Episode Transcript
[00:00:03] Speaker A: Hello and welcome to season seven of a Wonder Care podcast. My name is Sheena Mitchell. I'm a pharmacist, mum of three, and I am passionate about providing you with lots of health information to keep you and your family healthy all year round. I truly believe that knowledge is power, and in a time where our health service is struggling to cope with demand, I think it's more important now than ever.
[00:00:28] Speaker B: I've spoken about measles before, but I feel it's really, really important to give you an update. To do that, I need to explain a little bit about what's going on in the world and how close to home it's getting. So in the year 2000 in America, they declared measles to be eliminated. With this, they meant that measles was no longer constantly present in the country. And over the period of December to January, just gone that we're in, they've had eight cases in Philadelphia, and cases have also been identified in Delaware, New Jersey and Washington state. In the USA, they had the WHO recommended vaccine uptake of over 95% every year up until 2020, when the pandemic hit. However, in 2021, it was down to 94%, and in the school year 22 to 23, it dropped to 93%. I'm telling you this because in America, the consequences of falling below 95% of children vaccinated with the MMR are starting to become apparent. So if we bring it a little bit closer to home, the UK, our closest neighbors, their vaccination rate has dropped to 85%. This is 10% lower than the World Health Organization's recommendation to keep control over measles. There was 1603 cases of measles in England and Wales in 2023. This is a sharp increase from 735 in 2022 and 360 in 2021. So what's happening in Ireland? Well, I suppose we can't expect trends to be any different here. In 2023, uptake for the two doses of MMOR was less than 90%. So we know that around 10% of children born between 2016 and 2021 are missing both or one vaccinations. To maintain measles immunity in our communities, the World Health Organization strongly recommend an uptake of over 95%. Clearly, at less than 90%, we are falling significantly below that target, and the evidence is starting to become apparent here. Also, in August 2023, the HPSC in Ireland reported a small number of cases. This was the first outbreak since 2019. The World Health Organization european region reported over 30,000 measles cases between January and October 2023. This is 30 times higher than the 941 cases reported in 2022, just the year before. The key point I'm making is that where vaccinations are missed, outbreaks can follow. These outbreaks affect both the young and the old. Of the cases in Europe, two in five were among children one to four years of age. One in five cases were in adults 20 years or over. 918 of these cases were hospitalized. So why is measles so dangerous? And what can we do to try and prevent imminent outbreaks? That's what I'll be explaining in this episode, as well as describing the signs and symptoms and chatting about the MMR vaccine itself.
[00:03:33] Speaker A: Measles is a highly contagious, serious airborne disease caused by a virus that can lead to severe complications and death. Measles is not just a little rash, of course. Common symptoms typically include a high fever, which can go right up to 40.5 degrees celsius, a cough, runny nose, red watery eyes, and the rash, which breaks out three to five days after the symptoms begin. But the statistics to show that it can be serious are genuinely frightening. Around one in four people who get measles will be hospitalized. One in 1000 cases will develop brain swelling due to infection called encephalitis, which can lead to brain damage. One or two out of every 1000 people who get measles will die, even with the best possible care. These are really scary statistics for a preventable disease. Some more statistics which aren't really any more reassuring are that seven to nine out of 100 children will develop an ear infection with measles that can result in hearing loss. Eight out of 100 will get diarrhea. One to six out of every hundred will get pneumonia, which is the most common cause of death from measles in children. Measles can also cause the destruction of the cornea, which is the outer layer of the eyeball. This can lead to blindness. And finally, several years after having and recovering from measles, a rare but fatal brain complication can occur called subacute sclerosing panencephalitis. It really is a lot and something that we haven't had to be aware of because measles wasn't circulating and that is down to a global uptake of the mmor.
