In July this year, the UK Health Security Agency (UKHSA) issued a warning that, unless vaccination rates improve, London is at risk of a major measles outbreak.

Current MMR vaccine coverage is the lowest it has been in a decade, with about ten per cent of children not protected from measles by the time they start school. It is predicted that in some areas of the capital, this figure is as high as forty per cent. Young adults between the ages of nineteen and twenty-five are also particularly vulnerable. Referred to as the ‘Wakefield cohorts’ by UKHSA, this generation were exposed to misinformation published in the early 2000s and as a result, many were left unvaccinated. 

In a bid to mitigate risk, councils have written to households across the capital explaining the possibility of isolation requirements; Children who are identified as close contacts of a measles case, and who do not have an up-to-date vaccination record, may be required to self-isolate for up to twenty-one days. The NHS are therefore urging parents to check their children’s’ vaccination status. Records of their vaccines should be kept at their GP practice, or in their red book.

How many vaccines are needed?

Two doses of the MMR vaccine will provide lifetime immunity. In the UK, these are normally given to a child around their first birthday. The second is normally given at around the age of three and a half. If there is a risk of an outbreak, vaccines are sometimes given early. 

Should adults be worried?

Adults are also encouraged to check their vaccination status. In the first instance, in case of any doubt, you should call your GP for confirmation.  Alternatively, if you are unable to find your records, a simple blood test will be able to confirm if you are immune or not. If you were born before 1970, it is assumed you will be immune through natural infection with the disease.

Can adults receive the vaccine?

Yes. If you are unsure of your vaccination status, we would recommend a blood test to check your antibody level first. If we discover that you are not immune, you will require two vaccine doses, given a month apart. 

Book your vaccination appointment today.

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CONTINUED READING ABOUT THE UK HEALTH SECURITY AGENCY (UKHSA) “Isolation warning for London children without measles jab”

Read: Isolation warning for London children without measles jab

Parents are being urged to get their children vaccinated for measles, mumps and rubella following outbreaks of measles across Europe:

Anyone who is eligible to get vaccinated should get the MMR vaccine.

A measles outbreak across Europe has left UK officials urging parents to get their children vaccinated for measles, mumps and rubella.  As measles is highly infectious, anyone who has not received 2 doses of the MMR vaccine is at risk. Particularly those unvaccinated people travelling to countries where there are currently large outbreaks of measles.

In the first three months of this year, there have been 231 confirmed cases of measles and 795 of mumps. While Public Health England (PHE) figures showed while measles cases were lower than the 265 reported during the same period last year, they had more than doubled compared to the 97 reported between October and December. The number of mumps cases has nearly tripled compared to the 275 cases during the first three months of 2018. No new cases of rubella have been reported.

PHE has now appealed to parents to make sure their children receive the MMR vaccine when it’s offered, or to get a GP appointment booked if they missed it. Officials have also warned that not only is measles highly contagious, but it can also kill a child if they are not vaccinated. Anyone who has not received two doses of MMR vaccine is at risk of measles as it is highly contagious.

There have been 3,789 cases of measles in Europe during the first three months of this year, according to the European Centre for Disease Prevention and Control. The highest numbers were in Romania, France, Poland and Lithuania.

Advice for travellers

For all those planning to travel to Europe, make sure you are up-to-date with all currently recommended UK vaccines. This includes two doses of the MMR vaccine for protection against measles, mumps and rubella.

Anyone who is not sure if they are protected should check with their GP practice. Vaccination is usually done within your childhood vaccinations. However, the MMR vaccine is available to all adults and children who have not had their two-dose course. In some cases, the MMR vaccine can be offered to babies from six months of age. Cases such as travelling to countries where measles is common, or during an outbreak situation. Book a travel consultation with our travel nurse for advice on the best option for your children before you travel.

Head of immunisation at PHE, Dr Mary Ramsay, warned with measles outbreaks across parts of Europe, families should make sure they are vaccinated before travelling. ‘There are measles outbreaks happening across Europe so if you are planning to travel, make sure you check with your GP and catch-up if needed.’

Herd immunity

Measles elimination can only be sustained by maintaining and improving coverage of MMR vaccine in children, and by using all opportunities to catch up older children and adults who missed getting the MMR vaccine.

To achieve herd immunity for measles at least 90 to 95 per cent of the population needs to be fully protected. PHE said 94.9 per cent of eligible children aged five received their first dose of MMR in quarter 4 of 2018. However, the second dose of protection falls to 87.4 per cent for children aged five.

