A large outbreak of measles in the West Midlands, England, 2017–2018: descriptive epidemiology, control measures and lessons learnt

Abstract

In November 2017, eight confirmed measles cases were reported to Public Health England from a hospital in the West Midlands. A multidisciplinary incident management team (IMT) was established to determine the extent of the problem and coordinate an outbreak response. Between 01 November 2017 and 04 June 2018, a total of 116 confirmed and 21 likely measles cases were linked to this outbreak; just under half (43%) were aged over 15 years of age. 55 of the confirmed cases were hospitalised (48%) and no deaths were reported. At the start of the outbreak, cases were mostly individuals of Romanian origin; the outbreak subsequently spread to the wider population. Over the 8-month response, the IMT conducted the following control measures: extensive contact tracing, immediate provision of post-exposure prophylaxis, community engagement amongst specific high-risk groups, MMR awareness raising including catch-up campaigns and enhanced vaccination services at selected GP surgeries. Key challenges to the effective control measures included: language difficulties limiting community engagement; delays in diagnosis, notification and appropriate isolation of cases; limited resources for contact tracing across multiple high-risk settings (including GPs and hospitals) and lack of timely data on vaccine coverage in sub-groups of the population to guide public health action. Key results A large and challenging outbreak of measles in the West Midlands region of England occurred between November 2017 and June 2018, with 116 confirmed and 21 likely measles cases. Key challenges to effective control were community engagement in under-vaccinated populations, delays in diagnosis, notification and appropriate isolation of cases and lack of timely data on vaccine coverage in sub-groups of the population. Strong local and national oversight, co-ordination, and communication between multiagency stakeholders were essential in controlling the outbreak.

The effect of geographical variation in income measures on measles-mumps-rubella uptake and coverage in England; a protocol for an ecological study

“…The first dose is scheduled at the age of 12 months and the second at the age of 3 years and 4 months [2]. However, after more than thirty years of its introduction, measles is not considered something of the past as yet, as several measles outbreaks have been occurring in England during the last decade [3][4][5]. Consequently, the Measles elimination status was removed by the World Health Organization (WHO) in 2019 after outbreaks of Measles occurred in 2018 [5,6].…”