Skip to content

Immunisation

Published on:
22 August 2014

Next update: 26 September 2014
Last updated: 22 August 2014, Volume 8, No 33 (PDF file xxx KB)

Topic Archives: | 2014 |2013 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002 | 2001

Laboratory confirmed cases of measles, mumps and rubella (England and Wales): April-June 2014

Data presented here are for the second quarter of 2014 (i.e. April to June). Cases include those confirmed by oral fluid testing (IgM antibody tests and/or PCR) at the Virus Reference Department, Colindale and national routine laboratory reports (mumps infections only) (table 1). Analyses are by date of onset and regional breakdown figures relate to Government Office Regions.

Quarterly figures for cases confirmed by oral fluid antibody detection only from 1995 and annual total numbers of confirmed cases by region and age are available from:
Table 1. Laboratory-confirmed cases of measles, mumps and rubella and oral fluid IgM antibody tests in notified cases: weeks 14-26/2014
Notified and investigated cases  

Confirmed cases

Infecting virus
Cases reported to HPUs in England*
Oral fluid testing
Other samples
Total
Number tested
% of reported cases tested

Total
positive

Recently
vaccinated

Confirmed infections

Measles

707

518

73.2

27

17

10

6

16

Mumps

3214

2086

64.9

810

6

804

76

880

Rubella

137

84

61.3

2

1

1

1

* This represents the number of infections reported as possible cases and investigated by individual PHE centres in England.

Measles

Sixteen measles infections with onset dates in the April to June 2014 quarter were confirmed in England compared to 70 cases in the first quarter of the year [1].

Seven of the confirmed infections were identified in London with 4 cases reported from West Midlands, 3 cases the South East and one case each from Eastern and East Midlands regions. Across the UK, Scotland reported one case linked to recent travel to Vietnam but there were no measles cases reported from Wales or Northern Ireland.

Seven of the 16 English cases in the period reported a history of recent travel; 5 cases to the Far East (China and Vietnam) one each to Malawi and United Arab Emirates. Measles virus sequence was obtained from 11 out of the 16 English cases and the single Scottish case which either confirmed the importation of infection or suggested links to an importation.

Seven cases this quarter were in children aged 1 to 4 years and the remaining 9 cases were adults aged 20 to 64 years. Only one case reported previously receiving a measles-containing vaccine.

In the 12-month period July 2013 to June 2014, countries within the European Union and European Economic Area (EU/EEA) reported a total of 7,116 cases. More than three quarters of the cases were reported from three countries; the Netherlands 34.4%, Italy 30.7% and Germany 12.2%. The previously reported outbreak in the Hague, in the Netherlands is now over [1] but new outbreaks have been reported recently in Sweden and Belgium. Several outbreaks in EU Member States have a serological and epidemiological link to the large ongoing outbreak in the Philippines with 47,000 cases. Significant nosocomial transmission occurred in the three recent measles outbreaks reported from the Czech Republic, Latvia and Spain, demonstrating the continued presence of susceptible healthcare workers in EU Member States [2].

Mumps

There were 880 laboratory confirmed cases of mumps in England with onset in the second quarter of 2014 bringing the total number of mumps infections for the first half of the year to 1,734. This follows the trend observed over the last decade of an increase in cases in first two quarters of the year (figure) [1]. Additionally, 199 samples were confirmed from Wales this quarter bringing the Welsh total number of cases for the first half of 2014 to 349.

Cases continue to be identified predominantly in young adults between 16 and 30 years of age (647/880 74%, Table 2). Over 40% of all cases this quarter have reported receiving at least one dose of MMR vaccination in childhood, suggesting that some waning immunity may be contributing to transmission. Mumps cases were identified in all regions of England although greater numbers were identified in London, and the South East regions (table 2).

Table 2. Laboratory confirmed cases of mumps by age group and region, England:
weeks 14-26/2014
Region

<1

1-4

5-9

10-14

15-19

20-24

25+

Total

North East

2

4

4

10

North West

1

2

15

24

31

73

Yorkshire & Humber

1

6

2

1

12

15

23

60

East Midlands

1

1

7

37

57

26

129

West Midlands

1

2

6

37

31

45

122

East of England

3

10

21

25

59

London

3

3

11

23

47

91

178

South East

1

2

5

7

34

54

68

171

South West

1

3

18

25

31

78

Total

2

15

13

40

188

278

344

880

 

Laboratory confirmed cases of mumps by quarter, England, 2003-2014

Rubella

This quarter, the only confirmed rubella infection was in a newborn whose unvaccinated mother was infected during pregnancy and had acquired the infection abroad.

