UK Cynicism, fear and panic as measles returns

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http://www.scotlandonsunday.com/comment.cfm?id=295632002

Cynicism, fear and panic as measles returns

CAMILLO FRACASSINI HEALTH CORRESPONDENT

cfracassini@...

Parents were already confused about the safety of MMR

and angered by

government prevarication - now there are new fears

over a ‘vanquished’ disease

FIFE on Tuesday - and the news that every ish

parent has come to fear. Measles is back.

The admonishing predictions of doctors and politicians

have come true and the disease that many thought had

been wiped out forever has returned, bringing with it

the risk of deafness, brain damage and even death.

It is not as if there had been no warning signs:

recent outbreaks in England and Northern Ireland,

together with the plummeting rate of uptake of the

controversial MMR jab, had combined to raise the

spectre of measles - or mumps or rubella - north of

the Border.

There was an air of inevitability, then, when it was

announced that two children had been infected with

measles - the first cases in Scotland for two years.

Predictably, there was a flurry of renewed interest in

the MMR jab among parents . But some were left

confused, including Reid, of Glasgow, who just

weeks before had nursed her own son, , when he

contracted measles.

It started with sickness and a high temperature.

Within hours the four-year-old had developed the

tell-tale symptoms which his mother immediately

recognised.

Reid, a former hospital nurse who is qualified as a

nursery nurse, was in no doubt about her son’s

condition - even though he had been given the MMR

vaccine.

She says: " At first I thought it was a 24-hour bug but

when Ben developed the rash, runny nose, cough and

reddish eyes I was sure it was measles. My mother, who

was a child nurse and had seen measles cases before,

also had a look at him and said he had measles. "

However, she was astonished by the reaction when she

took her son to see a doctor. " He said Ben couldn’t

have measles because he had had the MMR vaccine - he

told me to take him home and give him paracetamol, "

says Reid.

" I overheard the doctor’s conversation with a

registrar at the Yorkhill sick children’s hospital,

who he called for advice. The registrar was shouting:

‘If it’s measles, for God’s sake don’t bring him in

here.’ "

It was only last Friday - more than a week after

had been seen by the doctor - that Reid

finally discovered that the condition had been

recorded as measles on her son’s medical notes.

" I suspect this is happening across Scotland and have

spoken to other mothers who are convinced their

children have had measles even though the doctors have

dismissed it, " says Reid.

In fact, hundreds of suspected measles cases are taken

to doctors each year. Many involve children who have

had the MMR jab, which does not give 100% protection -

which is why children are supposed to have a booster

in their pre- school year. Invariably the cases are

diagnosed as something other than measles.

Cynicism is high, and health authorities have had to

deny that news of the Fife outbreak - coming on the

same day as new figures showed a further slump in MMR

uptake - was designed to remind parents of the dangers

posed by the three diseases.

The conspiracy theory was aided by Fife Health Board’s

apparent departure from normal practice during disease

outbreaks by refusing to say which part of the Kingdom

the children were from. Patient watchdog

stone, of Fife Health Council , says: " It just

doesn’t seem to add up . You have to ask yourself

whether there is another agenda .

" Many parents who have contacted us believe this is an

attempt to encourage more people to take up the

vaccine. "

The cynicism is not restricted to Fife. Bendle,

a mother-of-two from Edinburgh, is one of a growing

number of parents who have taken the decision not to

give their children the MMR jab.

" I would not have a problem with my children getting

measles, which would give them life-long immunity. I

am more concerned about the risk from the

vaccination, " she says.

" I am convinced that GPs are seeing cases of measles

but do not believe it is measles because the children

have received the MMR vaccine. It could well be true

that the cases in Fife are not the first in two years.

"

The new outbreak has also placed Ward, a

mother-of-two from Fife, in an agonising position .

Her second daughter, Emma, developed autism shortly

after being given the MMR vaccine when she was 18

months old.

The 38-year-old is convinced the jab caused her

daughter’s condition and has refused to give Emma, who

is now six, the booster injection recommended by her

GP .

Ward, who works in a crèche in Dunfermline, admits:

" I’m sick with worry. I’m constantly checking Emma

from head to toe for measles symptoms. One of the mums

told me there was a suspected case of measles where

her husband works in Glasgow and I couldn’t help but

think that she or her wee boy could be carrying it.

There is a real sense of panic among mums. "

The confirmed Fife cases involve a child of pre-school

age and another at primary school. The primary school

child had been given one dose of the MMR vaccine,

while the other had not been given the jab. On

Thursday an adult was added to the list of confirmed

cases. Thirteen further suspected cases are still

being investigated in Fife and a further 11 in

Tayside, Argyll and Clyde and Lanarkshire.

Fife Health Board is adamant there is no hidden

agenda. It insists the parents of the first child to

be diagnosed requested that no information about them

be given out. In addition, the board says it did not

want to encourage " complacency " among parents living

outside the areas where the infected children live.

It seems to have worked. Throughout Fife, GP practices

have been reporting a rise in enquiries from worried

parents who have now decided to have their children

vaccinated despite earlier fears about the MMR jab.

And doctors insist the public should have faith in the

system. They argue that they are obliged by law to

notify their local health board of any measles cases

and that it would be almost impossible for children

infected with the virus to slip through the net.

Dr Colin Brown, a GP from Paisley, explains: " You

quite often come across measles-type rashes in

children and doctors might describe the condition as

such but that does not mean the illness is measles.

" All confirmed cases have to be notified and I have

not seen a typical case of measles in the last 20

years. "

Dr Christie, consultant epidemiologist at the

ish Centre for Infection and Environmental

Health, also insists that missed measles cases are

" highly unlikely " .

He says: " There is no other agenda other than wanting

to keep the number of measles cases to a minimum . "

Based on current vaccination rates, Christie predicts

that any further outbreaks are likely to be local and

Scotland is not at risk of a full-scale epidemic.

And experts say that, in the vast majority of cases,

children who are healthy and well nourished will come

through a dose of the measles without complications.

Nevertheless, in around one in a thousand cases,

measles can cause a serious brain condition -

encephalitis - which can lead to brain damage and

deafness.

Before a national measles immunisation programme was

introduced in 1969, many people were left damaged by

the condition and large numbers died.

In 1968, 14 people died in Scotland from measles and

in the five years before the introduction of the MMR

vaccine in 1988, there were six deaths from measles in

Scotland. The last measles-related death in Scotland

was in 1995.

The new outbreak in Fife follows two spates of measles

cases in London and the north of England. However, the

most devastating outbreak in recent years took place

in the Republic of Ireland.

Following the publication of controversial research

suggesting a link between MMR, autism and bowel

disease in 1998, uptake of the vaccine in the Republic

slumped. Two years ago two children died and many were

left disabled in an epidemic involving 1,500 measles

cases.

There is also growing concern among public health

experts about fresh outbreaks of mumps and, more

seriously, rubella.

Between 1989 and last year the number of confirmed

cases of mumps fell from 82 to six and for rubella

from 356 to two.

On the thorny question of whether, in the wake of the

new cases of measles in Fife, parents should be

offered single vaccines against all three diseases as

an alternative to MMR, Christie is resolute.

" If these cases refocus parents on the fact that this

is a real infection which can have very serious

consequences then I think that is only fair.

" We will not give in to anxiety and change our policy

to something we don’t believe in and have no evidence for. "

--------------------------------------------------------

Sheri Nakken, R.N., MA

Vaccination Information & Choice Network, Nevada City CA & Wales UK

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