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Measles: ‘We should expect the worst’

Saturday September 07, 2019 Written by Published in Health
Venesther Joseph, playing here with her mother Esther Strickland, was last week called in for an emergency measles vaccination for 12-month-olds. “It’s inevitable it will get here,” Strickland said. 19090689 / GRAY CLAPHAM Venesther Joseph, playing here with her mother Esther Strickland, was last week called in for an emergency measles vaccination for 12-month-olds. “It’s inevitable it will get here,” Strickland said. 19090689 / GRAY CLAPHAM

Health officials charged with preventing a measles outbreak say they are “expecting the worst”.

There have been no cases of the highly infectious disease reported yet, but Health Secretary Dr Josephine Aumea Herman says she can’t rule out undiagnosed cases. “It would be naive to believe the island is not at risk.”

Dr Herman says the focus of the current challenge is all about “protecting our babies”.
If just one baby becomes infected with measles here, the medical resources on the island will be under serious pressure to keep that baby alive.

“Our health system here is not at the level that New Zealand offers. If we have more than one sick baby presenting it would be very difficult for us,” she added. “We just don’t have the resources.”

Such is the seriousness of the illness as it affects babies, medical evacuation to New Zealand would not be an option, she said.

Babies up to 15 months old are the most vulnerable: they face life-threatening risks from measles infection.

Since May, babies between the ages of 12 and 15 months have been called in for emergency vaccinations – the age threshold is usually over 15 months.

Venesther Joseph was one baby who was called in for an emergency jab last week.

“It’s inevitable that it will get here,” said her mother Esther Strickland.

At the end of this month, when more vaccine supplies arrive, babies from 6 to 12 months will be called in for an early emergency dose of the MMR vaccine.

“We should expect the worst,” Dr Herman said.

“I would be great if we don’t see it here, but with the volume of people flying in from New Zealand, particularly Auckland, it’s only a matter of time before someone does come into Rarotonga with measles – in fact it could have happened already.

“It’s important that the health system is on standby and that we raise the awareness  of the threat to the Cook Islands, and we can only do our best.”

With 20 planes landing in Rarotonga from Auckland every week Dr Herman says it’s highly likely someone has, or will, get through the border who has the disease in the incubation period – which is one to two weeks. During that period the person might not have experienced any symptoms.

“They might have no idea that they are actually harbouring the disease – and that’s the problem we have.

“This is a major challenge. I encourage all parents to vaccinate their children if they aren’t. We don’t want to lose our babies.”

Dr Herman’s advice to any families with unvaccinated newborn babies planning non-urgent travel to New Zealand they should put those plans on hold.

Anyone unsure of anything about the measles threat should “come in and talk to us”
The first line of defence to the disease spreading on Rarotonga has long been in place – the fact that most people who were born before 1981 are most likely immune.

That, coupled with the generally high level of acceptance of the MMR vaccinations provided to babies since that date, has given the Cook Islands a high “herd immunity”.

That means a person with the disease is surrounded by a “herd” of immune people and the contagion is hopefully stopped in its tracks.

But there is always the risk that the disease will find someone unvaccinated, as Dr Herman says there are some people who are “conscientious objectors” to vaccination, living in the islands.

The fight against a local outbreak is also focused on quick response to the arrival of the disease, if and when it does. Health authorities are relying on the people of the islands to be the “guards at the gate” by being aware of the symptoms.

“We have a procedure at the outpatients at the hospital and at the Tupapa Medical Clinic, if a person thinks they have some of the symptoms of measles then they should stop where they are, put on a face mask and we have a bell that they can ring,” Dr Herman says.

“We don’t want them coming in to the waiting area because if they have the infection they could contaminate everyone in the room.

“Measles is highly infectious, so what we need to do is isolate this person very quickly.

“We really are relying on the patients to give the heads up that they have the symptoms and if they do, we have separate room to examine the person and make a diagnosis.

“We have also revised our information at the airport in regard to the measles threat.”

So far no one has yet presented with the illness at any of the clinics on Rarotonga.