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Pacific: Measles Outbreak - Oct 2019

Estado
Pasado
Países
Samoa
+ 7
Tipos de desastres
Epidemia

American Samoa

American Samoa: A measles outbreak has been declared by the Department of Health, American Samoa. There are 9 confirmed cases (5 travelers and 4 locally transmitted) reported. Source:- personal communication with country officials on 09 December 2019 and media articles from RNZ and Talanei retrieved on 08 December 2019. (Pacific Community, 10 Dec 2019)

Since the outbreak and State of Emergency declared 8 December, 10 confirmed cases have been reported in six geographically spread villages. There have been no severe cases or deaths. While there is no reliable data available on measles vaccination coverage, recent mass vaccination campaigns reported a coverage of MMR1 in all schools at more than 95 percent, with the second dose of MMR administered at a rate of almost 90 percent. American Samoa began a campaign to vaccinate all adults with no evidence of MMR vaccines on 11 December. Amnesty has also been granted during the vaccination campaign to illegal immigrants who receive the MMR immunisation. (WHO, UN Children's Fund).

Ten (10) laboratory confirmed measles cases have been reported by the American Samoa Department of Health, 4 suspected cases are pending laboratory results. - Source: American Samoa Measles Outbreaks Situational Report for December 15 - 28, 2019, sent on pacnet on 31 December 2019. (Pacific Community, 31 Dec 2019)

No new laboratory confirmed measles cases have been reported; however, samples collected from four suspected cases (fever, rash, coryza, conjunctivitis) have been sent to Hawaii State Lab for RT-PCR testing. American Samoa began its campaign to vaccinate all adults with no evidence of MMR vaccine 11 December 2019. As of 30 December 2019, 12,932 MMR doses administered (780 doses to children 6 months to 18 years old; 12,152 doses to adults 19 years and older). (WHO, UNICEF, 8 Jan 2020)

As for 19 January, a total of 12 laboratory cases have been confirmed via RT-PCR testing, and 3 suspected cases were pending on laboratory results. The last case was reported on 31 December 2019. The authorities confirmed that the Outbreak Declaration will be lifted after 2 incubation periods (42 days from 12/31/2019) without another laboratory confirmed case. (Govt. of American Samoa, 18 Jan 2020)

Fiji

The Ministry of Health and Medical Services is declaring an outbreak of measles for the Serua/Namosi Subdivision. There have been two confirmed cases and two suspected cases reported from Wailali Settlement in Wainadoi. Three of the cases have recovered or are recovering at home, and one is currently admitted in hospital. (Gov't of Fiji, 07 Nov 2019)

As of 11 November, one of the suspected cases from the 7th November update was subsequently confirmed to have measles after lab testing. There are three confirmed cases and one suspected case reported from Wailali Settlement in Wainadoi. The three confirmed cases are a four-month-old baby and two adults between the ages of twenty and twenty-five. (Gov't of Fiji, 11 Nov 2019)

Seven cases of measles have been confirmed by 19 November. The latest confirmed cases are a 7 month old from Wainadoi, a 3 month old from Wainadoi, and a 19 year old from Navunikabi in Namosi. There are 2 more suspected cases in Navunikabi Namosi. The 7 month old and 3 month old babies are currently admitted under isolation at Navua hospital. (Govt. of Fiji, 19 Nov 2019)

As of 20 November, there are 9 confirmed cases of measles from Serua/Namosi Subdivision. The latest two confirmed cases are a 15 year old from Wainadoi, and a 2 year old who had been staying in Waibogi Serua. The outbreak response teams are responding to the notification of the new cases, which includes vaccination and quarantine of contacts if needed. (Govt. of Fiji, 20 Nov 2019)

As of 22 November, there are now 10 confirmed cases of measles. The latest confirmed case is a 25-year-old pregnant woman from Samabula. The woman presented to the CWM Hospital on 21 November 2019 and is currently admitted under isolation. (Gov't of Fiji, 22 Nov 2019)