Countries within the EU/EEA with established rubella surveillance identified very few rubella infections. The outbreak in Poland is continuing, affecting predominately young male adults consistent with the country's selective vaccination of girls only between 1989 and 2004 [2].

References

1. PHE. Laboratory confirmed cases of measles, mumps and rubella, England: January to March 2014. HPR 8(20): immunisation, http://www.hpa.org.uk/hpr/archives/2014/hpr2014.pdf.

2. European Centre for Disease Prevention and Control (July 2014). Measles and rubella monitoring October 2013.

Laboratory reports of Haemophilus influenzae by age group and serotype (England and Wales): April-June 2014

In the second quarter of 2014 (April to June) there were a total of 206 laboratory reports of invasive Haemophilus influenzae. This represents a 16% decrease in cases compared to the previous quarter (n=206) and a 24% increase compared to the second quarter of 2013 (n=140).

Of the samples which underwent serotyping (n=142), 84% were non-capsulated Haemophilus influenzae (ncHi), a further 12% were serotype a, e, or f, and 4% were serotype b (Hib). These results indicate a slight decrease in the proportion of ncHi cases compared to the second quarter of 2013, when: 91% of serotyped samples were ncHi, 6% were serotype a, e, or f, and 3% were Hib.

Age group was well reported (table). Of the laboratory reports during the second quarter of 2014: 83% were aged 15 years and over; 7% were under one year of age; and 6% were among 1-4 year olds and 3% were aged 5-14 years. The age distribution was similar to that in the second quarter of 2013, where: 80% were aged 15 years and over; 12% were under one year of age; and 4% were among both 1-4 year olds and 5-14 year olds. The overall increase in numbers in the second quarter of 2014, compared to the second quarter of 2013, was largely due to a 30% increase in cases in the 15+ age group (from 111 to 144); cases also increased in the 1-4 year age group, from five to 11 cases (an increase of 120%) whilst they case fell in infants under one year of age.

During this quarter 92% of cases in children under 15 years were ncHi (n=22/24). There was one cases of Hib this age-group; an infant, who was too young to have received the first dose of the DTaP/IPV/Hib vaccine, who presented with fever and made a full recovery. This was comparable to the second quarter of 2013 were one case in a child under one years old was confirmed.

Age distribution of laboratory-confirmed cases of Haemophilus influenzae by serotype, England and Wales, second quarter 2014 (and 2013)
Serotype
Total, all quarters 2013 (2012) by age-group
Total, second quarter 2013 (2012)
<1y
1-4y
5-14y
15+
nk
b

1 (1)

(–)

(–)

5 (3)
(–)
6 (4)
nc

9 (13)

7 (4)

6 (3)

97 (87)

(1)

119 (108)

a,e,f

1 (–)

()

(2)

16 (5)

(–)

17 (7)

not typed

1 (3)

4 (1)

(1)

26 (16)

(–)

31 (21)

Total

12 (17)

11 (5)

6 (6)

144 (111)

(1)

173 (140)

Notes: " –" Indicates that testing yielded no positives. Percentages may not add up to 100 due to rounding.

Laboratory reports of hepatitis A and C (England and Wales): January-March 2014

This report which can be downloaded using the link below covers both laboratory-confirmed hepatitis A virus (HAV) and hepatitis C reports in England and Wales in the second quarter of 2014.

The HAV report includes molecular data for samples submitted to the PHE Virus Reference Department, including a phylogenetic tree that illustrates the travel-relatedness of a significant proportion of those cases.

Hepatitis A and C (E&W), Q1/2014 [175 kB PDF]

Acute hepatitis B (England): annual report for 2013

This report which can be downloaded using the link below presents surveillance data on acute hepatitis B incidence in England in 2013. A gradual decline in incidence since 2008 was continued in 2013. Cases classified as acute or probable acute are assigned a probable route of exposure. In 2013, as in previous years, the commonest reported risk was heterosexual exposure, followed by sex between men, and injecting drug use.

Acute hepatitis B (England), 2013 [300 kB PDF]