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Measles Outbreak in the Pacific - Situation Report No 7, December 17, 2019

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[Situation update]


  • A total 5,331 cases, including 75 deaths, have been reported since the beginning of the outbreak, including 638 in the last week. As of 14 Dec 2019, there were 150 measles cases admitted in six hospitals (nil remaining in Lalomanu and Faleolo hospitals on Upolu and Sataua hospital in Savai’i.

  • The highest age-specific attack rates continue to be reported in children aged 6-11 months (239.6 per 1000 which is over 1 in 5 infants in this age group), followed by infants 0-5 months (141.1 per 1000) and children aged 1-4 years (71.4 per 1000). Approximately 85% of deaths have occurred in the under 5s.

  • Over 90% of the target population of 6 months to 60 years has been vaccinated; however, agespecific coverage data are still being collated and validated.

  • The State of Emergency due to the measles epidemic was declared by the Government on 15 November 2019 and has been extended until Sunday 29 December 2019. Travel restrictions and social distancing measures on <20-year olds eased; now only apply to <15-year old age group.

  • As of 27 November 2019, 16 Emergency Medical Teams (EMT) from the region and globally have deployed in the field. EMTs that are staying longer are rotating over time. The Health Emergency Operations Centre (HEOC) will continue to meet over the holiday period, and is aligning the build down of EMTs with the caseload to avoid coverage gaps.

  • An emerging issue is the representation of children with post-measles infections. This situation is being monitored closely.


  • Tonga is seeing a 5th wave of transmission with fewer numbers of new cases being reported in recent weeks. Although it is too soon to call the outbreak post-peak, it appears to be slowing.

  • A total 572 generally mild cases, including 12 admissions and 0 deaths, have been reported since the beginning of the outbreak. The age group primarily affected remains those aged 10-24 years, with an increasing proportion of females being affected from their male cohorts.

  • The MOH is continuing to collect information on the vaccination status of the cases, aided most recently by two vaccine preventable disease epidemiologists from US Centers for Disease Control and Prevention (US CDC) to fully investigate underlying causes of the vaccination breakthrough cases.

  • Secondary school vaccinations have been completed on almost all islands. The MOH has consulted the secretariat on whether an expanded group of younger children should also be offered vaccination. The plan is to complete vaccinations before Christmas.

  • Although most government agencies are expected to close over the holiday period, selected staff of the Department of Public Health are slated to remain on duty.


  • Two additional cases have been reported in the last week, bringing the total from 19 to 21 cases with 0 deaths. All laboratory confirmed cases have been reported from the Central Division to date, with the majority from Serua/Namosi, with additional cases from Naitasiri, Rewa and Suva subdivisions. The new cases were known contacts of confirmed cases. Eight (8) cases are aged 0-4 years and 13 cases 19-39 years; 5 of the age-eligible cases were unvaccinated, 2 cases fully vaccinated for age, 4 had received post-exposure vaccination but later than recommended and vaccination status was unknown in one case.

  • Fiji aims to reach >95% coverage of the target population by 24 Dec. Over 200,000 people have been immunized, with overall 96% vaccination coverage in Serua/Namosi subdivision of Central division, the primary outbreak area in Fiji. Now entering the second and third phase of targeted immunization, in the Western & Eastern and Division Northern Division, respectively.

  • Coverage data from Rewa currently being collated with the aim of finishing next week. Rewa and Suva subdivisions are planning to go house-to-house. Eastern and Western divisions are updating their microplanning to ensure that they meet daily targets. Western will be working with the HEOC to access additional vehicles and drivers from other Ministries to support logistics for the immunisation teams.

  • The HEOC continues to provide daily updates of immunisation coverage. They will be working with WHO to map coverage using GIS (geographical information systems).

  • WHO will be supporting the Colonial War Memorial Hospital with additional PPE, especially disposable gowns.

  • Fiji continues risk communication in three languages (i-Taukei, Hindi and English). Includes 12 public advisories, media interviews in the 3 languages, boosted (push) Facebook posts and printing of home-based care leaflets with WHO support, photographs from staff in the field for social media posts on the MOH website, and Fiji immunisation team T-shirts supported by UNICEF.

American Samoa

  • 10 cases reported, 0 deaths.