Measles outbreaks at festivals can’t be blamed wholly on anti-vaxxers | Jules Montague

Your main concerns when you attend a festival might include any of the following: how will I identify my tent at 5am? Is glamping worth it? Will Este from Haim do bassface?

But one thing you should not have to worry about is: will I get measles?

Public Health England has confirmed a significant number of infections linked to music festivals and other large public events. There have been reports of 38 suspected measles cases at events in June and July alone. Glastonbury had 16 cases, with seven cases reported from the NASS festival near Bristol; six at the Triplicity festival in north Devon; three at Tewkesbury medieval festival; two at Nozstock: the Hidden Valley in Herefordshire; two at Noisily in Leicester; one at the Secret Garden Party near Huntingdon; and one at Yeovil Show.

In all, 234 cases have been confirmed between January and June, compared with 54 for the same period last year.

Why is this happening now? One possibility is that the Wakefield generation has come of age. The fraudulent study by Andrew Wakefield that incorrectly linked the MMR vaccine and autism was published 18 years ago. Although later discredited (with Wakefield being struck off the medical register), the rate of vaccination against measles plummeted after the study’s appearance in The Lancet. There were 56 cases of measles the year before its publication in England and Wales; by 2008 there were 1,370.

Many parents of the Wakefield era chose not to vaccinate their children and were understandably swayed by breathless media coverage, inconsistent messages from health providers, and apparent validation of Wakefield’s findings by the scientific community; it took The Lancet 12 years to retract the publication. If you were the parent of a toddler in those years, what would you have done?

Now, those unvaccinated children have grown up. They go to festivals. The virus is so contagious that if one person has it, 90% of those in close contact will also become infected if they are not immune themselves. And so Public Health England has urged teenagers and adults to check with their GP if they have been vaccinated and to receive two doses of the MMR vaccine if required.

The Wakefield-era children also grew up to account for most of the 1,219 measles cases in the Swansea measles epidemic in 2012, in which one person died. Although some recovered quickly from fever, conjunctivitis and a rash, others suffered more significant complications. According to the US Centers for Disease Control and Prevention, one or two out of every 1,000 children who become infected with measles will die from respiratory and neurologic sequelae including blindness, seizures and encephalitis. Since 2006, there have been three deaths from measles in England and Wales.

This historical legacy is compounded by anti-vax sentiment that has become more visible in recent years, albeit not necessarily more widespread. The consequences of this movement travel beyond forums and Facebook posts. It is easy to imagine it to be as infectious as the virus itself, but I think there is a more nuanced subtext, too.

Measles arrived at Disneyland, California with one case in December 2014. Within four months, there were 145 confirmed cases in seven states and three countries, all linked to Disneyland. The authors of an analysis in JAMA Pediatrics journal said the outbreak was directly associated with substandard vaccination compliance: “The ongoing measles outbreak linked to the Disneyland Resort in Anaheim, California, shines a glaring spotlight on our nation’s growing anti-vaccination movement and the prevalence of vaccination-hesitant parents.”

Vaccination is more than a personal choice; the inaction of others can affect even vaccinated children and adults

Vaccination is more than a personal choice; the inaction of others can affect even vaccinated children and adults. Community vaccination helps to halt the spread of the virus and thus protects the wider population. The sum is greater than its parts. But here’s what is crucial. Each outbreak is different, there are nuances to each one, and not all can be attributed simplistically to a groundswell of anti-vax sentiment. Swansea is definitely not California.

For example, early 2014 cases were linked to unvaccinated travellers returning home who had acquired the virus abroad (an outbreak in the Philippines was an important factor) and then infected others in communities with lower vaccination rates. Despite the concerns expressed in pockets of unvaccinated residents, there is no nationwide loss of confidence in vaccines. Sometimes it’s a case of missed doctors’ appointments or single vaccines refused rather than staunch dissent. And vaccine refusal does not correlate with a lack of knowledge. Moral outrage is too easy.

Julie Leask, an associate professor at Sydney University’s school of public health, provides level-headed discussion on this topic: “To be committed to the science of immunisation ideally comes with a commitment to the science of immunisation behaviour. Media often present this problem as refusal to vaccinate. But the evidence is clear and it’s more complex: under-vaccination is broadly about a lack of acceptance and a lack of opportunity to vaccinate fully or on time. It’s not just the haves, but the have-nots who don’t fully vaccinate.

“A typical measles outbreak will reveal this. There will be children whose parents refused vaccination; children whose parents were unwittingly not up to date for lack of access; affordability or awareness; adults and travellers who didn’t get a needed booster; and babies who are too young to be vaccinated.”

So although “festival measles” seems to largely fit with the coming of age of the Wakefield generation and more particularly a broader anti-vax narrative, it is too simplistic to conclude that this is applicable to all. But it does provide an opportune moment to discuss issues around vaccination, to strengthen public health infrastructure to deliver effective programmes, and to ensure there is never even the possibility of a Wakefield generation occurring again.

Related: Measles warning to young people at festivals after series of outbreaks

Measles outbreaks at festivals can’t be blamed wholly on anti-vaxxers | Jules Montague

Measles warning to young people at festivals after series of outbreaks

Young people planning to go to festivals or other mass events are being warned to make sure they have been fully vaccinated after a number of measles outbreaks.

