2019–2020 New Zealand measles outbreak explained

2019–2020 New Zealand measles outbreak
Date:1 August 2019 – 21 February 2020[1]
  • Christchurch

16 February – 16 May 2019[2]

  • Auckland

28 February 2019 – 7 February 2020[3]

The 2019–2020 New Zealand measles outbreak was an epidemic that affected New Zealand, primarily the Auckland region.[4] The outbreak was the worst epidemic in New Zealand since an influenza epidemic in 1999, and is the worst measles epidemic since 1938.[5] [6]

The D8 strain was confirmed to be the main strain of the epidemic,[7] [8] but the B3 strain has also been identified[9] and the epidemic has spread to several other countries. In Samoa more than 72 people have died. Cases in Tonga and Fiji have also been recorded, and an outbreak in Perth began in October 2019 after a New Zealander visited while infectious.[10] In New Zealand, two unborn foetuses in second trimester have died as a result of the outbreak.[11]

Response

The New Zealand Government has been criticised for its response to the epidemic, particularly due to shortages in the supply of vaccines.[12] [13] Scientists have also criticised the Ministry of Health for not acting on previous recommendations to conduct national 'catch-up' campaigns with the MMR vaccine prior to the outbreak.[14]

In 2017 the New Zealand Health Ministry produced documents that showed an urgent need to increase measles immunisation among young people and that a "systematic, programmatic approach" was needed to address an immunity gap. [15] Dr Nikki Turner, Chair of the National Measles Verification Committee, met in 2018 to discuss the immunisation gap. It was noted damage was historical and immunisation rates had improved but by 2019 the gap had not been fully addressed. Many young people did not know if they had been vaccinated which indicated that poor record keeping contributed to ineffective delivery.[16] David Haymen and Turner concluded that the best way to close the immunity gap was to undertake a formal catch-up programme.[17]

Research into the 2019 epidemic traced its history and showed it was young infants who were most at risk, followed by teenagers and adults under the age of 30.[16] Analysis by the Immunisation Advisory Centre found that a generation born between 1982 and 2007 had low immunization rates, and vaccination records are incomplete for that period as the National Immunisation Register was introduced in 2005.[18] Research also suggested management strategies such as a national campaign targeting the at-risk age groups; establishment of systems to ensure adequate supplies of vaccines; provision of support for their delivery at the practice level; and creative use of community facilities to improve accessibility.

During the COVID-19 pandemic in New Zealand, it became apparent that in the drive to obtain a vaccine for that outbreak, there was a stall in getting measles vaccination programmes rolled out effectively. Turner warned that because of this, it was possible that there would be "bigger problems with children dying from measles, and the damage from measles, than Covid."[19]

Although New Zealand has had a high demand for the MMR vaccine, resulting in a shortage, there has also been an increase in the number of people who have declined the vaccine since 2017.[20]

Cases

As of 24 February 2020, there had been 2,194 cases of measles reported throughout New Zealand since 1 January 2019. Auckland had been the worst-hit region, with 1,736 cases alone. The New Zealand government activated the National Health Coordination Center in August 2019 to respond to the outbreak.[21]

Confirmed cases by District Health Board (24 February 2020)! Region! Cases! Hospitalised
133 23
306 129
274 108
1,157 435
51 12
30 6
45 19
0 0
8 3
26 8
0 0
10 0
9 1
24 7
1 0
1 0
0 0
44 17
2 0
73 6
Total (nationwide)2,194774

