Schoolboy, 13, dies as measles makes a comeback

The Sunday Times, April 2 2006

Brian Deer

A 13-YEAR-OLD boy has become the first person in Britain for 14 years to die of measles in a sign that the disease, once a common killer, is resurfacing.

The boy’s death is the first since the scare over the combined measles, mumps and rubella (MMR) vaccine caused a drop in immunisation rates.

The World Health Organisation recommends vaccination of 95% of the population to ensure “herd immunity” and prevent outbreaks of measles.

After the MMR scare in 1998, rates fell to 80% nationally. In some areas, particularly in London, take-up has sometimes fallen almost as low as 50%. The number of confirmed measles cases nationally is already 100 for the first three months of this year, compared with 77 for the whole of 2005.

The victim, who had not received the MMR vaccine, is understood to have lived in a traveller community and was already on drugs for a chronic lung condition. He had been overlooked by health agencies. “He slipped through the net when he was younger and never caught up,” said a source.

The Health Protection Agency, the government authority which monitors infectious diseases, said that following the boy’s death near Manchester last month more than 100 traveller children had been vaccinated.

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“The first death from acute measles infection in 14 years ought to bring home to people how serious this disease can be,” said Professor David Elliman, consultant in community child health at St George’s hospital, south London. “All the evidence now shows unequivocally there is no justification for leaving children unprotected.”

Separately, it emerged on Friday that 32 measles cases had been confirmed in the area of Doncaster, south Yorkshire, so far this year. The health authority said it was also investigating 36 suspected cases in the biggest outbreak of the disease there in recent years. Following the introduction of MMR in 1988, immunisation against measles among children at age two rose from about 75% to 92%, bringing hopes that in developed countries measles would be eradicated in the way smallpox has been worldwide.

However, this success was badly damaged following research by Dr Andrew Wakefield, a former gut surgeon working at the Royal Free hospital medical school, London. In the late 1990s he claimed to have found evidence linking MMR first to inflammatory bowel disease and then to autism. His work was later discredited. Following Wakefield’s research, MMR take-up slumped to as low as 73% as parents became worried that the vaccine was dangerous.

In the past year rates have edged upwards again following a Sunday Times investigation. This showed that, when Wakefield made his claims, he was funded by lawyers who had employed him to build a case against the vaccine before he publicly called for it to be suspended in February 1998.

“We have anecdotal evidence that parents are still being put off by Wakefield’s stuff,” said Doncaster health authority, which has also recorded 100 cases of mumps this year. “We have around 85% of children immunised, and the only way we are going to stop these outbreaks is to get this rate higher.”

Before single measles vaccine was introduced in 1968, there were commonly more than 100,000 cases in Britain every year and as many as 100 annual deaths.

In recent years confirmed infections have fluctuated at a fraction of those levels: 308 in 2002, 438 in 2003 and 191 in 2004.

A final resolution to the MMR controversy is not expected until later this year or early next year, when Wakefield faces hearings before the General Medical Council over allegations of dishonesty, which he denies.