As of 27 November, there are 13 confirmed cases of measles. The latest confirmed cases are a 22 year old from Wailali Settlement and a 16 year old from Navunikabi, both in the Serua/Namosi Subdivision. The third case is a 1-year-old child from Vatuwaqa Suva, who was admitted at CWM Hospital but has since been discharged. To date all but 2 of the confirmed cases are from, or are linked to, the Serua/Namosi Subdivision. And all the confirmed cases are in the Central Division. (Gov't of Fiji, 27 Nov 2019)

As of 29 November, there are now 14 confirmed cases of measles. The latest confirmed case is a 36 year old from Makosoi, Deuba in Serua/Namosi. (Gov't of Fiji, 29 Nov 2019)

As of 3 December, there are now 15 confirmed cases of measles. The latest confirmed case is a 38 year old from Nasilai Village in Nakelo – Rewa Subdivision. The 15 cases to date are from the following areas: 11 cases from the Serua/Namosi Subdivision (Wailali, Wainadoi, Navunikabi, and Makosoi Deuba), 2 cases from Suva (Samabula and Vatuwaqa) Subdivision, 2 cases from Rewa (Koronivia, Nasilai Village Nakelo) Subdivision. (Gov't of Fiji, 03 Dec 2019)

5 December saw 16 confirmed cases of measles. The latest confirmed case is a 24 year old from Sakoca in Tacirua, Suva. (Govt. of Fiji, 5 Dec 2019)

Since the last update on 04 December, 18 cases of measles have been confirmed. To date, confirmed cases are from, or are linked to cases in Serua/Namosi Subdivision (12 cases from Wailali, Wainadoi, Navunikabi and Makosoi Deuba) from Suva (4 cases from Samabuka and Vatuwaqa) and Rewa (2 cases from Koronivia) subdivisions in the Central Division. (WHO and UNICEF, 6 Dec 2019)

There are now 19 confirmed measles cases. The latest case manifested in a nine-month-old from Davuilevu in Rewa who had stayed at Saumakia Settlement in Naitasiri, and the Korovou Prison Compound in Suva. All of the measles cases so far have appeared in the Central Division. More than 85,000 people in the Central Division have been vaccinated since the second phase of the measles mass immunisation campaign, which began 4 December. This is in addition to the approximately 100,000 people who were vaccinated nationwide since the outbreak was declared 7 November. (Govt. of Fiji, 11 Dec 2019).

Since the last update on 10 December, there are now 21 confirmed cases of measles. The latest confirmed cases are a 13 year old from Nasilai Village in Nakelo Rewa, and a 27 year old from Saumakia Village in Naitasiri. Both new cases are contacts of previously confirmed measles cases in those villages. The Rewa and Naitasiri outbreak response teams have carried out the necessary interventions including isolation of cases, quarantine and vaccination of contacts and at risk communities as appropriate. Since the outbreak was declared on Thursday 7 November 2019, around 200,000 people in Fiji have been immunised against measles. (Govt. of Fiji, 15 Dec 2019).

As of 18 December, there are 23 confirmed cases of measles from Serua/Namosi, Suva, Rewa and Naitasiri in the Central Division. The latest confirmed cases are a 13 month old and a 20 year old from Saumakia Village in Naitasiri. There are no confirmed cases of measles currently admitted in hospital. All cases have recovered or are recovering well at home. The Naitasiri outbreak response team has carried out the necessary interventions including isolation of cases, quarantine and vaccination of contacts and at risk communities as appropriate, and follow up of cases and contacts. (Govt. of Fiji, 18 Dec 2019).

The Government of Fiji is aiming for 95 percent vaccination coverage by Christmas Eve. As of 23 December, 24 measles cases had been confirmed, with ten females and 13 males affected by the disease. All are aged under 40, and have been confined to the Central Division. There have been 12 hospitalizations and no deaths reported. (WHO, UN Children's Fund, 23 Dec 2019).

One more case, an 11-month-old from Nabua, has been confirmed by the Government of Fiji. This brings the total measles cases in Fiji to 25. All have been discovered in the Central Division, with approximately half from the Serua/Namois Subdivision. (Govt. of Fiji, 26 Dec 2019).

