A measles outbreak swept through Brighton and Hove this year with dozens of people struck down. Many now believe the problem has gone away. But Tom Scanlon, the city's public health director, tells health reporter Siobhan Ryan why he believes we have not seen the last of the virus yet.
Most people were under the impression that measles had pretty much gone away.
The success of the measles, mumps and rubella (MMR) jab meant cases were very rare and there were none of the mass outbreaks of the virus often seen in the 1970s and 1980s.
But the virus returned to Brighton and Hove with a vengeance this year with almost 70 children and adults across the city struck down.
There were also dozens of unconfirmed cases, bringing the estimated total to more than 100.
When compared with the 2008 total of just six cases, it becomes pretty clear that something was afoot.
Years of having one of the lowest take up rates of MMR in the county had led to Brighton and Hove making itself more and more vulnerable to an outbreak.
Thousands of children and teenagers across the city either had none or just one of the two doses of the vaccination needed to protect them against measles.
It meant that once cases began to emerge in the city, they soon spread fast.
And it wasn't just individual houses or small, isolated groups.
It was affecting schools, nurseries and playgroups and took a few months to bring under control.
The Brighton and Hove outbreak this year prompted the Department of Health to brand it a measles hot spot and include it in an awareness roadshow in the summer.
Dr Scanlon says the situation had been building up over a number of years so when the outbreak came it was disappointing but not totally surprising.
He said: “We had a significant number of people in the community who were not protected against measles and so once it became established in the community it started to travel.
“Things have now calmed down and the outbreak is over. We have not had any new cases for several months.
“I would not expect to see a similar outbreak next year but unless the take up rates significantly improve then we are likely to see the same pattern emerging in a few years time.
“It may not be in 2010, but there is a chance it could return again.”
MMR take up rates fell dramatically in the late 1990s following the publication of a report alleging a link between MMR and autism.
Although the study has since been widely discredited, there are still a significant number of parents choosing either not to have their child vaccinated at all or to pay privately for them to have single doses for measles, mumps and rubella, At the moment the take up rate is about 80% in the city, nowhere near the 95% recommended by the World Health Organisation as needed to protect a community.
Dr Scanlon said: “Rates have improved a little over the years but there is still a long way to go.
“I think what happened this year helped some parents who were indecisive about getting their child vaccinated to go ahead and have it.
“Numbers have been steadily improving in general over the years but not at a fast enough rate to prevent an outbreak – as this year has shown.
“It has been so long since people saw cases of measles in the city they have forgotten what it can be like.
“Measles is not just an ordinary childhood disease. It is potentially very serious and we did end up with some people having to go into hospital. That was how serious it got.”
Dr Scanlon said health bosses were now looking at other ways to try and get the vaccination message across.
One of the ideas being considered is to get more schools on board and encourage them to champion the vaccination scheme.
Dr Scanlon said: “You obviously can't force people to do what they don't want to do and there are always going to be a small hardcore number of people who are not going to get their child vaccinated no matter what.
“I remember when I was in hospital where one patient was being cared for and even then the father was saying they still had no confidence or interest in the vaccination.
“As far as I remember, out of the people who went down with measles this year, only one had been vaccinated against the virus. The rest were all unprotected.
“The MMR jab does not give 100% protection for everyone but the more people in a community who have it, the more chances they will not catch measles.
“All we can do is get the information out to as many people who are willing to listen as we can.”
Children need to be vaccinated at just under two and again just before they start school in order to be fully protected.
About one in five children who catch measles will develop more serious complications like deafness, meningitis or brain damage.
About one in 5,000 who contract the virus die.
The year before the MMR vaccine was introduced, 86,000 children in the UK caught measles and 16 died.
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