The UK Health Security Agency (UKHSA) has issued an alert about the potential risk for a measles resurgence in London. The Agency said its modelling suggests that unless vaccination rates improve, the capital could see an outbreak, with tens of thousands of cases.
Outside London the risk is low, it says, although there could be smaller outbreaks in specific populations, including teenagers, young people, and under-vaccinated communities.
The latest epidemiological figures covering the period from 1 January to 30 June 2023, showed 128 laboratory confirmed measles cases in England, compared with 54 cases for the whole of 2022. Of the 128 cases so far this year, 85 (66%) were in London. Whilst 24 (19%) of the cases were imported or import-related, the remainder "reflect community transmission in England", the UKHSA said.
Reduced Uptake of MMR Vaccine
The latest risk assessment shows that about 10% of children in England and almost 20% in London had not received the MMR vaccine by the time they were ready to start school. This is the lowest coverage has been for a decade, partly due to pandemic measures impairing uptake of routine childhood immunisations. Efforts to improve coverage in the routine childhood immunisation programme should be prioritised, the Agency recommended.
Measles activity has been "ramping up globally" since 2022 and there are current large outbreaks in multiple countries in South Asia and Africa, "leaving the UK at risk of importations". The Agency noted that there was a particularly high risk of imported cases leading to outbreaks in specific population groups, including migrants, travellers, and ultra-orthodox Jewish communities, as well as certain inner city areas, particularly in London. However, the risk of spread to the wider community was limited, it said.
"The announcement that London could experience a large outbreak is no surprise," Dr David Elliman, consultant in community child health at Great Ormond Street Hospital, told the Science Media Centre. "MMR rates in London have never reached satisfactory levels and have been falling slowly, but steadily, over the last 10 years.
"Uptake of all routine vaccines in London has always been lower than most of the rest of the UK as a whole, and within London are pockets of very low uptake. It is in these areas that the danger of outbreaks is greatest."
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