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Practice comment

'Why did no alarms ring when children caught measles?'

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If your kitchen smoke detector starts to shriek, do you: (a) cover your ears and assume the din will eventually stop, or (b) act immediately to keep you and your loved ones safe?

I am guessing the latter. There are situations in which an immediate reaction is required to prevent a conflagration starting in your home and spreading to the surrounding streets.

Immunisation, like that smoke detector, is protection. Measles happens to be one of the most contagious diseases known, and irrefutable evidence confirms the safety and efficacy of the two-dose MMR vaccination regime. Unfortunately, we are now in the throes of a number of measles outbreaks in the UK, with the Health Protection Agency reporting the greatest incidence of measles in 18 years. To our shame, we may even see the return of congenital rubella syndrome.

Many primary care clinicians had to deal with the fallout from the MMR scare when it happened; whatever we said, did, or published in support of the vaccination was often rejected by parents who preferred conspiracy theories and pseudoscience to the factual data we were trying to provide. Indeed, many of us have had to wait sadly and passively for today’s inevitable outbreaks. “We told you so,” is the feeling from the pro-immunisation lobby, and, although there would appear to be a certain justification for this attitude, it may not be helpful in the current climate.

Before the sweeping NHS transformation that came into effect in April, I did occasionally wonder what would happen during the reorganisation process if some nasty virus were to come along, particularly when local authorities took on the majority of health promotion and health protection. Further enquiries offered reassuring words and phrases - robustness, safety, continuity of care.

But, while more and more children were catching measles, it has to be asked: just why alarm bells did not ring? And, if they did ring, why did no one listen to the clinical experts? Why was no executive plan for a catch up programme for MMR immunisation put in place a good deal sooner?

I understand that any new health body worth its salt probably likes to talk about driving transformation, creating sustainable change in public health and tackling inequalities. However, somewhere along the line, during the lead-up to April 2013 and immediately afterwards, an eye was taken off the ball. And right now many of our children continue to be at serious risk from measles and its consequences.

Thankfully, expert advice is being taken on board. A national catch-up campaign will be starting soon, based in general practices and schools.

The extra workload for nurses will be huge. Already, we are searching medical records for potentially unprotected children with a view to setting up clinics. In addition, we are trying to manage the expectations of some adults who demand the vaccine for themselves.

The smoke detector is shrieking. We are now listening and acting.

Jane Warner is general practice nurse, Creech Medical Centre, Creech St Michael, Taunton.

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Readers' comments (5)

  • We live in a "google age" where the public obtains most of its info from the pages of Wikipedia..........and swears by it.

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  • Agree with Anon above.

    But also healthcare is all too often reactive instead of proactive. Yes a catch up campaign should have started sooner, but then again a lot of parents wouldn't have engaged with it because they wait for the crisis.

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  • We have immunisations for measles and we're in an epidemic How soon will we be in an epidemic with TB seeing we are not protected with BCGs anymore Its a joke!!!!

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  • In many parts of the USA children who are not up to date with their vaccinations are denied access to schools, pre-schools and nurseries, unless there are valid, documented reason(s) for a child not being vaccinated.

    Maybe similar "incentive" in the UK would produce better results!

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  • It's one of the things the US system does do to protect public health. Barring unvaccinated kids from school offers better protection to the very rare child who can't have the vaccine because herd immunity is improved.

    I think it should be mandatory for UK children to be certified as fully vaccinated before school attendance.

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