Children who haven’t had both doses of their measles jab could be excluded from school or childcare for 21 days due to rising concern over cases.
Authorities in England have issued letters to the parents of school-aged children, urging them to check that their youngsters have had both doses of the MMR (measles, mumps, and rubella) vaccine.
The latest data shows there have so far been 128 cases of the virus in England this year, double the entire total for 2022.
Health officials are concerned that low uptake of the MMR (measles, mumps, and rubella) vaccine could lead to a major outbreak in the capital.
Here, MailOnline explains how the 21-day isolation period works, how and why officials might take this step, and which areas could be at risk.
Children who haven’t had both doses of their measles jab could be excluded from school or childcare for 21 days due to rising concern over cases
NHS England data released earlier this year shows that MMR vaccine uptake is just 89.2 per cent for one dose in two year olds, and to 85.7 per cent for both jabs among five year olds
Why could unjabbed children be told to self-isolate for measles?
Health chiefs recommend that children isolate for 21 days if they come into contact with someone infected with measles, if they have not had two MMR jabs.
The aim is to stop the infection from spreading further.
Two doses is 97 per cent effective at preventing measles.
But those who are unjabbed can become infected after spending just 15 minutes with an infected person, who spreads measles by coughing or sneezing, can be enough to catch the infection.
The unjabbed infected person is then at risk of transmitting measles to other unvaccinated people and becoming severely unwell themselves.
Measles is highly contagious, health officials estimate one infected child can spread the disease to nine out of 10 unvaccinated class mates.
The 21-day isolation period covers the potential incubation period for the virus, the time between infection and first symptoms.
Such a long period is needed because people infected with measles can be contiguous, and potentially pass the infection to others before their first obvious symptoms.
How would the isolation period work in practise?
Measles is a notifiable disease in the UK.
How do the MMR vaccines work?
The MMR vaccine is a safe and effective combined vaccine.
It protects against three illnesses: measles, mumps and rubella.
The highly infectious conditions can easily spread between unvaccinated people.
The conditions can lead to serious problems including meningitis, hearing loss and problems during pregnancy.
Two doses of the MMR vaccine provide the best protection against measles, mumps and rubella.
The NHS advises anyone who has not had two doses of the MMR vaccine to ask their GP for a vaccination appointment.
Two doses of the jab protects around 99 per cent of people against measles and rubella, while around 88 per cent of people are protected against mumps.
This means that, due to the dangers it poses to public, health authorities are alerted when a case is identified.
For a case identified in a school or nursery aged child, health officials would work with the establishment to identify unvaccinated children who may have been exposed, and therefore, at greater risk of contracting and spreading the infection.
They would then assess the next steps, which can include advising the child, and any unvaccinated siblings, to isolate for next 21 days.
Health authorities may also offer an unjabbed close contact of a measles case an MMR vaccine, after getting parental consent.
They may also offer a preventive course of medication to vulnerable contacts of the child, such as pregnant women or people with compromised immune systems.
A child under a 21-day isolation period would be advised to avoid unnecessarily mingling with other children, as well as vulnerable people to reduce the risk of spreading the infection to others.
Who makes the decision?
The decision to issue the 21-day isolation guidance is made by schools with input from teams from the UK Health Security Agency.
It is understood that headteachers make the decision based on the risk a potentially infectious child could pose to the rest of school, particularly if it has a high number of unvaccinated pupils.
Other factors could be if the school has the ability to teach the child separately from the class and if there are any concerns with that pupil’s home environment.
Is the 21-day isolation period legally binding?
The isolation period is guidance, there are no penalties associated with not following it.
However, such an isolation period helps prevent the spread of measles which can be fatal, with vulnerable people especially at risk.
Officials hope anyone advised to isolate for a period due to a measles risk would follow the guidance to help protect other people.
It is unclear what would happen if a parent refused to follow the guidance and tried to take their child to school after previously being asked to keep them home.
How do I know if my child is at risk?
All children in the UK are offered two doses of the MMR jab to offer maximum protection from a trio of childhood diseases.
In the UK, the first dose is offered when a child turns one and the second dose is administered at three years and four months.
If your child has had both doses of the MMR vaccine they would not be advised to self-isolate if they came into contact with a measles case.
Some children are not able to have the MMR vaccine due to being allergic to the ingredients.
These children could be at risk of a 21-day self-isolation period, the same as a child whose parents opted out of getting them the jabs.
What is the MMR vaccine?
The MMR vaccine is a safe and effective jab that has been used since the 80s.
It protects against three diseases that can easily spread between unvaccinated people — measles, mumps and rubella.
Two doses of the MMR vaccine are enough to offer 99 per cent of people from measles and rubella and 88 per cent of people from mumps.