Fleet Street Clinic’s medical director, Dr Richard Dawood explains, ‘When the rate of vaccination in the general population falls below 95%, outbreaks occur and can easily spread, with the highest impact on those most vulnerable populations, undermining years of hard work around the world to bring measles under control.’

Vaccination against Measles, Mumps & Rubella

One dose of the MMR vaccine is about 90 to 95 per cent effective at preventing measles. Protection rises to around 99 per cent after the second dose. Two doses of MMR in a lifetime are needed for a person to be considered fully protected.

The MMR vaccine schedule:

• Two doses, to be given at least 4 weeks apart.
• If the first dose is given before 12 months of age (due to the need for early protection), this should be discounted and the child should continue to receive 2 doses as per the normal schedule.
• The vaccine is also available to all adults and children who are not up-to-date with their 2 doses.

Anyone who is not sure if they are fully vaccinated should check with their GP.

You can book all vaccination appointments online.

Travel nurse Anna takes us on a journey to Tel Aviv. A city on Israel’s Mediterranean coast steeped in history and a vibrant cultural scene. From vaccinations to sun protection follow the top tips to travel safely.

Vaccines

All travellers are advised to ensure that they are in date with their routine vaccinations. Measles outbreaks have been reported in Israel since September 2018, and there are concerns that the increase of travellers heading to Israel for Passover in mid-April could see cases rise. Travellers should ensure that they have received two doses of measles vaccination (often referred to as the MMR) prior to departure.

Other travel vaccinations to be considered are diphtheria, tetanus and polio, and Hepatitis A. Some travellers may also wish to consider vaccinations against Hepatitis B and Rabies. It is always best to discuss which vaccinations are necessary for your trip with a travel nurse.

However, vaccinations cannot protect you from many diseases and dangers in Israel, the risk can be reduced through your behaviours…

Sun

Israel lies within the sub-tropical region with a Mediterranean climate. Summer temperatures can reach 40 degrees Celsius, and even higher in the Negev desert. Don’t let the Mediterranean summer breezes deceive you and stay sun safe. Keep hydrated, wear a high factor sunscreen and avoid the suns rays between 11am-3pm when at its strongest.

Food and Water

Israel is foodie heaven but travellers should still maintain good food and water practices to avoid tummy trouble whilst away. Avoid tap water and ice made from tap water: stick to bottled water. Ensure you wash your hands thoroughly before eating and after using the toilet. Ensure all food you eat is cooked thoroughly and served straight to you. For those who would still like the freedom to eat and drink without worry, it is advisable to carry a gastro kit with you. Inside will be various medications that can assist with travellers’ diarrhoea, should it occur.

Insects

Mosquitoes and sand flies can be particularly problematic during the summer months. Not only can their bites cause irritation, but they can also spread diseases such as West Nile Fever, dengue fever and leishmaniasis. There are no specific vaccinations and preventative treatments for these diseases, and bite avoidance is the only way. Try and cover up especially between dusk and dawn, and wear a good insect repellant that contains at least 50% DEET.

See our Ultimate Bug Kit.

From Red to Dead…

From the riches of the coral seas in the red to the abyss of the dead sea, take sensible precautions when taking the plunge. The dead sea lies 413m below sea level and is actually rather tricky to swim in. Tourist usually come to float on its surface as the high salt content makes it hard to submerge. Be careful. Cover any cuts you have with waterproof plasters to avoid a sharp sting. Do not splash when in the water, as it may cause injury or irritation to your eye if it enters. If you wear contact lenses, it’s best to swap to your glasses.

You can book all vaccination appointments or travel consultations online.

By Anna Chapman |  Travel Nurse | May 2019

Measles Outbreak – What You Need to Know

The WHO has issued a warning about recent outbreaks of measles in Europe and the USA. Cases of measles have risen rapidly in recent months in Italy, Romania and most recently in US.

Measles is a highly contagious virus with potential for serious complications.

Initial symptoms can include:

• Runny nose
• High Temperature
• Spots in the mouth
• Aches and pains
• Sore eyes and swollen eyelids

A rash appears after 2-4 days which can present as blotchy spots, often starting at the head and progressing down.

Medical Advice for Measles

If you think you may be suffering from measles, or are concerned about risk of infection when travelling, please see your doctor straight away.

Travelling to areas with a risk of measles

Make sure you are up-to-date with your vaccinations before you travel, including the measles, mumps and rubella (MMR) vaccine. If your child will be travelling, the MMR can be given from 6 months of age.  If you have not had measles or if you have not had two doses of MMR, you may be at risk.  Measles is easily passed from person to person and can be a serious illness in adults as well as children. It is never too late to have the vaccine.