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[00:05:51] Speaker A: Okay, as parents, we obviously want to be aware of the symptoms and what to look out for. On top of the regular flulike symptoms of fever, runny nose, dry cough, sneezing, sore eyes, your child may develop small white or blue gray spots in their mouth and throat. These are known as coplex spots. These spots usually are present before the typical skin rash occurs. I'll put some photos on my instagram so that you can see what they look like, and I'll save a measles highlight so that you can reference it anytime you need. The skin rash typically appears two to four days after the initial symptoms occur, and it can last for up to about eight days. It can be hard to differentiate measles rash from other childhood rashes, but it does usually start at the top of the head and works its way down the body. It often starts as small spots which quickly get bigger and then join together. I'll post a selection of measles pictures in my highlights. If you suspect measles at all, it is essential that you contact your gp. Of course. In the meanwhile, fever and routine symptoms of measles can be treated like a flu, using paracetamol and ibuprofen as appropriate for your child. Dry cough remedies can be given depending on your child's age and a big priority is to ensure that they remain hydrated. I'll cover dehydration in an upcoming podcast episode. Whilst of course treating the symptoms is sensible, it is crucial to contact your GP because they'll be able to monitor your child for complications. The people who are most susceptible to measles and its complications are children under one year of age, pregnant women and people with immunodeficiency. Okay, it's time to talk about the vaccine.
The MMR vaccine was introduced in 1963. At that time, measles epidemics occurred every two to three years and globally caused an estimated 2.6 million deaths every year. We are lucky to have a safe and cost effective vaccine at our disposal, provided for free under the state immunisation program. There is no doubt that every parent wants to keep their child safe and the MMR is the safest way to do this.
[00:07:58] Speaker B: Due to the dwindling numbers of children who have received two MMR vaccines in Ireland, the HSC are running a catch up vaccination campaign. Any child between 14 months and ten years inclusive who has not completed their two dose schedule, can get free vaccination from their GP. If you're unsure if your child received the second dose, they should get it now, on the catch up vaccine program. A third dose is much safer than being unsure if they got their second. I know in my own house, one of my kids was in junior infants during the pandemic, and that kind of cohort would normally have received their second dose while in school, and they obviously weren't in school. So I do remember we had to bring him to a public health office and get it done. So no one's basically judging you if you can't remember if they had the second dose. Because of all of the absenteeism throughout the last few years from school, it's very hard to know whether they got it or not. So if you're unsure and you can't find any record of it, then just wanted to say that it is actually safer to get an additional dose than not to receive that dose at all.
[00:09:03] Speaker A: The measles vaccine was introduced in Ireland in 1985. The number of cases dropped from 10,000 that year to 201 only two years later in 1987. These vaccines are really effective. So some more information and facts about vaccination. Children should be vaccinated at twelve months of age, and again in primary school or at their GP at four to five years of age. I did receive questions about whether your child will be considered vaccinated after their first dose, and yes, they will. But to maintain a high effective level of immunization, they do need to receive that second dose, or else the efficacy of their vaccine will not be maintained. So if your child received one, but not both vaccinations, they should receive the second one as soon as possible. It is never too late to be vaccinated for measles. In the past, some kids missed out on vaccination due to an egg allergy, but now we know how rare a reaction is and it actually can be given to children even if they have a severe egg allergy. You just have to flag it to your doctor or nurse. There was a huge amount of serious misinformation in the late 1990s about a link between the MMR and autism. This has been completely disproven. It is wrong information, but as a result of that, there may be adults out there who are aged 20 to 25 who have not been vaccinated. So I'd urge any of those to check with their GP. Obviously, this is a choice your parents would have made, not you as an infant. So you can check back in with your parents as well. Please be reassured that extensive research involving over half a million children showed that levels of autism are unchanged by vaccination status. In fact, Dr. Wakefield, who made the false claims and representations between the link of the vaccine and autism, was struck off the medical council as a result in 2010. So the reality is that with all vaccinations, minor side effects can sometimes occur. Examples of these are discomfort or redness at the injection site that affects around one in ten kids, and a rash can occur in about one in 20 kids after the measles vaccine. Indeed, this happened to my own children after vaccination. It's important to know that this goes away by itself within six to twelve days and it is not contagious. One in 20 kids may experience swollen glands or joint pains after vaccination. When you compare these risks to the risks that measles itself bring these pale into insignificance I really don't want to sound like a scare merchant, it's just that measles outbreaks are currently happening in Europe and our vaccination rate has dropped about 3% in the last few years. This is probably most likely due to the pandemic, and I just wanted to paint a picture of the bigger view and highlight that now is a good time to check over your vaccination records and to make informed decisions. I really hope that you found this episode helpful. I'd be delighted if you could give us a little review on Apple Podcasts or Spotify and feedback course is always welcome. In addition to any questions you may have by contacting me through Instagram and you can find me atcare iRL. Thank you so much for listening. I'll talk to you again soon.
