Measles
05/04/2006
A possible outbreak of measles may be upon us, as six nurses caught the highly contagious disease from two children admitted to hospital at the weekend. It follows the death of a teenage boy who contracted measles but who had not been vaccinated.
Measles Outbreak
More than 800 hospital staff were last night being vaccinated after an outbreak of measles struck down eight patients. Six nurses are ill in isolation after catching the highly-contagious disease from two children admitted to London's Central Middlesex Hospital with measles-type symptoms. The children, who were admitted last week, were confirmed as having measles on Friday. Six of the hospital's paediatric staff were confirmed as also having the virus on the same day. All six are now in an isolation unit at Northwick Park Hospital, Harrow.
From North West London Hospitals NHS trust: "The nurses are stable but they are quite sick. Measles is a really nasty disease in adults. So far there has been no sign of the disease spreading to patients. But it could be several days before we know whether the outbreak has been contained. Vaccinations will hopefully contain the disease."
Measles
Measles is an acute highly infectious viral illness transmitted via droplet infection. Almost all who are infected develop symptoms. Measles is a notifiable disease, which means that a doctor who sees a patient whom they suspect has measles is required by law to report it.
•The early warning signs in the first two to four days fever, conjunctivitis, coryza and Koplik spots inside the mouth, in line with the molars
•The characteristic rash appears on the body between the third to seventh day, spreads over four days and lasts for a week. Complications are common, and include pneumonia, croup or diarrhoea.
•Other complications may include bronchiolitis, sinusitis, hepatitis and low blood platelets resulting in a haemorrhage into the skin. Severe complications of measles are encephalitis, and subacute sclerosing pan-encephalitis (SSPE), a rare but fatal late complication of measles infection.
The incubation period is about ten days with a further two to four days before the rash appears. However, it may be as long as 21 days and is prolonged in the immunosuppressed. Exposed individuals are highly infectious from the beginning of the prodromal period to four days after the appearance of the rash. Contagiousness is similar to chickenpox and more infectious than mumps or rubella.
Danger Of Measles
Measeles can cause inflammation of the brain in one in 1,000 cases - and death in up to one in 2,500.
MMR and Autism
The MMR was introduced in 1998. MMR uptake needs to be at 95% to provide 'herd immunity' (a sufficiently high proportion of hte population is rendered immune by vaccination such that the virus can no longer find and infect those few individuals that remain susceptible). It is currently below this which is why there are measles outbreaks. Low levels of herd immunity will allow the virus to continue to be transmitted but at a reduced rate so that vaccinated individuals will still become infected although on average later in life. The current uptake of MMR is about 81% - i.e. the overwhelming majority, 8 out of 10 parents opt to have their babies protected against these three potentially serious diseases and their complications.
*Over seven years ago, Dr Andrew Wakefield first suggested a link between the MMR vaccine and autism. After a long running row, the findings have been undermined, but for many the MMR vaccine has remained a cause for concern.
*Dr Chris Steele says that any parents wanting the MMR jab for their children should contact their G.P.
*The Department of Health say that because parents aren't giving the MMR vaccine then you are going to get incidents of measles and mumps
*For further info on MMR or herd immunity see the HPA website www.hpa.org.uk