The MMR jab is part of series of standard childhood vaccines routinely offered to children.
Jabs like the MMR vaccine have been credited with largely banishing once common diseases that ripped through communities across the world.
What is the measles situation at the moment?
According to the latest data there were 141 cases of measles recorded in England in the first six months of 2023.
The map shows the number of measles cases per region of England in the first six months of 2023. London has been the worst hit (85), followed by the South East (12) and Yorkshire and the Humber (8)
Official data for October to December 2022 shows the areas most vulnerable to a potential measles outbreak with over a quarter of children in London missing out on the MMR jab
This is more than double the 54 cases recorded in the entirety of 2022.
Of the 2023 cases, 85 (60 per cent) were spotted in London.
Only a fifth of the cases were imported by an inbound traveller to the UK, meaning the rest were result of local community transmission.
Of total cases 58 per cent were in children under 10-years-of-age.
The rise in cases has prompted concern, given a low uptake of the MMR jabs.
At least 95 per cent of children need to get both doses of the MMR vaccine to prevent the risk of a major outbreak occurring.
However, nationally the rate only sits at about 85 per cent. The figure is much lower in some areas, particularly in the capital.
In England overall, 102,000 children aged four to five are believed to be at risk, with 32,000 of those in London.
Older children who missed out on the jabs when they were younger are also at risk.
The situation prompted health chiefs to warn that London alone is at risk of an outbreak that could hit up to 160,000 people.
Why are so many parents refusing the MMR jab for their children?
Uptake of the MMR jab collapsed in the wake of a study by the now discredited medic Andrew Wakefield, which falsely linked the vaccine to autism.
MMR uptake in England was about 91 per cent prior to Wakefield’s study being published but plummeted to 80 per cent in the aftermath.
While rates have recovered slightly, thanks concentrated efforts by health officials, experts fear a rise in anti-vax sentiment during the Covid pandemic is causing a resurgence in parents refusing to get the child a host of routine vaccinations.
Other factors, like the dangers of measles largely having faded from public memory thanks to public vaccination programmes, could also be a factor.
How dangerous is measles?
For the majority of people, a measles infection results in flu-like symptoms accompanied by the signature rash.
But it can cause very serious and even fatal health complications if it spreads to the lungs or the brain.
A fifth of children who catch measles will become so ill they need to go to hospital.
One in 15 will develop serious complications like meningitis or sepsis, which can be fatal or lead to lifelong health complications.
Despite global vaccination efforts measles still killed an estimated 128,000 people in 2021, mostly children, according to the latest data available from the World Health Organization.
My child isn’t up to date with their jabs. Should I get them?
All official health advice urges people to take up the MMR vaccine when offered.
If a child has missed a jab parents and carers can contact their GP to arrange a vaccination appointment.
Individuals who didn’t get a jab as a child can also talk to their GP to discuss getting a vaccine.
The only people who shouldn’t take the MMR vaccine are those who are at risk of an allergic reaction to some of the ingredients.
IS ANDREW WAKEFIELD’S DISCREDITED AUTISM RESEARCH TO BLAME FOR LOW MEASLES VACCINATION RATES?
In 1995, gastroenterologist Andrew Wakefield published a study in The Lancet showing children who had been vaccinated against MMR were more likely to have bowel disease and autism.
He speculated that being injected with a ‘dead’ form of the measles virus via vaccination causes disruption to intestinal tissue, leading to both of the disorders.
After a 1998 paper further confirmed this finding, Wakefield said: ‘The risk of this particular syndrome (what Wakefield termed ‘autistic enterocolitis’) developing is related to the combined vaccine, the MMR, rather than the single vaccines.’
At the time, Wakefield had a patent for single measles, mumps and rubella vaccines, and was therefore accused of having a conflict of interest.
Nonetheless, MMR vaccination rates in the US and the UK plummeted, until, in 2004, the editor of The Lancet Dr Richard Horton described Wakefield’s research as ‘fundamentally flawed’, adding he was paid by a group pursuing lawsuits against vaccine manufacturers.
The Lancet formally retracted Wakefield’s research paper in 2010.
Three months later, the General Medical Council banned Wakefield from practising medicine in Britain, stating his research had shown a ‘callous disregard’ for children’s health.
On January 6 2011, The British Medical Journal published a report showing that of the 12 children included in Wakefield’s 1995 study, at most two had autistic symptoms post vaccination, rather than the eight he claimed.
At least two of the children also had developmental delays before they were vaccinated, yet Wakefield’s paper claimed they were all ‘previously normal’.
Further findings revealed none of the children had autism, non-specific colitis or symptoms within days of receiving the MMR vaccine, yet the study claimed six of the participants suffered all three.