Measles cases now nearing 1000
Auckland infection tally up nearly 20 a day and could keep rising for weeks
The number of measles cases across the country is nearing 1000 and may keep climbing for a further two weeks, Prime Minister Jacinda Ardern says. Auckland is grappling with its worst measles outbreak in more than two decades and the Auckland Regional Public Health Service has confirmed 804 cases in the region alone — with a rise of 26 from Saturday.
Of these, 556 cases are under the Counties Manukau District Health Board, with 963 cases nationally.
The tally of cases has been rising at about 18 or 19 a day in Auckland and it is the largest outbreak since the 1990s by a significant margin.
In Auckland, about 50 schools and a similar number of early childhood centres have had confirmed cases this year with hundreds more pupils potentially exposed after an infected student went to the St Peter’s College school ball on Saturday.
Students from more than 20 schools attended the ball, with the college later notifying all schools that the partner of one of its students was suspected of having measles.
Principals have asked students who attended the ball to go into quarantine, if they are not vaccinated.
But ARPHS medical officer of health Dr William Rainger said yesterday that it was not asking unvaccinated students to stay home.
“If the case is confirmed, nonimmune students attending the ball would not be contagious until the weekend. Any quarantine period would start on Saturday, September 7,” he said.
Rainger said the health service was due to get the ball student’s blood test result back in the next couple of days and then would work with the school accordingly.
Meanwhile, he said, authorities needed to balance protecting vulnerable people with not inadvertently interfering with important events.
“It can’t be said often enough, measles is a preventable disease, it is prevented by vaccination and vaccination
is safe,” he said.
Manurewa High School, which had half of its 2000 students absent last week after 14 students were confirmed with measles, is now asking students to return to school except for a group of more than 300 unimmunised students who have been asked to stay away for the oneweek quarantine period.
A clinic will be at the school today to vaccinate unimmunised students.
Meanwhile, pharmacists and the National Party have also been calling for the Government to change rules to allow chemists to administer the measles vaccine.
There are 864 pharmacists who are allowed to give vaccinations for the flu, shingles, whooping cough and
meningitis, but current rules mean they don’t get funded to provide the MMR vaccine.
Associate Health Minister Julie Anne Genter said she had asked the ministry to look into the matter. But Ardern said there were a number of issues to be worked through, including opening up the immunisation register to pharmacists.
“We need to ask: are people currently unable to access immunisation? Are pharmacists needed in addition to [current efforts]?”
The Ministry of Health said it was urgently exploring what role pharmacists could play in helping improve uptake of the MMR vaccine.
New Zealand is in the thick of its worst measles epidemic in 22 years, with nearly 1000 cases so far. As one vaccinologist says, it was predictable, entirely preventable and the government were warned. So how did we get here? Jamie Morton and Natalie Akoorie explain.
Where did this outbreak come from? Whittling this year’s measles catastrophe down to a single origin is impossible, for the simple reason that there really isn’t one. It’s a messy story.
The first outbreak of measles in New Zealand this year began in the Waikato in January with 10 cases.
That strain came from Malaysia but authorities don’t know where the first person picked up the virus, according to Institute of Environmental Science and Research [ESR] data.
That same month the Bay of Plenty district health board (DHB) reported another outbreak, which spread to the Waikato. Three confirmed cases were contained by February.
ESR data shows the virus in that outbreak was contracted in Japan.
Again in February a third outbreak of a strain circulating in the Philippines developed in Canterbury and spread to Southern Canterbury and Waitemata¯ in Auckland, affecting 40 people and taking a month to control.
It was a strain that had never been seen before in New Zealand.
Six more outbreaks hit the North Island between March and June.
Outbreaks four, six and nine are “ongoing”, meaning health authorities have not been able to contain them.
Two of them started in Auckland and Waitemata¯, and one in the Lakes DHB catchment, with a total of 12 other DHB regions affected by the three outbreaks.
The data shows the virus is also coming from countries such as Thailand, Australia, Singapore, China, Afghanistan, Britain, and Vietnam.
Alongside the nine outbreaks that have infected nearly 1000 people across the country, there have been seven single cases where only one person was diagnosed.
The outbreaks are the worst in 22 years and have sparked a national response by the Government, including setting up drop-in vaccination clinics in South Auckland, where more than 500 cases of the virus have been notified.
In two of the smaller outbreaks, where only three people were
infected, one was a family, and the others members of the public in a doctor’s waiting room.
An ESR public health physician in the Health Intelligence Group, Dr Jill Sherwood, said in those small outbreaks the disease was contained because people either quarantined themselves quickly or they came into contact only with people who were immune.
The data showed all three different measles strains now in the country were contracted overseas, either by Kiwis returning home or by visitors to New Zealand.
Sherwood said Kiwis were not
taking the global measles outbreaks seriously enough and warned anybody travelling internationally to check their immunity status first.
“International airports are bad places to be. The problem is we will get ongoing importations because there is so much measles around in the world.”
Shots have been fired at the antivaccination crowd — but experts say they aren’t solely to blame.
University of Auckland vaccinologist Helen Petousis-Harris put the spate down to several reasons.
Firstly, there had been historically poor uptake of the MMR vaccine,
mainly affecting people in their teens through to around 30 years of age.
When measles vaccines were introduced, the incidence of the disease declined, meaning that fewer people caught measles so never became immune.
In more recent times, New Zealand improved its previously dismal vaccine uptake, partly thanks to hard work by health workers and a national electronic register.
But Petousis-Harris said we were still falling short of the national target for the MMR vaccine — that’s 95 per cent of all infants to be fully immunised by age 2.
While we nearly got there in 2014, the rate has dropped to 91 per cent — and to 86 per cent among Ma¯ori.
“This means there are too many toddlers and young children susceptible and, of particular concern, the unimmunised people are not evenly dispersed among the rest of the population, creating hot-spots for diseases like measles.”
Meanwhile, measles has been making a comeback across the globe — a direct result of anti-vaccination activities and a consequent rise in “vaccine hesitancy”.
“In fact, the World Health Organisation declared this problem as one of the 10 greatest threats to public health for 2019 — pretty sobering,” Petousis-Harris said.
“This means immunisation rates are plummeting and more people are susceptible to contracting and transmitting measles.
“It also means there are more people walking off planes and into our communities carrying the measles virus, so we are being challenged with the virus more often.”
Thanks to social media, the antivaccine lobby had become coordinated, funded and lawyered up.
This has resulted in “an explosion” of fake academia — or bad science funded by anti-vaccine lobby groups — with legal cases and the spread of this fake news that she described as an “insidious vermin hellbent on the destruction of public health”. “Welcome back to the dark ages.” She saw a targeted campaign of mass vaccination as the only solution.
Petousis-Harris said that, based on a study from 2017, there were 435,742 susceptible people in New Zealand, and vaccinating just 104,357 would make a big difference.
“National level authorities have known for years that these immunity gaps are a problem yet have failed to act, leaving the management to local DHBs,” she said.
“All the systems and processes required to deliver a targeted mass campaign to those that need it are already in place, they just need resourcing and support.”