Call Fleet Street Clinic for medical assistance, advice on vaccinations and travel precautions on  0207 353 5678  email info@fleetstreetclinic.com or book online now. 

With summer just around the corner, many are busy shopping for essentials. Sun cream, swimwear and toiletries are more likely on the list rather than travel vaccines. Many forget to check if they are up-to-date on the recommended travel vaccines.  To make sure you get full enjoyment out of your holidays it’s important to stay safe during and after your break.

Below we have highlighted some health concerns you need to know if you are travelling this Summer:

Measles:

Throughout this year we have seen an increased rise in measles cases all over the world. The disease can be easily prevented with two doses of the safe and efficient MMR vaccine.  A review of your childhood vaccine records will indicate if you have had the MMR course or if in need of a booster or the full course. Those struggling to confirm their immunity can have a simple immunity blood test which will either confirm if they are immune or not. 

Hepatitis:

When visiting areas with poor sanitation, which can affect the water and food consumed, travellers, should consider the Hepatitis A vaccination. A safe and effective vaccination which prevents the viral infection and stop travellers falling ill whilst away. In addition to the vaccination, travellers also should take caution and ensure all food is cooked thoroughly and served hot, stick to bottled water which is sealed and avoid ice (usually tap water).

Hepatitis B is a viral infection spread by contaminated blood and bodily fluids. Examples in which travellers can be at risk are contaminated medical equipment which may be used in an emergency for example needles and syringes. Hepatitis B can also be prevented with a vaccine course before travelling.

Malaria:

Every year there are more than 200 million new cases of malaria, another preventable and treatable disease. The World Health Organizations lists 91 countries and territories at risk of malaria transmission. Preventative medication can be taken to reduce the risk of catching Malaria as there is currently no vaccination.

Infectious diarrhoea:

In about 20% of travellers with diarrhoea, more than one bug turns out to be responsible for the illness. Bugs can be caught from drinking tap water and eating uncooked food or salads washed in tap water. It can put a dampener on holiday plans and make you feel under the weather. Antibiotics can be prescribed prior to travel, in case of a severe infection. Our gastro kit is designed to help travellers who may need medication to help cases of infectious diarrhoea whilst travelling.

“There may be avoidable risks to your health depending on your overall health, destination and planned travel activities. We can assess the risks and provide you with the best travel health advice to ensure you have an enjoyable trip and return healthy.”

If you wish to discuss how to stay safe on holiday or would like more advice on what vaccinations you may need, our travel nurses can help. Book a travel consultation to discuss your needs.

Cases of measles reported in the UK

A number of cases of measles have been reported in Liverpool and Leeds. Recent outbreaks in Europe, where countries such as Romania and Italy have been affected, are believed to have caused the increase in UK cases. To date, 17 cases in Leeds and 8 cases in Liverpool have been reported.

Measles virus

Measles is a highly infectious virus which can be transmitted to anyone who is not vaccinated, most commonly to young children. To prevent outbreaks, it is recommended that 95% of the population is vaccinated.

Initial symptoms can be similar to a cold and include:

• Runny nose
• High Temperature
• Spots in the mouth
• Aches and pains
• Sore eyes and swollen eyelids

A rash appears after 2-4 days which can present as blotchy spots, often starting at the head and progressing down. MEDICAL ADVICE FOR MEASLES

If you think you may be suffering from measles, or are concerned about the risk of infection, please see your doctor straight away.

Vaccination against MEASLES

Make sure you are up-to-date with your vaccinations including the measles, mumps and rubella (MMR) vaccine. Although the NHS immunisation schedule offers the vaccine to children from 12 months of age, the MMR can be given from 6 months. If you have not had measles or if you have not had two doses of MMR, you may be at risk.  Measles is easily passed from person to person and can be a serious illness in adults as well as children. In 2012 there were 122,000 deaths worldwide caused by measles.  It is never too late to have the vaccine.

MMR Vaccination at Fleet Street Clinic

You can book an MMR vaccination online.

It’s the 30th anniversary of the MMR vaccine! To commemorate this scientific breakthrough, we wanted to share some information about the MMR vaccine and why it remains as important as ever for people, especially children, to be vaccinated. 

The MMR vaccine is a combined vaccination that protects against three highly infectious diseases: measles, mumps and rubella (german measles). All three of which can be very serious and have the potential to cause long-lasting and severe health complications such as significant hearing loss, lung infection (pneumonia), brain infection (encephalitis), viral meningitis and even death. 

