Situation overview

Since 2017, a global resurgence of measles cases has been affecting all regions of the world. In the Asia Pacific region, outbreaks and clusters of measles cases are being reported from countries where measles has been eliminated, including Australia, Japan, New Zealand, Republic of Korea, as well as higher incidence in endemic countries such as Lao PDR, Malaysia, the Philippines, Thailand and Vietnam. As of early 2019, Samoa, Tonga and Fiji have started reporting measles cases.
The Samoa Ministry of Health declared a measles outbreak on 16 October, following which a state of emergency was declared on 15 November. As of 28 November there are 2,936 confirmed cases with 250 new cases in the last 24 hours. To date, 41 patients with measles have died, and most were young children. Hospital admissions for confirmed cases are increasing on a daily basis, including critically ill children in the ICU and pregnant women, and additional beds are urgently needed to manage the overflow. The population of Samoa is approximately 197,000 and this level of morbidity and mortality is therefore critical.
The outbreak is affecting most parts of the country, which at the onset of the outbreak had an overall measles vaccine coverage of around 30% (compared to 84% four years ago). After the deaths of 2 infants in July 2018 shortly after receiving the measles vaccine, which was attributed to incorrect administration by medical personnel, vaccination rates drastically dropped across the country.

A country-wide measles vaccination campaign began on 20 November, targeting children aged 6 months to 19 years, and non-pregnant women 20 to 35 years. To date 24,000 individuals in both Upolu and Savai’i islands have been vaccinated, with mobile outreach teams and vaccine tents continuing these efforts. Shortages in institutional capacities to respond to the outbreak persist. Management of the vaccination process, medical records and existing health infrastructure remain challenging. Proper planning, including procurement as well
as outreach and post-outbreak monitoring, is immediately needed due to persisting limited capacities in the health system of Samoa. There is a major increase in demand on equipment, consumables, facilities and staff. Additional spaces have been created to meet the growing demand for intensive care and isolation wards.