UKHSA calls for vigilance over threat of measles outbreak

Occupational health practitioners in London need to be on the alert for potential signs of measles among young workers, especially those aged 19 to 25, who may have missed out on being vaccinated against the condition in childhood.

The UK Health Security Agency (UKHSA) has warned that the capital could be at risk of “tens of thousands” of cases unless measles vaccine (MMR) vaccination rates improve.

Outside London the risk of large measles outbreaks is low, the UKHSA has said, but there could still be smaller outbreaks in specific populations, including teenagers, young people and under-vaccinated communities.

Those who have never received the MMR are at risk. MMR is part of the NHS Routine Childhood Immunisation Programme. The agency is urging parents whose infants missed out, or anyone of any age who is unvaccinated, to come forward.

Susceptibility is particularly high among 19- to 25-year-olds affected by unfounded stories in the early 2000s, the UKHSA has said, (the so-called ‘Wakefield cohorts’ after the now discredited former physician Andrew Wakefield) and some may still not be fully vaccinated.

The NHS has also launched a campaign encouraging people to check their vaccination status, with targeted outreach to groups in London.

Again, this is something OH teams can be communicating and promoting within their organisations.

Signs of measles include cold-like symptoms, such as a runny nose, sneezing, and a cough; sore, red, watery and swollen eyes that may be sensitive to light; a high temperature, which may reach around 40°C; small greyish-white spots in the mouth; aches and pains; loss of appetite; tiredness, irritability and a general lack of energy.

A measles rash normally appears around two to four days after the initial symptoms and usually fades after about a week. The rash is made up of small red-brown, flat or slightly raised spots that may join together into larger blotchy patches and usually first appears on the head or neck before spreading outwards to the rest of the body.

Data published by the UKHSA suggests there has been a steady rise in measles cases this year. A new risk assessment has also revealed the potential for a measles resurgence, particularly in London.

Between 1 January and 30 June this year, there were 128 cases of measles, compared to 54 cases in the whole of 2022, with 66% of the cases detected in London although cases have been seen in all regions.

The risk in London is primarily because of low vaccination rates over several years, further affected by the Covid-19 pandemic, particularly in some areas and groups where coverage of the first MMR dose at two years of age is as low as 69.5%, the UKHSA said.

Dr Vanessa Saliba, UKHSA consultant epidemiologist, said: “Due to longstanding sub-optimal vaccine uptake there is now a very real risk of seeing big outbreaks in London.

“Measles spreads very easily but is preventable. To help protect ourselves, our families and those around us it is vital we all ensure we are vaccinated with two doses of the MMR vaccine, free on the NHS whatever your age,” she added.