UK measles outbreak feared after Dublin deaths

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An outbreak of measles in Dublin that has claimed the lives of two children and put more than 100 people in hospital is raising fears the disease could spread to Britain.

An outbreak of measles in Dublin that has claimed the lives of two children and put more than 100 people in hospital is raising fears the disease could spread to Britain.

Low immunisation rates in the Irish capital have allowed measles to take hold in the worst outbreak for seven years. More than 1,220 cases have been recorded and the measles is spreading.

In Wales, with a heavy summer flow of visitors to and from Dublin, doctors have warned that low immunisation rates in some areas could lead to a similar outbreak.

Inner London is also vulnerable because of the high number of foreign visitors. Dr Mary Ramsay, consultant immunologist at the Public Health Laboratory Service (PHLS) in London, said: "The severity of the outbreak in Ireland reflects what we have have always said - that this is a nasty disease. It is a myth that measles is not serious. We underestimate how severe it is."

Annual cases of measles in Britain have fallen from 800,000 in the worst epidemics of the 1960s to a few dozen in the late 1990s. The MMR (measles, mumps and rubella) vaccine was introduced in 1988. But the past three years have seen outbreaks in unvaccinated groups in Rudolf Steiner schools and religious communities who oppose vaccination.

In Salford, 103 cases of measles have been notified from one religious community since last November, and three patients were admitted to hospital with complications. Most cases were among children under nine. One outbreak was recorded in east London. The total number of cases is believed to be substantially higher than those notified.

In Holland, 2,300 cases of measles have been reported since April 1999 from religious communities who oppose vaccination. There have been three deaths, and almost one in five cases had "serious complications", says the Communicable Disease Report by the PHLS. Complications of measles include ear infections, diarrhoea, pneumonia and encephalitis (swelling of the brain).

Dr Ramsay said: "We have always had measles on our doorstep. The threat is not just from Ireland. Germany and Italy have never had good measles control and Italy has a very high rate. That is why we need to keep our coverage up."

Vaccination rates in Britain have fallen from 92 per cent in the mid-1990s to 88.4 per cent in the past three years, fuelled by fears over the safety of MMR vaccine. The World Health Organisation recommends vaccination rates of 95 per cent to guarantee protection to the population. Dr Ramsay said the rapidly changing population in London made it hard to maintain vaccination rates, and in parts of Wales, such as Swansea, anti-vaccination campaigns had kept rates low.

"There are some parts of London and Wales where vaccination rates go as low as 75 per cent," she said. "We are always getting measles brought into this country and that is why we are concerned about the falling coverage."

Alarm over MMR vaccine followed research claiming it was linked with inflammatory bowel disease and autism but the findings have never been confirmed. Medical experts say there is no good evidence it is harmful and overwhelming evidence that it protects.

Parents in Ireland became worried in 1992 after the Irish Supreme Court found Kenneth Best was brain-damaged after being given a toxic batch of pertussis (whooping cough) vaccine as a child.

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