Authorities are closing in on Samoa to stop measles outbreaks

Just over two weeks ago, Samoa announced a state of emergency and closed the country's schools. By then, 716 cases had been discovered and six people had died, writes The Guardian.

But the measures failed to stop the outbreak, but the infection has continued to spread. On Monday, information came out that the number of people with illness has increased five-fold and the number of deaths is nine times as many as in mid-November.

In a new attempt to stop the progression of the disease, the country has now decided to close important social functions and ministries on Thursday and Friday so that public employees can also be vaccinated. In November, the government announced an emergency and introduced compulsory vaccination. Since then, 57,000 of Samoa's 200,000 inhabitants have received measles vaccine, writes Hufvudstadsbladet.

The vaccination level has been very low in the country, only about 31 percent compared to the 95 percent recommended for measles by the World Health Organization, which has made an outbreak of this size possible.

Last year, the country's vaccination program was stopped the moment after two children died after receiving a vaccine. It turned out that the children instead died from the wrong medication they received, but skepticism about the vaccine lives, TT writes.

But it is not just a low level of vaccination and skepticism that is the reason why it has become so serious on Samoa, says Adam Roth, a specialist physician and head of the vaccination program unit at the Public Health Agency.

- Island nations are special. Infections do not come in very often and then they can gather large groups that are susceptible. Once the infection arrives, it becomes more serious. It also depends on the health system in general. High mortality is a sign of other problems in society, he says.

So far, there are preliminary figures, but the mortality rate in Samoa's measles outbreaks seems high - about 1.5 percent of those infected have died. Compared to Europe, mortality among measles cases was around 0.09 percent in 2018.

The fact that the number of deaths has doubled in recent weeks despite many being vaccinated may be partly due to the fact that it takes a while before it starts to work.

- If you get your first dose, you have good protection only after a couple of weeks. It is also not uncommon for mortality to be greatest at the beginning of an outbreak before being seen to have care routines in place and providing proper care on time, says Adam Roth.

Unfortunately, most people who have died are young children.

- Children infected with measles before the age of five are at greater risk of death than children later infected in life, says Adam Roth.

Measles is one of the most contagious diseases we have. Therefore, a very high vaccination level is required for outbreaks not to occur.

- In Sweden, over 97 percent of two-year-olds receive the first dose of measles vaccine, and the second dose is given by 95 percent. It is among the best vaccination coverage in the world, says Adam Roth.