title: Measles outbreak in Greater Manchester, England, October 2012 to September 2013: epidemiology and control.
abstract: This paper describes the epidemiology and management of a prolonged outbreak of measles across the 2.7 million conurbation of Greater Manchester in the United Kingdom. Over a period of one year (from October 2012 to September 2013), over a thousand suspected measles cases (n = 1,073) were notified across Greater Manchester; of these, 395 (37%) were laboratory-confirmed, 91 (8%) were classed as probable, 312 (29%) were classed as possible and 275 (26%) excluded. Most confirmed and probable cases occurred in children within two age groups—infants (too young to be eligible for measles-mumps-rubella (MMR) vaccination according to the national immunisation programme) and children aged 10-19 years (low vaccine uptake in this cohort because of unfounded alleged links between the MMR vaccine and autism). During this one year period, there were a series of local outbreaks and many of these occurred within the secondary school setting. A series of public health measures were taken to control this prolonged outbreak: setting up incident management teams to control local outbreaks, a concerted immunisation catch-up campaign (initially local then national) to reduce the pool of children partially or totally unprotected against measles, and the exclusion of close contacts from nurseries and school settings for a period of 10 days following the last exposure to a case of measles.
authors.affiliation: Health Protection Team, Greater Manchester Public Health England Centre, Public Health England, Manchester, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Pegorie
authors.forename: K
authors.initials: K
authors.lastname: Shankar
authors.forename: W S
authors.initials: WS
authors.lastname: Welfare
authors.forename: R W
authors.initials: RW
authors.lastname: Wilson
authors.forename: C
authors.initials: C
authors.lastname: Khiroya
authors.forename: G
authors.initials: G
authors.lastname: Munslow
authors.forename: D
authors.initials: D
authors.lastname: Fiefield
authors.forename: V
authors.initials: V
authors.lastname: Bothra
authors.forename: R
authors.initials: R
authors.lastname: McCann
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018563:Disease Notification; D004196:Disease Outbreaks; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007114:Immunization; D017589:Immunization Programs; D015994:Incidence; D007223:Infant; D008297:Male; D008457:Measles / Q000453:epidemiology* / Q000517:prevention & control*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage* / Q000276:immunology; D011159:Population Surveillance; D011634:Public Health
chemical_list: D022542:Measles-Mumps-Rubella Vaccine