Resurgence of measles and mumps: not just a childhood problem

摘要

Measles and mumps are contagious viral illnesses. They are preventable with vaccines. Low uptakes of the MMR vaccine (the combined vaccine against measles, mumps and rubella), following the controversy starting in the late 1990s over a purported link between the vaccine and autism, have led to reduced herd immunity, and regular outbreaks of measles and mumps have been reported in the UK. Measles is caused by a morbillivirus of the paramyxovirus family. It has a prodrome of fever and presents with malaise, cough, coryza (cold-like symptoms, such as a runny nose), conjunctivitis, Koplik spots and a maculopapular rash. The incubation period for measles ranges from 7 to 18 days (Public Health England (PHE), 2013a). The maculopapular rash normally appears around 14 days after exposure, and is contagious from the onset of prodromal symptoms and for 4 days after the rash appears. Koplik spots may appear in the mouth 1 to 2 days before the rash itself-these are small red spots with blueish-white centres on the inside of the cheeks opposite the molar teeth (PHE, 2013a). Common complications include otitis media, bronchopneumonia, diarrhoea and convulsions (PHE, 2013a). Those at higher risk of complications of measles include children who are poorly nourished, chronically ill and immunosuppressed. There were 488 confirmed measles infections in England from January to September 2016, compared with just 92 in 2015 and 112 in 2014 (PHE, 2016). The majority of the infections were in young people aged 15-23 years, of whom 92 were not immunised.