In England, the Birmingham Children’s Hospital is currently grappling with a major outbreak of measles. More than 50 children have been hospitalized in the past month. Vaccine-preventable diseases such as measles and polio remain a public health threat. And with childhood vaccine hesitancy—or simply outright refusal—on the rise in the U.K., U.S. and Europe, the problem is likely to worsen.
The measles outbreaks in the U.S., including most recently in Philadelphia, are worrisome. But the situation appears to be more severe in England. There, cases have been surging. According to new figures released by the U.K. Health Security Agency there were 1,603 suspected cases of measles in 2023, which represents an increase from 735 in 2022 and 360 in 2021.
The spike in cases is fueled by vaccine hesitancy towards the measles, mumps and rubella shot. According to National Health Service England, in December 2022 the MMR vaccination rate in the Birmingham region was around 83%. To optimally protect the population, a rate of at least 95% is critical.
The UKHSA has confirmed that the West Midlands, which encompasses Birmingham and the area surrounding it, is the epicenter of the largest current outbreak of the infection in the country. In just the past month the agency’s figures show there have been at least 167 laboratory confirmed cases with a further 88 likely cases and more than 50 children hospitalized. Remarkably, around 80% of the most recent cases in Europe have been in the West Midlands.
Looking a bit further back in time, at the period from January to October of last year, there were 30,000 recorded cases of measles across Europe. This constituted more than a 30-fold increase compared to 2022.
The disease causes an initial flu-like illness with symptoms that include a high fever of over 103 Fahrenheit (39.4 Celsius), copious congestion, red eyes and a rash that spreads around the entire body. Patients with measles can develop ear infections, severe gastrointestinal upset, pneumonia and brain swelling. It’s the latter that killed author Roald Dahl’s seven-year old daughter, Olivia, in 1962. This was before the advent of vaccines.
In 1986, Dahl penned an essay about her death as an appeal to parents everywhere to vaccinate their children. Dahl wrote:
“Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of colored pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything.
“Are you feeling all right?” I asked her.
“I feel all sleepy,” she said.
In an hour, she was unconscious. In twelve hours she was dead.”
In the 1960s, measles was the single leading killer of young children globally. Vaccination campaigns significantly reduced mortality. Based on estimates published in the journal The Lancet, the global number of measles deaths in 2020 was 60,700, a 94% decrease from 1,072,800 deaths in 2000, and a 98% drop from 2,600,000 deaths in 1980.
However, from 2020 to 2022, measles fatalities worldwide have more than doubled, reaching 136,000.
And after having achieved measles elimination in 2017 the U.K. relinquished that status due to re-established endemic transmission of measles.
Measles isn’t the only vaccine-preventable disease that poses a public health threat in Britain and elsewhere. Others include polio. In 2022 there was sustained detection in London, according to an article published in The Lancet. Specifically, 118 type 2 poliovirus isolates were identified in sewage samples collected in the city between February and July 2022. After an intensive public health campaign to boost polio vaccinations, transmission levels, as suggested by wastewater monitoring, diminished by March 2023.
Reluctance on the part of vaccine skeptics to have their children receive the two-dose MMR series and other jabs targeting polio, diphtheria, tetanus, whooping cough and hepatitis B, is due to lingering fears around debunked claims linking the shots to autism and other disorders. The launch of Covid-19 vaccines seems to have prompted more unwarranted concerns about vaccination.
But the more people forego childhood immunizations, the greater the chances infectious diseases such as measles stage a comeback as we’re witnessing today. The now persistent problem of the return of vaccine-preventable diseases is a direct result of the steady increase in vaccine hesitancy lately.
In the wake of the upsurge in measles in England, British doctors and government officials are posting urgent pleas to parents to have their children vaccinated.
Going forward, elimination of measles and other communicable diseases such as polio can only be sustained by improving and then maintaining population-wide coverage of the vaccines children are supposed to take.
