Why are Scotland's measles cases bucking the trend amid health warning?

Cases of the infection are rising across Europe sparking a warning from the World Health Organisation.

Why is Scotland bucking the trend of rising measles cases amid world health warning? Getty Images

The World Health Organisation (WHO) has issued an urgent warning over a rise in cases of measles.

Last year, figures from health experts found cases across the WHO’s European nations rose by almost 30-fold but two cases were reported in Scotland.

More than 30,000 cases of measles were reported between January and October in 2023 in total, compared with just 941 cases in the entirety of 2022.

Children between the ages of one and four accounted for two in five cases, while measles was detected in one of five people over the age of 20.

Figures up to September 2023 from Public Health Scotland (PHS) showed 93.3% of children had the first dose of measles, mumps and rubella (MMR) vaccine by age two last year.

This figure rose to 95.8% for children who had reached age five.

Why are measles cases rising across Europe?

The warning from WHO comes amid a backdrop of cases accelerating in recent months.

The organisation has linked a drop in vaccination rates against measles among children during the Covid pandemic as a reason for the significant rise.

The vaccine is delivered in two doses – first at around the age of one and the second when the child hits about three years and four months old.

Vaccine.
Vaccination uptake at the beginning of the Covid-19 pandemic in Scotland was higher than the rest of Europe.

Dr Hans Kluge, the WHO regional director for Europe said: “We have seen in the region not only a 30-fold increase in measles cases, but also nearly 21,000 hospitalisations and five measles-related deaths (reported in two countries).

“Vaccination is the only way to protect children from this potentially dangerous disease. Urgent vaccination efforts are needed to halt transmission and prevent further spread.

“It is vital that all countries are prepared to rapidly detect and timely respond to measles outbreaks, which could endanger progress towards measles elimination.”

Why are cases of measles not rising at the same rate in Scotland?

A number of factors have been laid out by health experts as to why Scotland is bucking the trend on cases.

Researchers from Edinburgh University found in 2022 that an uptake in vaccination rates in Scotland could be closely linked to flexible working arrangements during the Covid-19 pandemic.

It was reported that parents had more time due to hybrid working models to take their children to vaccination appointments.

The overall increase, as investigated by Public Health Scotland (PHS) and the university, found an additional 7,508 pre-school vaccinations being delivered on time during lockdown compared with the same period in 2019.

Dr Fiona McQuaid, clinical lecturer in paediatric medicine at the University of Edinburgh, said in 2022: “It’s encouraging to find that more children under five received their vaccines on time during lockdown, despite concerns that uptake might fall.

“It’s important that we continue this research to find out why this happened and how we can continue to encourage high immunisation rates to ensure children remain protected against many infectious diseases.”

Researchers from Edinburgh University linked hybrid working to an uptake in appointments being met. Photo: iStock.

A spokesperson for PHS said: “Measles is a highly infectious disease.

“Having two doses of the vaccine is the best way to prevent measles.

“The vaccine is safe and highly effective in preventing measles infection.

“The MMR vaccine offers protection to children against measles after the first dose at 12-13 months; the second dose is offered at 3 years 4 months.

“Anyone who hasn’t had two doses of the MMR vaccine as a child should contact their local health board via the NHS Inform website about getting their free MMR vaccine.

“Public Health Scotland has been working with health boards and relevant partners to ensure that as many people as possible take up the offer of the measles, mumps and rubella (MMR) vaccination as well as all routine childhood immunisations.”

Health experts say there are still pockets of unvaccinated (no doses) and under-vaccinated (one dose) individuals which could lead to an outbreak.

How do cases in Scotland compare to the rest of the UK?

Last week, the UK declared a national incident amid a surge in cases as parents were urged to get the MMR vaccine for their children.

An outbreak of the highly-contagious infection in the West Midlands sparked concern among health officials.

The UK Health Security Agency (UKHSA) confirmed 216 cases and 103 probable cases in the region since October 1.

Britain had the most cases with 183 in the WHO’s Western Europe region in 2023.

Last year, experts say 20,918 people across Europe were admitted to hospital with measles while five deaths related to the infection were also reported.

An outbreak in the West Midlands lead to 216 confirmed cases according to the UK Health Security Agency.

Meanwhile data from NHS England suggests that over 3.4 million under 16s are unvaccinated.

The UKHSA warned last week that a “trajectory for everything getting much worse” was developing in the country.

Professor Dame Jenny Harries said “concerted action” was needed to tackle the spread of the infection.

She said: “What we are seeing at the moment with measles is that people have forgotten what a serious illness it is.

“We have had very high vaccination rates, especially for young families, but they are low at the moment.”

What are the symptoms of measles – and who is most at risk?

Measles can affect anyone at any age, old or young.

Symptoms normally start with a high fever and rashes which can clear after around 10 days.

Long-term complications can arise, however, with diseases such as pneumonia and meningitis.

Pregnant women can be at risk of stillbirth and miscarriage due to the infection.

Blindness and seizures have also been named as potential side effects to the infection.

Pregnant women, babies who are too young to be vaccinated and immunocompromised people are most at risk according to health experts.

During pregnancy, the infection can lead to stillbirth, miscarriage and babies being born at a low weight.

For more information on measles and the MMR vaccine, visit the NHSinform and MMR against measles websites.

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