Since the last update on 26 December 2019, there are now 27 confirmed cases of measles. The latest confirmed cases are a 12 year old from Sakoca in Tacirua who is linked to a previous case in the same area, and a 39 year old from Nasole in Nasinu who was admitted at CWM Hospital and later discharged home. All 27 cases are from the following areas in the Central Division: 12 cases from the Serua/Namosi Subdivision (Wailali, Wainadoi, Navunikabi, and Makosoi Deuba), 8 cases from Suva Subdivision (Nabua, Samabula, Vatuwaqa, Sakoca in Tacirua, Wailekutu and Naikorokoro Village in Lami), 3 cases from Rewa Subdivision (Koronivia, Nasilai Village Nakelo, Davuilevu) and 4 cases from Naitasiri Subdivision (Saumakia Village). The national measles immunisation campaign was temporarily suspended on 27 December 2019 due to Tropical Cyclone Sarai and will restart in all divisions by 6 January 2020. (Govt. of Fiji, 3 Jan 2020)

The Serua/Namosi measles outbreak declared on 7 November 2019 is now at an end. A total of 12 cases of measles were reported from Serua/Namosi during the outbreak. No new cases have been reported since the end of November, and more than 42 days (two incubation periods) have passed since the last case. The measles outbreak remains ongoing for the rest of Central Division. However, weekly reported cases have decreased and there have been no new cases reported since the last update on 9 January. The case count remains at 28, and all cases were from the Central Division (Govt. of Fiji, 20 Jan 2020)

Kiribati

On 17 December 2019 the first confirmed measles case was reported; an 11-monthold boy from Eita village. The second confirmed case was reported; a 7-month-old boy from Taborio, on 23 December 2019. Currently, both confirmed cases have recovered, and their contacts have been investigated for immunization status and measles symptoms. (Govt. of the Republic of Kiribati, 27 Dec 2019).

No new laboratory confirmed measles cases have been reported. Investigation of new suspected cases is ongoing, with on-site and remote technical support from WHO and UNICEF. The Ministry of Health & Medical Service (MHMS) is intensifying activities to support vaccination of workers in seaports and domestic flights airports as well as domestic travelers to Kiribati’s outer islands. Vaccination of all domestic travelers to and from Tarawa, who cannot show evidence of vaccination, is also ongoing. (WHO, UNICEF, 8 Jan 2020).

Samoa

The Ministry of Health held a news conference in Apia on 9 October to announce a suspected measles case that may be transmitted from the Auckland outbreak. The MoH further reported if lab results sent to Australia were positive, an outbreak would be declared. (ECHO, 11 Oct 2019)

A measles epidemic was confirmed by the Government of Samoa on 16 October. There were seven confirmed cases of measles[.] All were treated and discharged with no complications. However, there has also been one confirmed death, a one-year-old child. (Govt. of Samoa, 16 Oct 2019)

The Samoan government will close all schools in the country due to the current measles epidemic. The Cabinet has approved for all primary schools to be closed from 15 November and all high schools as of 29 November. More than 300 people, mostly young children, were suspected to have the viral illness. 3 people have died from suspected measles cases since the declaration of the epidemic last month. (ECHO, 04 Nov 2019)

In Samoa, the situation is deteriorating. There are at least 628 suspected measles cases recorded with 48 confirmed so far. A vaccinologist from Auckland University said the disease was at the stage where it was now difficult to stop. The necessary measure is to provide vaccinations. Samoa had a very low uptake of measles vaccines for years and the country had some of the lowest vaccine coverages in the world. (ECHO, 13 Nov 2019)

On 18 November, UNICEF announced that it is supporting the Government of Samoa to respond to a measles outbreak in the country. The Government of Samoa officially declared a state of emergency on 15 November 2019, four weeks into the continuing measles outbreak with more than 1,000 suspected cases so far. All schools have been temporarily closed in order to prevent the disease from spreading. The epidemic has claimed the lives of 14 children under-five years old and one adult. (UNICEF, 18 Nov 2019)

