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Two studies published today in the British Medical Journal show a sharp rise in the number of outbreaks among children and young people, a trend that has caused mounting concern in recent months. The dramatic escalation in cases at the beginning of this year, as revealed in The Times, resulted in a total of almost 5,000 people with mumps symptoms attending doctors.
Researchers from Guy’s and St Thomas’ NHS Foundation Trust claimed that Britain was “in the grip of a nationwide mumps epidemic”. They said that no opportunity should be missed to offer the measles, mumps and rubella (MMR) jab to those at the highest risk of mumps, such as anyone starting school or university.
The study shows that in January there were on average more than 1,200 potential mumps cases notified by doctors every week, and the rate is rising. “Most patients are aged between 19 and 23 and there is now the threat of outbreaks among under-immunised children,” the researchers said.
Another paper from the Health Protection Agency pointed out that last year the number of mumps notifications in England and Wales increased to 16,436, up from 4,204 in 2003. Of these, a total of 8,104 cases were confirmed, compared with 3,907 cases in the previous five years.
The agency said that most cases were seen in young adults born before 1988 — when the MMR jab was introduced — who would not have been routinely scheduled to receive the vaccine. The researchers said that the highest attack rate was seen in those born between 1983 and 1986, who were too old to be offered the MMR jab routinely although some may have received one dose of MMR as part of a catch-up programme when they entered school.
The Guy’s and St Thomas’ team said that cases in younger children may occur because of the fall in uptake of MMR among infants. Research published in 1998 caused widespread panic among parents when it suggested a link between MMR and autism, a claim rejected by the majority of experts.
The researchers said that the World Health Organisation recommended immunisation coverage of 90 per cent to prevent outbreaks of mumps.
“Uptake of the MMR vaccine among two-year-olds in the UK fell from around 92 per cent in early 1995 to around 80 per cent in 2003-04. In some areas of London, as few as 60 per cent of two-year-olds have received a first dose of MMR. This would account for our recent experience with mumps in younger children,” they said.
The researchers said that the initial success of the MMR programme in controlling mumps had been compromised in recent years by sporadic outbreaks. “Since 2004 the number of reported and confirmed cases of mumps has increased, culminating in the current epidemic,” they said. “This epidemic underlines the importance of ensuring that all children and young adults have received two doses of MMR.”
A Department of Health spokeswoman said: “We recommend that all at-risk school-leavers and other young adults who have not received MMR, or only received one dose, should ensure that they take up the offer of MMR vaccination.”
Mumps, which is an acute viral illness transmitted by direct contact with saliva of an infected person, begins with a headache, followed by fever and swelling of the parotid glands.
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