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Govt. mum on March measles warning

The Ministry of Health has not responded to questions asking what, if any, action was taken after international agencies warned Samoa and its neighbours in March this year about the potential of a measles outbreak.

Questions sent to the Director General, Leausa Dr. Take Naseri, were not responded to as of press time.

A letter signed by the Regional Directors of the World Health Organisation and United Nations Children’s Fund dated 28th March 2019 states: “a single case of measles constitutes an outbreak.”

The Ministry of Health declared Samoa was facing an epidemic on October 16. 

At that time, they said seven people had laboratory confirmed measles, and on October 23 revealed 169 suspected cases had been reported since September.

“We don’t want to panic the people, we were not sure,” the Ministry of Health Director General, Leausa Dr. Take Naseri, told the Samoa Observer in November

He also said, just days before it would eventually be announced, that a undergoing a State of Emergency might cause “unnecessary panic.

 “There is no need to cause unnecessary panic amongst the population,” Leausa said in a press conference on November 14.

“The Government is briefed daily and we are now working (and) getting assistance from overseas and it depends on the disaster advisory and the medical experts’ advice.”

A State of Emergency was declared the evening of November 16, and a mass vaccination campaign launched on November 20. Measles vaccines are now mandatory under the State of Emergency and new legislation was passed making them, and other childhood vaccines, mandatory for all children afterwards, too.

To date, there have been nearly 5,500 cases of measles and at least 79 people have died. 

The fatalities are mostly in children under five years old.

Eight additional children who died at home, not at hospital, have undergone forensic examinations to ascertain if they did in fact die of measles. The preliminary results of those examinations are expected from Monday 23.  

In March, the W.H.O. and U.N.I.C.E.F. clearly outlined the steps required to prevent and manage an outbreak of measles. 

Countries were encouraged to vaccinate their populations, which back in March had “suboptimal rates” of immunisation coverage, “making them vulnerable to outbreaks should a case be imported.”

That is exactly what happening. On August 28, a case was reported to disease surveillance. A forensic examination has confirmed what Leausa suspected, that the measles came on a flight from Auckland. 

As well as advising strengthening vaccine coverage, the letter offered eight other recommendations to the Pacific Health Ministers, to whom the letter was addressed. 

They included strengthening early warning systems like epidemiological surveillance for measles, and alerting all healthcare workers to look out for the symptoms of the disease, and ensuring cases of suspected measles are isolated until five days after the rash appears on their skin.

“Case and contact management should not wait for a confirmatory laboratory test. Clinicians suspecting measles should notify public health authorities as a matter of urgency.”

Contact tracing – finding anyone who came into contact with a suspected case of measles – should be done immediately, and those people offered the measles vaccine if they cannot prove they are already vaccinated, or be excluded from all public settings until the 12-18 day incubation period is over.

The risk of measles should immediately be communicated to the community, the letter recommends.

“Raise community awareness of the clinic symptoms and signs of measles, the serious nature of the disease in infants and young children, pregnant women… and others who are unable to be immunised, and the importance of immunisation.”

Leausa had not responded to questions asking whether any of the steps advised were taken. The Samoa Observer understands the Ministry of Health did alert W.H.O when the first suspected case was reported to disease surveillance at the hospital, as expected by W.H.O protocols.

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