See also

Notes and References

  1. Web site: 24 February 2020 . Measles weekly report . 4 March 2021 . Public Health Surveillance . 19 February 2020 . https://web.archive.org/web/20200219000610/https://surv.esr.cri.nz/PDF_surveillance/MeaslesRpt/2020/measlesReport20200210.pdf . dead .
  2. News: Canterbury measles outbreak declared officially over . en-NZ . TVNZ . 4 March 2021 .
  3. Web site: 10 February 2020 . Measles weekly report . 4 March 2021 . Public Health Surveillance . 19 February 2020 . https://web.archive.org/web/20200219000610/https://surv.esr.cri.nz/PDF_surveillance/MeaslesRpt/2020/measlesReport20200210.pdf . dead .
  4. Web site: 2019 measles outbreak information . 2 October 2019 . Ministry of Health NZ . en . 2 October 2019 . https://web.archive.org/web/20191002054354/https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/measles/2019-measles-outbreak-information . dead .
  5. Web site: A timeline of epidemics in New Zealand . 2 October 2019 . 18 May 2017 . https://web.archive.org/web/20170518204142/https://teara.govt.nz/files/27772-enz.pdf . dead .
  6. News: 9 February 2021 . Vaccines mean opening our borders to Covid . en-AU . 4 March 2021.
  7. Web site: Iannelli . Vincent . MD . 13 May 2017 . Measles Vaccines vs Measles Strains . 4 February 2021 . Vaxopedia . en-US.
  8. Web site: National Measles Response and Recovery Appeal, 6 December 2019 - Samoa . 5 February 2021 . ReliefWeb . 8 December 2019 . en.
  9. Web site: 2019 Canterbury Measles Outbreak – A summary of cases . live . 5 February 2021 . New Zealand Community and Public Health. https://web.archive.org/web/20200216224221/https://www.cph.co.nz/wp-content/uploads/cantymeaslesoutbreaksummary.pdf . 16 February 2020 .
  10. News: Bell . Frances . 2 October 2019 . Fears over growing and 'unprecedented' Perth measles outbreak linked to much bigger NZ one . en-AU . ABC News . 4 March 2021.
  11. News: Amid Auckland's measles outbreak, two second-trimester unborn babies die . en-NZ . TVNZ . 2 October 2019 . 29 June 2021 . https://web.archive.org/web/20210629003511/https://www.tvnz.co.nz/one-news/new-zealand/amid-auckland-s-measles-outbreak-two-second-trimester-unborn-babies-die . dead .
  12. News: Simon Bridges hits out at Government over measles outbreak handling. Fitzgerald. Katie. Newshub. 2 October 2019. en.
  13. News: 47 measles cases in North, MP says not enough action. Northern Advocate. Laird. Lindy. 20 September 2019. 2 October 2019. en-NZ. 1170-0777.
  14. Web site: 'Shameful' measles outbreak predicted. Hancock. Farah. Stuff. en. 2 October 2019.
  15. Web site: July 18, 2019. Measles outbreak: Call for national approach . 2021-02-05. www.scoop.co.nz.
  16. Web site: A measles epidemic in New Zealand: Why did this occur and how can we prevent it occurring again?. 2021-02-05. www.nzma.org.nz. 19 February 2020. https://web.archive.org/web/20200219202406/https://www.nzma.org.nz/journal-articles/a-measles-epidemic-in-new-zealand-why-did-this-occur-and-how-can-we-prevent-it-occurring-again. dead.
  17. Web site: 2019-05-25. Joining the dots: What's really causing New Zealand's measles epidemics. 2021-02-05. RNZ. en-nz.
  18. News: Newton . Kate . Joining the dots: What's really causing New Zealand's measles epidemics . 27 March 2021 . RNZ . 25 May 2019 . en-nz.
  19. Web site: Nikki Turner: Let's keep our eyes on the ball - The University of Auckland. 2021-02-05. www.auckland.ac.nz.
  20. Patel. Manisha. Lee. Adria D.. Clemmons. Nakia S.. Redd. Susan B.. Poser. Sarah. Blog. Debra. Zucker. Jane R.. Leung. Jessica. Link-Gelles. Ruth Link-Gelles. Ruth. Pham. Huong. Arciuolo. Robert J.. 11 October 2019. National Update on Measles Cases and Outbreaks — United States, January 1 – October 1, 2019. Morbidity and Mortality Weekly Report. 68. 40. 893–896. 10.15585/mmwr.mm6840e2. 0149-2195. 6788396. 31600181.
  21. News: Small . Zane . Lynch . Jenna . 'This is serious': National Health Coordination Centre activated over measles outbreak . Newshub.

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