Reporting of mumps and rubella

[mummysmellsofsick]

My DS and a few of his baby friends have recently had 'viral rashes' with all the symptoms of rubella and one had a 'mumps like infection'

With all due respect to the fact that CRS has been reduced by the vaccination programme, I don't like being fobbed off and given information that makes no sense by my GP.

Firstly I was told rubella is extremely rare so DS was unlikely to have it. In the same breath she added that it often has very few symptoms in children and that people often don't know they've had it. She examined DS and said it didn't look florid enough for a rubella rash and then later said it was impossible to diagnose from the rash as it comes up differently in different cases.

When I politely questioned the logic of some of these statements she finally admitted that rubella could well be much more prevalent than reported. So DS's case of what I'm fairly sure would have been diagnosed as rubella before MMR was introduced, is now recorded as 'non specific viral rash. This way I suppose it is hoped I won't question DS's immune status when he's old enough for MMR, and the stats for vaccine efficiency can continue to 'show' that the vaccination programme has made rubella 'very rare'.

My question is, on this basis how can we as parents trust any statistics we are given about vaccine efficiency, and why should we all give our DCs MMR when immune status tests would very possibly show many of them to be already immune to one or two of its components? I suppose it's cheaper to do it this way?

This isn't particularly a pro or anti vaccine rant, but more about public health information, reporting of notifiable diseases and the distinct feeling that I have been fobbed off with half truths and propaganda. As I left the surgery the doctor was mumbling something about him 'still having his MMR when he was 1 anyway'

Is there an NHS policy not to diagnose mumps and rubella these days? Has anyone actually had a diagnosis or a reported case?

dd2 had mumps recently. she is 5, and is unvaccinated for medical reasons (likewise, am not stating this as a pro or anti vaccine stance, just facts)

I had to push the doctor to swab for mumps, despite her known non-vacinated status. he was all for noting it as a 'mumps like virus' . and this despite dd2 being at school on a site with a nursery, so in fairly close contact with children too young to have had mmr anyway.

half her year at school had been off sick with similar, and when I reported her illness to the school, the information was met with 'oh, that's probably what all the others have had too - it did seem very severe for 'just' a virus'

obviously, that is not medical opinion. but if you have a large number of children of sick with a similar illness in a short space of time, and one of those has it confirmed (after much pushing) that it is in fact mumps, and not a non-specific virus, then it starts to look a bit suspect, tbh.

Interesting silverfrog. I think it must be a policy. Because before MMR I am convinced these illnesses would have been diagnosed as mumps and rubella. My siblings and I all had mumps & rubella (and I also had measles) and my mum says DS's rash & symptoms were exactly like ours when we had rubella.

As I said, I'm not in a mood for questioning the reasons behind these policies, I just dislike not having the facts presented honestly to me, and being told things that do not add up by doctors who clearly believe that those of us who don't have medical degrees are unable to notice when the things we are told do not make any sense.

Oh and she also told me definitely not to take him to see my pregnant friend (after I asked if it was safe) after telling me on the phone to bring DS to the surgery (where the waiting room is shared with the antenatal clinic). We had literally been sitting next to a pregnant woman 2 minutes before she gave me this advice (and I had said on the phone I didn't want to bring him in as there might be pregnant women there)

This lack of rigour in finding out which virus has struck the kids and then appropriate reporting drives me up the bend. That said - when DS came down with a virus, week long high fever and suspicious rash, they did run PCRs for a lot of bugs (none of which came back positive) and they didn't even ask me for his vaccine status (although that would be "on file", I am guessing)... is it costing GPs extra to order a test for such things? In Germany, extra costs for flu testing to the testing GP was one of the reasons it wasn't generally done some years ago...

Yes I think it must be a cost issue. Any MN GPs out there? Anyone else who has actually had mumps or rubella confirmed?