Public Health England says anyone visiting a music festival should ensure they have had two shots of the measles, mumps and rubella (MMR) vaccine. Some younger people may be at risk because they were not vaccinated as small children, after the scare generated by the suggestion of the now discredited scientist Andrew Wakefield that there was a link between the vaccine and autism.

There has already been an increase in measles cases this year, with 234 confirmed between January and June, says PHE, which has to be notified of every case. That is a more than fourfold increase over the 54 cases in the same six months last year.

Festivals have added to that. There have been 36 suspected measles cases in young people who attended events in June and July. Glastonbury – the biggest music festival of the year – had the most cases, at 16. There were seven cases reported from the NASS festival near Bristol; six at the Triplicity festival in north Devon; three at Tewkesbury medieval festival; two at Nozstock: the Hidden Valley in Herefordshire; two at Noisily in Leicester; one at the Secret Garden Party near Huntingdon; and one at Yeovil Show.

At least three of the cases were people who had measles symptoms but decided to go to the festival anyway rather than staying at home.

PHE is anxious to avoid further spread at festivals and gatherings where thousands of young people are in close contact and some may be susceptible to infection. Measles can be more complicated in teenagers than in small children.

“Measles is a highly infectious viral illness that can be very unpleasant and sometimes lead to serious complications,” said Dr Mary Ramsay, PHE’s head of immunisation.

“So if you think you might have measles, please don’t go to any of these big events. Measles isn’t common these days because most of us are vaccinated, but young people who missed their MMR jab as children are vulnerable, especially if gathered in large numbers at an event.

“If you think you’ve got it, call your GP or NHS 111. Please don’t turn up at the surgery or at A&E as you could infect other patients.”

Measles commonly causes diarrhoea and vomiting, which can lead to dehydration, earaches, conjunctivitis, fits caused by fever and pneumonia or bronchitis if the infection reaches the lungs.

Very rarely it can lead to serious eye disorders and even a fatal brain complication years later. Before vaccination, it was a regular killer. In 1941, there were 1,145 deaths from more than 400,000 cases. In 1998, the year in which the Wakefield paper was published in the Lancet, there were more than 3,700 cases and three deaths. In 2013, the latest year with published figures, although they are incomplete, there was a surge to 6,102 cases because of the Swansea outbreak – in an area of Wales where many parents had opted not to vaccinate their children – but only one death.

The MMR vaccination rate fell slightly in 2014-15 to 92.3% of eligible children. The previous year it was 92.7%, the highest rate ever achieved. But the overall figure obscures the problem of low vaccination rates in specific regions. In some places, less than 80% of children were vaccinated.

Anxieties about the vaccine have led to outbreaks in the US as well. In 2014, there were a record 667 cases, according to the Centers for Disease Control and Prevention. A substantial number of those were among the unvaccinated Amish communities in Ohio.

Last year there was an outbreak in California among children whose parents had refused to have them vaccinated, which began when somebody with measles visited Disneyland – another place where there are mass gatherings.

Measles warning to young people at festivals after series of outbreaks

Festivals black out against legal highs

Bestival organiser Rob Da Financial institution informed The Telegraph that he wanted the festival to get behind the campaign soon after an attendee committed suicide soon after taking a legal high in 2012. “We can’t kid ourselves that drugs and legal highs are not going to be taken”, he said, “it’s element of the material of the festival. Nevertheless, we do want to get the message to people who could have been contemplating legal highs, not to.”

The campaign is the function of the Association of Independent Festivals and Angelus Foundation, a charity that aims to educate individuals about legal highs. Maryon Stewart founded Angelus soon after her daughter Hester died in 2009 from taking GBL, a sedative that has euphoric side effects, but can be lethal if mixed with alcohol. She says legal highs are “a enormous but hidden dilemma since youthful men and women are acting in ignorance and no-1 is measuring the harms.”

Survey information collected by Angelus in 2013 located that far more than a quarter of 16-24 12 months-olds polled thought that legal highs have been a safer choice to unlawful drugs, and 76 per cent of those had close friends who took legal highs.

So far, all of the proof about the consumption of legal highs at festivals has been anecdotal. Even so, nitrous oxide, otherwise identified as laughing gasoline or balloons, is 1 of the a lot more common legal highs at festivals. Utilised for numbing dental individuals, as well a lot nitrous oxide can result in death due to a lack of oxygen in the entire body. Angelus’s Jeremy Sare stated that his colleagues described “a sea of cannisters” at Glastonbury last year.

The majority of legal higher deaths, however, come about when alcohol is mixed with stimulants that mimic the likes of ecstasy, MDMA and cocaine. Regulators are struggling to maintain up with the speed at which new chemical variants are getting produced.

Rob Da Financial institution stressed that legal highs had only begun to effect festivals “quite recently”, but that there was a need to tackle them. “There will be data on our website and at the festival internet site. We hope we’ll be in a position to place people off legal highs”.

IN Pictures: GLASTONBURY 2013

Festivals black out against legal highs