Measles has peaked in Samoa…

Flag of Samoa. Source: Nicolas Raymond, flickr

In one of the most satisfying graphs I’ve ever made, this plot of weekly measles cases – both suspected and confirmed (the minority) – shows that the epidemic of measles that swept across Samoa after arriving in an infected traveller from New Zealand killing over 70 Samoans, has peaked.

The epidemic is certainly not over yet, but with 91% of the nation’s eligible population vaccinated, it pretty soon will be.

This epidemic of disease and death was preventable but the safe and effective vaccine to prevent measles had not reached the levels required to prevent the wholesale spread of the world’s most easily transmitted virus.

Blame the drivers of low levels of immunity.

Rather than 92% or more of the population that needed to be immune, when this outbreak started back in early October, only around 30% of the population had received the full 2-dose course of the MMR vaccine. The exact reason for this dangerous level of susceptibility isn’t clear. Malevolent anti-vaccination disinformation undoubtedly contributed to this tragedy in recent times, and thus to the deaths which occurred mostly among babies and young children. But it wasn’t the main driver and thus the easy target for our disappointment. It’s much more complex, as biology often is.

The majority of this preventable death and the many serious cases of measles and its complications that required hospitalisation weren’t caused by anti-vaxxer lies and deception. They were the result of a lack of a successful vaccination program. This epidemic has been brewing for years and its fermentation was, paradoxically, fed by too little communication, relevant education, care in the storage and administration of a safe and effective vaccine, easy access to that vaccine, good vaccination records and reminders and a ton of hard work and funding.

Official and estimated data for the number of people in Samoa who have received the second (MCV2) measles-containing vaccine, over time.[1] WHO data go further back and highlight that first dose coverage used to be very high prior to 2002.[1,2]

What’s next for Samoa?

Much of what was missing can now be seen laid out in the National Measles Response and Recovery Plan.

Excerpt from the Samoan Government’s NATIONAL MEASLES RESPONSE AND RECOVERY APPEAL 6 December 2019 document.

What’s next is the after-effects of a virus that can temporarily suppress the immune response and in the longer-term, wipe the host’s immune memory of past infections. This means upticks in disease. And that mean lots of new emotional and economic costs for a small nation. On top of that, the need to act on that plan above, to strengthen Samoa’s health system.

If you want to donate to help out – don’t send bottles of useless vitamins or magic dust as suggested by someone who has no knowledge of the disease, viruses, vaccine or biology.

Please do as the Samoan Government has asked and donate funds to these organisations…

Organisations that will accept useful monetary donations or check out the National Measles Recovery Appeal website.

More measles numbers, graphs and musings

The weekly plot above better distils the gradual decline that I’ve been tracking on Twitter in another graph I made, which also uses the excellent daily data from the Samoan Government.

These daily updates from Samoa started on 20NOV2019 and had included a useful Table that gave a breakdown of the age groups affected. That Table stopped being included a few days ago (an example from 08DEC2019 below).

Most deaths and cases occurred in those aged less than 5 years. But deaths did occur in older children and adults as well.

Table excerpted from the 08DEC2019 measles update from the Samoan Government.

The curve of daily numbers has been levelling off – a sign that the outbreak has slowed, and as cases slow, so have new deaths. Both are very welcome signs of an outbreak brought under control. And you have an effective vaccine to thank for that. Measles has peaked in Samoa.

Not, as some absolute moron antivaxxers have tried to sell, an increase in cases after vaccination. Idiots.

This entire epidemic and those small, non-fatal outbreaks in neighbouring better-vaccinated islands have served to show time and again over the past few weeks how wrong these anti-science woo-merchants are. Every conspiracy they raised was proven to be grade-A 100% bull cookies (tip to the good Colonel Potter).

We’ve also watched the time it takes to reach the next 500 cases slow (below) and while it hasn’t been dramatic, it has been consistent across a few weeks. And that means fewer, not more, new cases each day; whatever the rate that’s a really good thing!

Communication: clear and constant

This latest measles epidemic has shown the world yet another terrible example of how measles used to be and how it could be again. We mustn’t forget this as we have before.

We all have to work hard to try and quash the deceptions of those who chose to believe in the fake. We need to be better at helping to communicate the facts in the right way for different communities and groups. We need to keep educating and amplifying the objective facts about the medicine and the science that has been meticulously conducted, to keep our children safe and healthy.

Measles has peaked in Samoa and to prevent it from coming back there or anywhere else we should never forget, that it’s always about better communication.

References

  1. WHO vaccine-preventable diseases: monitoring system. 2019 global summary | Coverage time series for Samoa  (WSM)
    http://apps.who.int/immunization_monitoring/globalsummary/coverages?c=WSM
  2. https://www.who.int/immunization/monitoring_surveillance/data/wsm.pdf – graphical version of Ref 1.

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