for eradicating measles (as smallpox was) in Europe is 2015 but it will be missed because not enough people are vaccinating.

lovemycrazykids that's a fairly loaded question, because of some basic statistics. We know that vaccine efficiency is around 99% (not got exact figure in front of me) for measles in MMR. This is fine as long as take-up is above about 95% because at that level measles is very very unlikely to become epidemic in the community.

I've followed this one poorly, but I thought MMR take-up around Swansea was about 90%? That means that out of every 100 children 10 are not vaccinated and 1 has had the vaccination but it didn't take. Therefore you expect about 1 in every 11 measles patients to be vaccinated but less than 1 in every 100 vaccinated children to get measles (because not everyone who isn't immune will get the disease).

Well here is info for the (much smaller) Merseyside epidemic

www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20226

so presumably there will eventually be data for this outbreak

There shouldn't be any cases and if everyone was vaccinated it would protect those who couldn't have it and those who are too young.

Noblegiraffe - the eradication of polio is also looking less likely due to a vaccination scare in Nigeria (a US plot to spread AIDS and infertility). New outbreaks in Nigeria, Yemen and Indonesia. It's heartbreaking that lives are being lost and ruined due to scaremongering, and interesting that different countries have different vaccination scares I think.

lovemycrazykids, can only speak for the whole of England and Wales but of the 629 lab confirmed cases in the last quarter of 2012, 26 had had 1 dose of a measles containing vaccine and 11 had had 2 doses. Which works out at about 4% and 2% respectively.

From what I can remember those percentages seem to correlate with the data from the Europe wide outbreak.

www.hpa.org.uk/hpr/archives/2013/hpr0813.pdf

One of the people who believes that the Wales measles cases were faked has the opinion that polio never existed!!