Following the recent outbreaks of measles and mumps,we write to add the perspective of hospital admission rates for these infections in England over the past five decades.

3 Salisbury D

Ramsay M

Noakes K Immunisation against infectious disease: the green book.

4 Public Health England

Completed primary courses at two years of age: England and Wales, 1966–1977, England only 1978 onwards.

3 Salisbury D

Ramsay M

Noakes K Immunisation against infectious disease: the green book.

5 Chou MR

Malik ANJ

Suleman M

Gray M

Yeates D

Goldacre MJ Time trends over five decades, and recent geographical variation, in rates of childhood squint surgery.

4 Public Health England

Completed primary courses at two years of age: England and Wales, 1966–1977, England only 1978 onwards.

Figure Hospital admission rates for measles (A) and mumps (B) in England (1968–2011) and the Oxford record-linkage study area (1963–2011), for people younger than 25 years

Cases of measles and mumps that were serious enough to warrant hospital admission were reasonably common until the mid-1980s ( figure ). Immunisation against measles was introduced in England and Wales in 1968,but its coverage was incomplete: 33% of 2-year-olds had completed primary courses in 1968, rising to 76% in 1985.Triple vaccine immunisation against measles, mumps, and rubella (MMR) was widely introduced in England from 1988.Routine collection of English national hospital statistics collapsed in 1985, and usable data did not become available again until 1990; but data in the Oxford record-linkage studycontinued, and the latter data show the decline in hospital admission at that time ( figure ). Admissions were very few during the 1990s and early 2000s ( figure ). Before the unsubstantiated concerns about the safety of MMR, raised in 1998, more than 90% of children aged 2 years in 1991–92, to 1997–98, had been immunised with MMR in England and Wales. In 2003–04, immunisation fell to 80% before rising again to 89% by 2010–11.Of particular note is the return in 2005 of hospitalised cases of mumps in England to pre-immunisation levels; and, from 2006, now the return of hospitalised measles. The historical profiles of hospitalised measles and mumps serve as a reminder of the serious nature of these infections.