Clusters of measles cases are now starting to be seen in other regions, following the initial outbreaks in the West Midlands, the UK Health Security Agency (UKHSA) has warned.

In an update sent last week, UKHSA reported a further 56 laboratory-confirmed measles cases in England, compared to 118 cases confirmed in the previous two weeks.

Since 1 October in England there have been 521 laboratory confirmed measles cases. Of these, 17 cases were reported in October, 42 in November, 160 in December 2023, 252 in January and 50 so far in February 2024.

And ‘although the initial outbreak in the West Midlands has driven the increase in cases, we are now starting to see clusters of cases in other regions,’ UKHSA’s update said.

In all, 69% (358 of 521) of the total number of cases have been in the West Midlands, 14% (71 of 521) in London and 7% (37 of 521) in Yorkshire and the Humber. The remaining cases were reported in other regions of England, according to the update.

In the four weeks since 15 January 2024, there have been 166 laboratory confirmed measles cases. The West Midlands accounted for the majority of these (55%, 91/166), mostly in Birmingham, although case numbers in that region ‘appear to be stabilising’, UKHSA said.

Elsewhere, 12% (20/166) of cases have been in London, 10% (17/166) in the North West, 10% in Yorkshire and The Humber (16/166) and 9% (15/166) in the East Midlands.

Dr Vanessa Saliba, UKHSA consultant epidemiologist, said: ‘As expected, due to worryingly low MMR vaccine uptake in some areas across the country, we are now starting to see clusters of cases in other regions.

‘While parents are coming forward to take up the offer of the MMR vaccine for their children, there are still 100s of thousands of children who remain unprotected and therefore remain at risk of serious complications or life-long disability.

‘But measles is completely preventable with vaccination. I strongly urge parents to take up the offer of the MMR vaccine now to make sure their child is protected.’

UKHSA added that these case numbers are provisional and likely to go up once more undergo confirmatory testing.

The measles outbreak was declared a national incident in January as top health officials warned that the virus would spread ‘rapidly’ to other areas without ‘urgent action’. 

And fresh calls were made for community pharmacies to become the ‘first port of call’ for vaccination programmes.

GPs have been asked to deliver a catch-up MMR vaccination programme for children aged between 12 months and five years, and in response to recent outbreaks, NHS England launched a campaign this month for children aged six to 11 who still require the vaccine.

NHS England advised healthcare professionals to wear PPE when dealing with suspected measles cases.

Dr David Elliman, community paediatrician at Great Ormond Street Hospital, said: ‘The continuing rise in cases and the spread to other areas of the country is worrying.  Hopefully the efforts of the already hard pressed NHS will result in large numbers of unvaccinated children catching up.

‘It would be a pity if we began to see deaths from measles, such as the sad death in the Republic of Ireland.’

MMR uptake rates lowest for over a decade

In September, UKHSA said it was ‘seriously concerned’ about an ongoing downward trend in uptake of childhood vaccines.

The agency’s annual figures showed that in England MMR vaccine uptake for first and second doses by five years has fallen to the lowest rates since 2010/11.

European countries saw a 30-fold rise in measles cases last year amid declining vaccination coverage, according to the World Health Organization (WHO).

Last week NHSE said it was launching 12 ‘demonstrator sites’ to test ‘new and innovative’ models of vaccination delivery, after a health and social care committee inquiry last year suggested that moving vaccinations away from GPs into other settings such as community pharmacies would boost uptake.

This article first appeared on our sister site Pulse.