What is measles? London remains second major national hotspot as outbreak spreads

Cases of the highly contagious disease are at their highest since the 1990s
Sian Baldwin|Ayan Omar15 February 2024

The outbreak of measles continues to spread rapidly across the country as London remains the second major national hotspot, latest figures show. 

According to data released by the UK Health Security Agency (UKHSA), 14 per cent of all measles cases recorded in England in the past week were from London.

An alarming 69 per cent of cases have been found in the West Midlands, the highest since the mid-1990s. The UKHSA  has declared the situation a “national incident”. In January, a national campaign to boost uptake of the measles vaccine was launched in England after increasing cases of the highly contagious disease.

Londoners were urged to book their children in for the MMR vaccine at a number of pop-up clinics that are being rolled out to meet the growing need for jabs.

Anyone with a child aged six to 11 will be contacted and urged to make an appointment for any missed measles, mumps and rubella (MMR) jabs.

More than one million people aged 11 to 25 in London and the West Midlands will be contacted as the scheme targets areas of low uptake.

In the last few weeks, there have been 166 confirmed cases of the disease, with 55 per cent in Birmingham, 20 cases in London, 17 in the North West, 16 in Yorkshire and the Humber, and 15 in the East Midlands. In October last year, there were 216 confirmed and 103 probable cases in the West Midlands, with the majority of those cases in Birmingham and among children aged under 10. The outbreak followed warnings that there had been a fall in uptake of the MMR vaccine since the pandemic.

The UKHSA says the cases in Birmingham “appear to be stabilising”.

Last November, NHS figures suggested that more than 3.4 million children under the age of 16 were unprotected against these diseases. 

Parents and medical professionals had been urged to be on “high alert” for measles after the vaccine rate among young children dropped to a 10-year low.

The BBC reported that at least 95 per cent of children should be double vaccinated by the age of five. However, the UK is well below that target. The UKHSA has warned that the thousands of unvaccinated children “remain at risk of serious complications or life-long disability.” London was revealed to have the lowest MMR vaccination rate last month. More than a third of children living in Hackney, Westminster, and Kensington and Chelsea have been unprotected against measles since September last year.

The latest figures from the NHS showed only 84.5 per cent had received a second shot of the MMR jab – the lowest level since 2010-11. 

So what is measles and what are the symptoms? 

What is measles?

The World Health Organization says measles is a highly contagious – and sometimes fatal disease – which remains an “important cause of death among young children”. It is a viral illness of the respiratory system, which, if left untreated, can have serious health complications including infection of the lungs and brain.

The disease can spread through contact with infected mucus and saliva. 

What are the symptoms of measles?

The NHS says the initial symptoms of measles typically develop about 10 days after the person is infected.

Symptoms include:

  • cold-like symptoms, such as a runny nose, sneezing and a cough

  • sore, red eyes that may be sensitive to light

  • a high temperature, which may reach around 40°C

  • small, greyish-white spots on the inside of cheeks.

A few days later, a red-brown blotchy rash will appear, usually starting on the head or the upper neck before spreading to the rest of the body.

How do you spot a measles rash? 

A rash will usually appear after the first few days of feeling ill. 

The NHS identifies four key characteristics of a measles rash: 

  • it is made up of small red-brown, flat, or slightly raised spots that may join together into larger blotchy patches

  • it is usually first appears on the head or neck before spreading downwards to the rest of the body

  • it is slightly itchy for some 

  • it can look similar to other childhood conditions, such as slapped cheek syndrome, roseola or rubella.

Is measles deadly?

Measles will usually pass in around seven to 10 days but, in some cases, it can lead to potentially life-threatening complications.

These include meningitis, febrile convulsions, liver infection (hepatitis), pneumonia and encephalitis (infection of the brain).

Can you get measles more than once?

Once you've developed immunity after vaccination or suffered from measles once, your body builds up a tolerance and it is unlikely you'll get measles again.

Who is most at risk of developing measles?

Unvaccinated children are most at risk of developing measles and contracting its subsequent complications. Pregnant women are also at risk.

Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected by the virus.

How can you prevent measles?

Routine measles vaccinations for children have been in use for the past 50 years.

In the UK, measles is prevented by giving the MMR vaccine. This is given in two doses as part of the NHS childhood vaccination programme.

How do you treat measles?

There is no specific antiviral treatment that exists for measles, but there are several measures you can take to help relieve your symptoms.

These include:

  • taking paracetamol or ibuprofen to soothe fever, aches and pains

  • staying hydrated by drinking plenty of water

  • keeping the curtains closed to reduce light sensitivity

  • using damp cotton wool to clean the eyes

  • taking time off work or school for at least four days when the rash first appears.

WHO also recommends that children diagnosed with measles should receive two doses of vitamin A supplements to prevent the risk of eye damage.

Who should have the MMR vaccine? 

The first dose of MMR vaccine is offered to all children at one year old. Children are given a second dose of MMR before they start school, usually at three years and four months.

There are certain circumstances where children should not have the MMR vaccination. There are more details on the NHS website.

Adults who missed out on the MMR vaccine as a baby and are therefore not immune can have the MMR vaccine on the NHS.

Is the MMR vaccine safe?

In the 1990s and 2000s, there was some controversy about whether the MMR vaccine might cause autism following a 1998 study by Dr Andrew Wakefield. This caused a dramatic drop in the number of children being vaccinated.

There was later found to be no evidence to link the MMR vaccine and autism.

While the MMR vaccine may not work for everyone and can cause side effects in some children, the vaccine is generally recognised as safe. However, deciding whether or not to get your child vaccinated is a personal choice, so make sure you speak to your GP who can best advise you.

In 2016, the WHO announced the UK had eliminated the disease because of the effectiveness of the vaccine.

When was the MMR vaccine introduced? 

The MMR vaccine was introduced as a single-dose schedule in 1988 and a two-dose schedule in 1996 with the aim of eliminating measles and rubella from the UK population. 

If you were born before that, you may have received the measles vaccine, which was introduced in the UK in 1968.

Since the MMR vaccine was introduced, the diseases have become rare in the UK.