It's nearly 4am on mother's day. My eight-month-old son is finally asleep, cradled in my arms. From time to time a sob interrupts his sleep. He is covered in a hot, raised rash, and a tube is trickling oxygen into his nostrils. His face and body are illuminated by the soft green light from a monitor which shows his heart and oxygen levels. The alarm goes off regularly - his heart rate is too high, or his oxygen level too low, or he has kicked out, trying to remove the sensor strapped to his tiny foot.
Samuel has measles. After two days with a raging temperature and a dry cough, diarrhoea, vomiting and conjunctivitis he was finally admitted to hospital. It has been a frightening few days, and we aren't out of the woods yet.
As I sit watching him sleep I feel this knot of anger. This is an illness that can kill, that can leave children deaf, it is highly infectious. But in the borough of Haringey, where we live in north London, so many parents have decided not to vaccinate their children against measles that it is making a comeback. Samuel is too young to be immunised. In the recent past, the vulnerable have been protected from this and other childhood illnesses by the fact most people have been immunised; so-called herd immunity.
Most parents know the controversy surrounding the MMR jab, and the study of 12 children which claimed there might be a link between the injection and autism or bowel problems. Since then large-scale trials around the world have found no evidence of an association between MMR and autism. The latest review of the data carried out by the Drugs and Therapeutics Bulletin concludes it is extremely unlikely that all these studies would have missed a link if it was there.
Still, after BSE and CJD people don't really trust scientists and the government any more. Having reported on the MMR controversy and read at first hand quite a bit of the scientific literature I felt the evidence was against a link with autism. Even so, as I took Jack along for his jab I still worried about whether I was doing the right thing.
We forget, though, just how terrible an illness like measles can be. The MMR vaccine was introduced in 1988. Before that there was a single measles vaccine, and the last death from acute measles in the UK was more than 10 years ago. But with take-up of the MMR vaccine now so low it may only be a matter of time before we are reminded.
According to the Public Health Protection Agency, in 1996 92% of children in England and Wales received their first dose of the vaccine by the age of two but, after claims of a link to autism, take-up dropped and, by 2002, only 84% of children were vaccinated by their second birthday. In our part of north London vaccination levels stand at about 75%, but for that all-important herd immunity it needs to be 95%.
Samuel's was the first case of measles our GP has seen in 15 years, within a week the surgery saw a second case. "At the very least," he says, "measles is a deeply unpleasant illness ... at the worst it can lead to inflammation of the brain." It is a sign of the strong feelings evoked by the MMR controversy that he didn't want his name to be used as it might make working with parents who don't want their children vaccinated difficult. "People can be very aggressive ... but once you have a pool of un-immunised children you have the potential for an outbreak of measles. One of the reasons I had my own children vaccinated was to protect other children. It is not just about the individual it is about the community in which you live."
Jackie Fletcher sees things differently. She is the coordinator of Jabs, the campaign group which works on behalf of vaccine-damaged children. She says her own son Robert developed inflammation of the brain soon after having the MMR and HIB meningitis vaccines, he now has epilepsy and autism. She has heard the government reassurances about the safety of immunisation, but says there still hasn't been research into the children whose lives changed dramatically shortly after being vaccinated.
"Parents aren't looking for the vaccine as something to blame, it starts a guilt trip for them," she says, "I don't want a child damaged by the disease, but I don't want another child damaged like my son."
She wants parents to be given the choice of MMR, single vaccines or nothing for their children. At the moment single vaccines aren't available on the NHS, as the Department of Health believes the time lag between injections leaves children unprotected for too long.
As vaccination levels drop, the risk of getting measles increases. Each parent has to make their own decision about whether to immunise their child, but they have to do that knowing just how nasty and how infectious these childhood illnesses can be.
Measles is highly infectious and has an incubation period of between eight and 14 days. A child is infectious for a week after the symptoms first show. It starts with a fever, runny nose, sore eyes and a cough. After three to four days a raised, red rash starts on the forehead and behind the ears, then works its way down the body. Shortly before the rash appears Koplik's spots may be found inside the cheeks and on the lower lip, they look like grains of salt with a red base. Complications can include ear and chest infections. There may also be diarrhoea, vomiting and stomach pain. In about one in a thousand cases the patient develops brain inflammation, this sometimes leads to brain damage or even death.
· Alison Holt is the BBC's social affairs correspondent