As of 21 November, Samoa was dealing with over 700 measles cases. The Samoan Ministry of Health (SMoH) issued a press release the day beforehand providing details of the mass vaccination campaign due to start tomorrow in urban Apia and Leulomoega. Approximately 70,000 people are in the targeted groups for vaccination, which includes children and infants aged 6 months to 19 years of age, and non-pregnant women aged 20 to 35 years. (ECHO, 21 Nov 2019)

The government also reported that 24,000 people had so far been immunised in a compulsory mass vaccination campaign launched under the state of emergency. Travel between Upolu and Savaii is prohibited for anyone aged 19 or younger. (ECHO, 26 Nov 2019)

As of 28 November, there were 250 cases recorded in the last 24 hours and 39 measles related deaths have been recorded. Approximately 98 per cent of the measles cases are from Upolu and notably concentrated in the Vaimauga West and Faleata West districts with about 92 per cent admission rates, of which highest are among children below the age of 5 years. (IFRC, 2 Dec 2019)

As of 3 December, there have been at least 55 measles-related deaths, the majority of whom were children under the age of four. Over 3,800 measles cases have also been reported. On 2 December, the Government announced a nationwide mass vaccination and instructed the shutdown of all public services to enforce the campaign. UN agencies deployed health specialists and are providing technical assistance to the Government. (OCHA, 3 Dec 2019)

As of 5 December 2019, there have been 4,217 cases since the outbreak started. There were 165 recorded in the last 24 hours. There have been 62 related deaths, with 2 fatalities in the last 24 hours. There are currently 172 measles cases who are in-patients at all health facilities. Admissions include 19 critically ill children in the Intensive Care Unit/ High Dependency Unit and 3 pregnant women and 1 postnatal at Tupua Tamasese Meaole Hospital. The total number of measles cases admitted to all hospitals recorded for the outbreak to date is 1,310. (WHO, 5 Dec 2019)

The Ministry of Health confirms a total of over 4,350 measles cases have been reported to the Disease Surveillance Team, since the outbreak started. There were 140 recorded in the last 24 hours. There are currently almost 180 measles cases who are in-patients at all health facilities. Admissions include 20 critically ill children in ICU/HDU and 3 pregnant women at Tupua Tamasese Meaole Hospital (TTMH). The total number of measles cases admitted to all hospitals recorded for the outbreak to date is approximately 1,370. Of that, 82 percent of patients have been discharged. The recovery rate remains the same since the last update. To date, 63 measles related deaths have been recorded, with 1 fatality in the last 24 hours. (Govt. of Samoa, 6 Dec 2019)

The UN’s Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Mark Lowcock has released US$2.6 million from the Central Emergency Response Fund to help fight the devastating measles outbreak in Samoa and support the wider region. The funds will provide emergency vaccinations, obstetric and neonatal care for mothers and newborns infected with measles, mental health and psychosocial support, clean water and sanitation, and lifesaving public health information for 1.25 million people. (OCHA, 9 Dec 2019)

The Ministry of Health confirms approximately 5,000 measles cases have been reported, with 75 recorded in the last 24 hours. There are almost 180 measles cases who are currently in-patients at Samoa's health facilities. Most of these in-patients are admitted to Tupua Tamasese Meaole Hospital (TTMH). Admissions more than 15 critically ill children in ICU/HDU and 3 pregnant women at TTMH. The outbreak has seen almost 1,600 measles cases admitted to Samoan hospitals, however, around 85 percent of patients have been discharged. To date, 72 measles related deaths have been recorded, with 1 fatality in the last 24 hours. Currently almost 95 percent of all eligible people in Samoa have been vaccinated against measles. (Govt. of Samoa, 12 Dec 2019).

