Why are UK measles cases on the rise in 2024?
Measles cases have increased rapidly in the UK this year. What are the reasons for the sudden increase in cases, and how can we prevent the spread of this disease?
6 minute read Before a vaccine was introduced in 1963, an estimated 2.6 million people worldwide died from complications of measles every year.
Now, despite an effective vaccine, there has been a recent dramatic increase in measles cases in the UK and around the world. In January 2024, the UK Health Security Agency (UKHSA) declared a national incident over rising cases of the disease.
But what is measles? Why are measles cases increasing? And what’s the best way to prevent the spread of this potentially deadly disease?
What is measles?
Measles is a highly contagious viral infection that is spread through droplets in the air when an infected person breathes, coughs, or sneezes. The infection starts in the respiratory tract before spreading throughout the body.
Measles is most common in children, but can affect anyone who hasn’t been vaccinated.
What are the symptoms of measles?
The first symptoms of measles are usually similar to a cold and may include:
Fever (a temperature above 38°C)
A blocked or runny nose
Coughing
Sneezing
Red, sore, watery eyes
These symptoms are usually followed three to five days later by a rash that starts on the face and spreads downwards to the rest of the body. The rash normally appears as flat, red or brown spots that may join together to form blotches. Sometimes, small, white spots may appear inside the mouth.
How is measles treated?
There is currently no treatment for measles. The disease normally gets better on its own after about a week. However, in some cases, serious complications can occur.
You can help relieve the symptoms of measles by:
Drinking plenty of fluids to avoid dehydration
Taking over-the-counter painkillers like paracetamol
Getting plenty of rest
Gently removing any crusts from your or your child’s eyes using cotton wool soaked in boiled, cooled water
Measles is highly contagious, which means it spreads easily from one person to another. A person with measles can pass the virus to others from four days before the rash appears to four days after.
To help prevent the spread of measles:
Stay home from school or work
Wash your hands frequently with soap and water
Cover your mouth and nose with a tissue when coughing or sneezing
Don’t share food and drink utensils, or any items that may be contaminated with saliva or respiratory secretions
Put used tissues and cotton wool straight in the bin
Avoid contact with others, especially babies, the elderly, people with weakened immune systems and pregnant women
Are measles symptoms getting serious?
Go to A&E or phone 999 if you or your child:
Have shortness of breath or difficulty breathing
Have a high temperature that does not come down with paracetamol or ibuprofen
Are coughing up blood
Are drowsy or confused
Are having fits (seizures)
If you are pregnant, or have a weakened immune system and have been in contact with someone with measles, see a doctor urgently.
Is measles serious?
In rare cases, measles can spread to other parts of the body, such as the lungs or brain, causing serious illness or even death. Babies and people with weakened immune systems, such as those with HIV/AIDS, people taking immunosuppressant drugs, or those receiving cancer treatment, have a higher risk of developing serious complications from measles. If you get measles when you are pregnant, it can harm your unborn baby.
Complications of measles include:
Meningitis
Blindness
Seizures
Can measles be prevented?
Measles is a preventable illness and an effective vaccine for the disease is available. This is known as the MMR vaccine.
The MMR offers protection from three serious illnesses, measles, mumps and rubella (german measles). It is given in two doses, the first at one year of age, and the second at three years and four months. If you or your child miss a dose of MMR, you can be vaccinated at any age.
Around 99% of people are fully protected against measles after two doses. If you do not want a vaccine that contains pork products (gelatine), you can request an alternative vaccine called Priorix.
How much have measles cases increased?
Before the introduction of the measles vaccine, between 160,000 and 800,000 measles cases were reported each year in the UK and around 100 people a year died from the disease. Around 80% of the population of the UK caught measles in childhood.
In 2016, the World Health Organisation (WHO) declared that measles had been eliminated in the UK, based on the low number of confirmed cases between 2014 and 2016.
In 2014, there were 121 confirmed cases of measles in England and Wales, followed by 91 cases in 2015. However, from 2016, numbers began to increase and, with the exception of the pandemic years between 2020 and 2022, have remained in the hundreds.
Between January 1st and December 31st 2023, there were 368 confirmed cases of measles in England. Since October last year, the total number of confirmed cases of measles in England stands at 521.
Why are measles cases increasing?