Whatever the cost issues, measles, mumps and rubella are now notifiable diseases. Therefore, one would assume that GPs suspecting these would be duty.bound to Seabrook for them, rather than falling back on the wishy washy "X-like virus"

The only reason I topmost dd2 to the doctors was to get verification of mumps/not mumps. There was nothing that I.could not.do.for her - get temperaturedown, keep.comfortable, etc - but since it is notifiable I felt obliged to.let both her school and dd1's school (where there is a high proportion of non-vaccinated and vulnerable children) know. I kept dd1 off school automatically, until it was known whether she was incubating, amd wanted the definitive yes/no (given current hpa guidelines about notifying etc)

And yet it still took 10 minutes of me debating with the doctor before he agreed to.swab her...

It's almost like they don't want to notify them because if there are more cases recorded it raises doubts about the effectiveness of the vaccine. Both DSs had rubella when they were under a year. I'm pretty sure the doctor didn't report it.

At dd2's nursery sibling of a child there has mumps and has had mmr vaccine. Mum notified nursery when I was dropping off. She was shocked as he is school age and has had both lots of mmr.

So how effective is the vaccine?

I had MMR as a child, after having had rubella.

I was recently tested for immunity of all 3. I had been tested for immunity to rubella in both pregnancies and am immune. I was not immune to mumps or measles .

The solution? I was given another MMR. My immunity was not retested afterwards as that was seen as good enough.

Makes me wonder if it works as well as we think.

It seems a kind of double-think which is so dishonest. Do doctors admit to themselves what they're doing when they deny it's mumps or rubella? How can they justify doing that?

The mumps vaccine is the least effective of the three and is known to be of questionable efficacy.

sumsumsumsum yes that's my question really. Have they been told not to diagnose as the MMR has been unpopular anyway, and they don't want more questions asked either about babies immune status when they come to have it, or about cases of mumps and rubella after they have had it.

I'm assuming measles doesn't suffer from under reporting as it's a lot more obvious than mumps & rubella... Having had it myself I don't think it was something I or my doctor would have missed. However, I no longer have any confidence that reporting of notifiable diseases is reliable. And I'm not aware that there are any publicly available stats showing the vaccination status of children who do catch measles mumps and rubella (and who are reported) Would be interested to see a link of anyone knows of one. Surely the collection of such statistics is vital when there is a relatively new national programme of vaccination for all children?

littleducks so your immunity to rubella could well have come from having rubella rather than from the MMR, meaning none of its components worked for you the first time round. I think you'd be quite justified in asking for tests to check if it worked the second time around.

It could have come from either and I don't suppose there is any way of knowing now. The only reason I was checked at all was because for an NHS occupational healthcheck because some computer glitch meant that couldn't see that I had already had an MMR (I definately did, I remember it and it is on my GPS paper records).

I won't be offered the chance to get it rechecked, I am now 'safe' to work with the general public

True littleducks

So no-one has heard of rubella or mumps being confirmed?

Thinking I should have posted in children's health maybe more people visit there. But thanks for all your answers so far...

apparently the surgery I go to has seen loads of mumps, rubella and one case of measles recently and my bloods are being sent off for viral diagnostics...

I'm not aware that there are any publicly available stats showing the vaccination status of children who do catch measles mumps and rubella (and who are reported)

HPA reporting is comparatively bad - this here for example has the hospitalisation rates but not the immunisation rates in each group www.hpa.org.uk/ProductsServices/LocalServices/NorthWest/NorthWestPressReleases/nwest120502Measlesupdate/ - reports from other countries are usually much more detailed (I read the German RKI releases) and they have a high rate of laboratory confirmation of cases and usually show around 90% of measles cases as entirely unvaccinated and most others vaccinated once.

Both DC probabaly did have rubella - they were not vacccnated and did have rubella like rashes one summer. Did not bother the GP as rubella is not a dangerous disease in children. Before i had the DC i arranged to be tested to see if i had anitboides - as it happens I had -if i hadn't i would have been vaccinated before ttc, as any sensible person would.

Catherina, did ou ever look into those other figures that were on the HPA site that suggested tht the majority of the cases in that outbreak were in vaccinated children? Someone had linked to it on another thread and I think you mentioned emailing them to ask for clarification iirc.

nope - did not write to them, but am not any happier about the listing of who is vaccinated (just lazy). Words like "mostly" or "majority" just don't cut it when you can count, even if you have to report "unclear" vaccination status for some who don't have proper documentation. Sigh.