As of 15 December, 5,210 measles cases have been reported by the Ministry of Health since the start of the outbreak. In the last 24 hours, over 50 cases were recorded in Upolu. There are currently 150 measles cases who are in-patients at all health facilities. Of these, almost 120 have been admitted to Tupua Tamasese Meaole Hospital (TTMH). Admissions include more than 15 critically ill children in ICU/HDU. The total number of measles cases admitted to all hospitals recorded for the outbreak to date is almost 1,650. However, almost 90 percent of these patients have been discharged. (Govt. of Samoa, 15 Dec 2019).

As of 18 December, the Ministry of Health confirms 5,371 measles cases have been reported. There were 40 cases recorded in the last 24 hours. There are currently 126 measles cases who are in-patients at health facilities. The total number of measles cases admitted to all hospitals recorded for the outbreak to date is 1,723. Of that, 1,521 (88%) patients have been discharged. To date, 76 measles related deaths have been recorded, with 1 fatality (child under 5 years old) in the last 24 hours. (Govt. of Samoa, 18 Dec 2019).

As of 22 December, the Ministry of Health confirms a total of 5,520 measles cases have been reported to the Disease Surveillance Team, since the outbreak started. There were 26 recorded in the last 24 hours. There are currently 83 measles cases who are in-patients at all health facilities. The total number of measles cases admitted to all hospitals recorded for the outbreak to date is 1,791. Of that, 1,629 (91%) patients have been discharged. To date, 79 measles related deaths have been recorded. (Gov't of Samoa, 22 Dec 2019)

Over 5,600 measles cases have been reported to the Disease Surveillance Team, as of 26 December. There are currently 43 measles cases who are in-patients at all health facilities. Of this, more than 85 percent of these cases are at the Tupua Tamasese Meaole Hospital (TTMH). Admissions include 7 critically ill children and 3 adults in ICU/HDU. The total number of measles cases admitted to all hospitals recorded for the outbreak to date is approximately 1,820. Of that, over 90 percent of patients have been discharged. To date, 81 measles related deaths have been recorded, with 1 fatality (child under 5 years old) in the last 24 hours. Approximately 95 percent of all eligible people in Samoa have been vaccinated against measles. (Govt. of Samoa, 26 Dec 2019).

The Ministry of Health confirms a total of 5,667 measles cases have been reported to the Disease Surveillance Team, since the outbreak started. There were 12 recorded in the last 24 hours for Upolu (0 new cases for Savaii). There are currently 45 measles cases who are in-patients at all health facilities. Of this, 37 are at the Tupua Tamasese Meaole Hospital (TTMH), 2 at Poutasi District Hospital, 1 at Lalomanu District Hospital, 4 at Foailalo District Hospital and 1 in Sataua. Admissions include 9 critically ill children and 1 adult in ICU/HDU, 1 pregnant woman admitted to TTMH in maternity ward and 1 pregnant woman in Poutasi District Hospital. The total number of measles cases admitted to all hospitals recorded for the outbreak to date is 1,846. Of that, 1,720 (93%) patients have been discharged. To date, 81 measles related deaths have been recorded. (Govt. of Samoa, 29 Dec 2019).

As of 6 January 2020, the Ministry of Health confirmed a cumulative total of 5,697 measles cases have been reported to the Disease Surveillance Team, since the outbreak started. Currently the outbreak is declining with 30 new cases reported between 29 December 2019 and 5 January 2020. The total number of measles cases admitted to all hospitals recorded for the outbreak to date is 1,860, of that, 1,761 (95%) patients have recovered and been discharged. To date, 83 measles related deaths have been recorded, with 2 fatalities (one infant and one adult) between 29 December 2019 and 5 January 2020. There are currently no travel restrictions or vaccination requirement for those travelling to Samoa. (Govt. of Samoa, 6 Jan 2020).

The number of reported measles cases per day is rapidly reducing and the situation is stabilizing. Emergency Medical Teams (EMTs) are scaling down but some will remain into January. Since 20 November 2019, the Ministry of Health (MoH) has successfully vaccinated 134,499 individuals in both Upolu and Savai’i. (WHO, UNICEF, 8 Jan 2020).

