Measles In The Mountains

Posted by Jeremy Windsor on Sep 20, 2018

Earlier this year I spoke to a retired GP who recalled a consultation with two siblings who'd recently returned from a family walking holiday in the Caucusus mountains. Both children presented with a high fever and flu-like symptoms. A few Koplik spots were seen in the mouth. A bright red rash was visible across the head, trunk and limbs. The diagnosis of measles was confirmed with a blood test. The eldest recovered quickly and soon returned to school. However the younger sibling developed breathing difficulties and was admitted to hospital where he was successfully treated for pneumonia. 

Koplik Spots - distinctive white spots sometimes seen during the early stages of measles. They are found on the buccal mucosa opposite the first and second upper molars. 

According to the WHO, there were 41,000 cases of measles reported across Europe in the first half of 2018. This was up from 24,000 cases for the whole of 2017. More than half of this year's cases were reported in countries that had been part of the former Soviet Union. In England there have been 828 cases confirmed across the country with 291 occurring in London alone. Whilst there will be many reasons for this increase, the success or failure of a vaccination programme is likely to play a crucial part. As Mark Muscat, medical officer for vaccine preventable diseases at WHO Europe, wrote, "this disease could be totally prevented by two doses of MMR vaccine". In England the MMR vaccination rate has fallen for the third year in a row and in 2016-17 stood at 91.6%. According to the WHO, herd immunity can only be maintained if 95% of the population are vaccinated. If the MMR vaccination rate continues to fall we are likely to see a significant increase in the number of measles cases in the future.

Were the two children vaccinated against measles? No. 


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