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Measles in the Travelling Community

The HPA in England has informed us that there has been a death of a 13 year old boy from measles and there are small clusters of measles among members of the travelling community.  These appear to be defined clusters in isolated isolated groups.  It is unclear how much interaction or movement there is between the travelling community inIreland and England but it may be useful to Primary Care Practitioners to be aware of the measles outbreaks in travellers in England.  It is important that those children who did not receive their two doses of MMR should be encouraged to have their full course of MMR.

Avian Flu

We are constantly updating our Avian Influenza Incident Plans in line with advice from the Health Protection Agency.  We also ran a test exercise with the Western Board, last weekend; this proved a valuable exercise in testing some practical aspects of the plan.

Avian Influenza has not been detected in poultry in the UK.  The Health Protection Agency website is constantly updated giving a comprehensive list of those countries where avian influenza has been detected in poultry and humans.  It also gives general advice for those intending to visit these countries.

www.hpa.org.uk/infections/topics az/influenza/avian/default.htm

A copy of the Northern Ireland Diagnostic Algorithm for Avian Influenza is available at www.cdscni.org.uk

Please continue to check avian influenza guidance on a regular basis on the above websites and at the following websites www.dhsspsni.gov.uk and www.who.int

Interval Between Live Vaccines

The updated (draft) chapter on measles in the Green Book has revised the interval between live vaccines to a minimum of 4 weeks.  Live vaccines such as MMR may be given at the same time, but at a separate site, preferably a different limb.  An immune response to both vaccines will be initiated.

Natural interferon is produced after a live vaccine is administered.  If a second live vaccine is given during this response, interferon may prevent replication of the second vaccine virus and so may attenuate the immune response to the second vaccine.  For this reason, if live vaccines cannot be given simultaneously a four-week interval is recommended.

Please see updated measles chapter available at:

http://www.dh.gov.uk/assetroot/04/12/44/88/04124488.pdf or search for Green Book then scroll down to download new replacement chapters and select Chapter 22, measles.

NB MMR can also be given at the same time as DTaP/IPV, Men C or Hepatitis B vaccines.

Planned changes to the routine Childhood Immunisation Programme

The proposed changes, recommended by the Joint Committee on Vaccination (JCVI),

are:-

• the introduction of a new vaccine to protect against pneumococcal infection
• a pneumococcal vaccination catch-up programme for all children under two years
• amending the MenC vaccination schedule to give two doses of vaccine in the first year of life, and a booster dose in the second year
• the addition of a booster dose of Hib vaccine in the

second year of life

The new routine childhood schedule will therefore be:-

The new programme will commence on the date announced by the DHSSPS.  This announcement is expected in the near future.

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