Fears of a measles epidemic grew yesterday after health officials in Gateshead revealed they had four suspected cases of the illness, just days after news of an outbreak among babies and nursery-school children in south London.
Three cases have been confirmed in Streatham, south London - two of them babies under 12 months old who are too young to have been innoculated against the disease. The third is at nursery school.
Another 22 suspected cases are understood to be small children who have not been given the measles, mumps and rubella vaccination. Results of their tests are expected today or tomorrow.
Anxiety over controversial research suggesting a link between the MMR jab and bowel disease and autism has made many parents reluctant to have their children vaccinated, and in the boroughs of Lambeth, Southwark and Lewisham, where the outbreak has occurred, take-up rates have fallen as low as 65%.
The Department of Health says only a 95% vaccination rate can prevent any measles cases. The national average is now 84.2%.
The Gateshead cases are unlikely to be the start of a big outbreak because the vaccination rate in the area is 91.6%.
There are around 100 cases a year in England, according to the public health laboratory service, but few deaths, except for those caused by complications of measles contracted many years previously.
Gill Sanders, director of public health for Gateshead and South Tyneside health authority, urged parents to take their children for vaccination. "Measles is still around and it's a very unpleasant illness but it is entirely preventable.
"Parents do not need to worry and should take up the MMR vaccine for their children. If you are looking for the best quality, cost-effective treatment then it is MMR. Anything else is second rate.
"People have been affected by what they have read in the media. The message is that MMR is safe, which is backed by the health practitioners, but not being accepted by some parents."
But just as public health officials were hoping that the London outbreak might encourage more parents to have their children vaccinated, a new scientific paper was released yesterday which raises more questions.
The paper outlines the research of John O'Leary, a professor with an international reputation at the department of pathology, Coombe women's hospital in Dublin. It will be published formally in the journal Molecular Pathology in April but wasposted on the journal's website (www.molpath.com) yesterday.
Prof O'Leary and colleagues tested tissue samples supplied to them by Andrew Wakefield's team at the Royal Free hospital in London, which published the original research into measles virus and a form of bowel disease, and suggested a further link to autism.
The samples came from the gut of 91 children with developmental disorders who had an unusual form of bowel disease. The scientists compared the samples with tissue from 70 unaffected children. They found measles virus in the in testinal tissue of 75 out of the 91 affected children, but in only five out of the 70 controls.
The paper and an accompanying editorial are at pains to point out that the scientists were not looking at the MMR vaccine. They have found fragments of measles virus, but do not know whether the virus is the same strain as the one in the MMR jab.
"It would be entirely wrong to jump to the conclusion that the measles component of MMR 'causes' the colitis (bowel disease) or the developmental disorder in these particular (or any other) children," says the editorial by Alan Morris and David Aldulaimi of Warwick University.
"Causation is rarely simple and never pure: most if not all diseases are multifactorial in nature and the data here could equally well be interpreted as indicating that the colitis or the developmental disorder 'cause' the persistence of measles."
But the research raises many questions, they say. "Doubtless the present (and other) authors are pursuing these (and many other) questions: we look forward to answers."
