All you need to know about measles

All you need to know about measles

04/10/2019

Not so long ago, childhood illnesses were commonplace, with children being off school for weeks and even months while recovering from ailments such as mumps, whooping cough, diphtheria, hepatitis and measles – it was just the way things were. While most survived to tell the tale, others were not so lucky.

Thankfully advances in medical science brought about vaccines which now protect our children from contracting these highly contagious viruses and ensure they aren’t at risk of serious side effects, or in some cases, death.

However, times are changing again and currently four countries (UK, Albania, the Czech Republic and Greece), which have been measles-free for decades, have lost this status and there are concerns that the US will soon follow suit.

And while Ireland has enjoyed a measles-free status for many years, the constant flow of people to and from our shores has meant that the disease can be carried here by a visitor and passed on to an unvaccinated person who either comes face to face with the carrier or simply visits a place where they may have been within a certain time period.

More worryingly, given the voracity in which the virus spreads, a certain number of people are now choosing not to vaccinate their children because they feel it is either unnecessary to do so, is somehow harmful to their child, or they simply do not realise how important it is.

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“Ireland still has the status of having eliminated measles, which is good news,” says Dr Suzanne Cotter, specialist in public health medicine for the HSE and HPSE. “But it can and does spread very quickly within a community and we are concerned by the reduced uptake of vaccinations, particularly in the Dublin and Wicklow region.

“We don’t know why this is but there could be a number of reasons; a minority of parents actively choosing to delay or avoid vaccination altogether, human error with people simply forgetting to go to an appointment, or perhaps a delay in doctors sending back returns to show how many have been vaccinated.”

Whatever the reason, Dr Cotter says it is vital that we do not return to a time when the disease was rife across the country.

“There were thousands of cases of measles in the 1940s in Ireland with people suffering complications such as ear infections, diarrhoea and pneumonia,” she says. “One in a thousand suffered with encephalitis and although rare, some did die from it.

“If you look back at our parents’ generation, measles did kill and it had a hospital admission rate of 25pc, so it is not a minor illness. Children do get very sick with it and during the outbreak in 2000, there were three deaths, so it can be fatal and is not something that children are somehow stronger for having beaten. I would advise everyone to make sure their children are vaccinated against this and other childhood diseases.”

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It is recommended by the WHO that an immunisation figure of 95pc or higher is ideal and the most recent figures show that across the country we have a 91pc uptake of the MMR (Measles, Mumps, Rubella) vaccine with Galway and Roscommon having the highest (95pc and 97pc respectively) while Sligo and Leitrim have the lowest uptake (89pc).

Aoife Halpin knows only too well the havoc measles can cause because she decided not to vaccinate her children and four years ago found herself holding a vigil beside her daughter’s hospital bed as the youngster battled with the disease.

“I lived in the UK for years and there was a lot of talk amongst parents about how measles was something our children should all go through in order to strengthen their immune systems,” says the Dublin woman.

“There was also some talk about the vaccine being unsafe. I had measles myself as a child and while I don’t remember anything about it, my mother says I was very sick. But when my two boys (aged 16 and 14) were young, most of the people I knew were saying no to the vaccine and either relying on herd immunity or actively encouraging their kids to get it by taking them around to someone’s house whose child had it.

“I didn’t go that far but I didn’t bother getting the lads immunised and they didn’t catch measles so I felt I had done the right thing. However, when my daughter was five, she became ill and initially we thought she had developed a regular flu virus and kept her off school.

“But within a couple of days she started to get worse and then developed a really angry-looking rash. Her temperature rocketed and she went totally limp and unresponsive. I rushed her to hospital where she was admitted immediately and kept in for several days. It was the most terrifying time of my life and I felt utterly ashamed that I had risked her life and future health over something which I could have prevented.”

The mother-of-three says she was so upset by her daughter’s experience with measles that she has since had her sons vaccinated for both this illness and several others.

“I learned my lesson the hard way because even though my husband always said we should get the kids vaccinated, I had listened to a few scaremongers about it not being safe,” she admits. “I now know that I should only have listened to my doctor and read reputable research rather than stuff which other parents have posted online.

“I felt that I had done the boys a disservice too because measles can strike at any stage of life – so not long after we moved back, I had them vaccinated and I have also got them immunised against hepatitis and will ensure they all get the HPV vaccine.

“I find it amazing that so many people are quick to discredit real medical science when it comes to vaccines and I truly believe that if they had to see their child at death’s door like I did, they would soon change their minds.”

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Currently, the MMR vaccine is offered to children across the country to prevent the spread of these highly infectious diseases, and although it has been 20 years since a medical doctor was discredited for his paper linking autism to the MMR jab and consequently struck off the medical register in the UK, some people still believe their child may be at risk from vaccination.

But Dr Cotter says that there is no evidence whatsoever to support the claims that vaccines such as the MMR are unsafe and would encourage parents to make sure their child is given every chance to avoid developing these serious childhood illnesses.

“I have seen first-hand the evidence that those who are most at risk of developing measles are those who are unvaccinated,” she says. “Those who haven’t had the vaccine will always be exposed to risk unless they plan to live alone forever.

“Measles is very contagious and easily transmitted – you don’t even have to come face to face with someone who has had it – you could catch it unwittingly in an airport, a doctor’s surgery, a shopping centre or anywhere else someone with the virus might have been (the site can be contagious for up to two hours after the infected person has left).

“So, as far as I am concerned, all the research and evidence points to the fact that the vaccine is safe – it has been effective since the 1970s, has been used routinely in Ireland since the 1980s and has had a very positive impact. So I would encourage everyone who is able to have it done, to ensure they are vaccinated against measles.”

Measles fact file

● Measles is an acute viral illness transmitted by airborne respiratory droplets, or by direct contact with nasal and throat secretions of infected individuals.

● About 90pc of non-immune people exposed to an infected individual will get measles.

● The main symptoms are fever, rash, cough, runny nose and inflammation of the eye.

● The first symptoms appear on average 10 days after exposure, but with a range of 7-21 days from exposure to onset of fever.

● The rash usually appears four days after the start of the first symptoms.

● Patients are infectious from about four days before until four days after rash appearance.

● Complications include pneumonia, inflammation of the brain (encephalitis), otitis media (fluid in the middle ear), diarrhoea. Subacute sclerosing panencephalitis (SSPE) is a rare and ultimately fatal progressive degenerative disease of the brain that may develop years after primary infection.

● The disease is preventable by vaccination, which provides lifelong immunity in most people who get two doses of vaccine.

For more information visit hse.ie

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