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Update: Lab confirms three new measles cases in American Samoa

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fili@samoanews.com

Pago Pago, AMERICAN SAMOA — American Samoa now has 15 laboratory confirmed measles cases after three more samples sent to Hawai’i’s state laboratory for testing came back positive last week, according to Health Department and LBJ Medical Center officials.

The latest update on the measles outbreak in American Samoa and Samoa was presented late Sunday afternoon during a cabinet briefing at the Emergency Operations Center, where an LBJ official identified children — admitted for other medical issues — not immunized, including undocumented children.

Gov. Lolo Matalasi Moliga told cabinet members that there are no changes to current policies implemented following the State of Emergency declaration issued Dec. 8, 2019 due to the measles outbreak and he urged continued border protection screening at the territory’s port of entries.

DOH PRESENTATION

According to DoH, as of Jan. 25, 2020, there were 38 suspected measles cases, with samples sent to a Hawai’i lab for testing. Of that number, there are now “15 laboratory confirmed” cases, up from 12 in the previous two weeks.  
The latest batch sent to Hawai’i included four samples, of which the Jan. 23rd results revealed three positive and one negative. The positive cases are:
•    female, 27, from Aoa, seen at LBJ on Jan. 8th and didn’t get the required two MMR doses;
•    male, 12, from Fagaitua, seen at LBJ on Jan. 14th and had already received the required two MMR shots; and
•    male infant, 6-months, seen at LBJ Jan. 20th and not vaccinated.

Of the total 15 positive cases, nine are locals and six are travel related.

DoH has already conducted the usual “contact tracing” and will continue to monitor these new cases. The latest update on the measles outbreak in Samoa was also presented: total cases remain at 5,707 and deaths remain at 83 — based on information last week from the Samoa Ministry of Health.

LBJ PRESENTATION

Profiles of the 27-year-old and 12 year-old with confirmed measles, were provided during the Jan. 19th cabinet briefing. For the 6-month old, LBJ data shows that the infant was born in Nevada and traveled here on Jan. 13th before being admitted to the Emergency Room with symptoms of measles, such as “dry, scaly muscular rash over the forehead and face” as well as coughing. The infant was treated and discharged after a swab was taken to be sent to Hawai’i for testing.

LBJ’s Dr. Tuato’o Reese reminded the cabinet meeting that 6-month-old children are not of age to be vaccinated and despite the mass vaccination held last month and thereafter on a weekly basis at designated locations, there are still children seen at the hospital for other medical reasons who are not vaccinated.

He explained that parents of children admitted to the hospital are asked about their child’s immunization records. He suggested that this protocol be carried out for children seen at DoH health centers. He shared data of recent cases of “noncompliance for all vaccinations” seen at LBJ.

For example, on Jan. 24th, a 3-year-old and an 8-year-old — who are siblings from Aoloau — were admitted to the LBJ Pediatric Ward. While the 3-year-old was born in American Samoa and vaccinated, the 8-year-old was born in Samoa in 2012 and arrived in the territory the following year.

Data shows that the 8-year-old was never vaccinated and “never sent to school” and  this child, along with the parents are “undocumented” immigrants and currently have no sponsor. He said undocumented immigrants make it difficult for DoH to reach these individuals to get vaccinated.

He said the governor's "short amnesty" program, which is extended to Feb. 6th, is not being taking advantage of by undocumented immigrants from Samoa, while other foreigners, such as Filipinos, are using this opportunity to become legal residents.

(Among the requirements under the program is that the person gets vaccinated, and convicted felons don’t qualify.)

Another “noncompliant for all vaccinations” case is a second pair of siblings — a 7-month-old and 1-year old — from Aua, both born in American Samoa, but not vaccinated. They were admitted to the Pediatric Ward on Jan. 23rd for flu and pneumonia.

OVERALL VACCINATION COVERAGE

According to DoH, the estimated overall territorial vaccination coverage now stands at 95% and overall coverage for public and private schools — including daycare centers — is currently at 99.5% for those who have completed the first MMR dose.

For the second dose, 98.1% of students have completed both MMR doses, leaving about 246 students needing their second shots. DoH continues to work closely with DOE and DHSS (which oversees daycare centers) to ensure that parents of these students are aware that the dose is needed before they can enroll in school.

DoH is also working with administrators at private schools for students who need both MMR shots.

Dr. Saleapaga Iotamo suggested that DOH take the services to the homes of students yet to be vaccinated. ”That's the only way we can do it — deliver the service to the people," he said.
Lolo strongly recommended that DoH look at all possible ways to ensure that students needing the MMR doses get vaccinated. He said current policy under the emergency declaration remains unchanged.

VACCINATION SCHEDULE
DoH said the vaccination program continues this week at health centers in Leone, Tafuna and Amouli for both adults and children; at the Fagaalu Well Baby Clinic for children only; and the DHSS office in Utulei for adults only.

DoH will also carry out school visits this week to update immunization records.