Research and analysis

Laboratory confirmed cases of measles, mumps and rubella, England: April to June 2014

Updated 27 February 2015

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Data presented here are for the second quarter of 2014 (i.e. April to June). Cases include those confirmed by oral fluid testing (IgM antibody tests and/or PCR) at the Virus Reference Department, Colindale and national routine laboratory reports (mumps infections only) (table 1). Analyses are by date of onset and regional breakdown figures relate to Government Office Regions.

Quarterly figures for cases confirmed by oral fluid antibody detection only from 1995 and annual total numbers of confirmed cases by region and age are available from:

0.1 Table 1. Laboratory-confirmed cases of measles, mumps and rubella and oral fluid IgM antibody tests in notified cases: weeks 14-26/2014

Table 1. Laboratory-confirmed cases of measles, mumps and rubella and oral fluid IgM antibody tests in notified cases: weeks 14 to 26, 2014

* This represents the number of infections reported as possible cases and investigated by individual PHE centres in England

1. Measles

Sixteen measles infections with onset dates in the April to June 2014 quarter were confirmed in England compared to 70 cases in the first quarter of the year [1].

Seven of the confirmed infections were identified in London with 4 cases reported from West Midlands, 3 cases the South East and one case each from Eastern and East Midlands regions. Across the UK, Scotland reported one case linked to recent travel to Vietnam but there were no measles cases reported from Wales or Northern Ireland.

Seven of the 16 English cases in the period reported a history of recent travel; 5 cases to the Far East (China and Vietnam) one each to Malawi and United Arab Emirates. Measles virus sequence was obtained from 11 out of the 16 English cases and the single Scottish case which either confirmed the importation of infection or suggested links to an importation.

Seven cases this quarter were in children aged 1 to 4 years and the remaining 9 cases were adults aged 20 to 64 years. Only one case reported previously receiving a measles-containing vaccine.

In the 12-month period July 2013 to June 2014, countries within the European Union and European Economic Area (EU/EEA) reported a total of 7,116 cases. More than three quarters of the cases were reported from three countries; the Netherlands 34.4%, Italy 30.7% and Germany 12.2%. The previously reported outbreak in the Hague, in the Netherlands is now over [1] but new outbreaks have been reported recently in Sweden and Belgium. Several outbreaks in EU Member States have a serological and epidemiological link to the large ongoing outbreak in the Philippines with 47,000 cases. Significant nosocomial transmission occurred in the three recent measles outbreaks reported from the Czech Republic, Latvia and Spain, demonstrating the continued presence of susceptible healthcare workers in EU Member States [2].

2. Mumps

There were 880 laboratory confirmed cases of mumps in England with onset in the second quarter of 2014 bringing the total number of mumps infections for the first half of the year to 1,734. This follows the trend observed over the last decade of an increase in cases in first two quarters of the year (figure) [1]. Additionally, 199 samples were confirmed from Wales this quarter bringing the Welsh total number of cases for the first half of 2014 to 349.

Cases continue to be identified predominantly in young adults between 16 and 30 years of age (647/880 74%, Table 2). Over 40% of all cases this quarter have reported receiving at least one dose of MMR vaccination in childhood, suggesting that some waning immunity may be contributing to transmission. Mumps cases were identified in all regions of England although greater numbers were identified in London, and the South East regions (table 2).

2.1 Table 2. Laboratory confirmed cases of mumps by age group and region, England: weeks 14-26/2014

Region <1 1-4 5-9 10-14 15-19 20-24 25+ Total
North East – – – – 2 4 4 10
North West – 1 – 2 15 24 31 73
Yorkshire & Humber 1 6 2 1 12 15 23 60
East Midlands – 1 1 7 37 57 26 129
West Midlands – 1 2 6 37 31 45 122
East of England – – – 3 10 21 25 59
London – 3 3 11 23 47 91 178
South East 1 2 5 7 34 54 68 171
South West – 1 – 3 18 25 31 78
Total 2 15 13 40 188 278 344 880
Laboratory confirmed cases of mumps by quarter, England, 2003 to 2014

Laboratory confirmed cases of mumps by quarter, England, 2003 to 2014

3. Rubella

This quarter, the only confirmed rubella infection was in a newborn whose unvaccinated mother was infected during pregnancy and had acquired the infection abroad.

Countries within the EU/EEA with established rubella surveillance identified very few rubella infections. The outbreak in Poland is continuing, affecting predominately young male adults consistent with the country’s selective vaccination of girls only between 1989 and 2004 [2].

4. References

  1. PHE. Laboratory confirmed cases of measles, mumps and rubella, England: January to March 2014. HPR 8(20): immunisation, http://www.hpa.org.uk/hpr/archives/2014/hpr2014.pdf.
  2. European Centre for Disease Prevention and Control (July 2014). Measles and rubella monitoring October 2013.
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