Measles outbreak: child dies in Liverpool as vaccine rate plunges
The child died in Alder Hey Children's Hospital in Liverpool, a city in the grip of an outbreak of the disease. They were in the intensive care unit and, while no details have been released about their care, it is understood they were severely ill with measles as well as other serious health problems.
The child is the first to have succumbed to an acute measles infection in Britain this decade. Their age and gender are not known, but they were one of 17 youngsters treated at the hospital in recent weeks after becoming severely unwell with measles.
Infections are increasing across Britain as low vaccination rates leave children vulnerable to the virus. It is not known whether the child who died had been vaccinated, but experts said that the jab provided 97 per cent protection against getting ill.
The MMR vaccination uptake rate for children by the age of five in Liverpool is just 73 per cent, significantly lower than the average across the northwest, 86 per cent, and the whole of England at 84 per cent. It is the lowest uptake outside of London. The World Health Organisation says a threshold of 95 per cent is needed to achieve herd immunity.
The number of children being treated at Alder Hey has public health officials worried that the virus could take hold in the city and 'spread like wildfire'. The number could mean there are more infections than are officially reported and suggests Merseyside is on the cusp of a significant large-scale outbreak.
Measles is highly contagious. An infected person remains infectious for up to ten days and could spread the virus to 15 people. With Liverpool's low vaccine uptake, this could mean approximately 288 people in every 1,000 across the region are at risk.
Last week, public health officials wrote an open letter to parents in the region, urging them to get their children vaccinated.
Professor Matt Ashton, director of public health for Liverpool, said: 'I'm extremely worried that the potential is there for measles to really grab hold in our community. My concern is the unprotected population and it spreading like wildfire.
'That's why we're trying to be proactive. It's really important that people understand the seriousness of this.
'We're not in a large-scale outbreak situation at the moment but what we are seeing is sporadic cases popping up more and more frequently, to the point where Alder Hey is really worried about the people presenting at the front door and needing treatment.'
Matt Ashton, director of public health for Liverpool, said more needed to be done to make it easier for people to get the jabs
Alder Hey Hospital, the local NHS and public health teams in Liverpool and Merseyside are co-ordinating a response to the increase in measles cases, trying to alert families to the risks and help parents get their children vaccinated.
As part of this, Alder Hey has begun vaccinating children in its A&E department who may have missed out on the jab and are being treated for other reasons. Its experts are drawing up advice for other hospitals to follow its lead in responding to rising cases. Across Merseyside a series of summer catch-up vaccination clinics have been organised, as well as a public health bus that will go out into communities.
Rachel Isba, a consultant in paediatric public health medicine at Alder Hey, said sufferers needing hospital treatment was a 'canary in the coalmine as to what's going on in the community'. She feared that many more cases are going unreported.
'It's concerning that [patients] are so unwell they require hospital treatment,' she said. 'What's happening during this episode is that more of them are more unwell and needing more treatment in hospital, which for me, doing this for more than 20 years, stands out. I think it is why Alder Hey has sounded the alarm, because it is so serious.'
A major outbreak in Birmingham and London contributed to 2,911 measles cases in England last year, the highest number since 2012.
So far this year there have been 529 confirmed cases, with 109 in the month to July 3. The majority, 357, were children under ten. In the past two months, several seriously ill children have been admitted to St Mary's hospital in Paddington, London. One had to be treated in intensive care.
According to the UK Health Security Agency, which is responsible for Britain's response to public health risks such as infectious disease, there have been 64 laboratory-confirmed cases of measles in the northwest since the start of the year. But the region's share of new cases is rising: in the month to July 3 it accounted for nearly a quarter of all new cases across England.
Measles can infect anyone at any age but can be particularly dangerous for children under one and those with conditions such as cancer. Initial symptoms can be a runny nose, sneezing and coughing, followed by fever. Measles can also cause red, sore eyes, followed by a rash on the face spreading to the rest of the body.
It can also weaken the immune system, leading to pneumonia, and in the most severe cases it can trigger encephalitis — swelling of the brain. It can also infect the central nervous system over many years to cause subacute sclerosing panencephalitis, or SSPE.
Since 2020, there have been seven SSPE deaths recorded, including six adults and one child. In 2023 Renae Archer died aged ten from measles complications caused by an infection she had contracted at the age of one — before she could be vaccinated.
Her mother, Rebecca, last year urged parents to get the MMR jab to protect children like her daughter who are too young to be vaccinated. She said: 'If there wasn't an outbreak and more kids had their vaccinations, then she wouldn't have got the measles in the first place. And it wouldn't have ultimately ended her life.'
Last month The Sunday Times highlighted that childhood vaccination rates nationally had slumped to their lowest levels for ten years, well below the 95 per cent threshold for herd immunity set by the World Health Organisation.
Ashton said: 'The message is quite straightforward. If you're in any doubt, contact your GP and check the MMR status of you or your loved ones. Immunisation is available through primary care.'
He said the reasons behind not having children vaccinated was complex and that more needed to be done to make it easier for people to get their jabs and to have conversations with medical professionals. The approach had to be to emphasise the threat of measles, rather than lecture on vaccines.
'We know from our insights and our behavioural research that people respond to something that's quite specific,' he said. 'Our focus is to highlight to the community that measles is a very nasty virus, and seeing your child with measles is horrid.'
With the summer holidays approaching, the fear is not only of infections spreading locally but also new infections being seeded into communities when people return from holiday.
Isba said: 'We in the UK are not alone in having measles. It's an issue in Texas and other bits of the United States. There's measles across Europe.' Two unvaccinated children have died in Texas and 98 patients are in hospital as of July 8.
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According to the Johns Hopkins US Measles Tracker, 1,283 cases have been reported to July 8, the highest level since 1992.
'If you're not vaccinated and you get exposed to measles you've got a 90 per cent chance of getting it, and it can cause acute but also long-term conditions that last for decades. It's a really nasty virus,' Isba said.
Children are vaccinated after their first birthday and then again at 18 months. The second dose used to be given at the age of three but has been brought forward from this month to try and ensure maximum protection. After one dose, 93 out of 100 people will be protected; after two doses this rises to 97 out of 100.
The offer of a measles vaccination is not restricted, and anyone can request a jab if they missed out on one as a child. People should contact their GP in the first instance.
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