2019–2020 New Zealand measles outbreak

The 2019–2020 New Zealand measles outbreak was an epidemic that affected New Zealand, primarily the Auckland region.[8] The outbreak was the worst epidemic in New Zealand since an influenza epidemic in 1999, and is the worst measles epidemic since 1938.[9][10]

2019–2020 New Zealand measles outbreak
Map of confirmed measles cases in New Zealand during the 2019–2020 outbreak by district health board (DHB)
Date1 August 2019 – 21 February 2020[1]
  • Christchurch

16 February – 16 May 2019[2]

  • Auckland
28 February 2019 – 7 February 2020[3]
Casualties
Country Cases (conf) Deaths Last update
New Zealand New Zealand 2,194 2*[1]
Australia Australia 74 0[4][5][6]
Fiji Fiji 24 0[7]
Total 2,093
(see note 1)		 2*
As of 24 February 2020

The D8 strain was confirmed to be the main strain of the epidemic,[11][12] but the B3 strain has also been identified[13] and the epidemic has spread to several other countries. In Samoa more than 72 people have died.[14] 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.[15] In New Zealand, two unborn fetuses in second trimester have died as a result of the outbreak.[16]

Policy Response

The New Zealand Government has been criticised for its response to the epidemic, particularly due to shortages in the supply of vaccines.[17][18] 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.[19]

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. [20] 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.[21] David Haymen and Turner concluded that the best way to close the immunity gap was to undertake a formal catch-up programme.[22]

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.[21] 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.[23] 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."[24]

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.[25]

Cases

As of 24 February 2020, there had been 2,194 cases of measles reported throughout New Zealand since 1 January 2019.[1] Auckland had been the worst-hit region, with 1,736 cases alone.[1] The New Zealand government activated the National Health Coordination Center in August 2019 to respond to the outbreak.[26]

Confirmed cases by District Health Board (24 February 2020)[1]
Region Cases Hospitalised
Northland13323
Waitematā306129
Auckland274108
Counties Manukau1,157435
Waikato5112
Lakes306
Bay of Plenty4519
Tairāwhiti00
Taranaki83
Hawke's Bay268
Whanganui00
MidCentral100
Hutt Valley91
Capital and Coast247
Wairarapa10
Nelson Marlborough10
West Coast00
Canterbury4417
South Canterbury20
Southern736
Total (nationwide) 2,194 774

See also

References
  1. "Measles weekly report" (PDF). Public Health Surveillance. 24 February 2020. Archived from the original (PDF) on 19 February 2020. Retrieved 4 March 2021.
  2. "Canterbury measles outbreak declared officially over". TVNZ. Retrieved 4 March 2021.
  3. "Measles weekly report" (PDF). Public Health Surveillance. 10 February 2020. Archived from the original (PDF) on 19 February 2020. Retrieved 4 March 2021.
  4. "Three cases of Measles in Australia". Nine News. 4 September 2019. Retrieved 6 September 2019.
  5. "2019 measles outbreak WA Information". WA Health. 18 October 2019. Retrieved 8 November 2019.
  6. "Measles outbreak hits Queensland". Seven News. 5 November 2019. Retrieved 8 November 2019.
  7. "Measles Outbreak declared in Fiji". Fiji Sun. 7 November 2019. Retrieved 8 November 2019.
  8. "2019 measles outbreak information". Ministry of Health NZ. Archived from the original on 2 October 2019. Retrieved 2 October 2019.
  9. "A timeline of epidemics in New Zealand" (PDF).
  10. "Vaccines mean opening our borders to Covid". 9 February 2021. Retrieved 4 March 2021.
  11. Iannelli, Vincent; MD (13 May 2017). "Measles Vaccines vs Measles Strains". Vaxopedia. Retrieved 4 February 2021.
  12. "National Measles Response and Recovery Appeal, 6 December 2019 - Samoa". ReliefWeb. Retrieved 5 February 2021.
  13. "2019 Canterbury Measles Outbreak – A summary of cases" (PDF). New Zealand Community and Public Health. Archived (PDF) from the original on 16 February 2020. Retrieved 5 February 2021.
  14. "WHO/UNICEF Secretariat Supporting Measles Outbreak Preparedness and Response in the Pacific" (PDF). WHO. Retrieved 16 December 2019.
  15. Bell, Frances (2 October 2019). "Fears over growing and 'unprecedented' Perth measles outbreak linked to much bigger NZ one". ABC News. Retrieved 4 March 2021.
  16. "Amid Auckland's measles outbreak, two second-trimester unborn babies die". TVNZ. Archived from the original on 29 June 2021. Retrieved 2 October 2019.
  17. Fitzgerald, Katie. "Simon Bridges hits out at Government over measles outbreak handling". Newshub. Retrieved 2 October 2019.
  18. Laird, Lindy (20 September 2019). "47 measles cases in North, MP says not enough action". Northern Advocate. ISSN 1170-0777. Retrieved 2 October 2019.
  19. Hancock, Farah. "'Shameful' measles outbreak predicted". Stuff. Retrieved 2 October 2019.
  20. "Measles outbreak: Call for national approach". www.scoop.co.nz. 18 July 2019. Retrieved 5 February 2021.
  21. "A measles epidemic in New Zealand: Why did this occur and how can we prevent it occurring again?". www.nzma.org.nz. Archived from the original on 19 February 2020. Retrieved 5 February 2021.
  22. "Joining the dots: What's really causing New Zealand's measles epidemics". RNZ. 25 May 2019. Retrieved 5 February 2021.
  23. Newton, Kate (25 May 2019). "Joining the dots: What's really causing New Zealand's measles epidemics". RNZ. Retrieved 27 March 2021.
  24. "Nikki Turner: Let's keep our eyes on the ball - The University of Auckland". www.auckland.ac.nz. Retrieved 5 February 2021.
  25. Patel, Manisha; Lee, Adria D.; Clemmons, Nakia S.; Redd, Susan B.; Poser, Sarah; Blog, Debra; Zucker, Jane R.; Leung, Jessica; 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. doi:10.15585/mmwr.mm6840e2. ISSN 0149-2195. PMC 6788396. PMID 31600181.
  26. Small, Zane; Lynch, Jenna. "'This is serious': National Health Coordination Centre activated over measles outbreak". Newshub.
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