The burden and impact of measles among the Gypsy-Traveller communities, Thames Valley, 2006-09.

BACKGROUND: Outbreaks of measles in Gypsy-Traveller communities are well recognized. Their contribution to the overall burden of disease is less clear. METHODS: Measles case-management information was collated retrospectively for the Thames Valley population comprising 2.2 million people over the 4-year period from 2006 to 09. Suspected cases notified by general practitioners and hospital clinicians were sent a saliva testing kit. Cases were defined as those whose measles IgM was positive. Risk factor information was collected and collated including vaccination and membership of the Gypsy-Traveller communities. RESULTS: Of 142 cases of laboratory confirmed measles, 63% were in Gypsy-Traveller communities. These included 10 family clusters and outbreaks confined to the Gypsy-Traveller communities and one with a wider spread. The pattern was consistent across the 4 years studied. Among the Gypsy-Traveller communities 27 of 55 cases eligible for measles, mumps and rubella (MMR) vaccination had received one MMR vaccination. Overall seven cases were admitted to hospital with either pneumonia or dehydration. CONCLUSION: These findings showed a more than 100-fold higher incidence in the Gypsy-Traveller communities than the rest of the population. The high burden of disease in the Gypsy-Traveller communities highlights the importance of targeting immunization resources towards these communities.