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UK measles outbreak in non-immune anthroposophic communities: the implications for the elimination of measles from Europe

Published online by Cambridge University Press:  02 January 2001

B. HANRATTY
Affiliation:
Nuffield Institute for Health, 71–75 Clarendon Road, Leeds LS2 9PL, UK
T. HOLT
Affiliation:
Dale End Surgery, Danby, Whitby, North Yorkshire Y021 2JE, UK
E. DUFFELL
Affiliation:
Gloucestershire Health Authority, Victoria Warehouse, The Docks, Gloucester GL1 2EL, UK
W. PATTERSON
Affiliation:
North Yorkshire Health Authority, Ryedale Building, 60 Piccadilly, York. Y01 1PE, UK
M. RAMSAY
Affiliation:
Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK
J. M. WHITE
Affiliation:
Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK
L. JIN
Affiliation:
Enteric and Respiratory Virus Laboratory, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5EQ, UK
P. LITTON
Affiliation:
Enteric and Respiratory Virus Laboratory, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5EQ, UK
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Abstract

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We describe the epidemiology of the first nationwide outbreak of measles infection in the UK since the implementation of a mass vaccination campaign. Notifications of infectious diseases, interview and postal questionnaire identified 293 clinical cases, 138 of which were confirmed by salivary IgM, measles virus isolation and PCR. Twelve were epidemiologically linked to confirmed cases. The outbreak began in London, after contact with measles infection probably imported from Italy. Measles genotyping determined by sequence analysis confirmed spread to other unimmunized anthroposophic communities in the north, south west and south coast of England. Only two cases had been vaccinated against measles infection, and 90% of cases were aged under 15 years. Measles virus can selectively target non-immune groups in countries with high vaccine uptake and broader herd immunity. Without harmonization of vaccination policies and uniform high coverage across Europe, the importation and spread of measles virus amongst non-immune groups may prevent the elimination of measles.

Type
Research Article
Copyright
© 2000 Cambridge University Press