Thankfully, the MMR vaccine is a highly safe and effective way of providing protection against measles, mumps and rubella. After 2 doses of the MMR vaccine, it is around 99% effective at protecting against measles and rubella and 97% effective at protecting against mumps. 

Some people may not remember but before the MMR vaccine rollout in 1988, measles, mumps and rubella were all relatively common illnesses in the UK, especially among children. It is only thanks to a successful NHS vaccination programme with support by the private healthcare sector that cases dropped drastically after this time. And while this is great, the target of 95% of babies being vaccinated is still not being met and there continues to be outbreaks among unvaccinated children and adults. As a result, there is a push from the medical community for even more adults, as well as children to be vaccinated in order to prevent such outbreaks. 

Didn’t have the vaccine as a child? That’s okay, there’s still time! It is really important to remember that it is never too late to catch up on childhood vaccinations. There is no upper age limit for receiving the MMR vaccine and so if you missed out on being immunised, it is strongly recommended that you have a “catch up” vaccine. This is especially important for anyone starting college or university, travelling abroad, planning a pregnancy or if you are a frontline health or care worker as your risk of exposure or serious health complications is increased.

As the 30th anniversary of the MMR vaccine is honoured, England’s top doctor and Chief Medical Officer (CMO), Prof Dame Sally Davies, has expressed her concerns that the uptake of the vaccine is “not good enough” and explains the dangers of children not receiving the vaccine. 

She suggests that the reason some people are not having their children vaccinated is the result of people listening to anti-vaccine propaganda “myths” and “social media fake news”. She stresses the importance of listening to the science that provides clear evidence that the MMR vaccine is both safe and effective, and has helped “save millions of lives”. 

Many of the false concerns over the MMR vaccine originated from a now-discredited study by former doctor, Andrew Wakefield, who incorrectly linked the MMR vaccine to autism back in 1998. This research has since been completely discredited and as a result, Andrew Wakefield was struck off the medical register for professional misconduct. Ever since, the medical community has worked hard to alleviate any lingering concerns over the safety of the MMR vaccine.

Our wonderful nurses at Fleet Street Clinic have been administering the MMR vaccine to our patients for over 25 years and we strongly believe in protecting all our patients with safe and effective vaccinations.

To read the full article, please click the link.  

You can book an MMR vaccination appointment online.

Measles: Don’t Get Caught Out

Cases of measles have risen rapidly in recent months in Europe, United Kingdom but most recently, Brazil. Measles is a highly contagious virus with potential for serious complications. It is a serious viral infection, spread by airborne droplets and is highly infectious. It is recommended that two doses of the measles vaccination should be given to individuals to prevent infection. Although many countries include the vaccination as part of the routine childhood immunisation schedule, international travellers should check that they are immune before departure.

Most UK citizens will have immunity in one of two ways:

Natural immunity can be assumed for those born before 1970, where individuals would have been exposed to the infection naturally.

Having received two doses of vaccination against measles. The vaccination was introduced in 1970 and is usually given in combination with rubella and mumps as the MMR vaccine.

Initial symptoms can include:

• Runny nose
• High Temperature
• Spots in the mouth
• Aches and pains
• Sore eyes and swollen eyelids

A rash appears after 2-4 days which can present as blotchy spots, often starting at the head and progressing down.

Advice for Adults

If you are in doubt about whether you have immunity to measles, a simple blood test can be taken to determine your immunity status. If you have no immunity to measles, you can be offered the MMR vaccination.

Advice for Children

Infants normally receive the MMR vaccination at 13 months old, as part of the national schedule. However, if you are travelling to a country where there is a significant risk of infection, the vaccination can be given to infants from 6 months.

Medical Advice

If you think you may be suffering from measles, or are concerned about the risk of infection when travelling, please see your doctor straight away.

The Fleet Street Clinic stocks travel sickness medication, travel vaccines and medical travel kits. Our experienced travel clinic nurses can help advise with any queries or more information on Measles.

Fleet Street Travel Clinic

Health Risks of European Travel

How many of us know that European travel can pose a threat to our health?  Health risks aren’t normally associated with European travel – we think of quick flights and familiar cultures so assume we’ll be relatively safe on short-haul holidays. However, there are actually several diseases to watch out for, especially if you are not vaccinated.

Stay aware of these key diseases so that you can prepare properly to have a safe and happy holiday.

