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Health: What does it take to scare people?

Health Check
A GOOD scare story is the health reporter's stock in trade. That, after all, is what their job is about - alerting readers to any possible threats to health. But yesterday's blanket coverage of fears over the MMR vaccine broke new ground in the realm of hype.

Most papers carried reports of "new" research by a team at the Royal Free Hospital in London suggesting a link between measles infection in childhood and the later development of bowel disease. Although the research did not include a study of the effects of MMR vaccine, many papers expressly made the link in headlines that read "New fears of MMR vaccine link to bowel disease."

There were two surprising aspects to these reports. The first was that the research was old - it appeared in the April issue of the US journal Gastroenterology. It was not even new to the lay press. A report of the research appeared in the Daily Mail on 20 April, but even the Mail chose yesterday to repeat its own story six weeks after the first version appeared.

So what accounts for the enthusiasm with which it was picked up? For that we must look to perceptions of the Government's reliability on matters of public health. Ministers are currently embroiled in a royal row over the safety of GM foods, fuelled in part by the continuing crisis over BSE and CJD. Vaccination has been energetically promoted as a key component of public health, but there are - very small - risks attached. (That is why parents are advised not to take their children for vaccination if they have a fever or a history of seizures.) It is into those fears that yesterday's story played.

The Royal Free research is itself vulnerable to challenge. It was based on 7,000 children born in 1970, and suggested that those who caught measles and mumps infections close together were at higher risk of developing Crohn's disease or ulcerative colitis in adulthood.

However, the findings depended on parents remembering when their children had fallen ill, up to nine years after the event, and could not show whether the measles preceded mumps or vice versa.

More importantly, it made no link with MMR vaccination - which was not introduced in the UK until 1988 - although one member of the research team, Dr Andrew Wakefield, has suggested in the past that the vaccine may be suspect.

Yesterday, a wary Dr Scott Montgomery, chief author of the latest study, fended off suggestions that his study had any implications for vaccination policy in the UK. "To answer that question would require further research," he said. Since bowel disease tends not to develop until adulthood, we are not going to get a quick answer.

Measles causes fever and, in rare cases, seizures and even brain damage. Already parents are refusing to let their children have the MMR vaccine - coverage rates have dropped from 93 to 87 per cent since 1995. In doing so they are exchanging a theoretical and unproven risk of bowel disease for a certain and proven risk of brain damage.