As for 20 January, a total of 83 measles related deaths have been recorded. The number of new cases reported was declining with only two new cases and no deaths reported during 13 - 20 January. Currently there are no travel restrictions or vaccination requirement for those travelling to Samoa. (Govt. of Samoa, 20 Jan 2020)

The measles outbreak in Samoa has been declared over since there have been no measles cases or deaths reported since 14 January and 2 January 2020 respectively .The recovery phase will continue with close monitoring by national health surveillance team [Source HEOC Situational Report 4th March 2020]. (WHO, 6 Mar 2020)

Tonga

The Tonga Ministry of Health advises that cases of measles have been identified in a high school rugby group, who were playing rugby in New Zealand in September. The team returned to Tonga on 1 October. The Ministry has taken rapid steps to prevent further spread of the virus, including isolating the current cases at home, vaccinating contacts of the cases and quarantining the remaining squad members, staff and other contacts. (Govt. of Tonga, 18 Oct 2019)

As of 28 October, 107 cases of confirmed, or suspected, measles cases had been identified in Tonga. Authorities reported that the cases are typically experiencing a mild illness. Approximately 65 percent of these cases were discovered in 15-19 year olds. (Govt. of Tonga, 28 Oct 2019)

As of 5 November, 177 cases of confirmed or suspected measles have been identified in Tonga. Clinicians have reported that most cases are experiencing a mild illness. (Gov't of Tonga, 6 Nov 2019)

The Ministry of Education and Training and the Ministry of Health of Tonga announced the closure of all government primary schools from 14-25 November 2019 to further contain the outbreak of measles. The Ministry of Health advised people in Tonga to take precautionary measures to minimize the spread of measles, especially among students. (ECHO, 13 Nov 2019)

The Tonga Ministry of Health officially declared a measles outbreak on 22 October. As of 19 November, 310 cases of confirmed or suspected measles and no deaths have been recorded. (ECHO, 25 Nov 2019)

As at 26 November, 394 cases of confirmed or suspected measles have been identified in Tonga. 344 (87%) of cases have occurred on the main island of Tongatapu, where the outbreak began. The smaller outbreak on Vava’u has a total of 44 (11%) cases. Additionally, 5 cases of rash illness have occurred in children on the island of ‘Eua, while a single case of rash illness has occurred in a child on the island of Ha’apai. Eight admissions to hospital have occurred among measles cases in this outbreak, with no deaths. The significant majority of cases have been managed in home isolation. (Gov't of Tonga, 27 Nov 2019)

As of 2 December, there have been 440 cases of confirmed or suspected case since early October, including 46 additional cases since SITREP7 (released the week prior). All 46 of the cases from the past week have been from the main island of Tongatapu, meaning 390 (89%) cases in total have occurred on Tongatapu, where the outbreak began. No further cases have been reported from any other island since SITREP7.There have been 10 hospitalisations for measles throughout the outbreak and reported deaths.

As of 6 December, 458 cases of confirmed or suspected measles and no deaths have been recorded. The two recent new cases have been reported from Eua island. Currently none is hospitalised. Of all cases 363 (79%) occurred among adolescents and young people aged 10 to 24 years. Eighty-seven percent (87%) are in the island of Tongatapu. Since the beginning of this outbreak, 10 measles cases required hospitalization. The Ministry of Health administered in total (as at December 3) 15,124, vaccines 69% in Tongatupu island. Source: Pacific Public Health Surveillance Network, Tonga, Situation Report 8, (04/11/2019) and daily briefings with MoH Tonga. (WHO & UNICEF, 6 Dec 2019)

The Pacific Public Health Surveillance Network reported that as of 9 December, 485 cases of confirmed or suspected measles and no deaths have been recorded. Currently none are hospitalised. Over 80 percent of these cases occurred among adolescents and young people aged 10 to 24 years. Almost 90 percent of the cases have been reported on the island of Tongatapu. As of December 3, the Ministry of Health administered more than 15,100, vaccines, with almost 70 percent of these being on Tongatupu island (WHO & UNICEF, 10 Dec 2019).

