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Plunging MMR uptake leaves UK close to endemic measles

Crashing MMR uptake means measles is fast approaching the point where it will become endemic in the UK, warns a team that includes researchers from the Government's Health Pro- tection Agency.

But the researchers played down a highly publicised warning based on their paper, from one of the experts at the centre of the MMR scare, that Britain is heading for major epidemics this winter.

The study found the reproductive number of measles outbreaks in the UK ­ used to predict the fate of a measles epidemic ­ has almost doubled in four years because of declining MMR uptake. Between 1999 and 2002 the reproductive number has fast approached one, the point where each measles case infects one other person, leaving the situation 'close' to a critical point.

Researchers, including scientists from the University of London, concluded in the paper in Science: 'If the current low level of MMR vaccine uptake persists in the UK population, the increasing number of unvaccinated individuals will lead to an increase in the reproductive number and possibly the re-establishment of endemic measles and accom- panying mortality.'

But Dr Mary Ramsay, co-author of the paper and consultant epidemiologist at the HPA, disputed claims in The Lancet earlier this month that Britain will face a measles epidemic this winter.

Dr Simon Murch, co-

author of the original Lancet study in 1998 suggesting a link between MMR and autism, claimed in a letter to the journal that 'major measles epidemics are likely in the UK this winter'.

Dr Murch, a paediatric gastroenterologist at the Royal Free and University College medical school, added that 'low MMR uptake has left the UK on the edge of major measles outbreaks'.

Meanwhile, research published in the Journal of Epidemiology and Community Health (November), based on 20 years of hospital records, found the measles vaccine does not cause Crohn's disease or ulcerative colitis.

Researchers from the University of Oxford hypothesised that if the measles vaccine was a cause of these diseases its introduction in 1968 would have led to a marked increase in the diseases in those people offered the vaccine as infants.

But hospital data showed the incidence of hospitalised Crohn's disease and ulcerative colitis showed no significant increase over the 20-year

period.

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