Measles outbreak in Greater Manchester, England, October 2012 to September 2013: epidemiology and control

Abstract

This paper describes the epidemiology and management of a prolonged outbreak of measles across the 2.7 million conurbation of Greater Manchester in the United Kingdom. Over a period of one year (from October 2012 to September 2013), over a thousand suspected measles cases (n = 1,073) were notified across Greater Manchester; of these, 395 (37%) were laboratory-confirmed, 91 (8%) were classed as probable, 312 (29%) were classed as possible and 275 (26%) excluded. Most confirmed and probable cases occurred in children within two age groups-infants (too young to be eligible for measles-mumps-rubella (MMR) vaccination according to the national immunisation programme) and children aged 10-19 years (low vaccine uptake in this cohort because of unfounded alleged links between the MMR vaccine and autism). During this one year period, there were a series of local outbreaks and many of these occurred within the secondary school setting. A series of public health measures were taken to control this prolonged outbreak: setting up incident management teams to control local outbreaks, a concerted immunisation catch-up campaign (initially local then national) to reduce the pool of children partially or totally unprotected against measles, and the exclusion of close contacts from nurseries and school settings for a period of 10 days following the last exposure to a case of measles.

Assessment of vaccine effectiveness during measles outbreak in the Federation of Bosnia and Herzegovina, 2014-2015

“…Despite the efforts to eliminate measles and rubella in Europe by 2015, the number of measles cases has been increasing in numerous European countries in the last few years (8)(9)(10)(11). Vaccine hesitancy has become a growing focus of attention for public health researchers (12).…”

Vaccine hesitancy, refusal and access barriers: The need for clarity in terminology

“…In most countries, although uptake of childhood vaccines is generally high, pockets of undervaccination pose a continued threat to individual protection and population immunity, with some of these pockets the foci of recent disease outbreaks [1,2]. Vaccination safety scares have led to long-term reductions in coverage, as evidenced by reduced coverage of MMR vaccine post the suggested association with autism in many countries [3,4].…”

The Brain-Gut-Microbiome Axis: What Role Does it Play in Autism Spectrum Disorder?

“…33 Efforts to avoid vaccines and chelate heavy metals that stemmed from misinformation and lack of medical evidence have caused deaths and have contributed to public health crises. 34, 35 Currently, there are ways to alter the microbiome, such as the use of dietary interventions, probiotic supplementation, anti-microbials, and fecal microbiota transplant. 36 Diet and probiotics are routinely used to treat various disorders, including ASD.…”