Four illnesses to be aware of when holidaying in Europe:

1. Measles

• Measles continues to spread within and throughout Europe this year. Large outbreaks of the disease have occurred, and it is thought that the drop in vaccination coverage within populations is responsible. Countries that are currently reporting outbreaks of measles include: AUSTRIA, BELGIUM, BULGARIA, CZECH REPUBLIC, FRANCE, GERMANY, HUNGARY, ICELAND, ITALY, PORTUGAL, ROMANIA SPAIN, SWEDEN.
• Measles is a highly contagious virus which can have life-threatening complications.
• International travel has played a large factor in the international spread of measles.

2. Tick-Borne Encephalitis (TBE)

• TBE season has begun in Europe this summer. TBE is a viral infection spread through the infected bite of a tick.
• TBE effects areas of northern and Eastern Europe, Russia and even China.
• Those at highest risk of the diseases are those that intend to spend time in rural forested areas during spring summer and autumn where ticks are present. Activities such as camping and hiking and cycling increase the risk.
• Those who are travelling to areas of transmission can minimise the risk of the disease by taking strict precautions against tick bites.

3. Hepatitis A

• Europe has seen an increase in Hepatitis A cases this year. The virus is spread through contaminated food and water.
• The highest risk countries are those in Eastern Europe, the Baltics, the Balkans and Turkey, but in recent months Germany and Portugal have seen an increase in cases.

4. Rabies

• Rabies is virus-spread through the bite of an infected mammal. The virus is almost always fatal if left untreated. Animals that can spread this disease include dogs, cats, bats, foxes and wolves.
• Eastern Europe poses the highest risk of rabies in Europe.
• Travellers at highest risk include those who plan on travelling to remote areas.

Vaccines can prevent travel-related illnesses

The good news is that all these diseases are vaccine preventable and can be avoided by organising vaccines before you travel.

Measles – All travellers should ensure that they have had at least 2 doses of vaccinations against measles. This is usually given as a routine vaccination in childhood (MMR vaccine) at 1 year of age, and then again as a pre-school booster

Tick-Borne Encephalitis – vaccination against the disease is available for individuals aged 1 year and above. It requires 2 vaccination 2 weeks apart.

Hepatitis A – A highly effective vaccination is available against Hepatitis A and can be given to children from 1 year of age. Once the schedule of 2 Hepatitis A vaccinations has been given, immunity lasts for 25 years.

Rabies – a vaccine-preventable disease which requires three doses of vaccination to be given prior to departure. Those who have not received the vaccination with potential exposure to rabies require more extensive treatment which is not always accessible.

Travel Vaccinations at Fleet Street Clinic

Fleet Street Clinic is a leading vaccination centre and offers all travel vaccinations at our clinic in the heart of London.

Book your appointment online today.

By Anna Chapman, Travel Nurse at Fleet Street Clinic

Measles on the rise:

The World Health Organisation (WHO), has reported that measles cases are on the rise worldwide and in Europe alone, outbreaks have surged to a 20-year high.

The WHO states that reported measles cases (provided by each country) currently show that about 229,000 cases have already been reported, compared with 170,000 for 2017. Worryingly the 2018 number is likely to rise as the reporting deadline ends April ’19.

With a 50% increase in measles cases last year, it is important to understand the benefits of vaccinating against measles:

Dr Richard Dawood, our Medical Director explains;

“I recently heard about a patient suffering a bad attack of shingles. She didn’t believe in doctors, medicines or vaccines, I was told, and was languishing at home, with a dreadful, crusted rash across her body, and burning with pain. She had stuck to her beliefs and refused to take antiviral medication that could have aborted the attack or reduced the probability of ending up with long term nerve damage and lingering pain. Shingles can strike more than once, but since she doesn’t believe in vaccines (there is a good one that is 95% effective) she will have to take her chances of a recurrence in future. I disagree with her opinions, but her latest actions will harm nobody but herself.

But measles is different: when it comes to vaccination, personal choices and opinions have a direct impact on the health and wellbeing of others – individually as well as for entire communities. Measles vaccination is a major public health issue. Memories of the past outbreaks, epidemics, tragic disability and loss of life that drove research and ground-breaking vaccine development now belong to a previous generation. In these days of “fake news”, “influencers” and social networks, it has become too easy to undermine confidence in matters of public health. In the case of measles, concerns about vaccine safety are down to the “fake research” of Andrew Wakefield, who was struck off the medical register for concocting a spurious link with autism in the 1990s. But the damage was long-lasting.

The complications of measles are most severe in babies who are not yet old enough to be vaccinated, and children with reduced immunity. When the rate of vaccination in the general population falls below 95%, outbreaks occur and can easily spread, with the highest impact on those most vulnerable populations, undermining years of hard work around the world to bring measles under control.

That is what is happening now”.