Cynicism, fear and panic as measles returns

Parents were already confused about the safety of MMR and angered by government prevarication - now there are new fears over a ‘vanquished’ disease

FIFE on Tuesday - and the news that every Scottish parent has come to fear. Measles is back.

The admonishing predictions of doctors and politicians have come true and the disease that many thought had been wiped out forever has returned, bringing with it the risk of deafness, brain damage and even death.

It is not as if there had been no warning signs: recent outbreaks in England and Northern Ireland, together with the plummeting rate of uptake of the controversial MMR jab, had combined to raise the spectre of measles - or mumps or rubella - north of the Border.

There was an air of inevitability, then, when it was announced that two children had been infected with measles - the first cases in Scotland for two years.

Predictably, there was a flurry of renewed interest in the MMR jab among parents . But some were left confused, including Erika Reid, of Glasgow, who just weeks before had nursed her own son, Benjamin, when he contracted measles.

It started with sickness and a high temperature. Within hours the four-year-old had developed the tell-tale symptoms which his mother immediately recognised.

Reid, a former hospital nurse who is qualified as a nursery nurse, was in no doubt about her son’s condition - even though he had been given the MMR vaccine.

She says: "At first I thought it was a 24-hour bug but when Ben developed the rash, runny nose, cough and reddish eyes I was sure it was measles. My mother, who was a child nurse and had seen measles cases before, also had a look at him and said he had measles."

However, she was astonished by the reaction when she took her son to see a doctor. " He said Ben couldn’t have measles because he had had the MMR vaccine - he told me to take him home and give him paracetamol," says Reid.

"I overheard the doctor’s conversation with a registrar at the Yorkhill sick children’s hospital, who he called for advice. The registrar was shouting: ‘If it’s measles, for God’s sake don’t bring him in here.’"

It was only last Friday - more than a week after Benjamin had been seen by the doctor - that Reid finally discovered that the condition had been recorded as measles on her son’s medical notes.

"I suspect this is happening across Scotland and have spoken to other mothers who are convinced their children have had measles even though the doctors have dismissed it," says Reid.

In fact, hundreds of suspected measles cases are taken to doctors each year. Many involve children who have had the MMR jab, which does not give 100% protection - which is why children are supposed to have a booster in their pre-school year. Invariably the cases are diagnosed as something other than measles.

Cynicism is high, and health authorities have had to deny that news of the Fife outbreak - coming on the same day as new figures showed a further slump in MMR uptake - was designed to remind parents of the dangers posed by the three diseases.

The conspiracy theory was aided by Fife Health Board’s apparent departure from normal practice during disease outbreaks by refusing to say which part of the Kingdom the children were from. Patient watchdog Christine Johnstone, of Fife Health Council , says: "It just doesn’t seem to add up . You have to ask yourself whether there is another agenda .

"Many parents who have contacted us believe this is an attempt to encourage more people to take up the vaccine."

The cynicism is not restricted to Fife. Linda Bendle, a mother-of-two from Edinburgh, is one of a growing number of parents who have taken the decision not to give their children the MMR jab.

"I would not have a problem with my children getting measles, which would give them life-long immunity. I am more concerned about the risk from the vaccination," she says.

"I am convinced that GPs are seeing cases of measles but do not believe it is measles because the children have received the MMR vaccine. It could well be true that the cases in Fife are not the first in two years. "

The new outbreak has also placed Mitchell Ward, a mother-of-two from Fife, in an agonising position . Her second daughter, Emma, developed autism shortly after being given the MMR vaccine when she was 18 months old.

The 38-year-old is convinced the jab caused her daughter’s condition and has refused to give Emma, who is now six, the booster injection recommended by her GP .

Ward, who works in a crche in Dunfermline, admits: "I’m sick with worry. I’m constantly checking Emma from head to toe for measles symptoms. One of the mums told me there was a suspected case of measles where her husband works in Glasgow and I couldn’t help but think that she or her wee boy could be carrying it. There is a real sense of panic among mums. "

The confirmed Fife cases involve a child of pre-school age and another at primary school. The primary school child had been given one dose of the MMR vaccine, while the other had not been given the jab. On Thursday an adult was added to the list of confirmed cases. Thirteen further suspected cases are still being investigated in Fife and a further 11 in Tayside, Argyll and Clyde and Lanarkshire.

Fife Health Board is adamant there is no hidden agenda. It insists the parents of the first child to be diagnosed requested that no information about them be given out. In addition, the board says it did not want to encourage "complacency" among parents living outside the areas where the infected children live.

It seems to have worked. Throughout Fife, GP practices have been reporting a rise in enquiries from worried parents who have now decided to have their children vaccinated despite earlier fears about the MMR jab.

And doctors insist the public should have faith in the system. They argue that they are obliged by law to notify their local health board of any measles cases and that it would be almost impossible for children infected with the virus to slip through the net.

Dr Colin Brown, a GP from Paisley, explains: "You quite often come across measles-type rashes in children and doctors might describe the condition as such but that does not mean the illness is measles.

"All confirmed cases have to be notified and I have not seen a typical case of measles in the last 20 years."

Dr Peter Christie, consultant epidemiologist at the Scottish Centre for Infection and Environmental Health, also insists that missed measles cases are "highly unlikely".

He says: "There is no other agenda other than wanting to keep the number of measles cases to a minimum ."

Based on current vaccination rates, Christie predicts that any further outbreaks are likely to be local and Scotland is not at risk of a full-scale epidemic.

And experts say that, in the vast majority of cases, children who are healthy and well nourished will come through a dose of the measles without complications.

Nevertheless, in around one in a thousand cases, measles can cause a serious brain condition - encephalitis - which can lead to brain damage and deafness.

Before a national measles immunisation programme was introduced in 1969, many people were left damaged by the condition and large numbers died.

In 1968, 14 people died in Scotland from measles and in the five years before the introduction of the MMR vaccine in 1988, there were six deaths from measles in Scotland. The last measles-related death in Scotland was in 1995.

The new outbreak in Fife follows two spates of measles cases in London and the north of England. However, the most devastating outbreak in recent years took place in the Republic of Ireland.

Following the publication of controversial research suggesting a link between MMR, autism and bowel disease in 1998, uptake of the vaccine in the Republic slumped. Two years ago two children died and many were left disabled in an epidemic involving 1,500 measles cases.

There is also growing concern among public health experts about fresh outbreaks of mumps and, more seriously, rubella.

Between 1989 and last year the number of confirmed cases of mumps fell from 82 to six and for rubella from 356 to two.

On the thorny question of whether, in the wake of the new cases of measles in Fife, parents should be offered single vaccines against all three diseases as an alternative to MMR, Christie is resolute.

"If these cases refocus parents on the fact that this is a real infection which can have very serious consequences then I think that is only fair.

"We will not give in to anxiety and change our policy to something we don’t believe in and have no evidence for."

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