2019 Tonga measles outbreak

The 2019 Tonga measles outbreak began in October 2019 after a squad of Tongan rugby players came back from New Zealand.[4] The epidemic as of December 8 is currently ongoing. As of January 5, there have been 612 cases of measles.

2019 Tonga measles outbreak
DiseaseMeasles
Virus strainD8 strain (genotype) of measles virus [1]
Index caseOctober, 2019
DatesOctober 22, 2019 –
present[2]
Confirmed cases612[3]
Deaths
0
Government website
https://reliefweb.int/report/tonga/tonga-measles-outbreak-2019-situation-report-8

Background
A hypothetical measles timeline exposure to illness

Beginning in 2017, the WHO began tracking measles outbreaks in the Asia Pacific Region. Measles has been spreading throughout the Pacific region, with outbreaks in Tonga, Fiji, Australia, Cambodia, Japan, the Republic of Korea, Malaysia, Thailand, Vietnam, Samoa, the Philippines and New Zealand.[5][6] Previously, measles had been believe to be eradicated in the Asia Pacific Region, with the last reported case in 2014, prior to the outbreak.[6]

Samoa, Tonga and Fiji have all declared states of emergency to tackle their 2019 measles outbreaks. When contrasting the scores of deaths in Samoa to the lack of fatalities in Tonga and Fiji, this is put down to the far higher vaccination rates in Tonga and Fiji compared to the 31% in Samoa.[7]

Most of the cases have been on the island of Tongatapu where the first cases started, with 88% of all cases located on Tongatapu and 10% located on the neighboring island of Vava’u.[8][9]

Vaccine hesitancy

The outbreak has been attributed to a sharp drop in measles vaccination in Samoa from the previous year, following an incident in 2018 when two infants died in Samoa shortly after receiving measles vaccinations, which led the country to suspend its measles vaccination program.[10] The reason for the two infants' deaths was incorrect preparation of the vaccine by two nurses who mixed vaccine powder with expired anaesthetic.[11] The nurses responsible were sentenced to 5 years in prison with manslaughter charges and Samoa began arresting anti-vaccination advocates.[12] The United States' Center of Disease Control sent representatives to Samoa, Tonga, and Fiji to coordinate vaccine efforts and combate vaccine misinformation.[12]

Government response

Ministry of Health chief executive, Siale 'Akau'ola, said more than 12,000 people had been re-vaccinated. This vaccination program targeted school children and 6-11 month old infants. A second vaccination program was conducted in February 2020, targeting children ages 1–9 years old.[13] The vaccination rate in Tonga was over 90% which might stem the infection rates seen in Samoa and New Zealand.[14] In November, 2019, the Tongan Minister of Education shut down all primary schools until the beginning of 2020.[15]

International response

UNICEF has sent almost 300,000 vaccines to Vanuatu, Cook Islands, Nauru, Niue, Tokelau and Tuvalu, Samoa, Tonga, and Fiji.[16] Samoa, Tonga, and Fiji have also declared states of emergency.[17] The WHO and UNICEF have developed a toolkit for Pacific Island Nations following the outbreak to aid in further measles prevention.[16] Tonga closed all schools for several days while American Samoa required all travelers from Tonga and Samoa to present proof of vaccination.[18] The United States' Center for Disease control placed a Level 1 travel ban to the Kingdom of Tonga following the outbreak.[15]

Vanuatu, Cook Islands, Nauru, Niue, Tokelau and Tuvalu.  

Since 1 October, UNICEF has delivered 12,000 measles vaccines to Tonga.[19] UNICEF later provided 6,000 additional doses of the vaccine cold chain following the success of the first administration.[15] Through domestic and internationally coordinated efforts, 44,605 individuals under the age of 24 were vaccinated by January 2020. This included administration of supplementary vaccines for previously vaccinated individuals in conjunction with routine childhood vaccination.[20]

On December 10, American Samoa declared a measle outbreak and closed public schools and park gatherings[21] and suspended all entry permits for those travelling through Samoa and Tonga to American Samoa.[22]

See also

References
  1. "WHO/UNICEF SECRETARIAT SUPPORTING MEASLES OUTBREAK PREPAREDNESS AND RESPONSE IN THE PACIFIC" (PDF). WHO. Retrieved 16 December 2019.
  2. "Samoa, Fiji and Tonga - Measles outbreak (DG ECHO, WHO, UNICEF and media) (ECHO Daily Flash of 25 November 2019) - Samoa". ReliefWeb. Retrieved 26 November 2019.
  3. "It's okay to vaccinate, Minister Aupito spreads the message". Samoa Observer. Retrieved 5 January 2020.
  4. "Tonga Measles Outbreak 2019 - Situation Report #8". Archived from the original on 8 December 2019. Retrieved 8 December 2019.
  5. Whyte, Chelsea (6 December 2019). "Samoan government takes drastic measures to fight measles outbreak". New Scientist. Retrieved 8 December 2019.
  6. "WHO | Measles – Pacific Island Countries and Areas". WHO. Retrieved 23 September 2020.
  7. "The wrong jab that helped cause a measles crisis". BBC News. UK. 2 December 2019. Archived from the original on 5 December 2019.
  8. "440 measles cases reported in outbreak". Matangi Tonga. 9 December 2019. Archived from the original on 11 December 2019. Retrieved 11 December 2019.
  9. "Tonga measles outbreak 2019-2020 update". Outbreak News Today. 13 January 2020. Retrieved 23 September 2020.
  10. France-Presse, Agence (28 November 2019). "Samoa measles outbreak: WHO blames anti-vaccine scare as death toll hits 39". The Guardian. Retrieved 30 November 2019.
  11. Beat, Pacific (2 August 2019). "'Her body was turning black': Samoan nurses jailed for infant vaccination deaths". ABC News. Retrieved 29 November 2019.
  12. Sun, Lena (11 December 2019). "CDC sends experts to fight measles outbreaks in Pacific islands neighboring Samoa".
  13. "Tonga Measles Outbreak 2019-20 - Situation Report #17 - Tonga". ReliefWeb. Retrieved 23 September 2020.
  14. "Tonga close to achieving measles vaccination targets - Ministry". RNZ. 29 November 2019. Retrieved 8 December 2019.
  15. "Pacific Island Measles Outbreak Gains Needed Support From UNICEF". www.vaxbeforetravel.com. Retrieved 24 September 2020.
  16. "UNICEF delivers over 260,000 vaccines and medical supplies to fight measles outbreaks in Samoa, Fiji and Tonga". www.unicef.org. Retrieved 24 September 2020.
  17. "Samoa measles outbreak worsens". BBC. 23 November 2019. Retrieved 26 November 2019.
  18. Samoa's measles crisis has claimed 15 lives but how did the outbreak start?, Tasha Wibawa, ABC, 18 Nov 2019
  19. "UNICEF delivers over 260,000 vaccines and medical supplies to fight measles outbreaks in Samoa, Fiji and Tonga". Retrieved 8 December 2019.
  20. "Tonga measles: Case tally now 659". Outbreak News Today. 17 February 2020. Retrieved 24 September 2020.
  21. "Hawaii Lt Gov Says Samoa Medical Mission Won't Be The Last". Honolulu Civil Beat. Retrieved 10 December 2019.
  22. "American Samoa tightens entry as measles fears grow". Retrieved 10 December 2019.
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