As of 15 December, 564 confirmed or suspected cases of measles have been identified in Tonga. 90% of the cases are from Tongatapu. Cases have been reported to be mild with 12 hospitalizations with no deaths. It is estimated that at least 94% of the reported measles cases will have already recovered from their illnesses. School-based vaccination program and ‘Zero dose’ for infants aged 6 to 11 months have been completed on all Islands. The mass vaccination campaign targeting 10-24-year-old age group, not picked up during the school campaign, is scheduled to begin on 17 December. (Gov't of Tonga, 18 Dec 2019)

The rate of measles transmissions is beginning to slow in Tonga, with more than 590 cases confirmed or suspected by 23 December. 90 percent of these cases have occurred on Tongatapu. Measles cases have been reported to be mild, with 15 hospitalizations with no deaths. The age group that primarily affected remains those aged 10-24 years. The mass vaccination campaign targeting those aged 10-24 years across the country has been completed. (WHO, UNICEF, 23 Dec 2019).

As of 31 December, 612 confirmed or suspected cases of measles have been identified in Tonga. The majority 534 (87.2%) cases have occurred on Tongatapu and 66 (10.7%) have occurred on Vava’u Island. Case presentations have been reported to be mild with 18 hospitalisations and no death. The majority of the cases have been managed by home isolation and all patients have been discharged. Given the duration of illness is typically less than 2 weeks, it is estimated that at least 96% of the 612 reported Measles cases will have already recovered from their illnesses. (Govt. of Tonga, 2 Jan 2019)

There is a downward trend in reported case numbers in Tonga, with fewer numbers of new cases being reported in recent weeks. Case presentations reported remain to be generally mild, with 18 hospitalisations and no death. Vaccination has been completed in the Islands of Tongatapu, Vavau’u and Ha’apai., the islands Eua and Niuatoputapu will be covered in January 2020. (WHO, UNICEF, 8 Jan 2020).

As of 9 January, 630 confirmed or suspected cases of measles have been identified in Tonga. Almost 90 percent of these cases have occurred on Tongatapu. Case presentations have been reported to be mild, with 19 hospitalisations and no death. It is estimated that at least 99 percent of the 630 reported measles cases have already recovered from their illnesses. (Govt. of Tonga, 10 Jan 2019).

About one week onwards, and almost 640 confirmed or suspected cases of measles have been identified in Tonga. Around 560 of these have occurred on Tongatapu, while about ten percent of cases have appeared on Vava'u Island. Case presentations have been mild, with 20 hospitalisations and no deaths recorded. It is estimated that at least 99 percent of the total reported measles cases have already recovered from the illness. (Govt. of Tonga, 17 Jan 2020).

As of 22 January, eight additional measles cases have been reported in Tongatapu. Of these eight, five were males and three females. In total, almost 650 confirmed or suspected cases of measles have been reported in Tonga. Of these, approximately 570 cases occurred on Tongatapu. Cases have mostly presented with mild symptoms. To date, there have been twenty hospitalisations. However, there have been no admissions since 25 December 2019. All cases have been discharged and no deaths have been reported. The majority cases have been managed in home isolation. (Govt. of Tonga, 23 Jan 2020).

As of 5 February, 656 confirmed and suspected cases of measles have been reported in Tonga. Till date, 98 specimens have been tested for measles, of which 78 (79.6%) have been PCR laboratory confirmed. Of 656 cases, 578 (88.1%) cases occurred on Tongatapu and 66 (10.1 %) occurred on Vava’u Island. (Govt. of Tonga, 6 Feb 2020).

Between 6 and 12 of February, three new measles cases were reported from the island of Tongatapu. This brought the total of confirmed and suspected cases to 659. Ninety eight specimens have been tested for measles, of which 79.6% have been PCR laboratory confirmed. Throughout the course of the outbreak, most cases presented with mild symptoms, and were mostly managed by home isolation. No deaths have been reported till date. No deaths have been reported till date. (Govt. of Tonga, 13 Feb 2020)