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Andrew Wakefield’s legacy

I hadn’t been planning on doing any serious pieces to intersperse within the reruns of old posts while on vacation. Despite the impression some have gotten from my Random Observations posts about London and Britain, we’ve had an absolutely wonderful time the last week and are sorry to see it end. (Although I understand that I might have ruffled a few feathers when I complained about restaurant service, who would have thought that a post about how polite and friendly Londoners seem to us or an intentionally silly post about our failure to have seen any squirrels in London would have ruffled a few feathers? I’m particularly puzzled at some of the reaction to the latter post, although I will point out that we have still not seen any squirrels. Perhaps we should go to Hyde Park and hang out a while as suggested. Over the three day holiday weekend, perhaps I’ll describe some of the great things we saw and did while in London. But I digress)

Then what should show up in front of me Friday morning at the news stand? Plastered on the front page of The Times underneath a banner advertising a special commemorative issue for the tenth anniversary of the death of Princess Diana, I found the headline: Vaccine warning as measles cases triple. I had thought that the damage done to the vaccine program by Andrew Wakefield’s bogus science and hysterical scaremongering had been starting to abate, but apparently I was wrong:

Parents are being urged to give their children the measles, mumps and rubella jab before the start of the new school year after an unprecedented surge of measles cases was recorded over the summer holidays.

Experts fear that hundreds of thousands of children returning to school as early as next week may cause the highly infectious disease to spread. Despite this the Government has ordered no extra stocks of the MMR vaccine and doctors may run out if they face a sudden rise in demand, The Times has learnt.

The Health Protection Agency (HPA) said that the number of confirmed cases of measles in children had more than trebled over recent months and was far higher than would normally be expected for this time of year.

By June 10 only 136 cases of measles had been confirmed. But just over 11 weeks later this number has risen to 480, with new cases being detected every day, the HPA said. This compares with 756 cases recorded during the whole of 2006 – the highest year on record.

Measles, which can be life threatening or cause severe disabilities, is most common among children aged 1 to 4 who have not been immunised, but can strike older children and adults, too.

It was difficult to explain the large increase this year, the HPA said, but parents not vaccinating their children and a lower uptake of a second MMR “booster” dose are thought to be key factors. The triple vaccine has proved highly controversial in recent years over unfounded concerns that it may be linked to autism. The study that first sparked fears about its safety is currently being scrutinised in a hearing by the General Medical Council, the medical watchdog. Andrew Wakefield and two co-authors of his research are currently appearing before the GMC on charges of serious professional misconduct.

MMR coverage began to drop in the late 1990s, though uptake is rising slowly again. The latest figures show that 88 per cent of British children begin school having had one dose of MMR.

This is Andrew Wakefield’s legacy. I do find some hopeful things in this reporting, however. The Times, at least, seems to be getting it. Note how Mr. Rose describes the concerns that the MMR might cause autism as “unfounded.” Compare this to previous credulous coverage by some papers and it it heartening to see, as is the accompanying editorial, which describes Wakefield’s ideas as “widely discredited.” What is disturbing about this report, which got wide play on BBC news, is that the number of cases rose during the summer holiday and have been remaining elevated:

The latest data, for January to March 2007, showed particularly high numbers of measles cases in London and southeast England, East Anglia and Yorkshire and Humberside.

Mary Ramsay, a consultant epidemiologist at the HPA, said yesterday: “We’ve been very worried because the cases have stayed up over the summer holidays. This means it is crucial that children are fully immunised with two doses of MMR before they return to school.”

In previous decades, measles could cause an average of 20 deaths a year. Officials are nervous that the numbers could creep up again after gaps in vaccination coverage. “Although the numbers are still small, compared to the history of measles, we’re always worried about measles because very rarely it can kill,” Dr Ramsay added. “We hadn’t had any deaths from measles since the early 1990s, but unfortunately we had one death last year and we don’t want any more.

“Measles is a highly infectious and dangerous illness and, as there is increased close contact in schools, it can spread easily.”

But here’s the money quote:

Michael Fitzpatrick, a GP in the borough, said that he was disappointed but not surprised by the latest figures: “Scepticism about the MMR vaccine results in outbreaks of measles like this,” he said. “This was inevitable and I think the only surprise is this hasn’t happened earlier, and on a bigger scale.”

Nine years after his trial lawyer-subsidized and shoddy study, Andrew Wakefield’s legacy to British children lives on–much to their detriment.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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