ALTHOUGH previously declared measles free by the World Health Organisation, the UK experienced an outbreak of the disease in 2018, with 913 confirmed cases, compared to 259 in 2017.

The majority of these were in those who had not received two courses of the MMR vaccination. One third needed admitting to hospital. Across Europe as a whole, there were 41,000 cases and sadly 37 deaths in the first six months of 2018, the highest figures in the last decade.

Measles is a viral illness, contained in the nose and throat of infected individuals. It is spread by coughing and sneezing. It also remains active outside the body for two hours, so can be caught by touching door handles and other contaminated surfaces. It is highly contagious; if 100 non-immunised people were exposed to measles, 90 would catch it.

The illness starts like most viral conditions with a general feeling of being unwell. Grey white spots develop in the mouth in 2-3 days, followed by a red blotchy rash, starting at the head and working its way down. This turns brownish before fading. Those who are strong enough to fight the disease may start to feel better after a week to ten days. As the body forms antibodies against measles, you are then immune and a second infection is very rare.

However, in those whose immune systems are not fully developed, namely children under five, or individuals with another major illness, complications can range from pneumonia to inflammation of the brain (encephalitis). These can be fatal. A rare complication of measles is Subacute Sclerosing Panencephalitis (SSPE), which develops many years after the initial infection, yet causes progressive and devastating destruction of the person’s nervous system.

A vaccination programme has existed since 1968, and its uptake has demonstrably saved millions of lives in the last five decades. The current UK vaccination schedule provides immunisation against Measles, Mumps and Rubella combined, in two injections, one at 12-13 months of age and another at 3 years and 4 months. It is entirely free, yet it is not compulsory unlike in some other countries, for example the United States.

Several reasons exist as to the drop off in vaccination uptake, including research linking it to autism and bowel disease, which has since been completely discredited. At the same time, fewer people today in developed nations will have had first-hand experience of measles.

There are not many reasons why your child, or indeed you yourself shouldn’t be immunised, if you haven’t been already. Life threatening allergic reaction to any of the components is the strongest reason, and if you are pregnant you should wait until after delivery. Attempting to acquire immunity naturally is more risky than getting vaccinated with a greater risk of developing complications. Success of a vaccination programme also requires a high uptake, with an estimated 95 per cent needed to cover those who cannot be immunised. If you are unsure about your child having the MMR vaccination, please discuss this with your GP rather than ignoring the matter.

Ask Dr Zak

Question: I passed some dark blood from my bottom a few weeks ago, which made me worried. I haven’t had any since. My GP put me on a stomach tablet some time ago, but I stopped it a few months back – Anton, 39

Answer: What you are describing sounds like melanea, the medical term for digested blood, which comes out looking dark and is often described as “tarry”. The cause of this is bleeding from high up in your gastrointestinal tract, usually the stomach. This may be due to excess acid in the stomach, hence your GP prescribing medication. The blood then gets digested on the way down and is a different colour from a haemorrhoidal bleeding, which is usually bright red. It is important to see your GP as soon as possible to discuss your symptoms. If you get the same type of bowel motion again, I would advise you to attend A+E immediately as a small bleed sometimes comes before a large bleed.

Question: I always spend the Christmas period going from one hangover to the next. Come January I feel absolutely awful. Is there anything you can suggest? - Jessica, 32

Answer: While we all like to get into the festive season, and certainly there will be more of a reason to indulge, the question may remain – do you actually need to drink? If there is no expectation, you may still get the same pleasure out of the event without alcohol. If alcohol is “essential”, set yourself a limit with which you feel comfortable. You will know your own alcohol tolerance. Try to avoid buying rounds in big groups. Having something non-alcoholic as every other drink may help. Please beware that after a heavy night you can still be over the limit the next morning, at a point in the year when police are particularly vigilant to road users.

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Dr Uddin’s advice is provided in good faith and in accordance with currently accepted evidence. However, this content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always seek the advice of a GP, or other qualified health provider, regarding a medical condition.