UK measles outbreak in non-immune anthroposophic communities: the implications for the elimination of measles from Europe

We describe the epidemiology of the first nationwide outbreak of measles in fection in the UK since the implementation of a mass vaccination campaign. Notifications of infectious diseases, interview and postal questionnaire id entified 293 clinical cases, 138 of which were confirmed by salivary IgM, m easles virus isolation and PCR. Twelve were epidemiologically linked to con firmed cases. The outbreak began in London, after contact with measles infe ction probably imported from Italy. Measles genotyping determined by sequen ce analysis confirmed spread to other unimmunized anthroposophic communitie s in the north, south west and south coast of England. Only two cases had b een vaccinated against measles infection, and 90% of cases were aged under 15 years. Measles virus can selectively target non-immune groups in countri es with high vaccine uptake and broader herd immunity. Without harmonizatio n of vaccination policies and uniform high coverage across Europe, the impo rtation and spread of measles virus amongst non-immune groups may prevent t he elimination of measles.