Measles outbreak 2023: Unvaccinated children forced to self-isolate for 21 days amid rapid rise in cases

Local councils have issued warnings to parents in London and its surrounding areas due to modelling that suggests a potential surge of up to 160,000 measles cases in London alone. Health officials are concerned about the low vaccination rates for the MMR (Measles, Mumps, and Rubella) vaccine, which has heightened the risk of this potentially deadly infection.

The Telegraph reported that parents were informed, through letters sent out by the councils, that if a student contracts measles, their classmates who haven't received both doses of the MMR vaccine may be required to go home and self-isolate for a period of 21 days.

The decline in MMR vaccine uptake can be traced back to the aftermath of the discredited 1998 Andrew Wakefield study that falsely linked the vaccine to autism. Although efforts were made to promote vaccination in the years following this controversy, vaccination rates have again dropped in recent years, partly due to the disruptions caused by the pandemic.

Children, particularly those at risk, have already experienced substantial interruptions in their education due to school closures and the need to self-isolate during the pandemic.

The widespread distribution of letters warning parents about the possibility of their children having to self-isolate for three weeks if they come into contact with a classmate with measles is considered an unprecedented measure.

According to data from the UK Health Security Agency (UKHSA), there were 128 measles cases in the first half of this year, compared to 54 in the entire previous year, with 66 per cent of these cases identified in London. 

Alarmingly, only 75 per cent of children in London have received both MMR vaccine doses by the age of five, in contrast to the national average of 85 per cent. The World Health Organization recommends a vaccination rate of at least 95 percent to establish herd immunity and prevent outbreaks.

The Telegraph said the letters were sent by Barnet Council, Haringey Council,  Hertfordshire County Council, among others. 

Dr Vanessa Saliba, a consultant epidemiologist at UKHSA, said: “When there are measles cases or outbreaks in nurseries or schools, the UKHSA health protection team will assess the situation, together with the school and other local partners, and provide advice for staff and pupils.

“Those who are not up to date with their MMR vaccinations will be asked to catch up urgently to help stop the outbreak and minimise disruption in schools.”

Paul Hunter, a professor in medicine at the University of East Anglia, said: “If a child is infected and there is a child in their class who isn’t immunised, there is a really high chance that the child will catch it and spread it to other unimmunised children. For children, measles is far more lethal than Covid ever was.”

What do National Measles Guidelines say about measles?

The National Measles Guidelines, published in 2019, say that susceptible contacts of someone who has it, such as unvaccinated siblings, should be advised to “self-isolate” from school during the incubation period, which can be up to 21 days.

The guidelines add that head teachers “may wish to consider excluding unvaccinated pupils who have been exposed because of the risk to other students”.

The MMR vaccine is 99 per cent effective after two doses, meaning children who had been vaccinated could still be at risk if an outbreak spread in a large school. The first dose, normally given around a child’s first birthday, gives protection of around 95 per cent.

Measles is one of the most contagious of all infectious diseases, with around nine in 10 unvaccinated people likely to develop it after close contact with a case.

Children under five, pregnant women and those with compromised immune systems are at highest risk of severe illness and complications. In the worst cases, it can cause acute encephalitis, leading to brain damage as well as respiratory problems, both of which can be fatal.