According to the UK Health and Security Agency (UKSHA), the increase in the number of measles cases is directly linked to a decrease in people receiving the MMR vaccine.
In order to achieve herd immunity — when the vast majority of a population is vaccinated to make it harder for a virus to spread, 95% of the population needs to be vaccinated. Currently, around 85% of children in England have received both doses of the MMR vaccine by five years of age.
So, what’s behind the decline in people getting vaccinated?
The pandemic
The pandemic put many things on hold, including routine vaccination programmes. Face-to-face contact was limited to emergencies to prevent the spread of COVID-19, and many children missed out on routine childhood vaccinations.
Though there is no age limit on when you can have the MMR, many children who missed routine vaccinations during the pandemic have still not received the vaccine. In addition, the pandemic gave rise to a wave of anti-vax conspiracy theories that spread rapidly around the world on social media, making some people distrustful and afraid of vaccinations.
Lack of awareness of the dangers of measles
As it had been virtually eliminated in the UK, many people are not old enough to remember a case of measles and don’t view it as a potentially serious and life-threatening infection. The idea that measles is a mild childhood illness may cause some parents to mistakenly think that vaccinating their children against measles is not important.
Fears about the MMR
In 1998, researcher Andrew Wakefield wrongly claimed that there was a link between the MMR vaccine and autism. This link was later dismissed and Mr Wakefield was struck off by the General Medical Council (GMC) in 2010.
Despite there being no evidence of a link, some parents still wrongly believe the MMR vaccine can cause autism. In addition, some adults that were children at the time of Wakefield’s claims may still be unvaccinated today.
Cultural factors
Vaccine hesitancy has been linked to cultural factors, the causes of which are complex, but include misinformation and a history of mistrust in the medical profession due to historical discrimination and unethical practices such as immoral experimentation.
Vaccine hesitancy is disproportionally higher among lower socioeconomic groups and some ethnic minorities, including those of Afro-Caribbean, Bangladeshi, Pakistani, and Eastern European descent.
Additional barriers to vaccination may include fear about what the vaccines contain (such as pork products), the language barrier, and difficulty accessing vaccines for families from overseas, particularly refugees.
What is the government doing to address the measles outbreak?
The Health and Security agency has warned that the measles outbreak could spread across the country, potentially infecting tens of thousands of people.
In January 2024, in an effort to tackle the rising cases of measles, the NHS launched a campaign targeting areas with a low vaccine uptake. The campaign aims to increase vaccination rates by:
Contacting around a million unvaccinated people between 11 and 25 years of age in London and the West Midlands to invite them to catch up on missed MMR vaccinations
Providing pop-up vaccination centres in convenient locations like schools
Asking GPs, teachers and community leaders to encourage people in their communities to get vaccinated
Sending text, email and letter reminders to parents and guardians of children under five who have not been fully vaccinated
Increasing awareness of the dangers of measles using health promotion materials in clinics, GP surgeries and on websites
Training NHS staff to provide support and information about measles and the MMR vaccine
Ensuring families from overseas and refugees have access to vaccines
The NHS Long-Term Plan includes a range of measures to increase the uptake of the MMR vaccine, including:
A fundamental review of the GP contract for vaccination and immunisation
Improved local co-ordination to increase immunisation coverage in each area and targeting communities where there is low vaccine uptake
Checking the MMR status of 10 and 11-year olds
Where can I get the MMR vaccine?
You can make an appointment for you or your child to get the MMR vaccine free at your local GP surgery. In addition, pop-up vaccination centres are being set up in some areas. Contact your GP, or check online for details of a pop-up clinic near you.
Alternatively, you can pay to have the MMR vaccine privately at a private GP surgery, and some pharmacies. Check online for details of where to get a private MMR vaccine in your area.
The measles outbreak in 2024: A summary
Measles is a highly contagious viral infection that can lead to serious complications and even death. It can be effectively prevented with a vaccine called the MMR. Despite being virtually eradicated in the UK, measles cases have spiked dramatically in recent months, largely because of poor uptake of the vaccine for various reasons, including vaccine hesitancy.
To prevent the further spread of measles, the NHS has launched a campaign to increase vaccination rates in children and unvaccinated adults.
If you would like to know more about measles, have any questions about the MMR vaccine, or would like you or your child to be protected against measles, contact your local GP surgery for more information.
