HPR volume 17 issue 7: news (14 July 2023)
Updated 28 December 2023
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Second update on UK measles epidemiology, 2023
From the 1 January to 30 June 2023 there have been 128 laboratory confirmed measles cases in England. The majority of the cases (n= 85, or 66%) have been reported in London, although all regions have reported at least one case.
A total 65% of the cases were in children under the age of 10 years and 20% of the cases were in teenagers and young people aged 15 to 34 years. Less than 1 in 5 (24 out of 128, or 19%) of the cases were imported or import-related, while the rest reflect community transmission in England.
Laboratory confirmed cases of measles by month of onset of rash or symptoms reported, London and England: January 2012 to June 2023
Note: Data for the past four weeks are provisional and are depicted as dotted lines.
Laboratory confirmed cases of measles by age group and region in England: January to June 2023
| Age group | North East | North West | Yorkshire and Humberside | East Midlands | West Midlands | East of England | London | South East | South West | Total |
|---|---|---|---|---|---|---|---|---|---|---|
| Less than 1 year | 0 | 1 | 1 | 1 | 0 | 0 | 18 | 2 | 0 | 23 |
| 1 to 4 years | 2 | 3 | 1 | 1 | 1 | 2 | 18 | 5 | 0 | 33 |
| 5 to 9 years | 1 | 1 | 2 | 0 | 0 | 0 | 20 | 3 | 0 | 27 |
| 10 to 14 years | 0 | 0 | 0 | 1 | 0 | 0 | 5 | 0 | 0 | 6 |
| 15 to 19 years | 0 | 0 | 1 | 1 | 0 | 0 | 4 | 0 | 2 | 8 |
| 20 to 24 years | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 2 |
| 25 to 29 years | 0 | 0 | 2 | 0 | 0 | 1 | 7 | 0 | 1 | 11 |
| 30 to 34 years | 0 | 0 | 0 | 0 | 0 | 0 | 4 | 0 | 0 | 4 |
| 35 years and older | 1 | 0 | 1 | 0 | 0 | 1 | 9 | 1 | 1 | 14 |
| Total | 4 | 5 | 8 | 5 | 1 | 4 | 85 | 12 | 4 | 128 |
Note: data, extracted on 30 June, is provisional.
UK MMR uptake: population immunity gaps
Due to the COVID-19 pandemic, vaccine uptake rates for routine childhood programmes have fallen globally. Coverage for the measles, mumps and rubella (MMR) vaccination programme in the UK has also fallen to the lowest level in a decade.
Uptake for the first dose of the MMR vaccine in children aged 2 years in England is 85.6% (1), and uptake of 2 MMR doses at age 5 years is 85.5%. This is below the 95% target set by the World Health Organization (WHO) as necessary to achieve and maintain elimination.
A new UKHSA assessment of the risk of measles resurgence in the UK shows that the risk of a large measles epidemic outside of London is considered low (2). Models suggest, however, that an outbreak of between 40,000 and 160,000 cases could occur in London where vaccine uptake has consistently been lower than the rest of the UK (2). Although outside London the risk of large measles outbreaks is low, we could still see smaller outbreaks in specific populations (teenagers, young people and under vaccinated communities) (2). Estimated susceptibility remains high in those aged 19 to 25 years, who were affected by unfounded scare stories in the early 2000s (‘Wakefield cohorts’), although it is not clear how many of this age group may have been vaccinated as part of earlier catch-up programmes.
UKHSA has been working closely with the NHS and other partners to support the recovery of the routine childhood immunisation programme and to catch-up children who missed out on their vaccinations during the COVID-19 pandemic. The UK Measles and Rubella Elimination Strategy sets out key recommendations for action including the development of local action plans that address specific population needs.
In London, a polio and MMR catch-up campaign targeting unvaccinated or partially vaccinated children aged 1 to 11 years is being rolled out through GP practices, primary schools and community vaccination clinics
References
1. UKHSA (2023). ‘Quarterly vaccination coverage statistics for children aged up to 5 years in the UK (COVER programme): January to March 2023’.
2. UKHSA (2023). ‘Risk assessment for measles resurgence in the UK’.
Infection reports in this issue
Group A streptococcal infections: 15th update on seasonal activity in England
Laboratory confirmed cases of pertussis in England: July to September 2022
Acquired carbapenemase-producing Gram-negative bacteria in England: October 2020 to March 2023