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Measles outbreak in Western Samoa: Lessons for Maui

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Western Samoa recently declared a national emergency since more than 4,800 new cases of measles have occurred since mid-October, of which more than 1,100 people have been hospitalized and over 70 have died (mostly young children).

These numbers are increasing daily. This measles-related death rate is higher than average given that Samoa is an underdeveloped area with poorer nutrition and health care. This outbreak occurred because the country went from being 74 percent to only 34 percent immunized from measles in a short period of time, hence a large percentage of their residents are susceptible for measles.

The outbreak in Samoa is important to Maui residents and visitors because people can travel between Samoa and Maui within hours. Visitors and returning residents may have measles while traveling and not know it until after they arrive here. In fact, Hawaii recently had four people infected with measles arrive to the state from other areas. Further, Maui has pockets of people, including children, who are susceptible to measles due to lack of herd immunity.

We as a community need to focus on protecting ourselves, our family and people who are at higher risk for complication, such as children under age 5 and people with compromised immune systems. Once measles comes to an area, it is very difficult to contain and eliminate. Hence, prevention is more effective than responding to an outbreak. Focusing on prevention is especially important right now given increased travel during the holidays.

Measles is a very contagious illness caused by a virus. First symptoms include high fever, cough, runny nose and red and watery eyes. These symptoms are then followed by a rash that starts three to five days later and lasts about five to six days. Serious complications can include pneumonia, brain swelling, permanent brain damage and death. Measles is spread from person to person through the air when an infected person coughs or sneezes. Oftentimes, people with measles are contagious for a few days before they develop symptoms of measles.

The best way to prevent getting measles is by getting the MMR vaccine at the recommended ages. The best way to prevent spreading measles is to stay home and isolated when the early symptoms begin. In order to protect our community, including those who cannot get the MMR vaccine, we need to build up herd immunity.

Herd immunity occurs when a large majority of the population is immune to the disease which prevents its spread through the community. Hence, protecting ìthe herd.î In order to create herd immunity, between 93 to 95 percent of the community needs to be vaccinated.

Since measles vaccination began, the U.S. has seen some years with zero cases of measles. Yet with specific groups refusing to immunize, measles has been coming back into the U.S. It’s also important to avoid traveling to high-risk areas, like Samoa, and to maintain a healthy and balanced diet, especially vitamins A and C.

The outbreak in Samoa has a relatively high death rate, especially in young children, which is not unusual for undeveloped poorer countries due to poor nutrition. Even though Maui is part of a developed country, it is important to assure your family, especially young children, eat a healthy and balanced diet.

We each need to take the recent measles outbreak seriously and work hard to keep families on Maui protected in order to prevent a situation similar to what is going on in Samoa. We need to keep up herd immunity. If you have concerns about vaccine safety, educate yourself with facts about vaccine effectiveness and safety. We need to avoid traveling to or from Samoa, especially if we are susceptible for measles. And we need to eat a balanced and healthy diet with each of the recommended nutrients, especially vitamins A and C.

Finally, if you suspect that you have measles, stay home and call your health care provider right away. Please feel free to call our office for more information at (808) 984-8216.

On the net: health.hawaii.gov/docd/disease_listing/measles/.wwwnc.cdc.gov/travel.

* Kristin Mills is a public health educator with the Maui District Health Office.