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Time for GPs to strive for greater fulfilment

Susceptibility to measles is soaring among nursery-age children, Health Protection Scotland researchers report.

Their study found an eight-fold increase in the number of areas with over 20 per cent susceptibility, prompting new warnings on the danger of measles outbreaks.

Paediatric specialists said the study suggested catch-up campaigns might be needed in schoolchildren outside London, where a campaign is already under way.

The study examined susceptibility in Scottish children aged 2.5 to 4.5 and found it rose significantly between 1998 and 2003, from 13 to 16 per cent. Particularly worrying was the rise in areas where over a fifth of children were susceptible, from just three postal regions to 25 over the time period.

The researchers said the rise in susceptibility, and particularly of high-risk clusters, was 'concerning'. They added: 'This situation is unlikely to improve, as MMR uptake among younger children is not increasing significantly. It will also lead to higher susceptibility in primary schools in future, as relatively few children are vaccinated after the age of two.'

Dr David Elliman, a consultant in community child health at Islington PCT and Great Ormond Street Hospital, said: 'If you have poor uptake then more concerted campaigns may well be appropriate. You can't just sit back.'

He urged GPs and health professionals to 'beef up' routine immunisation by 'chasing defaulters and immunising opportunistically'.

Professor Adam Finn, professor of paediatrics at the University of Bristol, warned: 'If you get sufficiently high numbers you only need one case and all susceptible children will get it. Then you will get significant cases and deaths.'

Dr George Kassianos, RCGP immunisation spokes-person, said the study suggested there was a risk of local measles outbreaks. He warned that MMR uptake would need to rise to 95 per cent to properly protect populations.

The study examined vaccination records of more than a million children between 1987 and 2003. It was presented at last month's European Society for Paediatric Infectious Diseases conference in Valencia.

By Nerys Hairon

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