Yor child next?

[Guest guest]

Oh dear. A journalist with a guilt complex. Now who's being

hysterical?

K

http://www.timesonline.co.uk/article/0,,7-2118360,00.html

Your child next?

By Nigel Hawkes

As measles claims a teenage boy's life, public health professionals

fear a new outbreak becasue parents were panicked into rejecting MMR

Measles is back: not in regiments, but in numbers sufficient to send

a shiver down many parents' spines. There have been more confirmed

cases of the disease in the first three months of the year than in

the whole of 2005. One boy has died, the first measles death since

1992. Nine have needed hospital treatment.

Outbreaks started in the travelling community, and spread. In

Doncaster, where there had not been a case of measles in the past 12

years, 36 children are affected. Six children in Chatham, Kent, have

measles, and two have needed hospital treatment. And six nurses at

the Central Middlesex Hospital in northwest London have gone down

with the infection after looking after an ill child.

These, of course, are nothing like the numbers who used to catch

measles, once a childhood rite of passage along with mumps and

chickenpox. But today there is no excuse for any case of measles in

a child younger than 18 because there is a vaccine, offered

routinely to all children since 1988, that protects against it: MMR.

Today's measles cases, which have the potential to grow into

something much worse, are appearing because parents were frightened

by bad science, and worse journalism, into refusing to have their

children vaccinated.

The scare that linked MMR to autism was a personal crusade by a

single doctor, Dr Wakefield, based on inadequate evidence and

backed by millions of pounds of public money, pumped in by the Legal

Aid Board over nine years as it supported a case brought by parents

against the vaccine manufacturers.

Almost everybody involved now admits they were wrong: The Lancet,

which published Wakefield's paper that triggered the panic; his

colleagues at the Royal Free Hospital in London, who allowed him to

turn it into a campaign; and the Legal Services Commission, which

funded a " fishing expedition " for evidence. It admitted at the end

of 2003 that " in retrospect, it was not effective or appropriate for

the LSC to fund research " . Never mind the " in retrospect " : it was

never appropriate.

Only Dr Wakefield, who now presents himself as a victim, seems

unrepentant, together with the journalists who backed him. But the

true victims are the children who find themselves suffering an

avoidable disease as a result of their activities.

It cannot be said often enough that MMR is safe, and has always been

safe. A large number of studies attest to that. Simon Murch, one of

Wakefield's co-authors, said: " No other vaccine has ever been

studied in such depth and the evidence for its overall safety is

comprehensive. "

No other country shared the panic over MMR. It was made in Britain,

flourished here and, thank heavens, never spread. But it always had

the potential to do enormous damage. The mystery is why so many

parents were persuaded to believe that MMR caused autism or, more

implausibly still, that single vaccines for measles, mumps and

rubella would be safer for their children than the triple MMR

vaccine. There was never even a shred of evidence for this

contention.

The MMR scare is a classic example of how confidence in science is

being lost in Britain. For lack of timely defenders, and because

even rational people are deaf to reassurances in the wake of the BSE

affair, MMR became a fearful symbol of overbearing medical

authority.

Weeping parents with autistic children were paraded as if they

constituted evidence. Middle-class columnists took up the theme with

gusto, combining — as Dr Fitzpatrick, a London GP, puts it —

" a high level of emotional engagement but no specialist knowledge

of the subject " . To watch this happening and be powerless to stop it

made me angrier than anything else I can remember in 40 years of

journalism.

Sometimes, journalists need to be reminded that what they write can

have consequences. Those of us old enough to remember the whooping-

cough affair of the 1970s should have been, in a sense, inoculated

against the error. That time, a false link between whooping-cough

vaccine and brain damage caused a flight from the vaccine, a

whooping-cough epidemic, and around 100 deaths.

So far, the resurgence of measles is on nothing like so alarming a

scale, but the cause is the same. Of the first 72 cases confirmed

this year by the Health Protection Agency, the vast majority had no

vaccinations at all — hardly surprising, as at the height of the

scare MMR uptake fell in some areas to less than 80 per cent,

leaving a vast number of unvaccinated children and teenagers to act

as tinder for the outbreaks.

Two among the 72 cases had had a single MMR jab, but not the follow-

up necessary for full protection; and three had had single jabs, two

of them in South Africa. It is hardly surprising that they were not

adequately protected.

The whole point of the triple vaccine is that it minimises the

number of times mothers have to take their babies to be vaccinated,

and increases the chances that they will be fully protected. Middle-

class mums who recommended single vaccinations took no account of

the fact that this would mean six visits to the clinic instead of

two, multiplying the risk that many babies — especially those of

hard-pressed working-class mothers — would never complete the

course. Clinics offering single vaccinations did super business,

though: it's an ill wind that doesn't blow somebody some good.

How much should we worry about the outbreaks? The issue is whether

there are sufficient numbers of unvaccinated children to enable the

disease to spread. For complete protection, the World Health

Organisation recommends a vaccine uptake of 95 per cent. The UK is

significantly below that, at around 83 per cent, but there are

pockets — in London in particular — where it has fallen much lower.

Dr Ann Marie Connolly, area health director for Haringey, where the

nurses have fallen ill, gives a bleak warning: " We run the risk of

high outbreaks of measles and its developments — pneumonia, long

term brain-damage, and even death. "

Talking of the Chatham cases, Dr Mathi Chandrakumar, director of

Kent Health Protection Agency, said: " I am concerned this is the

beginning of a wider outbreak of measles in Kent. " The Health

Protection Agency said: " The agency has warned over the last few

years that outbreaks are likely in areas where uptake has been low

and particularly when it has been low for longer periods of time. "

Fortunately, MMR uptake has shown signs of increasing, though a

computer glitch in several London primary care trusts has prevented

full figures being published for the past year. We may yet escape

without cases rising into the thousands. If we do, it will be thanks

to the public health profession, and not the one to which I belong

and of which, every time I think of MMR, I feel ashamed.