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Doctors' support for MMR key to halting measles in EU

By Kate Kelland

LONDON (Reuters) - With almost 30,000 cases of measles and eight deaths from the disease recorded in the European Union so far this year, a leading health official is urging doctors to do more to ensure parents have their children vaccinated with MMR.

Doctors' support for the triple measles, mumps and rubella (MMR) vaccine is vital if Europe is to halt the measles outbreaks and have a chance of beating the highly contagious disease, Marc Sprenger, director of the European Center for Disease Prevention and Control (ECDC), said.

He said it was crucial for pediatricians and family doctors to give balanced, evidence-based information to help parents decide on vaccinations.

But he is concerned that a significant proportion of them are not doing that -- a factor that means achieving the at least 95 percent vaccine coverage rate needed to win the battle against measles is a tough call.

"The good news is that parents trust doctors -- but doctors should be a bit more aware that they could use that position to convince parents to vaccinate their children," Sprenger said in a telephone interview from the Stockholm headquarters of the ECDC, which monitors the disease in Europe.

"The vaccine is extremely effective, but it's important that we get vaccination coverage of at least 95 percent (because) this virus is highly contagious."

All European countries were committed to a goal of eliminating measles and rubella by 2010, a target they have missed and has now been put back to 2015. Latest data, however, show the trend is going in the wrong direction.

France, Spain, Germany and Switzerland have experienced major measles outbreaks this year, each of them recording thousands of cases. Figures up to August 2011 show that more than 28,000 cases of measles were reported across the EU.

According to the ECDC, about a third of these cases required hospitalization, and in the first six months of the year, measles was responsible for eight deaths and 22 cases of a serious complication called acute encephalitis.

Rates of immunization with the MMR vaccine plummeted after 1998, when The Lancet medical journal published a study by Andrew Wakefield, a now-disgraced British doctor who researchers believe falsified data linking the triple shot with autism and bowel disorders.

The study has since been comprehensively dismissed as seriously flawed, The Lancet has retracted the paper and Wakefield has been struck off the medical register in Britain.

Measles is a viral disease affecting mostly children. Its symptoms include fever, coughs, runny nose, red eyes and a rash. Globally deaths from measles fell by 78 percent between 2000 and 2008, thanks largely to mass childhood vaccination campaigns.

But parents' refusal to have their children vaccinated because of fears of links to autism have caused a rise in measles cases in the United States and Europe in recent years. Experts warn death rates may rise further if complacency or misinformation allows immunization efforts to fall behind.

Sprenger said MMR vaccine coverage rates across the region are currently around 90 percent, leaving significant groups such as children or young adults unprotected.

Britain's Health Protection Agency (HPA) issued a warning as students returned to universities this month that parents should ensure they had had the MMR shot. Across England and Wales there were 777 cases of measles confirmed by the end of July 2011, compared to 374 for all of 2010.

Sprenger said that since family doctors and health visitors or nurses are the "backbone" of all national immunization programs in the EU, their role is paramount.

But he cited findings of surveys conducted in France, Italy and Germany showing that health workers were often ambivalent, ill-informed or skeptical about MMR vaccines -- even many years after the flawed Wakefield paper was dismissed and retracted.

In Germany, for example, a 2008 survey of 549 midwives showed that a quarter of them objected to measles vaccination.

"People trust their doctors ... so they can really make a difference," Sprenger said. "We know for sure that this disease is not disappearing. It's still increasing and the peak of this epidemic was far higher compared to last year.

"If we don't change this trend we will never be able to eliminate measles by 2015."

(Reporting by Kate Kelland; Editing by Janet Lawrence)

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